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I went to 50 different dentists: almost all gave a different diagnosis (1997)

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Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#21

At the very end of the article: "This article originally ran in the February 1997 issue of Reader’s Digest." Surely this should be noted in the HN title?

Dentistry has improved in leaps and bounds since 1997 - as the monetary incentive to over-prescribe treatments has now gone, right? /s

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#22

When I first went to Ithaca I went to a quack dentist who charged me a lot for unnecessary diagnostics. I did not see a dentist for two years, then I got a referral to my current dentist where the whole family gets a cleaning twice a year. My wife thinks the exam with the dentist after seeing the hygienist is a scam, I see the dentist only if there is evidence of a problem. In that time I got a referral to extract on…

(Wife is a dentist.) There are a lot of immoral people out there, but "see the dentist only if there is evidence of a problem" is a bad strategy.

Tooth decay is a slow process and the treatments slowly ramp up in invasiveness: when it's minor you can use sealant (like painting over it), if it progresses you get a filling (with some minor drilling), if that progresses you get a root canal (drilling out the whole nerve and replacing the bulk of the tooth). You may only reach the threshold of feeling pain at the point of needing a root canal when it can be preventable earlier.

(I do suspect hygienists are capable of spotting most of this but my impression is they're not licensed to diagnose.)

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#23
post #8

What I don't understand is why dentist work is not better regulated and covered by health. I can get a heart operation covered but if I have to do an implant I have to pay for it. I mean, I understand if you charged me something as a punishment (lets say 100/200 dollars), but I don't get why is not covered. We can even make it an additional monthly payment or something. But it is crazy that there is no coverage for m…

Wouldn’t covering it more just exacerbate the problem of overcharging and doing unnecessary work? Not sure this really helps.

The real problem is that dentists business model assumes they will do a lot of restorative work but people’s dental health has improved so it’s far less necessary than before.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#24
post #19

My wife was shocked to learn in dental school how many people were there focused on the money. From her experience I learned that dentistry in particular is a profession that has a low investment / high payoff ratio. Relative to medical school dental school is easier to get into and shorter, and unscrupulous dentists can extract a lot of money out of patients. PS: I feel compelled to share her best advice re oral hyg…

Reminds me of that argument scene between Capt. Holt and the dentist from Brooklyn 99.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#25
post #15

This is the one place I like insurance because it at least gives some cost conscious perspective to proposed procedures. My insurance sucks but at least it’s useful that insurance considers optional what my dentist says is essential. For example, my dentist only does tooth colored fillings and my insurance doesn’t cover them. My dentist says the covered ones are unsafe. It’s a weird situation. My last dentist said I…

It’s at the point where I’m saving up to get my dental work in Mexico or Colombia. There’s no point of doing it in the states. I paid $6k for one implant. Ridiculous.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#26
There's a lot of perverse incentives baked into dentistry. This is true of allopathic medicine was well, though I think it can be more difficult for someone to dispute a diagnosis from a dentist; who are you to say that little dot on your X-ray isn't serious enough to be drilled? It wouldn't surprise me if there are many fill-n-drill dentists out there. I knew people whose oral hygiene and diets were far worse than mine and yet they almost never were told they had cavities, and then there were those who ate properly who have had root canals and crowns.

In my experience, and in my own opinion, the industry of dentistry would be nowhere near as necessary as it currently is if people largely gave up consuming too much carbohydrates and sugar, which feed the bacteria that are ultimately the root cause of tooth decay. Acidification of saliva is of course an issue as well, but I think the whole "drinking cola will rot your teeth" thing is an exaggeration and a sort of red herring. It's not the soda per se, or so much the acidity of carbonated water, but the fact that you're feeding bacteria which colonize in the crevices and pores of your teeth, forming biofilm, creating isolated pockets of acid that wear holes in teeth. If it was all about exogenous acid, then the entire tooth would be rotting evenly, but that's usually not what you see.

My teeth aren't perfect. In fact, there's some decay that I've let sit there for nearly two decades now. Ever since I cut sugar from my regular diet, any caries I had either reversed (when extremely early) or stopped progressing. I do plan on seeing a dentist soon to actually address the decay, because it's silly to leave it there, but I'm confident that I otherwise stopped it in its tracks. My gums don't bleed, and I've seen no meaningful changes to my teeth in all that time. If my hypothesis is correct, then there's a real conundrum because the most affordable food available to people also tends to promote more tooth decay; dentistry largely exists to compensate for the fact that the cheapest available energy for humans comes with negative side effects.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#27

'While you've got good insurance, we can upgrade all your teeth now, before they get bad'? There may be stereotypes about the British having bad teeth, but I've never had a dentist try to milk my wallet like that despite a poor diet having done a fair bit of damage over the years. Dentistry here seems much more about doing the minimum necessary work to save teeth and relieve pain. The thought of getting crowns done e…

> I've only had one done, and it wasn't a fun experience - it's something I see as a last resort to save a tooth, certainly not something I'd want to go through for cosmetic improvements.

What was "unfun" about it? I'm familiar with what they are, but not the pain-points (in the non-literal sense lol) of getting them.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#28
post #15

This is the one place I like insurance because it at least gives some cost conscious perspective to proposed procedures. My insurance sucks but at least it’s useful that insurance considers optional what my dentist says is essential. For example, my dentist only does tooth colored fillings and my insurance doesn’t cover them. My dentist says the covered ones are unsafe. It’s a weird situation. My last dentist said I…

The thing about teeth and crowns is, it's fine until it isn't. I've actually had a molar collapse while eating almonds. It's honestly more traumatic than you'd think. Anyways, as a result I did a bunch of research and it turns out that crowns are important for reducing further damage to the root. A split down the the root is it for a tooth, and prosthetics are not a great replacement. My dentist gave me a price breakdown between extraction or root canal and crown both as valid options. Just because they say it's optional doesn't mean they're trying to price gouge you (though clearly the former was).

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#29

At the very end of the article: "This article originally ran in the February 1997 issue of Reader’s Digest." Surely this should be noted in the HN title?

Dentistry has improved in leaps and bounds since 1997 - as the monetary incentive to over-prescribe treatments has now gone, right? /s

Yeah, agreed, I totally don't believe this problem has gone away. In fact, it is still a noteworthy article for the very reason that it was 26 years ago but sounds like it could have happened yesterday. But, it should be noted in the HN title.

Re: I went to 50 different dentists: almost all gave a different diagnosis (1997)

#30

Man I had a really serious overbite as a kid and had a lot of orthodontia work done. I'm obsessive with my teeth now because of it. I'm also the child of doctors and coincidentally, when you're the child of medical professionals, other medical professionals treat you very very well. I had stellar dentists up until I moved to a new city and had my first experience with a bad dentist. Never again. Now I'm old enough to…

> I had stellar dentists up until I moved to a new city and had my first experience with a bad dentist. Never again.

Is the only way to determine a bad dentist by going to many? I am in need of lots of work, but the thought of going to a ton of car-salesman-esque "medical professionals" to pick the correct one .. is terrifying.

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