Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Routine dental X-rays are not backed by evidence

arstechnica.com

Post reply on HN
Print view View original

291–300 of 390 posts

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

#291

Post by Loudergood »

reneherse wrote: post #256
mtalantikite wrote: post #252

Earlier quoted context omitted.

I started going to a new dental office a few years back with a bunch of younger staff here in Brooklyn. They clearly spent a ton of money on the build out, and all the dentists were probably 30s/40s. They did the typical "you skipped your x-rays last checkup, you're now 1.5 years behind. You need to do those now" thing. When I asked how much it'd cost out of pocket, they told me an update was $80. I thought "oh wow,…

My guess is the dental practice was owned by a private equity firm and the young docs were "just following orders". Highly capitalized, expensive leasehold improvements plus obscure pricing and surprise charges seem to be the typical playbook of that business model. Reliable doctor-owned dental practices seem to be increasingly hard to find, at least here in the urban Southeastern US

Can confirm, I used to have a lot of dental IT clients and most of them have left because of being purchased by PE that has their own IT staff and only wants break/fix support.

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

#292

Post by dannyobrien »

daveguy wrote: post #270
reneherse wrote: post #256

Earlier quoted context omitted.

My guess is the dental practice was owned by a private equity firm and the young docs were "just following orders". Highly capitalized, expensive leasehold improvements plus obscure pricing and surprise charges seem to be the typical playbook of that business model. Reliable doctor-owned dental practices seem to be increasingly hard to find, at least here in the urban Southeastern US

My dentist was bought out by one of these operations a couple of years ago, and quit after a few months of observing their tactics. I never actually saw her when I went for two 6 months checkups. It was non-stop upsell on water piks, "preventative" procedures, cosmetics. So I switched back when I found out my original dentist had re-opened a private practice. Stay away from venture capital dentistry operations. Same…

wait, aren't venture capital and private equity different?

Why would a venture capitalist take over a dentistry or veterinary practice? (Unless it was a growth play, like One Medical)

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

#293

Post by s1artibartfast »

ericmcer wrote: post #280
agentultra wrote: post #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

My dentist said something like "it exposes you to less radiation than eating a banana", but she also left the room when the machine was firing.

radiation workers practice ALARA, which is an acronym for "as low as reasonably achievable".

Nothing wrong with eating bananas, but I wouldn't want to eat 20 a day for all sorts of reasons.

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

#294

Post by parpfish »

mtalantikite wrote: post #252
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…

I started going to a new dental office a few years back with a bunch of younger staff here in Brooklyn. They clearly spent a ton of money on the build out, and all the dentists were probably 30s/40s. They did the typical "you skipped your x-rays last checkup, you're now 1.5 years behind. You need to do those now" thing. When I asked how much it'd cost out of pocket, they told me an update was $80. I thought "oh wow,…

a couple years ago i needed a new dentist and the only place that I could get into was a big chain that has just expanded into the area (Aspen Dental).

it had clean new office and lots of fancy tech that to scan my teeth that i hadn't seen at my little hole-in-the-wall old dentist. i was optimistic.

they tell me that I needed four fillings and a root canal, and i was a surprised because i'd been going to a dentist every six months and nobody had mentioned anything like that. but hey, that must be the advantage of all those fancy scanners. right?

they walked me down to the "payment center" which was an office holding four employees whose job was to come up with payment plans to cover dental work. that's when i knew that the whole place was a racket.

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

#295

Post by ApolloFortyNine »

Eumenes wrote: post #194

Routine dental work is not backed by evidence. Water pick, floss, brush, high quality mouth wash 2-3x per day = no need for dentist. Reduce your sugar and fake food consumption. Don't smoke or drink alcohol. There's a famous blog post of some guy who went to a ton of dentists and got like 100 different diagnosis/cost, can't find it though.

>Water pick, floss, brush, high quality mouth wash 2-3x per day = no need for dentist. Reduce your sugar and fake food consumption. Don't smoke or drink alcohol.

Everything you said could be true and ironically, you'd actually be making an argument that routine dental work is backed by evidence.

The percentage of people who do all the things you said has to be below <5%, if not even lower.

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

#296

Post by mekoka »

pizza234 wrote: post #222
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,…

> 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…

It is baffling and sadly pervasive. There are multiple such little tests of minor consequences, that people could just try out for themselves for a month and observe how their body reacts. But they're waiting for "evidence". It seems that we live in times where it's been drilled into us that if how we feel isn't backed by statistics, then we're probably not feeling it.

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

#297

Post by mtalantikite »

steveBK123 wrote: post #283
mtalantikite wrote: post #252

Earlier quoted context omitted.

I started going to a new dental office a few years back with a bunch of younger staff here in Brooklyn. They clearly spent a ton of money on the build out, and all the dentists were probably 30s/40s. They did the typical "you skipped your x-rays last checkup, you're now 1.5 years behind. You need to do those now" thing. When I asked how much it'd cost out of pocket, they told me an update was $80. I thought "oh wow,…

Any chance this new dental office was in Williamsburg, because I'm pretty sure I know the spot...

It is, although I'm pretty sure there are a few in the neighborhood these days that I'd guess would likely do the same thing! This one is close to Domino.

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

#298

Post by ninalanyon »

nlnn wrote: post #141
arethuza wrote: post #139

Earlier quoted context omitted.

Bone graft and implant for a single tooth can be up to £9K...

For sure, stuff like implants, cosmetic dentistry, braces, crowns etc. still cost a non-trivial amount (though hopefully most are once in a lifetime things).

A Cerec crown created on a CNC machine with the aid of 3D imaging costs about 500 GBP at my dentist in Norway including the work.

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

#299

Post by dehrmann »

dannyobrien wrote: post #292
daveguy wrote: post #270

Earlier quoted context omitted.

My dentist was bought out by one of these operations a couple of years ago, and quit after a few months of observing their tactics. I never actually saw her when I went for two 6 months checkups. It was non-stop upsell on water piks, "preventative" procedures, cosmetics. So I switched back when I found out my original dentist had re-opened a private practice. Stay away from venture capital dentistry operations. Same…

wait, aren't venture capital and private equity different? Why would a venture capitalist take over a dentistry or veterinary practice? (Unless it was a growth play, like One Medical)

VC is a type of PE that focuses on younger growth companies.

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

#300

Post by racnid »

daveguy wrote: post #270
reneherse wrote: post #256

Earlier quoted context omitted.

My guess is the dental practice was owned by a private equity firm and the young docs were "just following orders". Highly capitalized, expensive leasehold improvements plus obscure pricing and surprise charges seem to be the typical playbook of that business model. Reliable doctor-owned dental practices seem to be increasingly hard to find, at least here in the urban Southeastern US

My dentist was bought out by one of these operations a couple of years ago, and quit after a few months of observing their tactics. I never actually saw her when I went for two 6 months checkups. It was non-stop upsell on water piks, "preventative" procedures, cosmetics. So I switched back when I found out my original dentist had re-opened a private practice. Stay away from venture capital dentistry operations. Same…

The option these days for Vets is sell to PE, shut down, or try to find a younger DVM who wants to take over the practice and work in for a couple of years. But the younger DVMs have debt to pay and need to take the PE job. There's little love for the PE route but it gives an exit to older vets I suppose. I doubt many like watching their life's work being hollowed out and worn as a skin suit.
Post reply on HN