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Dentistry is less scientific and more gratuitous than people think (2019)

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Re: Dentistry is less scientific and more gratuitous than people think (2019)

#91

Post by usrn »

dentalthrowaway wrote: post #68

Throwaway because I run a large dental software company. Dentistry is practiced as a business focused on maximizing revenue. Dentists are routinely coached to deploy sales tactics to increase their treatment acceptance beyond what is needed. If you walk into a dental office, you need to protect yourself from being abused. A second opinion unfortunately puts you in the same position, but now with a new dentist who wil…

I've gone to my current dentist for years and he's always extremely reluctant to even do fillings (last time he gave me a speech about how you can't replace what "God gave you" so you should just monitor it or so.) I think there are some dentists that legitimately care.

EDIT: Mine is actually in a very wealthy neighborhood and the lady who runs the practice (I think that's how it works?) has a reputation for buying state-of-the art tech.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#92

Post by bigmattystyles »

epmaybe wrote: post #37

If you think this is bad, wait till you hear about [insert field of medicine here]! In all seriousness, fraud is rampant, and cash pay or low regulation fields like dentistry can easily take advantage of patients and their health literacy. In ophthalmology, you hear of “laser” cataract surgery, “floaterectomies”, telling patients they need cataract surgery well before they are symptomatic, dry eye treatments. Hell, i…

I am especially skeptical of offerings that deal with therapy and the massive advertising campaign some companies like betterhelp. Improvement from therapy is not something that’s easily measurable and I’ve know a few therapists (not psychologists) and their coursework from reputable universities absolutely shocked me in its lack of scientific rigor. I have no doubt there are wonderful and competent folks working at online therapy shops, and I have benefited tremendously from an in person psychologist and everyone benefits from mental health resources being available, but online therapy and the therapists and the bit I know about their studies scares me.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#93

Post by taeric »

tartoran wrote: post #73
taeric wrote: post #64

Earlier quoted context omitted.

This sort of undermines the necessity of modern dentistry, though. Didn't it? You can even take it further back. How many of those fillings were truly necessary at the time?

It doesn’t undermine the necessity of modern dentistry because there are times you really do need a dentist. If you travel to poor countries where people don’t have access to dentistry you’ll notice that by 30s or 40s they’re missing a lot of their teeth.

The vast majority of modern dentistry is scheduled deep cleaning.

And be careful that you aren't looking at places with malnourished people.

Adults should expect some teeth issues, sure. The question is if modern treatment is going a bit beyond what is necessary.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#94

Post by lostcolony »

usrn wrote: post #91
dentalthrowaway wrote: post #68

Throwaway because I run a large dental software company. Dentistry is practiced as a business focused on maximizing revenue. Dentists are routinely coached to deploy sales tactics to increase their treatment acceptance beyond what is needed. If you walk into a dental office, you need to protect yourself from being abused. A second opinion unfortunately puts you in the same position, but now with a new dentist who wil…

I've gone to my current dentist for years and he's always extremely reluctant to even do fillings (last time he gave me a speech about how you can't replace what "God gave you" so you should just monitor it or so.) I think there are some dentists that legitimately care. EDIT: Mine is actually in a very wealthy neighborhood and the lady who runs the practice (I think that's how it works?) has a reputation for buying s…

Yeah; the ones who treat conservatively are gold. I'm still looking for one in my current location over ones who are aggressive in pushing additional treatments and things.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#95

Post by taylodl »

misja111 wrote: post #21

Well it's only anecdotical of course, but I had a similar experience a couple of years ago that made me very confused about dentistry in general. At the time a had a small tooth ache so I was planning to visit a dentist to check it. I was living in Switzerland, where dentist costs are very high, but I was about to go on holiday to Tenerife, where prices are much lower. So I checked on the Internet and chose the denti…

Dentists are a lot like software developers - they're not interchangeable. Just like if you ask two software developers what needs to be done to solve a problem you're going to get at least two different answers, the same is true for dentistry. Actually it's true of any professional service. We all have our biases for risk, we all have biases for wanting work - we all have biases. Those biases will manifest themselves in our recommendations for a course of action. That's why they say to get a second opinion. It's not just to assess whether the first opinion is off-base, it's to get a better assessment as a non-expert as to what you're up against and what course of action you should take.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#96

Post by floppydiskette »

tbran wrote: post #77

A compelling book on tooth care is Kiss Your Dentist Goodbye by Ellie Phillips. It advocates for: - Using flouride toothpaste. - Using a combo of bad-bacteria-killing mouthwash and flouride mouthwash (especially before bed). - Eating or finishing meals with tooth-protective foods. - Chewing xylitol [0] gum or mints. Xylitol is a sugar-replacement (with a lower insulin response) found in plants . I think Epic Dental h…

> You can solve this while sleeping by taping your lips together.

Uh...what? Nobody is going to do that.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#97

Post by hgomersall »

JoshTko wrote: post #85
tbran wrote: post #77

A compelling book on tooth care is Kiss Your Dentist Goodbye by Ellie Phillips. It advocates for: - Using flouride toothpaste. - Using a combo of bad-bacteria-killing mouthwash and flouride mouthwash (especially before bed). - Eating or finishing meals with tooth-protective foods. - Chewing xylitol [0] gum or mints. Xylitol is a sugar-replacement (with a lower insulin response) found in plants . I think Epic Dental h…

Daily mouthwash is a horrible idea. Mouthwash contains Corsodyl which has been shown to increase blood pressure. Regularly blasting any part of your body with a harsh antiseptic is probably a bad idea. It took us decades to realize that antibiotics messes up our gut floura, I'm sure we'll see similar consequence for mouth bacteria with mouthwash.

Interestingly, there is research on xylitol and gut flora. The suggestion is it helps with creating a more healthy balance of bacteria.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#98

Post by juskrey »

usrn wrote: post #91
dentalthrowaway wrote: post #68

Throwaway because I run a large dental software company. Dentistry is practiced as a business focused on maximizing revenue. Dentists are routinely coached to deploy sales tactics to increase their treatment acceptance beyond what is needed. If you walk into a dental office, you need to protect yourself from being abused. A second opinion unfortunately puts you in the same position, but now with a new dentist who wil…

I've gone to my current dentist for years and he's always extremely reluctant to even do fillings (last time he gave me a speech about how you can't replace what "God gave you" so you should just monitor it or so.) I think there are some dentists that legitimately care. EDIT: Mine is actually in a very wealthy neighborhood and the lady who runs the practice (I think that's how it works?) has a reputation for buying s…

Basically you go to several dentists and chose the conservative one - it is not that hard. Yeah, most of them are in so so neighbouhoods and have outdated equipment, but you wanted to have less intervention in any case, right?

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#99

Post by rgersten »

usrn wrote: post #91
dentalthrowaway wrote: post #68

Throwaway because I run a large dental software company. Dentistry is practiced as a business focused on maximizing revenue. Dentists are routinely coached to deploy sales tactics to increase their treatment acceptance beyond what is needed. If you walk into a dental office, you need to protect yourself from being abused. A second opinion unfortunately puts you in the same position, but now with a new dentist who wil…

I've gone to my current dentist for years and he's always extremely reluctant to even do fillings (last time he gave me a speech about how you can't replace what "God gave you" so you should just monitor it or so.) I think there are some dentists that legitimately care. EDIT: Mine is actually in a very wealthy neighborhood and the lady who runs the practice (I think that's how it works?) has a reputation for buying s…

This. I come from a family of dentists and they are very hesitant to drill unless absolutely necessary. Their rationale as I understand it is that all fillings, crowns, bridges, etc fail eventually. That anytime you attach something to a tooth you add a failure point and potential for infection.

The problem is their businesses can’t compete with the ones that play the insurance game. Insurance reimbursement rates haven’t kept up with overhead and so conservative dentistry is losing marketshare to ones willing to push treatment. We know multiple dentists that have filed bankruptcy in the last couple years.

Keep in mind that many people are very reluctant to pay out of pocket for dentistry. Until insurance reimbursement rates favor conservative dentistry, nothing will change. More responsible dentists will lose their practices or turn to over treatment.

Maybe the HN crowd wisdom has some ideas on how we can improve this situation.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#100

Post by rashkov »

InCityDreams wrote: post #83
jordanpg wrote: post #81

Earlier quoted context omitted.

I would also add electric toothbrush to this list. This has been transformative for me. I wish I could hand one to my 6 year old self. They are cheap and you can use them in the shower.

A revelation for myself was the purchase of a water-based toothbrush. Then use a regular brush. Then water-based again. Then an electric.

What did you learn
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