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

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

#21
Well it's only anecdotical of course, but I had a similar experience a couple of years ago that made me very confused about dentistry in general.

At the time a had a small tooth ache so I was planning to visit a dentist to check it. I was living in Switzerland, where dentist costs are very high, but I was about to go on holiday to Tenerife, where prices are much lower. So I checked on the Internet and chose the dentist with the best reviews near my holiday resort. When I was there and had explained my problem, the dentist said he'd like to do a full check of my teeth. He did that with a little camera so I could see my teeth on a screen as well. Next he went past all my fillings. I had quite a few of them, and for every one of them his comment was the same: 'decay'. He said they were old, or didn't fit properly, so around the edges decay had started. And indeed the image on the screen showed some brown edges. In the end he offered to replace all of them with some modern alternative. The treatment would cost a couple of thousand euro and would take my entire holiday week.

I didn't entirely trust him so I said I needed some time to think about it. Back in Switzerland I went to my usual dentist. I didn't tell him about the Tenerife episode but just explained about my complaint and asked him to check. He concluded that there was not really any problem, it might be my gum was infected and this gave me some pain. Then I told him the diagnose of his colleague in Tenerife. I expected that he would be shocked but he wasn't: he asked how much the guy was charging and just said it wasn't a bad price.

I then told the story to a friend whose both parents were dentists. He wasn't surprised either and he explained like this: he said dentists were like car mechanics. When a car mechanic is checking your engine and some parts were a bit worn out, some would say they should be replaced, but others would say they are still working so let's only replace them when they break.

It's 5 years later and all those 'decayed' fillings haven't given me any problem so far. But maybe I was just lucky? I'm completely confused now.

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

#23

In my experience, the majority of dentists are criminal crooks. It‘s generally not nice to trick and steal from people, but dentists are in the unique position of leaving their victims in severe, chronic pain that can only be fixed by other dentists. I myself suffer from varying, chronic pain after a pointless visit where two "tiny" holes were drilled.

The problem is you can only evaluate them over years , which is incredibly sucky. I haven't found a solution to working out which dentists are actually the best yet, which makes me loathe to leave the one I have currently because it has been almost 10 years of good care (I can contrast with the bad ones that had fillings that fell out within 3-4 years etc.)

Here’s an easy heuristic:

The trust you should afford to a dentist is inversely proportional to the amount of time and energy that dentist promotes teeth whitening products and solutions.

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

#24
post #11

Always be skeptical when the person giving you a diagnosis also directly benefits from giving you a particular diagnosis. This goes for dentists, banking and so much more.

Insurance is a similar one. The one who benefits from not paying is the one who chooses to accept or deny claims.

It looks that way to the consumer, but I don’t believe that to be true. I’ve worked in the industry for a few years and most of insurance products I’ve seen are structured in a way that the company reviewing and processing the claim isn’t actually responsible for paying out the claim.

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

#25
I had a cavity about 20 years back and the tooth needed to be extracted to alleviate the pain. The dentist said something like “you need to replace that tooth or else your jaw will lose the bone and all your other teeth will shift and it’ll cause problems down the road!” I thought about it and deferred the decision… for 20 years. Recently, I received an X-ray to see how much my teeth shifted and if it was problematic. None.

The total cost to get a new tooth was like $5k. I got an implant done so that a crown could be placed later down the road and I am deferring the crown. And of course, the new dentist is using a similar scare tactic:”act now! The implant might blah blah blah.”

Sometimes, I wonder if dentistry is the world most accepted sham.

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

#26

Earlier quoted context omitted.

Insurance is a similar one. The one who benefits from not paying is the one who chooses to accept or deny claims.

It looks that way to the consumer, but I don’t believe that to be true. I’ve worked in the industry for a few years and most of insurance products I’ve seen are structured in a way that the company reviewing and processing the claim isn’t actually responsible for paying out the claim.

The reviewing company is paid by the other company. There is the incentive to decide in its favor to ensure contract renewals.

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

#28
post #23

Earlier quoted context omitted.

The problem is you can only evaluate them over years , which is incredibly sucky. I haven't found a solution to working out which dentists are actually the best yet, which makes me loathe to leave the one I have currently because it has been almost 10 years of good care (I can contrast with the bad ones that had fillings that fell out within 3-4 years etc.)

Here’s an easy heuristic: The trust you should afford to a dentist is inversely proportional to the amount of time and energy that dentist promotes teeth whitening products and solutions.

Probably a good heuristic, but weirdly I've never had a dentist try to sell me a single whitening product of any kind. Unfortunately that hasn't prevented some of my dentists from being terrible. Thankfully some of the bad ones have given me such obviously bad advice ('wait until you start feeling pain before you come back to me') that I knew to find another one pronto. I wonder if pushing products differs a lot between countries, my experience is exclusively of Australian dentists, I'd be curious to know if anyone has experience in multiple countries!

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

#29
post #11

Always be skeptical when the person giving you a diagnosis also directly benefits from giving you a particular diagnosis. This goes for dentists, banking and so much more.

Can you give an example of a professional for whom this isn’t the case? Maybe a general practice doctor referring to a specialist? But often this involves trips back to the GP for checkups as well.

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

#30
I'll preface this by saying that yes there are unethical dentists out there and clearly this Lund guy is one of them and patients should never hesitate to get a second opinion if they feel uncertain.

However, this whole thing would be more informative and impressive if they had gone after the elephant in the room. Aspen Dental overtreats more than the rest of the dentists in USA put together. They are a "large health-care organization with substantial oversight... and standardized treatment regimens", but that oversight and standardization is geared entirely toward convincing every patient to get at least ten crowns. Aspen Dental are also large enough to hire lots of lawyers, so Atlantic isn't going to touch that with a ten-foot pole.

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