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Routine dental X-rays are not backed by evidence

arstechnica.com

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

#121

Post by bigstrat2003 »

bsimpson wrote: post #30
hcrisp wrote: post #13

Earlier quoted context omitted.

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-…

I had mine done in college. I really didn't want to do it. I would have been totally happy to buck the pressure of "this is what everyone does," but the thing that made me reluctantly agree to it was an explanation that if I didn't, they would bore holes into my then-back teeth as they grew in and I'd have a big problem to deal with. As I understood it, teeth normally grow straight up, but wisdom teeth grow sideways…

My wisdom teeth came in like you describe. They meet my back molars at a 90 degree angle. They never bothered me, though - I have had two removed because they got infected, but otherwise they never caused any issues.

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

#122

Post by ktosobcy »

Uhm... Most of my life I went to a doctor that simply checkeed my teeth "physically". Then a couple of years back she send me to get x-ray to her's son place "just in case". And then she retired and I moved to him. And while he does x-ray more often it's mostly as a fallback when he checks my mouth and has some doubt/x-ray was done more than 2 years ago.. but again - it's not very expensive - like $25 :D

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

#123

Post by ktosobcy »

rdtsc wrote: post #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…

Those prices are insane... I wonder if it's due to the insurance f-up of the whole health system in the USA (i.e. ballooning the prices because "insurance will pay"))

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

#124

Post by Pikamander2 »

smt88 wrote: post #25
Log_out_ wrote: post #12

PSA: to hot beverages and food are a constant source of scartissue and cell damage in mouths . and if the dice falls wrong to many times, chancer precursors.. so dont risk to hot stuff

I don't know why you're being downvoted. It is a little off-topic, but you're correct that drinking too-hot liquids increase the risk of multiple types of cancer. The same is true of alcohol-based mouthwash and alcohol itself. Anything that routine damages cells is going to be a carcinogen.

> I don't know why you're being downvoted

Because it's unrelated to the article, doesn't have a source, has multiple typos, and even if it's true, I'm not going to give up hot beverages and food just to avoid (what I assume they're implying to be) a tiny increased mouth and throat cancer risk.

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

#125

Post by zerocrates »

bsimpson wrote: post #30
hcrisp wrote: post #13

Earlier quoted context omitted.

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-…

I had mine done in college. I really didn't want to do it. I would have been totally happy to buck the pressure of "this is what everyone does," but the thing that made me reluctantly agree to it was an explanation that if I didn't, they would bore holes into my then-back teeth as they grew in and I'd have a big problem to deal with. As I understood it, teeth normally grow straight up, but wisdom teeth grow sideways…

Definitely not all wisdom teeth come in like that: it's possible to have all 4 aligned normally and have have enough room (I do).

But coming in towards other teeth and hitting them, or other forms of impaction, are pretty common. You probably saw (or could have seen) the situation pretty clearly on an x-ray.

That being said, there is/was definitely an air of "this is just what we do, it's easier this way" for removing wisdom teeth, akin to say, what removing tonsils once was.

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

#126

Post by pandatigox »

bdjsiqoocwk wrote: post #114
pandatigox wrote: post #109

Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefull…

I'm glad curriculum is improving, but nothing stops a dentist from overtreating of is so decides, and the incentive is there.

I think that applies to any industry! Like nothing is stopping a car mechanic from overcharging you. But dental treatments need to be clinically justifiable, so I'm sure any well-meaning dentist will happily explain their reasoning for any treatment.

Patients regularly push back on some treatments I've recommended, and I've always enjoyed the discussion. If a dentist is offended, then something is not right

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

#127

Post by pandatigox »

newman314 wrote: post #120
pandatigox wrote: post #109

Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefull…

How about for cavities? I remember reading an article recently about major increases in the number of cavity related treatments because $$$. My kid has had multiple recommendations for cavities and I've got some suspicions about the absolute necessity of all of it.

Fillings are definitely a staple of the procedures a dentist would perform. The article does mention overtreatment, so really depends on your child's caries risk. As mentioned in another comment, healthy dose of skepticism is always required. I usually try to show signs of decay either intraorally or detected on radiographs.

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

#128

Post by ninalanyon »

rdtsc wrote: post #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…

Those prices are absurd. My whole annual check up including a digital X-ray, visual inspection, tartar removal, polishing, costs less than that.

And that is in high cost Norway.

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

#129

Post by shellfishgene »

xnx wrote: post #40

Not just x-rays: "As a profession, dentistry has not yet applied the same level of self-scrutiny as medicine, or embraced as sweeping an emphasis on scientific evidence." https://www.theatlantic.com/magazine/archive/2019/05/the-tro...

One thing is evidence based medicine, another just simple greed: I like this older study from Switzerland where they sent the same healthy guy to 180 dentists, about 30% of whom performed unnecessary treatments, often on different teeth.

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3036573

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

#130

Post by rurban »

g-b-r wrote: post #53

Wow, the US are crazy. Here in Europe I never heard a dentist recommend that (yearly check-ups yes, of course, but they're manual - and accurate)

Because in civilized countries insurances pay 100% of x-ray exams, and needed treatment.

But some countries still believe in the advantages of the middle ages.

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