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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)

#531

Post by fnordpiglet »

mpsprd wrote: post #409
pfisherman wrote: post #389

Earlier quoted context omitted.

One thing that I think people need to understand is the distinction between science and the practice of medicine. The practice of medicine is not science. The practice of medicine can be informed by science - to a degree that is almost entirely up to the practitioner. ; but it remains more art than science. The distinction is similar to that between an aviation maintenance and aerospace engineering. Sometimes doctors…

Doctors are technicians. Technicians with a large toolkit, but technicians nonetheless. When you compare their behaviors to IT it all starts making sense.

“Have you tried turning it off and on again?” Doesn’t have quite the same applicability. I imagine quite a lot of medical issues could be solved if reboots were simpler.

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

#532

Post by KoftaBob »

jonny_eh wrote: post #441
sarchertech wrote: post #421

Earlier quoted context omitted.

Reread your article. There’s no evidence that “brush your teeth and you’ll be fine”. There’s no good evidence that flossing is effective because there are nearly no large randomized controlled studies of flossing. Nearly all of the studies rely on self reporting. Flossing isn’t some kind of conspiracy. Dentists make no money off it. Many dental associations and government agencies outside of the US recommended it. De…

I suspect dentists push flossing as a way of convincing their patients that they're not doing enough, and can therefore push more services. "Well sir, if you only flossed regularly like we tell you, you wouldn't need all these regular deep cleanings!"

I'm not sure how it works in other countries, but in the US, dentists generally need to provide xray/imaging of the mouth to back up whatever diagnosis/procedures they recommend, or dental insurance will reject it.

It's only when a patient is paying fully out of pocket when a dentist would perhaps have an easier time getting a way with over-diagnosing. Even then, they can still get in trouble with the ADA since that treads closely with medical fraud.

As is the case in many parts of the healthcare industry in the US (and many other countries), for practitioners who don't care as much about the ethics of it, they'll tread as closely as they can without crossing over into outright fraud.

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

#533

Post by donatj »

CommieBobDole wrote: post #31

I've posted this before, but I went to a new dentist one time and though I'd never had a cavity, the new dentist said I had nine, some of which were pretty bad and needed immediate treatment lest they require a root canal. I didn't have any money or dental insurance at the time, so I didn't go back and just worried about it a lot for a while. That was twenty-five years ago. Haven't been to a dentist since. My teeth a…

I had a very similar experience. Hadn’t been to a dentist in a couple year, had a filling fall out and wanted it replaced. Old dentist didn’t take my new insurance. Tried the place my girlfriend had been using. Place insisted on an initial evaluation before they’d fix my tooth. Told me I had 14 cavities and laid out a financial plan for how I would be paying them off over the next decade. They were honestly strangely rude about the whole thing too. Really bad experience.

I got a second opinion, they fixed my tooth there and then. Been seeing this dentist on and off for ten years with insurance changes. I have had 2 cavities in ten years.

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

#535

Post by cramjabsyn »

Waterluvian wrote: post #47

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…

Sadly there is no conspiracy needed. The for profit health care model is a significant contributor.

Dentists are also business people, and there are strong monetary incentives for them to upsell.

That's not to defend the behavior, but I think we should acknowledge the problem is systemic and that a non profit healthcare approach would be more appropriate for the vast majority of situations.

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

#536

Post by jjk166 »

I can't speak to other professions, but I know for mechanical engineering if you asked 50 engineers what they thought the best solution to a problem was they'ed give you 50 different answers. Of course if you got them all together in a room, probably 40 of them would say "oh that's a much better idea" right away, and a few more would as well after a bit of back and forth. Still, you'd probably be left with three or four proposals, each with a few die hard proponents and detractors.

I'm sure any profession that it takes years of training to practice probably comes with enough complexity that broad consensus becomes generally unachievable.

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

#537

Post by datavirtue »

Waterluvian wrote: post #47

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 have had a lot of work done on my mouth. I consider all dentists as incompetent, swindling, quacks until they prove otherwise.

My current dentist's niche is NOT performing anything that is unnecessary. A lot of people are taken aback when they say everything looks good. Makes for a great culture in his office.

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

#538

Post by Rudism »

Some years ago I was seeing a dentist that I had no complaints about--I try to take good care of my teeth, and she would tell me what I was used to hearing, teeth look great, nothing concerning, and so on. Then one day I go to my 6 month cleaning appointment and something is off. The name of the practice is the same, my dentist's name is still on the door, but I don't recognize anyone on the staff. When I'm greeted by the hygienist (who I've also never seen before), she says I'll need x-rays taken, even though I had them taken the previous appointment, because their computers crashed and they lost all their old ones. Um. Ok. Then after my cleaning, a _new_ dentist I've never seen before comes in to check my teeth. I can't remember what excuse he gave for why the previous dentist (whose name was still on the door, I remind you) wasn't there, but it was something hand wavy. Anyway, surprise, surprise, it turns out I needed several thousand dollars of dental work done, also it's apparent that I grind my teeth and need a night guard to prevent further damage, all my enamel is cracked or something and needs sealant, and all other kinds of craziness. Anyway, I said no thanks and high-tailed it out of there. Not sure what happened--almost seemed like some new money hungry dentist weaseled his way into my old dentist's existing practice, somehow got all her patient details and appointments, and then tried to pull a switcheroo on everyone.

I found a new dentist for my next cleaning 6 months later and got my usual teeth look great, no problems, see you in six months. That whole experience does not foster feelings of trust toward the profession, to say the least.

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

#539

Post by supertofu »

Waterluvian wrote: post #47

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…

Just wait until you hear about how the majority of gastroenterologists treat IBD.

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

#540

Post by joker_minmax »

Waterluvian wrote: post #47

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 had a friend in 2014 who said her orthodontist wanted to pull 3 of her molars in order for her teeth to ever be straight. She went to another orthodontist who said "WTF, your condition doesn't even need metal braces, you can use the clear aligners", and was angry that the other one wanted to pull her teeth... Always get a second opinion.
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