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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

#171

Post by mywacaday »

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,…

My dentist back in the 80s didn't even wear gloves, he was an older man but I can't imagine gloves were not required then or even when he would have trained in the 40s or 50s.

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

#172

Post by appendix-rock »

throw4950sh06 wrote: post #159
pprotas wrote: post #149

Earlier quoted context omitted.

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]

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

#173

Post by thyristan »

bsimpson wrote: post #60
thyristan wrote: post #44

Earlier quoted context omitted.

It can be true for some people. Look at the lower right one on the xray here: https://www.jwz.org/gruntle/wisdom-teeth.html

Unless you wanna see an adviceanimals take on a hairy ballsack, you've gotta open that incognito. I don't think Jamie wants HN traffic on his blog.

Ah, that explains the downvotes. Sorry. My browser just doesn't send a referrer for clicked links, so I didn't notice.

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

#174

Post by bonoboTP »

andsens wrote: post #164
pprotas wrote: post #149

Earlier quoted context omitted.

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?

Here’s a good answer that tracks with what my parents, who are dentists, told me: https://www.reddit.com/r/explainlikeimfive/s/H4MsnWKatM > For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spect…

Note that "optometrist" is distinct from "ophthalmologist", which is the actual eye doctor. The optometrist job is only about fitting glasses and contacts for near/farsightedness, while ophthalmologists can treat all manners of eye diseases.

And the final form of dentists, oral-maxillofacial surgeons are an all in one and have to study general medicine, surgery and dentistry.

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

#175

Post by g-b-r »

rurban wrote: post #130
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.

My middle age country offers largely free dental care (not for crowns and implants, unfortunately)

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

#176

Post by bonoboTP »

mywacaday wrote: post #171
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,…

My dentist back in the 80s didn't even wear gloves, he was an older man but I can't imagine gloves were not required then or even when he would have trained in the 40s or 50s.

Is your opinion based on evidence? Sorry for sounding harsh, the article is about evidence, but your comment seems to be more based on feels / ick / sheen / vibe of squeaky cleanliness. If it's imagine vs imagine: I imagine that a washed and disinfected hand without open wounds has no measurable risks, and the tactile feedback the dentist gets may improve the treatment.

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

#177

Post by throw4950sh06 »

viraptor wrote: post #162
throw4950sh06 wrote: post #159

Earlier quoted context omitted.

[flagged]

You lost at "European" and "everywhere in EU". The system is different between countries. For example Poland covers free annual review and basic procedures. (even if it's worse quality than on a private insurance) You're just trolling or really misinformed.

You said the same thing I said... You only get basic care to survive, nothing else.

The system is different but this aspect is pretty much the same everywhere around here.

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

#178

Post by throw4950sh06 »

appendix-rock wrote: post #172
throw4950sh06 wrote: post #159

Earlier quoted context omitted.

[flagged]

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I have taken my 3 decades of personal experience - hundreds of situations - and combined it with what my family, friends and acquaintances experienced. It's really not just me. And the national news say the exact same thing - healthcare is expensive, inadequate and unavailable (you wait for months - if you find a doctor that would take you, which is definitely not guaranteed).

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

#179

Post by ricardobayes »

nlnn wrote: post #134
throwaway2037 wrote: post #132

Earlier quoted context omitted.

How much did it cost? If _much_ lower than 200 USD per visit in a very wealthy country, then I assume: (a) dentists don't make very much money. Less than 100K USD? (b) most of the work is done by poorly paid dental assistants (20 USD per hour or less). Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?

It's pretty similar in the UK for private dentistry, x-rays ~£10-30, hygienist/scale/polish ~£50-120, filling ~£70-150, root canal/extraction ~£120-300. Dentist salaries seem to range between £70-200k depending on experience, specialty, etc.

Very similar prices in Spain too, funny how the UK is generally considered _very_ expensive for dental work, in fact I just paid 40 EUR for an x-ray here yesterday.

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

#180

Post by bradfa »

gregwebs wrote: post #168

You might be surprised that treatment recommendations vary dramatically from one dentist office to the next. [1] I am glad to know this about X-rays as well- it’s probably a useful indicator that if X-rays are not overprescribed the dentist will more likely not over treat. And if they react defensively to being told you want to follow the ADA guidelines that’s probably a sign they don’t think about whether they are o…

My old dentist retired a few years ago. She had been excellent, in my opinion. The dentist who bought out her practice comes from the school of thought that bitewing x-rays are required every year. I generally decline to have the x-rays done every year, instead opting for every 2ish years cadence. Feels like now I have even more justification to delay future x-rays.

And thanks for the Readers Digest article. A bit of a blast from the past with that publication for me but well written and clearly makes its point about the inconsistencies of dental practice.

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