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Routine dental X-rays are not backed by evidence

arstechnica.com

361–370 of 390 posts

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

#361

Earlier quoted context omitted.

A friend of mine is an orthopedic surgeon and says he's basically a carpenter.

For a good time (citation needed) you can find clips online. Jaw surgery was particularly eye opening.

This is a perfect case to illustrate that while knowledge is power, ignorance is bliss.

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

#362
post #261

Earlier quoted context omitted.

It may start with Radiographs but it certainly doesn't end there. What is being taught in schools has no relation to reality. Sure, it may somehow influence it, but it won't dictate how each dentist or clinic will work, as they are probably free to and work do almost as they please. Not too long ago there was a wonderful research story by a journalist of good dental health (as diagnosed by multiple university profess…

I remember reading this article (or a very similar one) as well. It sent me down a path of looking for evidence based dentists, which are quite hard to find. I couldn't end up finding one that seemed to fit that bill in my local area. I talked to a recent dental school graduate friend who described some evidence that school debt is highly correlated to over-treating. I ended up going the direction of looking for dent…

An interesting approach could be to visit at least a few, 3 to 5, and get an idea of the scope and work they want to do on you (or your bank account), and then go with the one you like most, out of those wanting to do the LEAST work on you.

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

#363

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…

And the money is actually from the Insurance industry, whose goal is to drive down utilization while driving up fee-for-service. This way, they make a little money on non-insured procedures but make a shit load of money by keeping more of the insurance premium. It's messed up... (I work in the dental industry, and see practices getting bought by DSO's, PEs and VCs only to go from $1M / chair / year to 50k / chair / year. all the time).

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

#364
post #29

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

That's one of those statements, like a natural empiricist saying they don't believe in the big bang, that people tend to latch onto and run with without stopping to evaluate. Flossing daily isn't necessary if you're an adequate manual brusher. Relatively few people are adequate manual brushers. Buy a good electric toothbrush, floss periodically.

> Flossing daily isn't necessary if you're an adequate manual brusher.

Anecdote. I went my whole life not-flossing, having occasional procedures until every molar had work done to it. I started flossing daily and the need for procedures stopped.

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

#365

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…

It may start with Radiographs but it certainly doesn't end there. What is being taught in schools has no relation to reality. Sure, it may somehow influence it, but it won't dictate how each dentist or clinic will work, as they are probably free to and work do almost as they please. Not too long ago there was a wonderful research story by a journalist of good dental health (as diagnosed by multiple university profess…

You might be thinking of this one: "I Went to 50 Different Dentists and Almost All of Them Gave Me a Different Diagnosis" - https://www.rd.com/article/how-honest-are-dentists/

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

#366

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,…

There's some evidence if you know where to look for some of these things (i.e. the programme Dr. Ellie recommends on youtube does actually have papers backing what she says), but overall the dental industry has a long sordid history. You don't understand the power of the ADA/flouride lobby. Even just 20 years ago it was routine to have mercury (toxic heavy metal) placed in your mouth for fillings, evidence said the c…

For those people who can't even be bothered to find the papers.

Here's a site that gives you those references. Do the critical thinking and reasoning. If you actually do the reading, you'll find what I have said is quite correct (and your downvotes are you exercising your opinion to silence others irrationally, which is coercive and evil when its arbitrary and unbacked by rational evidence).

https://fluoridealert.org/content/50-reasons/ (the list is at the bottom)

Then there is also a good paper here for the history of Flouride.

For those that don't pick out the critical parts, conclusion isn't appropriate because it neglects common factors like funding (rather the lackthereof for anti-flouride research), the lack of ability to publish (subverted journals refusing publication), and a great many papers after the 1950s; and only briefly touches on methodological issues such as the fact that early studies used young men (not infants, kids, older populations, or women), and extrapolated out for the general population.

Women's health, birth, and allergies/thyroid changes were largely ignored, and rather than correct the bad science in a rational way; the expert voices involved were minimized and discredited, while simultaneously being barred from publishing in research pools (for a perceived stance rather than for actual science, ideologically against science). Its not hard to see why the thought that Communism was playing a role in this line of inquiry.

When seeing these tactics, they were commonly known by the public at the time, and were used primarily by Communists and Marxists who weren't follow western thought based in rationalism (science) to try to subvert the population, and if this were the case, its hard to argue that they didn't succeed in subverting the bureaucracy to force the changes despite the health consequences.

Read for yourself, also that objective 15% benefit (not 2/3) extrapolated didn't properly account for increasing tooth hygiene during that same time.

Even the CDC today recognizes the benefits are mainly from topical uses. Most western countries don't allow flouridated water supplies.

Much of the research over the years had to be independently funded, or were government funded by those countries, and the science has been overwhelming, but this isn't how public trust science is supposed to work (in the US). More specifically biasing funding on safety issues to push unsafe options for profit/benefit would fall under political corruption, and a violation of the public trust.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504307/

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

#367
post #82

Earlier quoted context omitted.

Remember the old adage--it's the dose that makes the poison. There is *nothing* that is not lethal if consumed in sufficient quantity. That includes *everything* that we require to live, although in some cases it becomes effectively impossible to ingest a lethal amount. Thus showing that something is toxic doesn't mean it's something you should never consume. And note that fluoridation started because it was observed…

Fluoridation started because they wanted to get rid of toxic byproducts from making aluminum, the rest is marketing.

What's added to tap water isn't the compound used in aluminum refining. Thus they would have to separate it out and at that point they can simply react it with aluminum and continue to use it. There's nothing to discard.

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

#368

Earlier quoted context omitted.

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 ev…

Everything seems to be going in this direction. We were recently looking for someone to clear out insects and other pests from our property, and every one of them tries to steer you to a very expensive "plan" where you're billed monthly. We looked around for a long time for a veterinarian where there were more actual vet and vet tech staff than there were billing staff. We were recently referred to an orthodontist fo…

Sadly business has given up on improvements/efficiency gains and is instead trying to maximize solely via extraction.

I hired a service to help with my trees because an old try was dying. Each time they come out they send me a 'survey' only it's barely a survey with most of the focus on 'Do you want to tip for the services performed'.

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

#369

Earlier quoted context omitted.

Completely anecdotal but my gums flare up and just feel disgusting when I don't floss for too long. I don't do the dentist recommended 2/week but if I stop flossing for over a month I notice significant decrease in my gum health. It becomes excruciatingly painful to brush and this stage and my mouth is full of blood afterwards. So I'm sticking to flossing pretty often now.

You might be going at it too hard. Please see a dentist or get a second opinion from another dentist. According to my dentist, you can damage your gums by brushing them too hard. I don't floss so he didn't address that, but in both methods, force is being applied to delicate tissue. The point of brushing and flossing is to remove food particles. You don't have to abuse your teeth or gums to do that.

I have been told by him not to brush too hard. And i dont brush hard. But the issue is not related to my brushing. What I meant with the blood was;

First I don't floss for a month. Then what looks like gingivitis shows up. And when I brush (normally -- not hard) after this, the sites that have the gingivitis bleed and are extremely painful.

If I don't floss my dentist notices immediately and tells me to floss more often because there's food and shit in there, hence why I tend to floss.

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

#370
post #250

Earlier quoted context omitted.

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.

Interesting. I have never used any recreational drug other than junk food. I deal well with the pain of frequent kidney stones and don’t even take aspirin.
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