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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

#201

Post by konfusinomicon »

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 95yr old grandmother who still has her OG chompers always told me to only floss the teeth i want to keep, and given hers are still usable after 9 decades, i listened

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

#203

Post by zoky »

bonoboTP wrote: post #176
mywacaday wrote: post #171

Earlier quoted context omitted.

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.

> I imagine that a washed and disinfected hand without open wounds has no measurable risks

To the patient maybe. On the other hand (so to speak), if I were gonna spend my day sticking my fingers in people’s mouths, I’d want to wear gloves.

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

#204

Post by pavel_lishin »

vardump wrote: post #5
pavel_lishin wrote: post #3

I'm going to also throw anecdotes into the bucket: three dentists completely missed a cavity on one of my rear molars (wisdom teeth) until I mentioned pain, and then they poked around physically and said, "oh yeah, that's a big one."

What kind of dental x-rays they took? Panoramic (shows the whole row of teeth in one image), CBCT (volumetric 3D) or intraoral (a digital sensor or film was put inside your mouth)?

Panoramic and intraoral.

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

#205

Post by sevensor »

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…

Any thoughts on the cancer screen they’re always trying to upsell?

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

#206

Post by lesuorac »

MVissers wrote: post #197
matwood wrote: post #195

Earlier quoted context omitted.

A friend of mine is an orthopedic surgeon and says he's basically a carpenter.

Doc here. They are basically carpenters. They us drills and saws and hammers and stuff.

Image removing somebody's leg without a saw. You just gunna twist it like thumbtack or clay until it separate?

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

#207

Post by Frost1x »

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.

There’s a current trend of obsession with “data driven” or “evidence based” assessments. While measured data from reality is useful, it’s not without its own sets of flaws. Much data may not be representative or usefully representative of reality due to complexity of the situation (what we measure isn’t isolated or cant be easily linked, or our measurement process itself is flawed). The sort of pinnacle of relying on data assessments is the assumption of removing bias, which is often simply not true.

Not only is bias introduced from accidental collection flaws, it’s also often tampered with intentionally cherry picking data, choosing interesting data or in some cases flat out falsifying data. In addition, evidence based reasoning often suffers from there being a lack of evidence to make a decision from. Or in some cases some critical aspect surrounding the decision is very niche to the case so the data may not take that into account unless it’s highly tailored data (evidence based reasoning tends to focus on breadth of applicability because gathering evidence is a long and often expensive process).

There’s still a lot of place for using theory and reasoning in conjunction with or in absence of data. Things like experience, professional opinion, etc. Medicine should be no different in that regard to any profession. The key is of course to always strive for sound empirical evidence/data where possible, but to use sound documented reasoning and theory in its absence if you want the best objective results.

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

#210

Post by fma »

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…

My younger dentist did 2 xrays for me in a row (6 months apart)

I don't remember exactly what was done last time and only knew when they pulled up the xrays and I saw the date of the last one. They hygienist sits you down and just does it as if it is normal. I googled and found what you mentioned.

I am low risk for cavities. Those exact words came out of his mouth. I was pissed off after the fact, because I'm paying out of pocket for this, and for fluoride treatment. I have in my records to not give me fluoride treatment but she called it "varnish" which caught me off guard.

I speculate the office got bought out by PE as dentists have changed over the last few years.

They also told my wife she needs a night guard. She's been wearing one for 12 years.

I slowly see why there are people who do not trust medical professionals.

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