Do you need a dentist visit every 6 months? That filling? The data is weak
arstechnica.com
arstechnica.com
One of the few times in managing hospital systems I was actually shocked at unethical behavior was when we took over management of a system that through accidents of history included a series of dentistry clinics. Dentists do not have any equivalent to a hippocratic oath, they have no professional obligation to be honest with their "patients". The overriding operational theme of the clinics was how to defraud "patients" with completely unecessary work to maximize profits and borderline defraud dental insurance. I understand that people have a dim view of ethics in american healthcare but this was what I would consider criminal behavior in a medical setting but as further experiences taught me, is the norm in american dentistry. Suffice it to say that we divested from the dentistry clinics asap.
Here is one swiss study showing that 30% of dentists committed fraud in the studed visits or were so incompetent that their behavior constituted fraud. I would guess that american dentistry is closer to 50%.
Have you had your wisdom teeth out? You are very likely to be the victim of dental fraud.
As if that meant something for regular doctors. Agree with all your post and would like to share a some anecdata in case it's good for anyone here someday.
When I was around 16 I lost a premolar (I had an extra one, that messed up the real one, both died and fell down), all dentists immediately suggested I get an implant. Reasons given where:
* Your face will deform (no, really) because of your missing tooth
* Your other teeth will start moving and will get misaligned and fall as well
* Your bone around that area will disappear and you'll need a bone graft and you could die
I read a bunch about that online and came to know that implants do massive damage to your mandible and that's not to be taken lightly. Average implant life, if all goes well, is ~20 years, then you have to do it again, each time you do it you weaken your mandible and palate bones significantly. Back then I thought, in 20 years I'll be in my 30s, nowhere near being old and I would start having issues with this for life. I decided not to get it, and guess what? I'm 37 now and have never had a single problem because of that, ever. Every single time I go to a dentist I get the same speech, over and over, "get an implant or you'll die, do you want me to book the appointment now?" "no, I just want some cleaning done, thanks". Dentists are as unscrupulous as it can get.
More than 15 years have passed and my jaw line is better than ever.
In canada, if the dentist find out you have private health insurance its a free for all loot. They even insist of x-ray every 6 months. Very infuriating.
My Dentist has 3D imaging done in seconds during every visit, 3D printers so you they have a crown done same day, lasers to prevent scarring, ultrasonics. They’re using tools, chemicals, adhesives, and methodologies that are cutting edge. I have no doubt that a decade from now they’ll be growing and implanting replacement teeth.
Meanwhile, American doctors are still arguing about the value of preventive healthcare, refuse to use diagnostic tools, scoff at MRIs and imaging, won’t prescribe new drugs (GLP-1s), and struggle to use computers. And for the privilege of dealing with this entitled, technically illiterate industry costs insane amounts of money due to the AMA monopoly and artificial shortages of doctors. It’s really the biggest scam there is.
Just the way things are. There's a reason firemen are more popular than doctors.
Scientists have been learning how crucial and vital good oral health is, because it affects the health of every other organ system in the body. Periodontal disease is a direct cause of both diabetes and heart disease. They even recently learned that poor gum health is a causal factor in colorectal cancer.
Also: My dad never really brushed his teeth much if at all. No fillings ever. No teeth removed. He used toothpicks "relentlessly" (in the XP sense) like while on the couch, while thinking through some chess moves etc. Turns out that's how our (smart) ancestors "brushed": with sticks.
If you're eating the diet our prehistoric ancestors ate, are at their level of physique and generally okay with their life expectancy, this is fine advice. For everyone else, there is limited evidence it helps prevent gum disease and halitosis [1].
With respect to flossing, this shouldn’t have been news either. A systematic review in 2011 concluded that, in adults, toothbrushing with flossing versus toothbrushing alone most likely reduced gingivitis, or inflammation of the gums. But there was really weak evidence that it reduced plaque in the short term. There was no evidence that it reduced cavities. That’s pretty much what we learned recently.
It's like type systems and productivity: we don't have a lot of data to say whether type systems make people more productive or not, but there are ton of SWEs who think that type systems make them more productive, and they are probably right (at least for their domains). Dentists, in their anecdotal experience, probably see patients improve once they start flossing and brushing. That's why they suggest it.
Blows my mind every time I this kind of nonsense. "Never been shown"? It has been shown to me. If in slack my flossing enough soon enough bits of food get stuck in between the teeth and gun and start rotting. When youve had breath smelling like rotten food you start being more meticulous with your flossing. I have to presume that you have awful breath and are unaware.
I also do hope that since Covid everyone with bad breath knows they have it. Except for anti maskers I guess.
I also mentioned copious use of toothpicking in my original post, though mostly as a replacement for some of the brushing.
You hate toothpicks, fair enough.
Flossing is faster but it would be an extra step / thing to do at the end of the day (the recommended daily flossing). In the way I told my parent here to try replacing that, you're correct. Flossing would be faster!
In the original comment I made about toothpicking by dad, I'm wasn't talking about using a toothpick to just get some food that's stuck out. Everyone uses that from time to time I suppose. And also not as a floss replacement task at the end of the day. The kind of toothpicking I mentioned that he did was basically "automatic" and while doing other stuff. Basically a way to keep your hands occupied while otherwise idle and not as a specific "do this X minutes every day as part of your brushing routine".
Less painful: That really depends as well. The flossing the dentist does is super painful. I hate it when they do that. Using a toothpick? Not painful at all. I don't poke it into the gums. What do you do?
Thorough: Potentially, I'll give you that. It can reach some parts that toothpicks never will be able to I suppose. Then again, those are the parts in my experience where the floss gets stuck, feathers out and bits stay in between the teeth and you gotta try to get them out with yet more floss. They're also the parts that make flossing painful because you have to apply so much force to get the floss through that it tends to hit the gum line. That hurts. It's why it sucks so much when the dentist does it. If you do it yourself you at least have a bit of control and will be able to try to avoid that. But the dentist just wants to get through the flossing as fast as they can, so they really jam it in there and pull it down hard.
I find toothpicks painful because they are wider and shaped like a wedge, and so they tend to push some food in deeper (like the thin, hard fragments that come from eating popcorn). Instead I use very thin, tape-like floss, which is minimally invasive and does not get stuck. It functions more like a scoop, slipping neatly under trapped food so it can be lifted out.
I also do flossing as an idle activity. I keep floss in the shower and at my desk. I almost never floss when I brush my teeth (can't be bothered) and only floss while I'm occupied with something else, like watching a show or waiting for hair conditioner to soak in.
Sorry, but unless one is blessed with near-perfect genetics, oral hygiene is real work. But it's worth it if you want to stay in good overall health into old age.
I thought that diabetes was glucose processing dysfunction?
There doesn't seem to be any logical connection there but with nature anything is possible.
I should write a long post because any time the topic comes up I have a lot to say, but don’t want to wear my thumbs out on my phone. What they did and then further tried to do to my children made me violently livid and completely disenchanted with the industry.
Never thought I’d be a conspiracy theorist type person about anything but I do not trust dentists.
I am quite sure there are a very large amount of people who had cavities drilled that never had to be.
I grow tired relying on the potential laziness, ignorance, apathy, and complacency that a doctor might have to help me - or even their own prerogatives getting in the way of their treatment and care.
Something more objective, unbiased and empirical would be nice. I often wonder how many lives would have been improved - or saved - if we achieved such technology sooner.