Dentistry is less scientific and more gratuitous than people think (2019) • Hacker News Board

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

#281

Post by bombcar » Mon, Jun 20, 2022, 9:07 PM UTC

guerrilla wrote: post #128

aleksandrh wrote: post #126

Earlier quoted context omitted.

#2 is terrible advice. Acidic food weakens your enamel. Brushing after eating will make things worse. It's actually recommended that you wait after eating acidic foods to brush. Rinsing (with water) is totally safe, though.

Interesting, I'd always heard the opposite but I do see a lot supporting what you say, so I removed that for now... Hmm.

Heh I thought you were going for a 2. "there is no step 2" joke, or suggesting that you could just remove all your teeth and then have no tooth problems anymore.

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

#282

Post by bombcar » Mon, Jun 20, 2022, 9:11 PM UTC

psim1 wrote: post #212

spupe wrote: 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.

In my state, annual automobile safety inspections are required. I have always been suspicious of this because naturally the auto shop doing the inspection offers to repair any flaws they discover. In most cases, the safety issues are obvious (thin tire treads, worn brakes, rust damage) so if you have a little bit of understanding you can verify the shop's claims and seek repairs elsewhere if the cost is too high.

California has "test only" smog stations, though this was mainly to combat stations that would "just pass everyone" but they couldn't prove it.

Something like that can be worthwhile if you don't know who to trust; find someone who doesn't sell anything but the test.

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

#283

Post by eliseumds » Mon, Jun 20, 2022, 9:12 PM UTC

Broken_Hippo wrote: post #60

moffkalast wrote: post #18

Earlier quoted context omitted.

In my experience we've got these two options here: - socialized dentistry, where unless you're screaming in pain dentists take two peeks into your mouth and say it's fine and tell you to get out so they can take the next patient in the 200 person line outside (and shill their afternoon private practice to you if they happen to be the more shady type) - private dentistry, where they'll always find something random tha…

IIRC, Brazil includes dentistry in its regular healthcare. Cleanings are cheap-to-free so folks wind up getting cleanings and the like. There are also a lot of dentists in Brazil - I think it is the 3rd largest dental system and employes something like 15% of the world's dentists. Hardly rushing folks through while they scream in pain. (I don't know the intricacies of the Brazilian system other than it includes denti…

I'm Brazilian, lived in Portugal, Germany and Australia for a few years each, and can attest that dental care in Brazil is at least 100x better in every way. It's much less bureaucratic.

Many universities offer free-of-charge consultations, although in a limited fashion. In big cities, I've seen mobile clinics helping the homeless. It's just part of the culture now. I'll even risk saying that Brazilians don't smoke because it stains the teeth. Lots of people do drink black coffee but they'll brush their teeth afterwards.

A private company called Sorridents has taken over dentistry in Brazil with more than 500 branches. It works like Subway/McDonald's. It's affordable.

Yes, there are many more dental professionals in Brazil, but the population also spends more on it (relative to income), so it balances out. You can even get dental insurance through your energy company, but I believe the vast majority of the population doesn't have any [1].

As an anecdote, I've waited TWO YEARS for Bupa (Australia) to tell me that my wisdom teeth extraction would cost 7000AUD and they'd need to move an entire team to a hospital to do it, and I'd need to pay for general anesthesia too (some 1500-200AUD more), which is absurd. I've also consulted with three other top-rated dentists in Sydney who told me the same. I flew to Brazil, paid 500AUD in a top-notch clinic, and the procedure took less than an hour.

In both Germany and Australia, dental cleaning felt rushed, polishing wasn't done properly, they always came up a thousand little things that added to the final cost. It's ugly, it's scammy.

In Portugal you can get decent dental care due to the large amount of Brazilian dentists.

[1] https://www.iess.org.br/publicacao/blog/brasileiro-ainda-tem...

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

#284

Post by spa3thyb » Mon, Jun 20, 2022, 9:12 PM UTC

freedom_dev wrote: post #271

Disclaimer: Dentist here (and programming enthusiast) The other side of the story, that nobody really talks about, is the psychological abuse that -dentists- are subjected to, by patients. As an introduction: I was above average at my uni in terms of clinical and theoretical skills, bought my own practice from a retiring dentist and always behaved 100% ethically (I'm one of those that don't overtreat at all and I bui…

This might be a naïve idea and you didn't ask for any advice, but have you considered doing free/reduced cost work for children or the impoverished? I'm sure you'd face a similar range of responses, but that last line - "no good deed" - made me wonder if using your considerable skills for a bit of charity work might help with the burnout.

Side note: I've had to prepay for appliances and night guards in the past when the cost exceeded some threshold - the latter wound up being supremely disappointing considering it was ~$600 and broke within a fortnight, but I didn't bother complaining to the dentist since the staff would just have to argue with the fab.

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

#285

Post by clairity » Mon, Jun 20, 2022, 9:12 PM UTC

bombcar wrote: post #260

clairity wrote: post #215

Earlier quoted context omitted.

my dental group actually calls/emails me on a regular basis to get me to come give them that sweet, sweet free insurance money. but note for instance that cavities and fillings are prone to being overdiagnosed for the sake of income, not patient outcome. glasses are regularly overprescribed for the same reason. patients really need to understand the incentives and motivations of medical professionals to make the best…

Optometry at least you can track it (if you actually do need and use glasses) because the differences should be noticeable on the prescription. What does happen is that if you buy a new pair even with the same exact prescription, the fact that it's new and clean and not bent in anyway will make it look much clearer. So that can trick people into thinking they need yearly new glasses. A good optometrist will tell you…

sure, but wearing glasses also weakens your eye muscles. we're living, dynamic, nonlinear, and stochastic systems, not automata with orthogonal settings that we can tweak simply. glasses can actually make the problem worse (i've personally experienced this in my younger, naiver days[0]). optometrists don't question orthodoxy because doing so could threaten profits.

note, that's not to advocate the other extreme of never trusting anyone about anything, but every decision is a trade-off and has drawbacks. the visual acuity afforded by glasses should clearly outweigh the downsides, rather than outsourcing your brain to a hammer-wielding optometrist.

[0]: i still have dry-eye from an eye infection that was likely caused by contacts. that was actually the impetus for getting rid of corrective lenses altogether and the subsequent realization that i didn't need them in the first place.

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

#286

Post by bombcar » Mon, Jun 20, 2022, 9:18 PM UTC

criddell wrote: post #80

zippergz wrote: post #70

Earlier quoted context omitted.

Most home inspectors are beholden to real estate agents. While it may seem like you are the client because you are paying them, at the end of the day it's the real estate agent they want to make happy, so they keep sending them business. That may mean not being too thorough, in order to not "kill the deal," or finding some stuff to request repair/credit for to show the buyer how hard the agent is working to earn thei…

That's why I qualified with the word certain . I'd never use an inspector recommended by my agent and I'm not sure how to find a trustworthy inspector. In the past I've used a person recommended by somebody I trust. What you said is true though and it became clear to me during the inspection. At the time my realtor told me my inspector was being ridiculous because he was documenting lots of things that weren't really…

I don't even really consider "home inspector finds a fault that cancels the sale" to be a "thing" - I'm mainly hiring them to find all the likely things I'll need to work on going into the house.

And the quality varies incredibly because they're basically paid to rubber stamp things (and usually if they DO find something, it's already been disclosed or is quite obvious).

Some go to more trouble and I'd say that running a camera down the sewer line is a good indicator that they're doing this (and ALWAYS GET THIS DONE if the house hasn't been lived in recently, or just in general).

https://structuretech.com/all-blogs/ is an example of one that uses their blog to promote, and they mention "roof walk" and "sewer camera" as examples of their value-add. They also have an example report to look at (many, many reports end up with fifty pages of photographs and 'an expert should look at this' which is great for covering the inspector's arse but useless for the homeowner).

Inspectors that openly offer inspections for houses that are not being sold would be another one, they have to provide value.

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

#287

Post by dennis_jeeves1 » Mon, Jun 20, 2022, 9:19 PM UTC

freedom_dev wrote: post #271

Disclaimer: Dentist here (and programming enthusiast) The other side of the story, that nobody really talks about, is the psychological abuse that -dentists- are subjected to, by patients. As an introduction: I was above average at my uni in terms of clinical and theoretical skills, bought my own practice from a retiring dentist and always behaved 100% ethically (I'm one of those that don't overtreat at all and I bui…

>So yes, there are bad dentists just as there are bad -anything-, but there are also bad patients. I guess I just wanted to vent and let you see the other side of the coin...we say "no good deed goes unpunished" and it's true indeed

I hear you, the vast majority of humans are fucked up. On an average the patient is more messed up than the medical practitioner, what to do?

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

#288

Post by glennonymous » Mon, Jun 20, 2022, 9:45 PM UTC

I live in Silicon Valley. I went to one of the few clinics covered by my insurance, and the dentist spoke in heavily accented English I could barely understand, exacerbated by wearing a mask and a face guard. They showed me my X-rays and told me “something something cavity something something” and had me make an appointment for a filling. I came back and got the filling, then they told me to make another appointment for another filling. This happened eleven times. Eleven fillings after not having received one filling in the previous 20 years.

For my next checkup, I searched and searched for a dentist who spoke in unaccented English I could clearly understand. He checked my teeth and cheerfully told me I needed to have all my lower front teeth removed and a bridge implant. Out of pocket cost: $30,000.

I couldn’t possibly afford this and decided to get a second opinion. The problem is, my insurance only covers one checkup every 6 months. In the meantime I agonized over how I would possibly pay for my extensive dental work, and I managed to find another dentist with whom I could communicate.

I asked this dentist if I needed the $30,000 procedure and she scoffed!

I was instantly furious and gave the Rolls Royce doctor bad reviews on Yelp and Google Maps. I’ve been getting a real-life lesson on the practices described in the article. I plan on sharing it with everyone I know.

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

#289

Post by borski » Mon, Jun 20, 2022, 10:02 PM UTC

bombcar wrote: post #270

borski wrote: post #234

Earlier quoted context omitted.

Not quite true; sometimes, if an infection develops (even without a cavity, just because food got caught in the gums) it can be significantly more painful to deal with than getting it taken care of when they're healthy.

Isn't this more of an argument for getting a toothache handled quickly than waiting until the pain's almost unbearable before going in? In either case if you're using an oral surgeon they're gonna numb the area first anyway, and you're gonna have to deal with the hole afterwards.

Sure - it depends on the case, and that’s entirely my point. If it hasn’t erupted but still is, it may move teeth. If it has partially erupted it may be harder to clean, etc. My point is blanket “don’t worry until it’s infected” isn’t quite right either.

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

#290

Post by WalterBright » Mon, Jun 20, 2022, 10:17 PM UTC

bombcar wrote: post #256

systems_glitch wrote: post #237

Earlier quoted context omitted.

I think this was the only heathcare thing I ever fought with my mom over, in high school. Demanded we get a second opinion. The oral surgeon agreed that my teeth were fine. Still have them 20 years later, still no cavities. It just seemed nuts to me to remove something through surgery that wasn't causing problems. My favorite "reason" for why they should come out was, "you're more likely to bite your cheeks."

One of my wisdom teeth is laying sideways and I've been told I need to get rid of it for ... twenty years now and still haven't bothered, since the cost of getting rid of it now and when it starts to do whatever horrible thing it's plotting to do is basically the same, I continue to punt. My current dentist is ambivalent about it.

One of my teeth is currently being resorbed. It has no known cause and is untreatable, eventually resulting in tooth loss. The dentist wanted to preemptively remove it. It could fail tomorrow, or 5 years from now. I opted to do nothing until it does fail. So far, it's been a year and a half.