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

> If my experience is as ubiquitous as I suspect, there seems to be a perverse incentive among dentists to allow adults to ruin their own teeth.

If you read the thread, some dentists will perform needless work on healthy teeth to make money, so I doubt there’s an incentive to let adults ruin their teeth when you can just lie and say they need the work anyways.

> "Improvement from therapy is not something that’s easily measurable"

Is it not? I have commented before about the work of Dr David Burns[1], and one thing he drills over and over is that therapists need to start measuring their work, and it is easy, and they don't because they either don't want to hear that they are doing a bad job or they depend on their clients for long term income and so aren't incentivised to want improvement. He endorses a mood survey[2] which the patient/client fills in at the start and end of every session. If the patient self-reports "I feel 5/5 hopeless" and two sessions later they report "I feel 2/5 hopeless", isn't that a measurable improvment? if instead they say "I still feel 5/5 hopeless" isnt' that a measurable lack of improvment?

It isn't an objective quantification but if the reason for seeking help is self-reported bad feelings, and afterwards the bad feelings are reduced or gone, the evidence for improvement is at least as strong as the original evidence of a problem existing. And it's easy to find out if the bad feelings are reduced or gone by asking. See some examples in the podcast summary here[3] talking about studying the effectiveness of the therapy app they are working on: "two groups, including 60 participants with moderate to extremely severe depression at the start of the day, and 73 participants with no or only mild feelings of depression. [...] The reductions in depression in both groups, as well as the additional six negative feelings, were substantially greater than the reductions reported in large numbers of published outcome studies with cognitive therapy, other schools of therapy, and antidepressants. All seven types of feelings were dramatically reduced in both groups. For example, the depression reduction was 62% and 51% in the severe and mild groups, respectively, and the anger reduction was 70% and 81%, respectively"

and

"The feedback we received on the app has been largely totally unexpected. Some things that we thought were blow-away were criticized, and some parts that we thought were weak were strongly celebrated. This experience has been much like using David’s feedback scales in therapy. Therapists learn that their perceptions of how their patient feel are often not[?] off-base, and that many of your favorite techniques and strategies are not effective. This information, if processed with respect and humility, can transform your clinical practice."

[1] Dr Burns does the Feeling Good podcast ( https://feelinggood.com/list-of-feeling-good-podcasts/ ) and book, is a retired Professor from Stanford Uni, was a pioneer in Cognitive Behavioural Therapy, and now works promoting his TEAMS CBT model which has insights on how to hone in quickly on the reasons people are stuck and can't change, and then how to get past that.

[2] One of the mood surveys https://feelinggood.com/wp-content/uploads/2013/10/brief-moo...

[3] https://feelinggood.com/2022/02/28/the-feeling-good-app-part...

Like many others I thought my family was predisposed to bad teeth based on the number of diagnosed cavities my sister and I had in HS/college (she had probably 10 fillings before college and I had 3). Then I moved to a new city and that last cavity I’d needed to get treated ASAP suddenly disappeared when I received my new dentist’s check up. She mentioned that there’s a lot of leeway in how cavities are defined and some dentists will lean very aggressive in their diagnosis (IMO crossing over into outright fraud or deception in my case). I’ve never had a cavity since that first dentist.

In Italy until not long ago, dentists were a branch of medicine: you had you study medicine and then specialize in dentistry.

Now, also in Italy the Anglo American idea that dentists are not fully medicine has been adopted as well, and at the university there is a path for dentistry alone. And it doesn't make any sense.

The tooth cleaning is much the same as what happens on the yearly cleaning your insurance pays for (and highly recommends you do). Is that one also "basically useless"? How much study does one need to judge if mechanical dental tartar removal is beneficial?