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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)

#161
post #146

Some easy heuristics that will save you: - shower curtains instead of glass doors: subpar airbnb - Kikkoman soy sauce: probably not the best sushi - teeth whitening services: dentist not optimizing for dental health The problem is that they all push teeth whitening ... but it's a strong signal if you find one that doesn't.

I probably don't agree with Kikkoman one. Maybe with sushi, but other Chinese food here it is more premium brand. Many others are cheaper and worse.

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

#162
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…

>What I don't understand is why dentist work is not better regulated and covered by health.

If you read into the history, it's because the doctors of the past didn't consider dentistry to be a real field (basically considered it more cosmetic), so the early pioneers of dentistry profession formed their own club.

And now that there's so much money in keeping the peasant bloodsucking machine known as healthcare going in the US, nobody is going to alter it to even include dentistry. For fear of losing out money.

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

#163
I know HN will have the answers if no one else will:

Anyone have links to good studies (or even RCTs) about flossing, different kinds of toothpaste, etc.?

I don't wanna open up the whole fluoride debate, but it seems _stannous_ fluoride is more effective than _sodium_ fluoride. The mouthwash I bought stained my teeth (can't find the link, but you had to dilute it with water. Something like [0]).

I remember reading a study that pulling wisdom teeth was unnecessarily common. I can attest that, as the best dentist actually compared two X-rays six months apart to see whether they moved.

P.S. Castle Dental is the worst. They quoted me for almost $3k worth of work! A second opinion told me I just needed a cleaning and maybe a filling.

[0]: https://www.amazon.com/3M-ESPE-PerioMed-Stannous-Concentrate...

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

#164

My son when 3 had a fall and a few teeth were bent. Went to our local dentist who mostly had a wait and see opinion. But then calls a day later and says they’ve decided they should just come out. Two top front teeth. Would have no top front teeth for years. I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meanderi…

>> I’m not a conspiracy nut. I believe in listening to experts (but ultimately making an informed decision). I believe in modern medicine. But that experience shook me and forever changed my trust in the dental industry.

Ask anybody who’s experienced a “chronic” illness about the “experts” and they’ll tell you a tale or two. The experts are great until they have a case that is unusual. The don’t have the time or knowledge to treat you properly. You get passed from “expert” to “expert” each time having your hopes dashed. You start feeling like a conspiracy nut chatting with other patients online sharing what’s anecdotally helped. After running into this issue more than once I’ve lost all blind trust in medical experts. I’ll verify what they tell me as best I can and get second opinions if necessary. In one case I was passed up the chain of experts until I finally found the right one myself after a year, and it still blows my mind that this wasn’t the first referral. The system is at the same time incredible and awful.

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

#165

My son when 3 had a fall and a few teeth were bent. Went to our local dentist who mostly had a wait and see opinion. But then calls a day later and says they’ve decided they should just come out. Two top front teeth. Would have no top front teeth for years. I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meanderi…

>>I believe in listening to experts (but ultimately making an informed decision). The problem for the most part in all industries is we have moved from a system of experts to a system of credentials. Now one would say that in order to get a credential in something one must be an "expert" but this is far far from the truth, there are all kinds of competing incentives to ensure an ever increasing supply of "credentiale…

> Consumers often lack the resources, information, or decisions tree in most instances to look for any indicators of actual knowledge in the field beyond that credential

This is true. I have no clue how to check the expertise of my dentist, apart from using my own mental bullshit detector (of limited use here) and reading reviews by others (also of questionable use, because who reviews their dentist? And where?).

The analogous problem exists for certain kinds of expensive products with the property that they usually work well, but sometimes become flaky. Think a washing machine. Who posts a review about their washing machine four years post-date that it's still going strong? And absence of base rate information makes absolute numbers of bad reviews mostly meaningless.

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

#166

My son when 3 had a fall and a few teeth were bent. Went to our local dentist who mostly had a wait and see opinion. But then calls a day later and says they’ve decided they should just come out. Two top front teeth. Would have no top front teeth for years. I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meanderi…

Once I had bad pain and went to a dentist, he pulled out a tooth. Later I heard it's absolutely last ditch and replacement teeth are finicky and will make your life much more problematic. Thankfully it's just enough to the side to not be visible so I am getting away without one. (Though I think it's also problematic long term, because remaining teeth would shift.) Never again to trust a dentist, no matter if it's a p…

I’m missing quite a few teeth not mostly biologically but had two that grew in weird and had to be extracted. Found an amazing dentist that’s on the local board and they’re not pushy about implants but does say don’t wait too long since it’ll end up costing more if the other teeth move. He’s also managed to save a tooth my last dentist absolutely demolished trying to put a crown on it.

It’s hard to shop around for dentists but when you find a good one it’s life changing.

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

#167

My son when 3 had a fall and a few teeth were bent. Went to our local dentist who mostly had a wait and see opinion. But then calls a day later and says they’ve decided they should just come out. Two top front teeth. Would have no top front teeth for years. I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meanderi…

>>I believe in listening to experts (but ultimately making an informed decision). The problem for the most part in all industries is we have moved from a system of experts to a system of credentials. Now one would say that in order to get a credential in something one must be an "expert" but this is far far from the truth, there are all kinds of competing incentives to ensure an ever increasing supply of "credentiale…

Systems of experts are hard to scale since you need experts that you know are experts to vouch for experts. Systems of credentials that are at least theoretically assigned by experts are the next best thing, but obviously not ideal.

It’s at least better than the populist solution of anti-experts chosen on the basis of charisma or “truthiness.”

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

#168

My son when 3 had a fall and a few teeth were bent. Went to our local dentist who mostly had a wait and see opinion. But then calls a day later and says they’ve decided they should just come out. Two top front teeth. Would have no top front teeth for years. I went into engineer mode and while I acknowledged I didn’t have domain expertise, I asked questions and probed the whole situation. Very unsatisfactory, meanderi…

>For the first time ever I did the “call in a personal favour” thing and asked my dad to reach out a family friend, a former cosmetic dentist and former head of the province’s dental association for a second opinion.

Why aren't you using connections on a daily basis to get reliable services?

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

#169
I asked my dentist about this (someone who has never done any major work on me despite 20+ years of the option to do so) and he said that insurance reimbursements are such that you need to do X amount of work per Y patients to make money.

With him, I pay a 50% premium on the regular dentistry, well above what insurance will pay. Worth it, but makes sense.

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