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Routine dental X-rays are not backed by evidence

arstechnica.com

231–240 of 390 posts

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

#231
I am all for evidence-based medicine making its way into dentristry if it's lacking... but if you're someone who is worried about cumulative exposure to X-ray length radiation, what is the dosage? And can we compare it relative to to say, millimeter scanners at the airport or a domestic flight?

I was under the impression that the digital machines they use these days are:

1. localised 2. very, very low dose

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

#232

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…

It may start with Radiographs but it certainly doesn't end there. What is being taught in schools has no relation to reality. Sure, it may somehow influence it, but it won't dictate how each dentist or clinic will work, as they are probably free to and work do almost as they please. Not too long ago there was a wonderful research story by a journalist of good dental health (as diagnosed by multiple university profess…

I went to a dentist in Manhattan after moving to the city. Googled a good dentist in my area (UES) and just went. I got there and he wanted $20k to replace all my teeth with veneers. "Wow, we gotta get this all out", were his words.

I've never had a single cavity or needed braces. I happen to be blessed with very good teeth. I told him to fuck off (unfortunately not in so many words) and never went back.

That was 10 years ago. Still no cavity or any issues at all.

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

#233

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?

It’s an interesting case study in the US. Want to see a doctor for a minor issue? Good luck knowing the price in advance. Want to see a dentist? Ask for pricing on the phone, and you’ll get it.

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

#234

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,…

> the robust evidence for even things as common as flossing I'm always baffled by all the discussions about flossing, as it's something that can be very easily verified empirically: one can just floss for a month, then stop doing it for another month, then resume and get a feeling for how the gums react. If they bleed or burn (lightly), then the efficacy is evident; if not... lucky person! No need for research either…

When I encounter these baffling things, I just remember how my grandparents and everyone around them were hacking their lungs out and everyone smoked tobacco everywhere all the time. You’d think the common sense approach would be to assume inhaling dense smoke directly into your lungs was not healthy, especially given the “look around you” factor of ailments (cancer, emphysema, etc). Yet still, there was a large group of people who refused to believe it could be unhealthy without hard evidence.

The tobacco industry was a contributing factor but common sense and independent thought was already gone or it wouldn’t have worked for as long as it did.

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

#235

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,…

> the robust evidence for even things as common as flossing I'm always baffled by all the discussions about flossing, as it's something that can be very easily verified empirically: one can just floss for a month, then stop doing it for another month, then resume and get a feeling for how the gums react. If they bleed or burn (lightly), then the efficacy is evident; if not... lucky person! No need for research either…

What evidence is that exactly? It’s evidence that your gums don’t like being traumatized by a small string of plastic?

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

#237
post #193
post #190

Earlier quoted context omitted.

I strongly suspect my dentist is making shit up, too. I had to refuse a couple of expensive treatments. The main goal seems to be to “use up” my dental insurance more than anything.

My dad has been a dentist for 30+ years and retired a few years ago. Recently he did some 3-month contract work for a very large dental chain, let’s call it Penass. I’ve never seen him so depressed in my live. He said that Penass’s business model was all about running up insurance and selling loans for large operations. He was directly encouraged to do extra, not necessary work to run up the bill. He came out of reti…

I had a dental chain say I needed periodontal scaling because I was having terrible pain in my upper gums. It took two years and another dentist to tell me I actually had a cyst and the cyst growing had almost dissolved my nose bone. Another few months and I’d likely have a weird sunken nose if a surgeon hadn’t properly removed it. So they charged me for an expensive procedure but it wasn’t even the correct expensive procedure!

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

#238
post #29

Isn't flossing not supported by science also, but all the news articles said you should keep flossing?

My partner is an orthodontist. (That’s a specialization within dentistry.) I’m a software engineer btw.

The saying goes that you only need to floss the teeth you want to keep.

If you think about it, a toothbrush will only clean 3 sides of a tooth. Top, outer side, inner side. Not the 2 sides facing neighbour teeth.

How on earth is it very important to clean those 3 sides but not the remaining 2? That just doesn’t make sense. If you think flossing is not useful, to be coherent, you must believe toothbrushing is not useful.

On the flip side, learn how to do flossing right to not hurt your gums. The floss must follow the shape of the tooth, and not be straight. (Ie. move along a U path.) Flossing in a straight line does more harm then good.

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

#239
post #223
post #210

Earlier quoted context omitted.

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…

> I slowly see why there are people who do not trust medical professionals. The opinions I trust the most are the doctors that have previously told me that no treatment is necessary and the problem will resolve on its own. The more often they’ve said that, the more I’d value the opinion, especially if it suggested something invasive.

Yep, I'm never leaving my dentist because he tells me things like "this crown will probably need to be replaced some time in the next twenty years, but it's not worth spending the time and money to do it yet."

Bonus anecdote: My previous dentist, who I went to once, had an office full of hygienists that were young, blonde, skinny women without exception. Something tells me the interview process was not merit-based...

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

#240
post #29

Isn't flossing not supported by science also, but all the news articles said you should keep flossing?

My partner is an orthodontist. (That’s a specialization within dentistry.) I’m a software engineer btw. The saying goes that you only need to floss the teeth you want to keep. If you think about it, a toothbrush will only clean 3 sides of a tooth. Top, outer side, inner side. Not the 2 sides facing neighbour teeth. How on earth is it very important to clean those 3 sides but not the remaining 2? That just doesn’t mak…

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