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Routine dental X-rays are not backed by evidence

arstechnica.com

311–320 of 390 posts

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

#311
post #29

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

Anecdotally, my gums used to bleed fairly easily (like during a dental cleaning) and they don’t anymore since flossing somewhat more regularly. So I think you can judge this by how dental cleanings go.

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

#313

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.

I hate when people bring this up.

Yes, it's an incredibly small amount of radiation for you because you're only in there for one X ray maybe once a year.

For someone who operates the Xray maybe a half dozen times in a day (or more), every day, that number changes dramatically. It's still likely fine, but it's far better to be safe than sorry.

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

#314

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…

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,…

There just wasn't evidence-based studies for a lot of common dental practices. Not unlike when the FDA was created, a lot of old medicines were just given a pass, even though they aren't useful (like how Acetaminophen is barely better than placebo — it'd never be approved today).

Just because there's no actual studies for flossing, that doesn't mean that flossing is bad or not-needed per se, but there does need to be more basic-level studies for it. I had bad gum-disease in my 20s, but once I actually started flossing daily, it stopped progressing. So it clearly helped me, but a better study on whether everyone needs to floss and how often should be done.

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

#315
post #301

Earlier quoted context omitted.

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.)

I've been self-employed for years now (USA), and never buy dental insurance, because it's not really insurance, it's basically a non-taxable way for companies to give their employees extra money. Buying it as self-employed persons is basically just giving the "insurance" companies your own money.

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

#316

Earlier quoted context omitted.

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.

Oh yes, that's the place.

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

#317

Earlier quoted context omitted.

In my experience (average teeth), dental insurance doesn't pay out enough to cover the premiums, and it's not worth the bother.

For private dental insurance yes. It almost never makes sense to get private dental insurance and it’s almost always better to pay out of pocket. I mean think about it from the insurer’s point of view. The only reason you’d ever get “the platinum” dental plan is if you were planning to use it. And it isn’t like you have that many “dental emergencies” if you have healthy teeth. If you don’t have healthy teeth you’d al…

It's also tax-payer subsidized (i.e. regressive, because it's mostly higher-income people that get dental insurance) because it's money from your employer that you or your employer don't have to pay taxes on.

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

#318
post #302

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

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

Pensioners gotta get paid somehow

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

#319

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.

That’s a good point. I’m unsure how to frame my observation in a way that makes vets look like they are intentionally doing something wrong. I guess what I’m saying is when I work with a vet it’s hard to know if the vet is going overboard with diagnostics and tests because me, the owner, want to “do everything I can” for my pet.

It’s a tricky subject to phrase correctly and way to early in the morning to come up with a good example.

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

#320

Earlier quoted context omitted.

I'm inclined to believe that preventing food particles from rotting between my teeth is a measurable impact in itself, regardless of whether it directly impacts my health.

Your assumption is that the floss is removing something that brushing does not. Ask your dentist why you should floss and the answer is not removing occasional lodged pieces of food from between your teeth, but cleaning under the gum line. There is no evidence to suggest it works that way, this is what the long term studies have determined.

So by that rationale, after a thorough brush, flossing would never remove anything?
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