Do you trust your dentist? | Hacker News Reader

Do you trust your dentist?

My father and I were shocked after hearing a story where a dentist literally told his assistant to treat healthy teeth just to hit their revenue goals. My father is also a dentist and gets many requests from his friends to check the diagnoses of their dentists and those are often so wrong. Most of them want to treat your teeth with the most expensive method and rarely showcase the alternatives. After some feedback my father and his colleague who have loads of experience now decided to help combat this problem with an independent online consultation: https://www.dentale-zweitmeinung.com/en

Do you trust your dentist or are you consulting with several people?

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I go to the Teaching/University dentist clinic in my city.

It's a very reputable University and the times I've gone, I have felt very confident in the quality of attendance that I am receiving. Mostly because it's usually 1-2 students that see you and whatever they do they get checked by a supervisor.

This inspires trust in me because, well, the supervisor is there to make sure the students learn. It's not so much about profits here at all. Obviously this means that sometimes you get students that might not have all the techniques down and so they might take a bit longer... but quality wise I know these are going to be very successful dentists too; as this is one of the top unis in the country.

I think if I were to need to find a private sort of arrangement. Most likely I would go to the university dentist clinic and ask around for recommendations. But why would I do that?

I think it also varies depending on country. There was an interesting post on Instagram recently where an American traveller got her teeth examined in Malaysia (I think) and couldn't believe the difference in diagnosis, especially regarding which teeth needed filling - the comments had a lot of folk in the US talking about the necessity of 'preventative' fillings, which to me in the UK sounds like a moneymaking scam

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In the UK there's a an obvious principle agent problem. My uncle told me how in the 70s the school dentists were paid by the government, 5 quid for every filling they did. The perverse incentive to drill away healthy kids teeth was overwhelming, as you can see in the crooked smile of everyone of that generation.

I am a victim from the 60s. Not at school but same principle.

Crooked smiles are more to do with fewer people having orthodontic treatment, not fillings. Also, dentists in most countries are, in one way or another, paid for the work they do, so this perverse incentive exists pretty much everywhere. Whatever problems may be specific to the UK can't simply be explained by the fact that dentists get money in return for performing dental procedures.

Let me be clearer: Multiple Brits now in their 70s and 80s have told me how school dentists in the "old days" routinely performed surgery that was unnecessary, and ultimately harmful.

Sure, that may be true. My point is that if that happened to an unusual extent, it's unlikely to be merely because the dentists were paid for doing the surgery. Most dentists in most countries get paid for their work and can get more money by doing more of it.

There's a name for this paradox/mode-of-failure, where the incentive to help/care produces harm.

It's "Iatrogenics" [0]

[0] https://en.wikipedia.org/wiki/Iatrogenesis

I don't trust any doctors. Sometimes it's revenue goals, but often it's also just a lack of specialized knowledge. But you obviously can't go to a specialist if you don't know what exactly is wrong with you. When I get multiple opinions, they are usually completely different.

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