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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

#301

Post by Vinnl »

pprotas wrote: post #149
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,…

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?

What's extra fun is that that insurance only covers treatments to a fairly low amount, just slightly higher than the price of your regular checkups.

(That said, I believe dental issues that are the result of e.g. accidents do get covered by the default care package.)

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

#302

Post by r00fus »

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

Private Equity taking over all businesses is going to be our undoing.

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

#303

Post by userabchn »

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,…

The dental office where I used to get my teeth cleaned every six months did X-rays every time and then no one ever looked at them. If you went there for a checkup they required you to get another set done. I am quite certain that they just assumed everyone had dental insurance and it was effectively insurance fraud.

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

#304

Post by [deleted] »

ein0p wrote: post #190
FollowingTheDao wrote: post #185

Earlier quoted context omitted.

Two stories. 1) Just yesterday I went to a an acclaimed dental school (UNC) for low cost dental care. They not only gave me a panoramic x ray but also a full set of bite-wing x rays. I read this and I want to break the world apart this morning. 2) When I was a child I kep needing root canals. It turned out our dentist was making these all up and was later found passed out from laughing gas in his office.

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.

[deleted]

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

#305

Post by xeromal »

xyst wrote: post #211

And why is dental insurance in the USA picking up the bill? I haven’t directly paid my dentist for these annual exams in quite a long time. The X-rays I can probably avoid the next time, but I feel the cleanings do really help. I used to have bad plaque build up on my incisors but keeping up with the cleanings and improving flossing technique keeps it at bay.

They liked paying for preventative maintenance which includes xrays.

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

#306

Post by consteval »

koolba wrote: post #223
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. 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.

The trouble is some doctors (a lot, actually) take this too far. So they'll insist absolutely nothing is wrong, and you should just lose weight or manage your stress or whatever.

So sometimes people, typically women and typically larger people, live for years with painful conditions because doctors didn't bother to look deeply at all.

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

#307

Post by skybrian »

pgwhalen wrote: post #288
zamadatix wrote: post #286

Earlier quoted context omitted.

I assume you mean it's covered by some sort of insurance (private or public) in which case you are paying for it you just don't really control how much you pay by individually opting in or out.

True, but dental insurance is so cheap relative to medical insurance.

If your teeth are in good health (no work done in years and none expected), paying out of pocket for dental appointments might still be cheaper. Though that assumes you could cover an unexpected expense - this is effectively self-insuring.

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

#308

Post by ninininino »

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,…

Is it Tend?

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

#309

Post by consteval »

xyzzy_plugh wrote: post #263
cruffle_duffle wrote: post #255

Earlier quoted context omitted.

> 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. This applies double or even triple for vets. There is a lot of cash to extract from pet owners who would “do anything”, no matter how unnecessary or ineffective, for poochy.

I don't think this is charitable. I've been lucky to have a view into the back office of a veterinary clinic and the fact of the matter is it's just difficult medicine to practice. Every vet I know works hard to save their clients money. If pet owners are inclined to take the "do anything" route it can open a lot of doors. I don't see anything wrong with that.

I've known a few people who worked in vet clinics, and they've all told me horror stories of how pets are mistreated. I'm talking left to sit in their own feces and urine overnight, fixed when they weren't supposed to be, injured during surgeries and then not communicated to owners.

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

#310

Post by consteval »

exe34 wrote: post #244
ambicapter wrote: post #243

Earlier quoted context omitted.

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).

That's great but the trouble is that as you get older medical conditions become harder and harder to find out. They also become more dangerous.

I'm telling you this because my father was the same way you are. he avoided going to the doctor at all and diagnosed himself.

He also smoked for 60 years. Yeah. He had his first heart attack in his 30s. Very avoidable. His second in his 40s. Then another in his 50s. Finally died of lung cancer in his 70s. Honestly a miracle he made it that far.

You can tell if you're feeling okay. But a lot of diseases have no symptoms. The reality is you cannot run your own blood tests. If you're young, maybe it's fine. But as you get older it no longer flies. What happens is you will become very sick, realize it's due to something like high blood pressure or diabetes, and you're WAY too far gone to fix it. The earlier you get on top of bad markers, the better. You don't want to live 30+ years with something like high blood pressure or high cholesterol.

Maybe you don't smoke (good for you), but that doesn't save you. Neither does living an active lifestyle. You can get high blood pressure, high cholesterol, diabetes, heart failure, etc regardless of your lifestyle. There're people who die MUCH younger than my father did while being much healthier.

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