Dentistry is less scientific and more gratuitous than people think (2019) • Hacker News Board

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

#151

Post by csdvrx » Mon, Jun 20, 2022, 4:10 PM UTC

Tozen wrote: post #138

Part of the problem is that dentists don't have the incentive nor arguably the training and knowledge to cure the problem. Cavities and lost teeth, brings them money. So don't expect them to be looking around for cures like regrowing teeth or reversing cavities, unless some unusual "one in a several billion" fellow comes along (who the others won't like) to change things (like how we got Penicillin or the cure for Po…

> over the insane amalgam fillings with mercury. And yet, many dentists still put the health hazard of oamalgam with mercury in people's mouths

The "mercury" metal fillings last much longer - no longer why dentists try to use the fear of mercury poisoning to sell you on a replacement plan. Thanks, but no thanks.

The dose we are exposed to, as patients, is negligible. If there's a health problem, it's for dentists.

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

#152

Post by verisimilitude » Mon, Jun 20, 2022, 4:11 PM UTC

jessaustin wrote: post #30

I'll preface this by saying that yes there are unethical dentists out there and clearly this Lund guy is one of them and patients should never hesitate to get a second opinion if they feel uncertain. However, this whole thing would be more informative and impressive if they had gone after the elephant in the room. Aspen Dental overtreats more than the rest of the dentists in USA put together. They are a "large health…

I wish your comment had more upvotes -- it is an accurate critique of both the journalism and the chief problem. Thank you.

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

#153

Post by throwawash » Mon, Jun 20, 2022, 4:11 PM UTC

jghn wrote: post #120

throwawash wrote: post #106

Earlier quoted context omitted.

>Also, uh, don't drink your mouthwash, spit it out. doesn't cut it for me. someone I know who doesn't smoke or drink and was sub-40 years old got diagnosed with tongue cancer. Cancer specialists were miffed at the cause. The only thing that stood out: he was a meticulous user of mouthwash 3x a day since he was a teenager.

Sometimes people just get unlucky and there's not some direct causal factor. Yes, it could have been the mouthwash. It also could have been a combination of their germline genome having some unfortunate mutations and/or a series of unlucky somatic mutations.

If mouthwash has harmful ingredients keeping it in your mouth for a prolonged duration and spitting it out instead of drinking it will not solve your problems, contrary to the quoted line.

If an patient who is an outlier exhibits an extreme habit related to the affected cancerous organ, it seems advisable to take note even if it is possible there are undiscovered more serious contributing factors.

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

#154

Post by [deleted] » Mon, Jun 20, 2022, 4:12 PM UTC

bityard wrote: post #137

Near the beginning of the pandemic, I had a pretty bad toothache spring up out of basically nowhere. Bad enough that sleeping was difficult and eating was impossible. I went to see a dental surgeon (I forget the proper name for this) and he told me I needed a root canal, and backed it up with X-rays. It made sense, I had trouble with this tooth before and a previous dentist told me that a root canal and crown on this…

[deleted]

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

#155

Post by ransom1538 » Mon, Jun 20, 2022, 4:13 PM UTC

This article rings true for me. As an 11 year old I got a root canal. Now that I am an adult / parent I realize how evil that dentist really was. I still have that fake tooth. My parents could only pay cash - we couldn't afford insurance. So I was a pretty regular patient no matter how advanced my brushing and flossing was. Other kids in my neighborhood had it worse with silver front teeth.

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

#156

Post by peteradio » Mon, Jun 20, 2022, 4:13 PM UTC

guerrilla wrote: post #125

What I can't understand is how dental managed to escape medical coverage, not just in the US but seemingly globally. Just this year the main confederation of Swedish labor unions will be pushing for consolidation of dental into medical but... how did we even get here, especially considering how fragmented the dental industry seems to be (mostly comprised of small private practices with some public ones to supplement.…

Used to be you'd get your dental work done by the same guy who cuts your hair and shaves your beard.

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

#157

Post by cableshaft » Mon, Jun 20, 2022, 4:15 PM UTC

corry wrote: post #136

Ah this article put the finger on why I don't trust my 'new dentist': The operation is just too slick from a business POV. As someone familiar with SaaS or in general this kind of recurring business model, you can sense all the little operational policies and procedures designed to increase your LTV. It's a well-oiled machine. Without fail, the hygienist recommends cleaning not once every 12 months or even every 6 mo…

> ...but every 3 months. When pressed on why, eventually they'll admit it's how nice it feels to have clean teeth and how important your smile is - but NOT strictly necessary for health.

Sometimes they can give a proper reason. Like in my example I've got some largish gum pockets around three of my teeth that are getting better but still not great (was a lot worse before they did some deep cleaning 9 months ago, I was seriously worried I had a couple of abscesses, lots of pain, gum swelling, and bleeding), so every 3 months makes sense to check in on them and keep them cleared out enough they can heal better.

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

#158

Post by dEnigma » Mon, Jun 20, 2022, 4:17 PM UTC

mypastself wrote: post #44

massysett wrote: post #4

It’s really not fair to take an example of one unethical dentist and sell the story as “the truth about dentistry”.

Chalk me up as another anecdatum of being subjected to questionable dentist practices. If you’ll permit me to grossly oversimplify, I feel like dentists are to medicine what software developers are to engineering. Both professions tend to play faster and looser with rules and standards, and tend to be closer to trade careers than most of their superset.

If only there was as much development (pun intended) in dentistry as there is in software engineering. With all the amazing advances in medicine we're experiencing it often feels to me like dentistry is stuck.

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

#159

Post by anonporridge » Mon, Jun 20, 2022, 4:18 PM UTC

floppydiskette wrote: post #96

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.

https://www.sleepfoundation.org/snoring/mouth-taping-for-sle...

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

#160

Post by kcplate » Mon, Jun 20, 2022, 4:20 PM UTC

corry wrote: post #136

Ah this article put the finger on why I don't trust my 'new dentist': The operation is just too slick from a business POV. As someone familiar with SaaS or in general this kind of recurring business model, you can sense all the little operational policies and procedures designed to increase your LTV. It's a well-oiled machine. Without fail, the hygienist recommends cleaning not once every 12 months or even every 6 mo…

Here is my hack…

Caveat: I have a couple of “Cadillac” dental insurance plans due to great employee benefit packages for both me and my wife. So they cover quite a bit.

I just tell the hygienist before I get in the chair that if my insurance doesn’t cover it, I won’t be doing it, and don’t even suggest it. Generally that stops the upselling.