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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

#241

Post by red-iron-pine »

wccrawford wrote: post #31
jebarker wrote: post #9

Earlier quoted context omitted.

My bugbear with dentists in the US (after living my first 30 years in the UK) is that they all continually hassle me to have my wisdom teeth removed. Said teeth have never caused me any problems and are all through the gums. I can only assume it's dogma or an opportunity to bill insurance for costly unnecessary surgery.

I had the opposite experience. I told the dentist that I thought my wisdom teeth were causing my migraines, and they said it was possible but unlikely, and didn't really recommend removing them. I pushed, and they relented. They were right, it didn't make any difference. Oddly, I only had wisdom teeth on one side, and not the other. So only 2 teeth were removed.

sounds like the dentist was on the level. lotta things it could be, and those may be easy to address without dental surgery.

did you ever figure out what the root cause of the migraines was?

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

#243

Post by ambicapter »

smrtinsert wrote: post #228
fma wrote: 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. I think the slider isn't between trusting and not trusting medical professionals - it's between being a passive and active patient. We have to involve ourselves in our care. Educate yourself, get second opinions, connect with fellow patients and national experts. And ffs, do not listen to yt/x/tiktok people for anything.

You don't have to be an "active" patient and "self-advocate" if you trust your medical professional to make the decision that is in your best interest. Ergo, if you're advocating active medical involvement, you don't trust your medical professional either.

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

#244

Post by exe34 »

ambicapter wrote: post #243
smrtinsert wrote: post #228

Earlier quoted context omitted.

> I slowly see why there are people who do not trust medical professionals. I think the slider isn't between trusting and not trusting medical professionals - it's between being a passive and active patient. We have to involve ourselves in our care. Educate yourself, get second opinions, connect with fellow patients and national experts. And ffs, do not listen to yt/x/tiktok people for anything.

You don't have to be an "active" patient and "self-advocate" if you trust your medical professional to make the decision that is in your best interest. Ergo, if you're advocating active medical involvement, you don't trust your medical professional either.

I can't trust my own mother, so I'll look up things myself before committing to one decision. as far as I can remember, as an adult, I've only been to the doctor's once without diagnosing myself, and I've never been wrong yet (the handful of times I've needed medical care anyway).

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

#245

Post by exe34 »

wincy wrote: post #235
pizza234 wrote: post #222

Earlier quoted context omitted.

> 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?

it's the other way round for me - if there's nothing stuck in my gums, flossing feels no more painful than washing my hands. whenever it hurts, it's because there's something stuck in the gum causing an inflammation. once I manage to clean it, either with the floss stick or a small metal brush, the next time I floss it doesn't hurt in the slightest.

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

#246

Post by ambicapter »

ap99 wrote: post #218
FollowingTheDao wrote: post #200

Earlier quoted context omitted.

And it is the biggest reason we need universal healthcare.

I would say education is a more appealing solution to this problem than universal health care. People similarly get unnecessary work done on their car to boost dealership profits. Do you want to create a government agency to budget how much we can all spend on car repairs and then take it out of our taxes?

The difference here is we're talking about a person's health, not their motor vehicle, so a different calculus is in play.

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

#247

Post by [deleted] »

meowster wrote: post #183
pushupentry1219 wrote: post #81

Earlier quoted context omitted.

Completely anecdotal but my gums flare up and just feel disgusting when I don't floss for too long. I don't do the dentist recommended 2/week but if I stop flossing for over a month I notice significant decrease in my gum health. It becomes excruciatingly painful to brush and this stage and my mouth is full of blood afterwards. So I'm sticking to flossing pretty often now.

That does not sound normal.

[deleted]

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

#248

Post by exe34 »

Frost1x wrote: post #207
michaelt wrote: post #151

Earlier quoted context omitted.

> 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…

> Much data may not be representative or usefully representative of reality due to complexity of the situation

I've personally been on the receiving end of "the data we collected shows...x" (in a non-medical setting), but when I asked to have a look at it, it turned out that while this was true for a large part of the population sampled, there was a material difference between that population and a smaller population that can be clearly identified and for the latter, the data showed the exact opposite conclusion.

(think 100 men and 30 women, kind of scenario, except the difference wasn't gender, but job role).

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

#249

Post by meowster »

pushupentry1219 wrote: post #81
kart23 wrote: post #29

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

Completely anecdotal but my gums flare up and just feel disgusting when I don't floss for too long. I don't do the dentist recommended 2/week but if I stop flossing for over a month I notice significant decrease in my gum health. It becomes excruciatingly painful to brush and this stage and my mouth is full of blood afterwards. So I'm sticking to flossing pretty often now.

You might be going at it too hard. Please see a dentist or get a second opinion from another dentist.

According to my dentist, you can damage your gums by brushing them too hard. I don't floss so he didn't address that, but in both methods, force is being applied to delicate tissue.

The point of brushing and flossing is to remove food particles. You don't have to abuse your teeth or gums to do that.

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

#250

Post by tomcam »

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…

Sorry to hijack this, but have you heard of people on whom no local anesthesia works? I have to be put under general anesthesia (yes, requiring an actual anesthetist at an extra $8,000 or so). The pain is not endurable otherwise.
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