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Routine dental X-rays are not backed by evidence

arstechnica.com

11–20 of 390 posts

Re: Routine dental X-rays are not backed by evidence

#11
> "Financial aspects of dental radiography also deserve further study," Feit added

No joke. That is a major money maker. There is minimal cost per-use and your insurance pays $200 for it (my last one was $186.00 for instance). The dentists would be crazy not to recommend them as of often as possible.

Fluoride "rinses" are likely up there too. Rinse for a few seconds and they charge the insurance $50 or something for it.

Re: Routine dental X-rays are not backed by evidence

#13
post #9
post #2

Other outdated yet still routine dental practices include polishing of teeth during checkups for any justification other than cosmetic reasons

My bugbear with dentists in the US (after living my first 30 years in the UK) is that they all continually hassle me to have my wisdom teeth removed. Said teeth have never caused me any problems and are all through the gums. I can only assume it's dogma or an opportunity to bill insurance for costly unnecessary surgery.

I asked mine, and he said the wisdom teeth can crowd teeth if the jaw size is too small causing buckling (a cosmetic issue). More seriously, it can interfere with nerves in your jaw (again because of size constraints) causing numbness / paralysis, etc. Likely the decision to remove them comes down to your genetic / jaw structure and whether they have fully come in yet or not.

https://www.webmd.com/oral-health/wisdom-teeth-removal-neces...

Re: Routine dental X-rays are not backed by evidence

#14

Earlier quoted context omitted.

and fees. But are checkups themselves backed by evidence? Unless you say “It hurts there”, will the dentist find anything on their own?

> will the dentist find anything on their own? In my experience they always find something that they "have time to take care of right now if you want". I've heard anecdotes of folks going to get second opinions that reaches a different conclusion.

In Australia they always found me exactly 4 things to do for a total sum of just above $1000 (but never the same things to do). It’s so regular that I can only assume this is the recommended amount by the marketing that a dentist can extract each time.

Re: Routine dental X-rays are not backed by evidence

#15
post #5

I'm going to also throw anecdotes into the bucket: three dentists completely missed a cavity on one of my rear molars (wisdom teeth) until I mentioned pain, and then they poked around physically and said, "oh yeah, that's a big one."

What kind of dental x-rays they took? Panoramic (shows the whole row of teeth in one image), CBCT (volumetric 3D) or intraoral (a digital sensor or film was put inside your mouth)?

Not OP, but I have only ever had the type of dental x-ray where they stick the L-shaped plastic into your mouth and make your bite down while they take photos. I had no idea there were others.

Re: Routine dental X-rays are not backed by evidence

#16
Some dentist practices (maybe they are chains) do seem very shady when it comes to overtreatment. I remember on my first visit to an office that I was recommended customized trays that I could wear overnight to have my teeth/gums soaked in hydrogen peroxide gel. This recommendation felt like a sales pitch and when I researched the proposed treatment code later I started to find some dentists online claiming that they wouldn’t recommend those because they are not clinically proven to work against gum disease.

I understand that radiation effects are cumulative but is this overexposure source worth fighting against as a patient?

Re: Routine dental X-rays are not backed by evidence

#17
post #9
post #2

Other outdated yet still routine dental practices include polishing of teeth during checkups for any justification other than cosmetic reasons

My bugbear with dentists in the US (after living my first 30 years in the UK) is that they all continually hassle me to have my wisdom teeth removed. Said teeth have never caused me any problems and are all through the gums. I can only assume it's dogma or an opportunity to bill insurance for costly unnecessary surgery.

I am in the US and I had my wisdom teeth filled. Granted after the procedure my dentist said he was never filling wisdom teeth again, lol.

Re: Routine dental X-rays are not backed by evidence

#18

Earlier quoted context omitted.

and fees. But are checkups themselves backed by evidence? Unless you say “It hurts there”, will the dentist find anything on their own?

> will the dentist find anything on their own? In my experience they always find something that they "have time to take care of right now if you want". I've heard anecdotes of folks going to get second opinions that reaches a different conclusion.

Just for one anecdote, three years ago my then-dentist (who was a part of a franchise practice and probably under pressure to bill) told me that I had 12 (!!) cavities across all quadrants of my mouth that needed to be filled immediately.

I went to another dentist in the area, they took some x-rays themselves, and told me that there was nothing that needed immediate work - maybe one pre-cavity that would eventually turn in to something but certainly not worth doing anything with now.

Three years later (and sticking with that new dentist) I still haven't needed to have anything done (and certainly don't have any pain in my mouth anywhere either).

Re: Routine dental X-rays are not backed by evidence

#19
post #9

Earlier quoted context omitted.

My bugbear with dentists in the US (after living my first 30 years in the UK) is that they all continually hassle me to have my wisdom teeth removed. Said teeth have never caused me any problems and are all through the gums. I can only assume it's dogma or an opportunity to bill insurance for costly unnecessary surgery.

I was told they get harder to remove when you’re older

It's one of these areas where people (including medical professionals) hold strong beliefs, but then it turns out that there are other highly-developed countries where this is not routinely practiced, and the outcomes aren't necessarily different.

Routine wisdom teeth removal is not a thing in most of Europe. Another random example are colonoscopies and routine flu vaccines (except for the elderly).

Re: Routine dental X-rays are not backed by evidence

#20
post #9

Earlier quoted context omitted.

My bugbear with dentists in the US (after living my first 30 years in the UK) is that they all continually hassle me to have my wisdom teeth removed. Said teeth have never caused me any problems and are all through the gums. I can only assume it's dogma or an opportunity to bill insurance for costly unnecessary surgery.

I was told they get harder to remove when you’re older

https://www.jwz.org/gruntle/wisdom-teeth.html
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