Routine dental X-rays are not backed by evidence • Hacker News Board

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

#151

Post by michaelt » Tue, Oct 15, 2024, 9:27 AM UTC

crimsoneer wrote: post #138

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…

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

> Slightly worrying that evidence-based dentistry wasn't the default position

I see what you mean.

But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.

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

#152

Post by aaronmdjones » Tue, Oct 15, 2024, 9:30 AM UTC

fifticon wrote: post #137

anecdote on their usefulness. I recently had my yearly inspection, _without_ xrays (which she said it was probably about time for "next time"). A month later, I had pain in a rear molar, and went for a checkup. They reacted "that is not good, because that tooth is root-treated - no nerves, so pain from a place without nerves is not good". They then did an xray, which revealed the tooth had started rotting - a lot - i…

My dentist gives me x-rays every two years, and I have checkups every 6 months to check for things like newly forming cavities, inflammation, decay, etc (nothing ever found so far, apart from some minor cavities as a child). It always struck me as prudent.

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

#153

Post by cmgbhm » Tue, Oct 15, 2024, 9:30 AM UTC

crimsoneer wrote: post #138

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…

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

There was a podcast on history of dental insurance that explained it from US perspective.

https://freakonomics.com/podcast/dental-insurance/

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

#154

Post by MandieD » Tue, Oct 15, 2024, 9:30 AM UTC

tzs wrote: post #80

doe_eyes wrote: post #19

Earlier quoted context omitted.

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).

Flu may not be too dangerous in people who aren't elderly but it still sucks. Can a non-elderly, not in any other high risk group, person get seasonal flu vaccination in Europe if they ask for it, and is it covered by European health care systems?

They're not only covered by the gesetzliche Krankenkassen (German public health insurance providers, mandatory if you don't meet the criteria for private insurance), mine gives me a little bonus if I prove I've gotten various vaccines, including annual COVID booster and flu.

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

#155

Post by MandieD » Tue, Oct 15, 2024, 9:32 AM UTC

doe_eyes wrote: post #19

electronbeam wrote: post #10

Earlier quoted context omitted.

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).

Not sure which country you're talking about, but in Germany, the public health insurances cheerfully pay for annual flu and COVID boosters for everyone.

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

#156

Post by edgineer » Tue, Oct 15, 2024, 9:35 AM UTC

alexjplant wrote: post #36

genter wrote: post #20

Earlier quoted context omitted.

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

This guy infamously has a problem with each and every HN user and chooses to display an NSFW image saying such if your request's referrer header has news.ycombinator.com. Don't click.

"Some people, when confronted with a problem, think 'I know, I'll quote Jamie Zawinski.' Now they have two problems."

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

#157

Post by exitb » Tue, Oct 15, 2024, 9:37 AM UTC

michaelt wrote: post #151

crimsoneer wrote: post #138

Earlier quoted context omitted.

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

> Slightly worrying that evidence-based dentistry wasn't the default position I see what you mean. But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.

If I decided to charge my customer specifically for indenting my code, I imagine they might be interesting in evidence that they're getting their money's worth.

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

#158

Post by vardump » Tue, Oct 15, 2024, 9:42 AM UTC

exitb wrote: post #157

michaelt wrote: post #151

Earlier quoted context omitted.

> Slightly worrying that evidence-based dentistry wasn't the default position I see what you mean. But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.

If I decided to charge my customer specifically for indenting my code, I imagine they might be interesting in evidence that they're getting their money's worth.

They'd probably want to pay if you were coding in Python.

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

#159

Post by throw4950sh06 » Tue, Oct 15, 2024, 9:56 AM UTC

pprotas wrote: post #149

crimsoneer wrote: post #138

Earlier quoted context omitted.

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

Not directly related to the topic at hand, but it amazes me how Dutch healthcare insurance does not cover dental care by default, and you have to get an extra package for that. As if dental health is not part of my regular health? Why are teeth treated differently from the rest of the body?

[flagged]

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

#160

Post by trq01758 » Tue, Oct 15, 2024, 9:59 AM UTC

Back in USSR times in the 80s my high school had a room for a dental work. Of course it had a soviet electric motor drill, not any fancy or not so fancy compressed air turbo anything (because it's cheap like some great RBMK reactors which of course cannot fail) and a young visiting dentist to test their skills on kids. I do not have any great memories related to this. But now I'm also thankful that at least there were no resources to have an X-ray machine for some practice.