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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

#321

Post by lainga »

consteval wrote: post #306
koolba wrote: post #223

Earlier quoted context omitted.

> 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.

I encourage you to explore, as a thought experiment, what profit opportunities can arise from the intersection of mass medicalisation and body positivity.

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

#322

Post by rootusrootus »

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 don't think I've ever had a dentist recommend annual bitewings, and I've been going to the dentist since the days we had to spit in a bowl. It's always been once every few years.

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

#323

Post by rootusrootus »

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?

There is already an opaque bureaucracy that stands between me and my doctor. We do not have a free market in healthcare, so I cannot just choose another bureaucracy. I don't see how delegating this responsibility to a government agency can make it any worse for me.

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

#324

Post by butlike »

tomcam wrote: post #250
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.

No, but I used to have a pretty bad "aine" habit, and the novocaine wouldn't start to work until the 3rd application.

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

#325

Post by rootusrootus »

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.

I remember taking my kid for an x-ray of his wrist and the tech lined it all up, and then said "okay, dad and me are going over here while I take the picture." My son immediately wanted to know what the hell we just exposed to him that wasn't safe for us.

In retrospect, the policy should be to let the parent stay. The risk to me is no worse than the risk to my kid. It's easy enough to explain why the tech should go behind a shield.

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

#326

Post by rootusrootus »

skybrian wrote: post #307
pgwhalen wrote: post #288

Earlier quoted context omitted.

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.

> Though that assumes you could cover an unexpected expense

Given how low the typical (non-DMO) coverage limits are for dental insurance, this is probably reasonable for many people.

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

#328

Post by miles »

Pikamander2 wrote: post #124
smt88 wrote: post #25

Earlier quoted context omitted.

I don't know why you're being downvoted. It is a little off-topic, but you're correct that drinking too-hot liquids increase the risk of multiple types of cancer. The same is true of alcohol-based mouthwash and alcohol itself. Anything that routine damages cells is going to be a carcinogen.

> I don't know why you're being downvoted Because it's unrelated to the article, doesn't have a source, has multiple typos, and even if it's true, I'm not going to give up hot beverages and food just to avoid (what I assume they're implying to be) a tiny increased mouth and throat cancer risk.

Drinking very hot tea almost doubles risk of cancer, new study says https://www.cnn.com/2019/03/20/health/hot-tea-linked-to-high...

A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.32220

> Previous studies have indicated that hot tea may increase the risk of esophageal cancer. In this large, prospective study, the authors found that drinking hot tea is indeed associated with an increased risk of esophageal squamous cell carcinoma (ESCC). Furthermore, a preference for “very hot” tea more than doubled this risk.

A very-hot food and beverage thermal exposure index and esophageal cancer risk in Malawi and Tanzania: findings from the ESCCAPE case–control studies https://www.nature.com/articles/s41416-022-01890-8

> Thermal exposure metrics were strongly associated with ESCC risk. Avoidance of very-hot food/beverage consumption may contribute to the prevention of ESCC in East Africa.

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

#329

Post by consteval »

lainga wrote: post #321
consteval wrote: post #306

Earlier quoted context omitted.

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.

I encourage you to explore, as a thought experiment, what profit opportunities can arise from the intersection of mass medicalisation and body positivity.

I encourage you to be more straight forward with what it is you are implying.

These doctors were, and are, actually reducing profit by not treating illnesses and instead prescribing things such as diet, exercise, and stress reduction.

And yes, doctors do that. All of them. If you're obese, the first thing out of their mouth is weight management. And yes, this is typically a good thing. But it does mean that lots of genuine issues are missed because any problem is attributed to weight. When in actuality they actually do have a tumor in their colon and no, they aren't just eating bad. And then they die when it was easily preventable.

To believe we live in a body positive world is to be deeply delusional. At the absolute most extreme, you have people asking not to be ridiculed for their weight. There are almost 0 people who legitimately think being fat is good for health. I would say 0, but then I remember some people think the Earth is flat.

All that is to say: yes, we know being fat is bad. Yes, even fat people know being fat is bad. Yes, doctors often prescribe not medicine to treat obesity. And yes, this often leads to missing genuine issues. And no, before anyone asks, I'm not a fatty, I'm actually quite thin. Not that I think it matters, but people are vain so it might matter to you.

If this comment feels very ungenerous to you, that's because you have forced me to make many assumptions about what you're trying to say. You can avoid that by not speaking as though you're an oracle in a medieval fantasy movie.

And, before I hear some nonsense about how you have no biases and you just want to conduct a thought experiment - uh, no. You are implying something, and we both know it. You do have an opinion on this topic. It's best to just let it out or say nothing at all. Otherwise, I might assume your opinion is dumb.

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

#330

Post by exe34 »

consteval wrote: post #310
exe34 wrote: post #244

Earlier quoted context omitted.

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 d…

oh it's not an issue for me, I've been suicidal since I was 12, but don't have the guts to off myself. a few years ago I gave up entirely and decided to wait it out the long way, but the sooner something takes me out, the better. but thank you for the concern :-)
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