Dentistry is less scientific and more gratuitous than people think (2019) • Hacker News Board

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#161

Post by quantumduck » Mon, Jun 20, 2022, 4:22 PM UTC

tbran wrote: post #77

A compelling book on tooth care is Kiss Your Dentist Goodbye by Ellie Phillips. It advocates for: - Using flouride toothpaste. - Using a combo of bad-bacteria-killing mouthwash and flouride mouthwash (especially before bed). - Eating or finishing meals with tooth-protective foods. - Chewing xylitol [0] gum or mints. Xylitol is a sugar-replacement (with a lower insulin response) found in plants . I think Epic Dental h…

I've read reports that say the mouth bacteria develop Xylitol resistance in about 9 months. So I'm not sure how sustainable it is in long term

https://pubmed.ncbi.nlm.nih.gov/22218085/

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#162

Post by thr0w4w4y8523 » Mon, Jun 20, 2022, 4:23 PM UTC

After college, I went to a new dentist on the recommendation of a coworker, a father-son practice. It was fine for a few years, then all of a sudden, multiple cavities. They mentioned a failed sealant which I halfway buy, but they "found" a few others.

I'd never had a filling before, so this was a very big deal for me. The dentist had time, so he just did it right after my cleaning. The only word I have for how I felt was raped. I don't use that lightly. It was emotionally traumatic to have someone pressure you like that, not give you a clear choice, and violate your body.

I kept going there just because I was lazy, and I went on a day the dentist was out of the office, so the hygienist just showed him the xrays. When he found another one several years later, I got a second opinion. He said it was something a more aggressive dentist might go after, so the diagnosis wasn't outright wrong, but probably overly aggressive.

Never went back to the first dentist. 7 years later, it's still fine. I suspect most of my fillings were the same story.

My current dentist probably overtreats with 4 cleanings per year, but I'd rather pay for the extra cleanings.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#163

Post by wing-_-nuts » Mon, Jun 20, 2022, 4:25 PM UTC

Tozen wrote: post #150

tbran wrote: post #77

A compelling book on tooth care is Kiss Your Dentist Goodbye by Ellie Phillips. It advocates for: - Using flouride toothpaste. - Using a combo of bad-bacteria-killing mouthwash and flouride mouthwash (especially before bed). - Eating or finishing meals with tooth-protective foods. - Chewing xylitol [0] gum or mints. Xylitol is a sugar-replacement (with a lower insulin response) found in plants . I think Epic Dental h…

Many argue that pushing flouride on the public is an outright scam and lie. Fluoride is a known toxic substance that damages the body and can compromise one's health. It was being dumped in the water by factories, and the industry helped pull off a con by paying for studies to show that their industrial waste was actually "good" for people. The public fell for it, and here we are today. All these people drinking in a…

There are multiple studies showing how flouride in toothpaste and drinking water prevents cavities, and is non toxic. Where is your evidence to the contrary?

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#164

Post by ecommerceguy » Mon, Jun 20, 2022, 4:28 PM UTC

When I owned a bar for a short period of time a regular was a dentist and he said most dental procedures are unnecessary. I mentioned the last time i went to the dentist 10 years ago I was told I had seven cavities. He took a quick look and called their bullshit.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#165

Post by projektfu » Mon, Jun 20, 2022, 4:30 PM UTC

allan_s wrote: post #147

bityard wrote: post #137

Near the beginning of the pandemic, I had a pretty bad toothache spring up out of basically nowhere. Bad enough that sleeping was difficult and eating was impossible. I went to see a dental surgeon (I forget the proper name for this) and he told me I needed a root canal, and backed it up with X-rays. It made sense, I had trouble with this tooth before and a previous dentist told me that a root canal and crown on this…

Not asking directly to you, but in these cases is there (depending of the country) a way to make this kind of malpractice stop ? Organization to which to report the dentist ?

It's not yet considered malpractice. There is usually a standard of care, but that is not a clearly written standard. It's more like, "we think it is up to standard or not" in each case. I'm not a dentist but this is the way state boards work in my field (veterinary medicine) which is similar. Naturally they are more worried about practitioners who overlook problems than practitioners who are overly cautious.

Malpractice would be if you had no evidence of a caries (exploratory, radiographic or other test) and you recommended a procedure anyway. That may have been the case, but usually they have varying opinions of whether a particular lucency on an x-ray representes a caries, or whether it should be filled. Or there is also a machine that is used to detect caries that are not always radiographically evident. So your dentist probably could claim it was there but other dentists wouldn't recommend filling until there was more evidence of a problem.

Until the governing bodies or associations dictate what the go/no-go criteria are for filling, the dentists will have wide leeway to convince you either way.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#166

Post by helij » Mon, Jun 20, 2022, 4:30 PM UTC

cableshaft wrote: post #157

corry wrote: post #136

Ah this article put the finger on why I don't trust my 'new dentist': The operation is just too slick from a business POV. As someone familiar with SaaS or in general this kind of recurring business model, you can sense all the little operational policies and procedures designed to increase your LTV. It's a well-oiled machine. Without fail, the hygienist recommends cleaning not once every 12 months or even every 6 mo…

> ...but every 3 months. When pressed on why, eventually they'll admit it's how nice it feels to have clean teeth and how important your smile is - but NOT strictly necessary for health. Sometimes they can give a proper reason. Like in my example I've got some largish gum pockets around three of my teeth that are getting better but still not great (was a lot worse before they did some deep cleaning 9 months ago, I wa…

Did the hygienist measure your gaps and recommend interdental toothbrush sizes so you can do it yourself regularly? Tepe is a good brand but any really will do as long as you know what size to use. My hygienist measured and wrote sizes down for each gap between teeth.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#167

Post by cableshaft » Mon, Jun 20, 2022, 4:30 PM UTC

bityard wrote: post #137

Near the beginning of the pandemic, I had a pretty bad toothache spring up out of basically nowhere. Bad enough that sleeping was difficult and eating was impossible. I went to see a dental surgeon (I forget the proper name for this) and he told me I needed a root canal, and backed it up with X-rays. It made sense, I had trouble with this tooth before and a previous dentist told me that a root canal and crown on this…

I had fillings that failed and three of my teeth needed crowns (they really did). I was quoted $2500 per crown. My insurance only covered up to $1000 per year and I didn't have a great job at the time, so I was like "well, no way I can afford $6500" and did nothing.

Eventually the teeth got so bad they had to be removed, and had to get two bridges put in. That was quoted at $6k apiece. At that point I did have a good job again and could afford it, but yeah, that hurt.

Since then one of the teeth in the bridge had to have a root canal, and then the top part of the tooth cracked when the root canal was checked, and so now I need to replace the anchor teeth in one bridge to 2 implants. I was quoted $7k for those (that's one of the cheaper quotes, I've also been quoted over $10k), not including a new bridge that will have to be made, which will be another ~$6k.

I've put that off for three years now (even had a scheduled surgery to start the process I ended up cancelling). My bridge just has a good amount of temporary cement over that cracked tooth, which has oddly stayed in place the whole pandemic. Eventually I'll have to get it done, but I'm putting it off as long as possible.

If I had somehow figured out how to get those crowns in the first place, I might have saved all this grief and extra expense after. I'm up to 3 removed teeth and 4 teeth stripped of their enamel to become anchor teeth to put the two bridges on, which can never just be 'normal teeth' again.

I've also since heard that some places have machines to 3D print crowns onsite and can do it for as little as $300 each. I wish I knew that was a thing before I decided I was too poor to afford proper dental care.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#168

Post by guerrilla » Mon, Jun 20, 2022, 4:31 PM UTC

peteradio wrote: post #156

guerrilla wrote: post #125

What I can't understand is how dental managed to escape medical coverage, not just in the US but seemingly globally. Just this year the main confederation of Swedish labor unions will be pushing for consolidation of dental into medical but... how did we even get here, especially considering how fragmented the dental industry seems to be (mostly comprised of small private practices with some public ones to supplement.…

Used to be you'd get your dental work done by the same guy who cuts your hair and shaves your beard.

That was a long time ago... before many of the societal transformations we've been through.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#169

Post by ghaff » Mon, Jun 20, 2022, 4:33 PM UTC

guerrilla wrote: post #125

What I can't understand is how dental managed to escape medical coverage, not just in the US but seemingly globally. Just this year the main confederation of Swedish labor unions will be pushing for consolidation of dental into medical but... how did we even get here, especially considering how fragmented the dental industry seems to be (mostly comprised of small private practices with some public ones to supplement.…

If it were part of medical, I'd expect to see most expensive procedures (that aren't already covered under medical) such as crowns, implants, and root canals wouldn't be covered because they'd be considered cosmetic given that extraction is usually an option. Routine dentistry is pretty inexpensive, especially in the context of medical costs generally.

Any company dental plan I've ever had is mostly a tax advantaged benefit that saves you a bit of money but the annual max of mine is something like $2,000.

Re: Dentistry is less scientific and more gratuitous than people think (2019)

#170

Post by UIUC_06 » Mon, Jun 20, 2022, 4:37 PM UTC

Anytime the person recommending X is also the person who sells you X, you should be suspicious. The guy who comes to your door saying your roof needs fixing? That guy.

Without discounting any of the bad experiences people have had here: I've been going to the same dentist for 30 years. He never suggested teeth whitening to me, even though I obviously could have benefitted from it, and did when I explicitly asked for it.

In a way, painless dentistry probably increases the profit-seeking. At one time, drilling and other procedures were incredibly painful. Now they're only painful to your wallet.