https://www.cochrane.org/news/featured-review-how-often-shou...
In my experience they always find something that they "have time to take care of right now if you want". I've heard anecdotes of folks going to get second opinions that reaches a different conclusion.
No joke. That is a major money maker. There is minimal cost per-use and your insurance pays $200 for it (my last one was $186.00 for instance). The dentists would be crazy not to recommend them as of often as possible.
Fluoride "rinses" are likely up there too. Rinse for a few seconds and they charge the insurance $50 or something for it.
https://www.webmd.com/oral-health/wisdom-teeth-removal-neces...
I understand that radiation effects are cumulative but is this overexposure source worth fighting against as a patient?
I went to another dentist in the area, they took some x-rays themselves, and told me that there was nothing that needed immediate work - maybe one pre-cavity that would eventually turn in to something but certainly not worth doing anything with now.
Three years later (and sticking with that new dentist) I still haven't needed to have anything done (and certainly don't have any pain in my mouth anywhere either).
Routine wisdom teeth removal is not a thing in most of Europe. Another random example are colonoscopies and routine flu vaccines (except for the elderly).
> For instance, a 2021 systemic review of 77 studies that included data on a total of 15,518 tooth sites or surfaces found that using X-rays to detect early tooth decay led to a high degree of false-negative results. In other words, it led to missed cases.
The article isn't just saying you're getting unnecessary radiation. It's also saying that relying on x-rays lets dentists be lazy about finding problems while also billing you for unnecessary work.
The same is true of alcohol-based mouthwash and alcohol itself. Anything that routine damages cells is going to be a carcinogen.
I would have been totally happy to buck the pressure of "this is what everyone does," but the thing that made me reluctantly agree to it was an explanation that if I didn't, they would bore holes into my then-back teeth as they grew in and I'd have a big problem to deal with.
As I understood it, teeth normally grow straight up, but wisdom teeth grow sideways (with the tops facing the front of your mouth). The wisdom teeth then hit the rest of your teeth and basically bulldoze your mouth.
I have no idea how true/bullshit that is, but it's what I was told to get me to finally acquiesce to the procedure.
Oddly, I only had wisdom teeth on one side, and not the other. So only 2 teeth were removed.
Then I mentioned I had pain around the crown whenever I ate something sweet or sour. The dentist took another look and said "oh yeah the crown is cracked"
So now I know I either have a cracked crown or I don't. Great service.
Presumably flu shots are good business for the manufacturers, though I'm not sure about the science. After having the flu as a healthy late-twenty-something a while ago, which was...intensely horrible, I've chosen to get it ever since.
I haven’t decided yet since they cause me no problems now and so far I’m to keep them relatively clean, but I have known several elderly family members who eventually needed molars removed because they hadn’t/couldn’t clean them well enough and it was a very difficult surgery for them.
https://www.theatlantic.com/magazine/archive/2019/05/the-tro...
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.
This may be specific to location, but would it be the same dentist recommending the treatment as performing the surgery? Here (BC, Canada) everyone I've known who's had wisdom teeth removed had it done by a specialist, not the dentist that suggested it (which presumably cuts down on self-serving recommendations).
That's not a meaningful standard for any health intervention. If I'd apply everything to my body that wasn't proven to hurt I'd spend a hundred bucks every morning and two hours in the bathroom. If "it doesn't hurt" was sufficient basis for a recommendation our doctors would tell us to swallow homeopathic medicine every morning.
It seems pretty obvious that anything you apply has to have at least some measurable impact, otherwise you're basically in the same category as the supplement industry.
I get an annual dental checkup (military) with the around-the-face x-ray machine. The first thing the dentist does is to compare it to last year's scan. The x-ray allows them to spot all sorts of things they would otherwise miss, especially since I don't think I've ever seen exactly the same dentist twice. Teeth move. Teeth wear down or chip. Sometimes this can be spotted by eye but the x-ray record is more reliable and more easily communicated between offices.
As for radiation, if you are worried about an annual dental x-ray then you better not fly in an airplane, live in Colorado, or hang around too long near the bananas at the grocery store.
The root canal was eight years ago. I brush and floss twice a day (brushing without flossing feels weird to me now). I haven't been to the dentist since before the pandemic and my teeth feel completely fine.
https://www.consumerreports.org/toxic-chemicals-substances/d...
https://www.health.harvard.edu/mind-and-mood/good-oral-healt...
It's demonstrable that something like a bean skin, lodged in your teeth, will erode the teeth touching it.
However you don’t swallow mouth rinses like Act, so any nonobvious issue is also greatly reduced.
I personally intend to stay vigilante to dihydrogen monoxide poisoning.
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 that the people in areas with higher natural levels benefited.
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.
Interestingly, I lived in Central Europe for a while and all my private dentists just used visual inspection for teeth. I never had an issue with that, all decay was spotted in time and in many cases earlier than with the x-ray only method, because more attention was paid to how the teeth look up-close, at all angles.
However, the visual inspection takes more time and skill. One might argue x-ray is the cheaper and quicker option. Though it costs more to the patient in many cases. Ah, the world of dentistry.
Only reason I'm being pedantic here is because if the study was in-fact looking at parachutes from helicopters, it could actually be plausible that parachutes had no improvements when used with helicopters. Most, if not all pilots, don't wear parachutes because there's not enough time to jump out of a crashing helicopter to deploy one and the blades would probably hit you anyway (unlike a plane which you could glide for some time, helicopters are notoriously more likely to fall straight like a brick)
Also, this may be a good application for AI. I would assume this is an issue with dentists being able to read X-rays carefully and not that the X-rays are unable to capture the signs.
This is a systemic review. A RCT would absolutely find a difference. The whole point of this satire is to point out that there's not always studies on what you want to know. "No randomised controlled trials of parachute use have been undertaken"
Flossing has absolutely been studied. Professional flossing seems effective at combating gum disease. Telling people to floss doesn't seem to be. It's unclear why (is it just compliance effects? are people educated on how to floss still ineffective? etc.)
I think the real point is that systemic reviews often will have a pretty tilted set of included studies, because they are influenced by what things researchers choose to study.
Indeed, you probably couldn't publish a study saying that parachutes work; it's not an interesting enough finding for publication. So the only stuff you'll find, in many cases, are studies that buck the prevailing wisdom.
But yes, the item you want studied might not have been studied. ("However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps.")
Incentives are 100% misaligned and even good actors are forced to shorten your lifespan/quality of life to make somebody money
They have much higher rates of these diseases, and recently in a court case the death of a farmers daughter has been shown to be caused by these pesticides.
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.
But coming in towards other teeth and hitting them, or other forms of impaction, are pretty common. You probably saw (or could have seen) the situation pretty clearly on an x-ray.
That being said, there is/was definitely an air of "this is just what we do, it's easier this way" for removing wisdom teeth, akin to say, what removing tonsils once was.
Patients regularly push back on some treatments I've recommended, and I've always enjoyed the discussion. If a dentist is offended, then something is not right
And that is in high cost Norway.
If _much_ lower than 200 USD per visit in a very wealthy country, then I assume:
(a) dentists don't make very much money. Less than 100K USD?
(b) most of the work is done by poorly paid dental assistants (20 USD per hour or less).
Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?
To be fair, the quantity of fluorine that would kill you if you consumed it is too small to notice. What's saving you from the fluoride isn't that there isn't enough fluorine to be dangerous - it's that the fluorine is accompanied by things that make it less dangerous.
Table salt is 60% highly toxic chlorine, but you're free to coat your food in it because it's 40% sodium, too. In combination, they're fine and in fact necessary to life. Consumed separately in equal amounts, either would kill you. The quantity isn't what matters.
Dentist salaries seem to range between £70-200k depending on experience, specialty, etc.
How we've ended up regulating medicine to the nth degree, but when it's teeth we're like "oh well, lol", continues to mystify me.
A more likely scenario is that dentists are employed by a dental clinic (even if you see the same dentist every time). The dental clinic wants to maximize profit for shareholders, so they invented the "routine dental X-ray" guideline. The guideline is then imposed on the destists as a "performance quota". E.g. if you have 300 patients assigned to you, you are expected to prescribe at least 150 panoramic X-rays to you patient pool. Drop below the quota, and there goes your performance bonus, which you may otherwise be totally worth of.
Of course, there will also be cases where the dental clinic is owned by a single greedy dentist.
I've had the dentist themselves always do most of the work. The assistant is often shared between multiple dentists in the same office in my experience.
It is a normal procedure to be able to safely land this way when power has been lost, and in some ways is safer than a gliding fixed wing aircraft as you don't need a runway to land on.
Of course catastrophic failure is possible in a helicopter where the rotorblades can't turn, and then autorotation won't work. But then if a wing falls off a fixed-wing aircraft, they generally can't be controlled (interesting exceptions do exist like with the Israeli F15[1]).
[0] https://en.wikipedia.org/wiki/Autorotation
[1] https://en.wikipedia.org/wiki/1983_Negev_mid-air_collision
I see what you mean.
But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.
Find new professionals when that happens. There are plenty of professionals that understand that not everyone is willing to just do whatever without more understanding and are happy to explain further when questioned.
> For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spectacles in their shop. Doctors were University educated in Latin and Greek to read ancient medical texts and despised the uncouth yokels.
> Surgeons muscled their way into the medical profession, originally with the help of the Royal Navy, who only had space for one or two people in charge of both cutting off legs and looking after crew health on their ships.
> Dentists and optometrists never did, so they started their own universities, certification boards, etc. By the time they became respectable enough for people to try to merge them with the medical establishment, in the 1920s, they had no desire to give up their independence.
> The first insurance policies were private contracts with groups of doctors and the system developed from there.
Details vary from country to country of course, but the gist of it generally holds true.
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 professors) going across the US for a check up at tens of clinics, and seeing what work will be offered to them.
This journalist has encountered just a few few honest dentists saying no work at all is needed, or something very minor, all the way up to dentists saying he needed work in the tens of thousands of dollars, with the worst offender being in NYC as far as I remember wanting ~$30K for his services.
Unfortunately I can't locate the story right now. If anyone can, please link us.
I didn't yet find the right one, but this one is not too bad either https://www.usatoday.com/in-depth/news/investigations/2020/0...
Let's just say that it feels like quite a high percentage of dentists don't strictly adhere to the Hippocratic Oath.
Europe takes a clinical risk (e.g. caries risk) based approach combined with a patient age factor. To have annual X-Rays in Europe you would have to have some sort of dental issue that puts you in that high-risk category, and even then, the clinic would keep you under review and lengthen the periods as soon as it was clinically possible to do so.
This has always been the case, even before the latest scientific evidence on the potential harms of X-Rays.
And the final form of dentists, oral-maxillofacial surgeons are an all in one and have to study general medicine, surgery and dentistry.
The system is different but this aspect is pretty much the same everywhere around here.
And thanks for the Readers Digest article. A bit of a blast from the past with that publication for me but well written and clearly makes its point about the inconsistencies of dental practice.
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 compounds were stable and no one would fund anything that rocks the boat in the US. They did that for children, but they didn't call it mercury, they called it silver fillings (50% by weight mercury).
Normally flouride has very limited uses prior to government mandates, and was so common that it was largely considered a waste by-product not worth selling.
I've yet to find an evidence based study or information on why government require flouride ingestion in any population center above 30,000 when studies have shown its just as effective topically. A study out of african really put the nail in the coffin on this one.
Side effects include lethargy, neurological damage, cognitive decline, hypertension, acne, seizures, and gastrointestinal issues.
It also damages your kids brains more than an adult brain (seemingly lowering IQ permanently), can't be filtered out except by specialized filters that cost a lot (and rapidly become less effective over time).
If they get too much which is very simple indeed, this can happen since its in everything (even bottled water and sodas, GRAS and no label needed under a certain concentration that's well above the toxic limits of new studies).
Nursery Purified bottled Water for infants is a primary source of business.
https://www.readyrefresh.com/medias/sys_master/images/images...
Makes you wonder what's really going on, and why they have to drug broad swaths of the population under the guise that it helps fight dental decay (through ingestion), when most of those studies have been debunked outside the US.
When cities don't have the funding, they magically get the funding for it. When local municipalities don't keep the levels up, they go after them heavy handed, and they disappear from public view.
https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
1) Just yesterday I went to a an acclaimed dental school (UNC) for low cost dental care. They not only gave me a panoramic x ray but also a full set of bite-wing x rays. I read this and I want to break the world apart this morning.
2) When I was a child I kep needing root canals. It turned out our dentist was making these all up and was later found passed out from laughing gas in his office.
NB No criticism of the dentist that did it - took two dentists and an assistant nearly 5 hours and they have an impressive amount of kit...
I suspect that it's also a question of market forces. A dentist that charged much more for an annual check would simply lose that business as there are plenty of dentists here. And quite likely they would lose any follow up work as well.
The profit margin on treatment is much higher but even that seems cheaper than what some of my US friends say they pay (or their insurance pays). Here's the price list for my dentist. In Norwegian but Google Translate does a good job:
http://www.drammen-tannlegesenter.no/om-oss-priser/priser
They do some cosmetic work as well, I imagine that the profit margins are higher for that.
I have two crowns, both created by an automated process of 3D photography and CNC machine in the clinic (Cerec). The most recent one went like this: I made an appointment to see my dentist at about 8:30 one morning complaining of toothache, she discovered that an old amalgam filling had cracked and taken part of the tooth with it and that the only practical repair was a crown. She then apologised profusely that she didn't have time to do it there and then but could I come back at 13:00 that afternoon? I said yes and by 13:30 the crown had been manufactured, fitted, ground down to an exact fit and I was leaving. The crown was a bit over 5 kNOK altogether, about 500 USD, for half an hour's work. The price has gone up a little since.
None of the work I have done, including the annual check-up, is done by a dental assistant, poorly paid or otherwise. I think that this might be because of the high cost of employing anyone in Norway.
Recently he did some 3-month contract work for a very large dental chain, let’s call it Penass.
I’ve never seen him so depressed in my live. He said that Penass’s business model was all about running up insurance and selling loans for large operations. He was directly encouraged to do extra, not necessary work to run up the bill.
He came out of retirement after that and started another practice out of, what I can only guess, was frustration and guilt.
A lot of these large dental chains absolutely tack on extra work and do a shitty job to keep people coming back.
In the US, I highly recommend looking for independent “boutique” dentists. Even if they are out of your insurance network, a lot of them will give better rates if you pay in cash.
My friend is getting an implant and the total cost is about USD8000. The government is covering most of it because it was an accident (sporting).
The hospital has been under intense investigation by the local news.
https://www.wral.com/holly-hill-hospital/21507953/
This is the newest scam running, privatize health care so that these companies can rake in billions. I am sure this dental school probably gets millions for doing this.
To the patient maybe. On the other hand (so to speak), if I were gonna spend my day sticking my fingers in people’s mouths, I’d want to wear gloves.
Not only is bias introduced from accidental collection flaws, it’s also often tampered with intentionally cherry picking data, choosing interesting data or in some cases flat out falsifying data. In addition, evidence based reasoning often suffers from there being a lack of evidence to make a decision from. Or in some cases some critical aspect surrounding the decision is very niche to the case so the data may not take that into account unless it’s highly tailored data (evidence based reasoning tends to focus on breadth of applicability because gathering evidence is a long and often expensive process).
There’s still a lot of place for using theory and reasoning in conjunction with or in absence of data. Things like experience, professional opinion, etc. Medicine should be no different in that regard to any profession. The key is of course to always strive for sound empirical evidence/data where possible, but to use sound documented reasoning and theory in its absence if you want the best objective results.
I don't remember exactly what was done last time and only knew when they pulled up the xrays and I saw the date of the last one. They hygienist sits you down and just does it as if it is normal. I googled and found what you mentioned.
I am low risk for cavities. Those exact words came out of his mouth. I was pissed off after the fact, because I'm paying out of pocket for this, and for fluoride treatment. I have in my records to not give me fluoride treatment but she called it "varnish" which caught me off guard.
I speculate the office got bought out by PE as dentists have changed over the last few years.
They also told my wife she needs a night guard. She's been wearing one for 12 years.
I slowly see why there are people who do not trust medical professionals.
The X-rays I can probably avoid the next time, but I feel the cleanings do really help. I used to have bad plaque build up on my incisors but keeping up with the cleanings and improving flossing technique keeps it at bay.
Not only do you actually get to see the same person on every visit, they're not as likely to do this sort of thing.
I used to do this periodically because I hated doing it. But as a result, plaque would build up. Especially on the front bottom incisors.
Eventually added it to my daily routine after the nth time being told to floss daily. And now my dental cleanings are more like spot checks.
I suppose it’s anecdotal and unique to everyone though. Something about mouth flora.
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?
Apparently teeth are luxury bones
I'm always baffled by all the discussions about flossing, as it's something that can be very easily verified empirically: one can just floss for a month, then stop doing it for another month, then resume and get a feeling for how the gums react. If they bleed or burn (lightly), then the efficacy is evident; if not... lucky person! No need for research either way.
In my case, I don't need to floss daily, but I still need to do it regularly. Two weeks without flossing, and I'll definitely feel the burn once I resume flossing.
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.
Hard to balance at night, but a humidifier using distilled water near the sleeping area will slow the rate of drying.
I think the slider isn't between trusting and not trusting medical professionals - it's between being a passive and active patient. We have to involve ourselves in our care. Educate yourself, get second opinions, connect with fellow patients and national experts. And ffs, do not listen to yt/x/tiktok people for anything.
If you manage to do double-blind studies for every single piece of knowledge out there, kudos for you. There's nothing bad in this.
Anyway, it's on topic for several sidelines people are raising. But not on topic for the main article.
I was under the impression that the digital machines they use these days are:
1. localised 2. very, very low dose
I've never had a single cavity or needed braces. I happen to be blessed with very good teeth. I told him to fuck off (unfortunately not in so many words) and never went back.
That was 10 years ago. Still no cavity or any issues at all.
The tobacco industry was a contributing factor but common sense and independent thought was already gone or it wouldn’t have worked for as long as it did.
The saying goes that you only need to floss the teeth you want to keep.
If you think about it, a toothbrush will only clean 3 sides of a tooth. Top, outer side, inner side. Not the 2 sides facing neighbour teeth.
How on earth is it very important to clean those 3 sides but not the remaining 2? That just doesn’t make sense. If you think flossing is not useful, to be coherent, you must believe toothbrushing is not useful.
On the flip side, learn how to do flossing right to not hurt your gums. The floss must follow the shape of the tooth, and not be straight. (Ie. move along a U path.) Flossing in a straight line does more harm then good.
Bonus anecdote: My previous dentist, who I went to once, had an office full of hygienists that were young, blonde, skinny women without exception. Something tells me the interview process was not merit-based...
did you ever figure out what the root cause of the migraines was?
I've personally been on the receiving end of "the data we collected shows...x" (in a non-medical setting), but when I asked to have a look at it, it turned out that while this was true for a large part of the population sampled, there was a material difference between that population and a smaller population that can be clearly identified and for the latter, the data showed the exact opposite conclusion.
(think 100 men and 30 women, kind of scenario, except the difference wasn't gender, but job role).
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 never went back. I found an older dentist and every patient in the office was a retiree, which made me feel confident they knew what they were doing (I'm sure they've got a lot of hard cases). I asked about the possible cavity and they said they saw nothing, everything is fine.
That's all just to say that the young dentists likely have a lot of debt between school and office build outs, and I wouldn't be surprised if they're up-selling services to try and get their practice out of it. I wouldn't trust them any more to be honest about practices just because they're young.
To put that into perspective, that's roughly the average income for a developer as well here in Norway.
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.
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
It's frustrating but I agree that new builds or expensive locales seem to amplify this effect. Established shops in less fancy areas tend to leave me feeling much better and are almost always quicker while being more thorough.
Another part of the problem, as it has been described to me, is that so many dentists are perfectionists, and they find minor non-issues to be glaring. Like if I have a discoloured filling in a molar... is replacing it really warranted just for cosmetic purposes?
I will also add that, a visit to most dentists where you clarify up-front that you have no insurance can be a very different experience.
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 already know it when you pick out the insurance plan, so of course you’d get the upper tier.
The only scenario where it makes sense is if your employer picks up a healthy portion of the premium, in which case you are basically getting dental care subsidized by your employer. In that case you’ll likely come out ahead because you knew in advance pretty much how much dental care you’d need.
The same goes for vision care, really. You know in advance how many contacts, glasses and eye exams you’ll need. It isn’t really an insurable thing. If your employer pays for most of the premium, it’s employer subsidized eyewear & contacts for you!
…of course the math does change a bit when you have to pick the same type of plan for a family. In that case it’s time to bust out a spreadsheet and do the math to see the optimal course.
I ended up going the direction of looking for dentists unlikely to have debt and found a former army dentist and have been thrilled with how much less "well, let's do it all just in case" she is than my previous dentist (who had a TVs on the ceiling of every room and a new piece of major equipment every time I went).
It's the same phenomenon as something like the calluses guitar players get. If they take a few weeks off, it'll hurt a bit when they play. That doesn't mean the activity improves their health. It means if you poke a part of the body enough it handles being poked better.
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.
If the operation is owned/financed by venture capital, stay away. Their priority is obviously not health and wellbeing.
And why can't we have education AND universal healthcare? I want a government agnecy (the people) to control the morality of corporations and private equity. Like we have laws against fraud already that protects us from "unnecessary work done on their car to boost dealership profits".
Adding still, why would anyone be against universal healthcare? I mean it is the biggest insurance pool you can create and that immediately lowers costs.
The importance of the distinction is a lifetime of non-ionizing radiation is not known to cause any adverse effects while any instance of ionizing radiation is known to damage cells, even when it's a low amount in a controlled area. The debate people have with the former is whether or not it might even causes a problem in the first place while the debate with the later is where the best balance on the damages vs advantages is.
I think they are working on it. My dentist has cameras shaped roughly like a toothbrush. Before and after performing work, they record images of the affected area. He says insurance likes them to thoroughly document their work to help justify the cost.
Why would a venture capitalist take over a dentistry or veterinary practice? (Unless it was a growth play, like One Medical)
Nothing wrong with eating bananas, but I wouldn't want to eat 20 a day for all sorts of reasons.
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 every six months and nobody had mentioned anything like that. but hey, that must be the advantage of all those fancy scanners. right?
they walked me down to the "payment center" which was an office holding four employees whose job was to come up with payment plans to cover dental work. that's when i knew that the whole place was a racket.
Everything you said could be true and ironically, you'd actually be making an argument that routine dental work is backed by evidence.
The percentage of people who do all the things you said has to be below <5%, if not even lower.
(That said, I believe dental issues that are the result of e.g. accidents do get covered by the default care package.)
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'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 died of lung cancer in his 70s. Honestly a miracle he made it that far.
You can tell if you're feeling okay. But a lot of diseases have no symptoms. The reality is you cannot run your own blood tests. If you're young, maybe it's fine. But as you get older it no longer flies. What happens is you will become very sick, realize it's due to something like high blood pressure or diabetes, and you're WAY too far gone to fix it. The earlier you get on top of bad markers, the better. You don't want to live 30+ years with something like high blood pressure or high cholesterol.
Maybe you don't smoke (good for you), but that doesn't save you. Neither does living an active lifestyle. You can get high blood pressure, high cholesterol, diabetes, heart failure, etc regardless of your lifestyle. There're people who die MUCH younger than my father did while being much healthier.
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.
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.
It’s a tricky subject to phrase correctly and way to early in the morning to come up with a good example.
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.
Given how low the typical (non-DMO) coverage limits are for dental insurance, this is probably reasonable for many people.
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.
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.
If it helps, keep in mind most medical issues don't kill you. They just lower your quality of life, sometimes a lot. So, if you've decided to stick it out, you might as well try to live the best life you can. Nobody wants to be chronically fatigued, or have bathroom troubles, or lose their hair, or whatever.
I feel like as the years go by, more and more of my cognitive cycles are spent trying to avoid scams and predatory businesses.
If 99% of the time it's just a symptom of being obese, is it really a good idea to put 99 people through unnecessary procedures because 1 other person has a fixable problem? What if said testing procedure has a 1/1000 chance of perforating the colon and causing a serious problem for those 99 people without a tumor?
One notable effect when regular flossing is sustained is that your whole mouth just feels generally less sensitive and healthy. Less pain when you chew, your breath feels fresher for longer. The reverse can also be noticed when you stop flossing.
As I said, this is not universal since not everyone has the same teeth arrangement. Which is one more argument in favor of not waiting for evidence. It's considerably cheaper to just get some 3$ dental floss, try it for a month, and see for yourself.
It's not just the dentists that are perfectionists, but culturally perfect teeth is an expectation in a lot of the world now. I get it; a kid who's hesitant to smile because they're embarrassed with their teeth is heart-breaking, but it's also very expensive.
>> 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.
How about just like people-medicine: diagnostic tests when there is no likely treatment should not be proposed. Or charging 20-50x the generic cost for the same drugs humans use? The fact that some people will "do anything" when there's nothing that can be done is prone to abuse.
Meaning that, because they are fat, they will be treated differently than they would have been if they were thin. Meaning their symptoms won't be listened to, they won't be taken as seriously, they will be assumed to know very little about health, etc. In through one ear, out the other.
This subconscious bias is the same reason why simply having a non-white sounding name on your resume greatly reduces your chance of being hired. It's not like anyone is actively racist, but in their mind there exists connections already made and those influence their decisions, without their knowledge.
In actuality, if you have, say, anal bleeding, pain, bloating, and dark stools you should get a colonoscopy.
Women and larger people face much more of this subconscious bias. Many women aren't taken seriously at all.
I told this story to a friend years later and he said the same thing happened to him.
So my friend asks for the explanation. Guy asks him "what's the strongest animal?"
The answer (which I would dispute) was 'the gorilla'
"And what do gorillas eat?"
It's even more amazing to see this at play in domains that are directly tied with your well-being, where there's abundant anecdata, but people are holding out until very long and very expensive research have made a pronouncement. Like, thousands of people claim this particular herb is {$positive_claim}. I could try it for a week and see for myself, but I think I'll hold on to my 10$ and wait until research confirms this by the time I turn 90.
Another aspect of this fallacy is nicely highlighted by the aphorism Not everything that counts can be measured. Not everything measured counts.
The entire dental industry is only in business because of sugar and ignorance. Fortunately for them, the overall vanity level of society is increasing, so they'll likely make up for it with whitening sessions and veneers.
When they have something costly to do, they even say that if the dentist alone pays for their all their trip expenses.
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.
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.
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'.
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.
I dunno what exactly he did, but him applying the anesthetic sucked way worse, but I didn't feel anything whatsoever during the root canal itself. So I'm definitely asking my regular dentist next time if he knows of any anesthetic methods that involve injecting it really slowly and it hurting, and if not if he could maybe have some conversations with his colleague about that.
So I guess nothing super helpful, other than the knowledge that the way the anesthetic is done has a LOT of influence on how well it works.