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Google almost convinced me to spend $400 on useless laser treatments

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Re: Google almost convinced me to spend $400 on useless laser treatments

#401

Post by Ma8ee »

a2tech wrote: post #41
matsemann wrote: post #12

Why are dentists so scammy? In Norway I've seen documentaries about them sending the same people to multiple dentists, and some of them receive wildly different advice. Some of that can be ascribed to some being in the school of pro-active, so they want to fix your teeth at the first glance of issues. But in the end, most of the things being quoted were unnecessary. They all seemed very intent on removing wisdom teet…

Dentists are trying VERY hard to get included under standard medical insurance in the US. If you think they're scammy now, wait until they can start billing your insurance. People with insurance are often divorced from the cost of services rendered so they'll really be able to reap profit then.

Ah yes! I had to repair a broken tooth when I was in the US, which was covered by our insurance. The dentist took 19(!) x-ray plates of my teeth, which she then charged the insurance company for.

Re: Google almost convinced me to spend $400 on useless laser treatments

#402

Post by selcuka »

exo-pla-net wrote: post #301
smileysteve wrote: post #169

Earlier quoted context omitted.

> Is it best to go ahead and get those fillings now? Probably, as far as your dental health is concerned. Modern science says no, you should apply topical fluoride for most early cavities; and if the teeth use a modern pronamel (cough stuck behind USDA approval) should be able to recover quickly.

Could you add more regarding pronamel, so I can begin my negotiations with The Algorithm?

Previous mention: https://news.ycombinator.com/item?id=26644350

Re: Google almost convinced me to spend $400 on useless laser treatments

#403

Post by argonaut »

tomxor wrote: post #166
Unklejoe wrote: post #62

Earlier quoted context omitted.

I had a dentist appointment before COVID. They found a cavity and scheduled me to have a filling. Then, COVID hit and I cancelled the appointment. I went back two years later for another checkup/cleaning. They didn't find any cavities. Maybe it healed itself? Apparently that's possible via re-mineralization. Either way, if that was possible, then perhaps they shouldn't have been so eager to drill and fill?

To add to the confusion of the very real risk of immoral and unnecessary dental work mentioned elsewhere in this thread - xrays can be legitimately difficult to interpret when looking for small cavities. Ideally you do want to get even small ones filled as a preventative measure. However IME trustworthy dentists will acknowledge the potential for false positives on less obvious xrays upfront and offer a choice of eit…

> Ideally you do want to get even small ones filled as a preventative measure.

To add even more confusion, this is mostly untrue. Fillings don't last forever, so prematurely filling "starts the clock" because the filling will eventually fail and every time a filling is made, more healthy tooth must be removed. (I say mostly untrue because mercury amalgam fillings really can last multiple decades, but these have fallen out of favor).

Re: Google almost convinced me to spend $400 on useless laser treatments

#404

Post by argonaut »

mbg721 wrote: post #104
drspock11 wrote: post #87

What the article author doesn't seem to realize is much of dentistry (and medicine in general) is not based on evidence. There is zero clinical evidence that flossing actually does anything beneficial. I wouldn't be surprised if there was a lack of evidence for 6-month cleanings actually being beneficial. Similarly, doctors make decisions based mostly on hunches and gut feelings unless you're actively bleeding from a…

Something is working, even if it may not be clear specifically what that is. My grandfather had a full set of false teeth by the time he was the age my parents are now. The other big change in that time would be diet, but I don't think more refined sugar improves tooth quality.

I mean, some things that dentists believe in do have strong evidence, like water fluoridation and fluoride in toothpaste. And some things dentists believe in don't, like flossing.

Re: Google almost convinced me to spend $400 on useless laser treatments

#405

Post by ClumsyPilot »

WalterBright wrote: post #395
FollowingTheDao wrote: post #387

Earlier quoted context omitted.

> Yes, in the US before the government took over health care. When did that happen? If you are thinking Obama care, uhm, no. > BTW, no government is going to spend unlimited sums to save your life. You are missing the point. Supply and demand curves break when it comes to life and death matters. That is why prices should not be dictated by a free market. Well, I guess that is fine if you are a sociopath.

> When did that happen? Not all at once, but decision by decision. One big change was when the AMA was granted a monopoly over the education of doctors. Then there was when companies got around wage controls in WW2 by tying health insurance to employment. Then in the 1960s there was enormous expansion of the FDA, and then Medicare and Medicaid. Then there were laws that required emergency rooms to treat people for fr…

Present your case - show that it worked well before government.

Re: Google almost convinced me to spend $400 on useless laser treatments

#406

Post by argonaut »

asdff wrote: post #355
ccwilson10 wrote: post #254

Earlier quoted context omitted.

Wife is a dentist. There certainly are practices where treatments are recommended as a function of money and cashflow (laser treatment and other "optional" treatments are a great example of this). However, crown / cavity recommendations are largely dependent on how aggressive that particular dentist's philosophy is. E.g. my wife only goes to her father for treatment because he focuses on saving teeth whenever possibl…

This is why I like going to dental schools faculty or student practices. They are all about saving the teeth if it can be saved and will need to see sufficient evidence in the imaging before moving forward with just about anything. Things seem to take longer and involve more appointments (e.g. i have to schedule a separate appointment with dept of radiology vs the private practice dentist walking me to the next room…

I've looked into this myself and one negative is that students still have some pressure to overtreat because students have graduation requirements (e.g. must do a certain number of fillings, crowns, etc.). Granted, having to run everything by a supervisor will eliminate the egregious cases.

Re: Google almost convinced me to spend $400 on useless laser treatments

#407

Post by argonaut »

someotherperson wrote: post #237
drspock11 wrote: post #87

What the article author doesn't seem to realize is much of dentistry (and medicine in general) is not based on evidence. There is zero clinical evidence that flossing actually does anything beneficial. I wouldn't be surprised if there was a lack of evidence for 6-month cleanings actually being beneficial. Similarly, doctors make decisions based mostly on hunches and gut feelings unless you're actively bleeding from a…

Limited evidence doesn't mean it doesn't work. The reasoning behind flossing makes a lot of sense: 1. You remove food sources for streptococcus mutans 2. You avoid inflammation from teeth shifting 3. You disrupt biofilm (plaque) formation in the joints of your teeth I imagine the evidence is limited because genetics, diet and other oral hygiene routines significantly impact the outcome. There is a whole microflora sy…

Yeah, but these same arguments apply in favor to the diode laser treatment the original article talks about. There is biological and chemical reasoning behind it. There are favorable vitro studies. And a couple of the systematic reviews linked in the original article conclude there is weak evidence that it is weakly effective (same with flossing).

Re: Google almost convinced me to spend $400 on useless laser treatments

#408

Post by treeman79 »

jnovek wrote: post #40

“ Medicine has become a three-way negotiation between you, your doctor, and The Algorithm.” This characterization makes it sound like a good thing. In reality, the doctor’s responsibility is being pushed to the patient because they are overbooked in the name of economic efficiency. As a patient with complex, non-specific medical condition, I can tell you how miserable this is. I can’t count on doctors _at all_ to mov…

Copied from an older post. ——

Congratulations, you have earned the achievement “chronic condition”.

Your rewards are as follows.

You have max exhaustion at all hours of the day!

Exercise recovery is bumped from next day to 2 weeks! Your pain level is now on par with dying cancer patients! Everyone now considers you lazy and incompetent! Doctors now blame all symptoms on anxiety!

You gain +1 to medical research ability. But -20 to Reputation.

You now get spontaneous and useless medical advise from people that believe in essential oil.

You are now on timer with your job until sympathy runs out!

Disability now can mock you openly as clearly your faking and don’t have a real condition!

You are now a burden to your family!

+10 sneak score; you quickly learn to hide your suffering! +20 to loneliness! -20 to persuasion! Asking for help gets little from doctor's. +10 Planning! Your kids may be orphans soon, make sure they get taken care of. Read fine print on death benefits. ——- Staying positive when you have a chronic condition is incredibly difficult. Your not going to get through it without losing your mind now and then.

Re: Google almost convinced me to spend $400 on useless laser treatments

#409

Post by treeman79 »

throwawayboise wrote: post #335
mmcdermott wrote: post #294

Earlier quoted context omitted.

> The slow diagnosis is because the specialists are so reluctant to see people. Right now I am on a six month wait to see a rheumatologist. Why? Capitalism. This remark seems somewhat lacking in rigor. I know bagging on capitalism is a common reflex, particularly in medicine, but something more is almost certainly going on. The default thought process for a retailer is to move units. A lawyer wants to rack up billabl…

Specialists are called that for a reason. They are not general practitioners and their time is extremely valuable. Access to them needs to be managed so that they do not waste their time on people who do not need their specialty. The way it's supposed to work is that the general practitioner rules out a bunch of stuff, and then starts referring to specialists who can diagnose/treat the rare things. In practice it's n…

I probably cost insurance company 300-500,000 while figuring out what was wrong with me.

A full round of blood tests by a few specialist would’ve saved everyone involved a lot of money.

Wasn’t even a super rare thing. Just 2 somewhat common conditions. One of which is known for being dismissed as anxiety.

Re: Google almost convinced me to spend $400 on useless laser treatments

#410

Post by treeman79 »

FollowingTheDao wrote: post #322
JamesBarney wrote: post #290

Earlier quoted context omitted.

There are too many patients and not enough doctors. This isn't caused by capitalism, capitalism doesn't limit the # of doctors. Becoming socialist doesn't magically allow doctors to see patients for twice as long. If we had socialism more people could afford doctors(a good thing!) but it would make this specific problem worse, because there would be more patients. This is caused by the AMA lobbying to limit the suppl…

It’s funny you say this has nothing to do with capitalism but all the countries you listed have largely socialized medicine. Once capital gets power it uses a government to enforce that power.

Then that’s not capitalism.

Veterinary care would be much closer to the model of a capitalistic solution.

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