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

theatlantic.com

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

#211

Post by nsxwolf »

cableshaft wrote: post #157
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 wa…

My pockets got better after I started using a WaterPik with a special attachment called the "Pik Pocket". I use warm water with a little splash of hydrogen peroxide and irrigate them all.

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

#212

Post by psim1 »

spupe wrote: post #11

Always be skeptical when the person giving you a diagnosis also directly benefits from giving you a particular diagnosis. This goes for dentists, banking and so much more.

In my state, annual automobile safety inspections are required. I have always been suspicious of this because naturally the auto shop doing the inspection offers to repair any flaws they discover. In most cases, the safety issues are obvious (thin tire treads, worn brakes, rust damage) so if you have a little bit of understanding you can verify the shop's claims and seek repairs elsewhere if the cost is too high.

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

#214

Post by jaywalk »

diob wrote: post #190
iforgetti wrote: post #177

Personal anecdote about this: My wisdom teeth grew in about 15 years ago and have sat comfortably behind my molars since. I saw a new dentist for a routine cleaning “intro package” where she suggested that I have the wisdom teeth removed. I asked her why should I have a surgery for this since I never had problems with them. She said it was a good idea because they were “more likely to develop a cavity” because they a…

I often wonder about this, because they made me remove mine due to "risk of infection". But afterwards I now get infections there if I get food stuck in the pocket left behind and can't get to a water pik soon enough.

Those pockets should have healed and closed up within a few days after surgery. It sounds like you had dry sockets that weren't properly dealt with.

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

#215

Post by clairity »

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…

my dental group actually calls/emails me on a regular basis to get me to come give them that sweet, sweet free insurance money. but note for instance that cavities and fillings are prone to being overdiagnosed for the sake of income, not patient outcome. glasses are regularly overprescribed for the same reason. patients really need to understand the incentives and motivations of medical professionals to make the best decisions for themselves.

dentistry, optometry, therapy, veterinary, and even primary care all are vulnerable to the "recurring revenue" model. it's reasonable to be skeptical of their motivations even as we go to them for help and care. that's why patients should view medical professionals as an informed but biased opinion, not an authority. the patient needs to become knowledgeable about their own malady to make the best medical decisions they can, and it's part of the professional's job to aid that journey, not to make the decisions for the patient. that's also why patients need to see multiple professionals to triangulate their best option, rather than getting locked in to a single care provider. monopoly forces are antithetical to this process.

the shaman strategy is alive and well, and will be for many centuries/millenia to come (in other words, we're not uniquely advanced in the history of humanity).

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

#216

Post by vitaflo »

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…

My wife has a similar story. She had a decent dentist for a while but after a botched crown install she was dissatisfied with the response and started looking for a new dentist. Found one that had a nice modern practice. New dentist said she had NINE cavities. She may have had one cavity in the prior 10 years at most.

This immediately caused suspicion. So we started looking for a second opinion. We got a referral from a friend to a dentist that was more conservative. So she made and appointment with him and wouldn't ya know, ZERO cavities. Not even any "watch" areas.

Turns out this conservative dentist used to teach dentistry at the local state university and actually taught the overtreatment dentist. His response when he found out who said she had 9 cavities was "he was a very ambitious student".

We've been going to him for 15 years now and she hasn't had a single cavity, and he fixed her crown perfectly.

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

#217

Post by nsxwolf »

somehnacct3757 wrote: post #33

I had a dentist in SF that did this, first visit to him I had 12 (?!) cavities that needed filling. Got suspicious -- their office was very very nice and in a prime location -- more importantly, none of my teeth hurt. A second opinion confirmed that the fillings were not necessary at that time. I did start flossing regularly as a result, so that I don't have to rely on dentistry as much.

This is why I have been going to the same dentist for 25 years. If I ever move out of state I will fly back for dental visits.

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

#218

Post by nsxwolf »

ghaff wrote: post #169
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.…

If it were part of medical, I'd expect to see most expensive procedures (that aren't already covered under medical) such as crowns, implants, and root canals wouldn't be covered because they'd be considered cosmetic given that extraction is usually an option. Routine dentistry is pretty inexpensive, especially in the context of medical costs generally. Any company dental plan I've ever had is mostly a tax advantaged…

Yeah, it's always been my impression that if it were covered by medical, most of us would just have all our teeth pulled.

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

#219

Post by DaveExeter »

mb7733 wrote: post #180
DaveExeter wrote: post #171

Earlier quoted context omitted.

>cost out-of-pocket to address the cavities and they gave a number somewhat north of $200 Sorry for the all caps, but YOU HAVE TO NEGOTIATE PRICES! $200+ per filling is an ASKING PRICE. You counteroffer at $75/per filling. Maybe meet at $90/each. IF YOU DO NOT NEGOTIATE PRICES YOU WILL BE CHEATED!

Well, in this case he would have been cheated no matter the price.

In that case, yes.

But I saw a quote from a dentist who wanted to charge some woman $260 per filling for 4 fillings.

Who pays $260 per filling? That is a crazy price. $1,040 for an hours work? You have to put your foot down.

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

#220

Post by GordonS »

DaveExeter wrote: post #171
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…

>cost out-of-pocket to address the cavities and they gave a number somewhat north of $200 Sorry for the all caps, but YOU HAVE TO NEGOTIATE PRICES! $200+ per filling is an ASKING PRICE. You counteroffer at $75/per filling. Maybe meet at $90/each. IF YOU DO NOT NEGOTIATE PRICES YOU WILL BE CHEATED!

You have to haggle at the dentist?!
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