About the only thing that seems to be in agreement across the board is flossing and brushing your teeth.
The problem is the same as the CT scan: as much as my health anxiety would love another set of CT scans to feel relieved about, even if they do find something potentially interesting it may be worse to act on it than to do nothing, while leaving other things that can't show up on imaging unnoticed, potentially diverting attention and giving you a false sense of security.
YouTuber and doctor Dr. Bernard "Chubbyemu" Hsu recently covered an upsetting example to demonstrate how doing additional routine scans wouldn't have helped and may have harmed in a specific sort of scenario that I'm sure many of us fear from time to time. It doesn't prove or even assert that such scans would be useless, only that they are far from a panacea and that it isn't settled science that we'd be better off with it.
And to me, I think that ties into how we're doing dentistry wrong: I think taking routine X rays for patients with healthy mouths, no history of issues and no symptoms is reckless. Maybe it is sometimes beneficial, but every single year as a requirement seems insane. Why not every 3? Are we really catching things early or are we drilling into teeth that are fine? I question it.
Of course, I'm just some chuckle fuck on the Internet with zero dentistry experience, but my knee-jerk is that something seems off here.
I personally have a preference for having the maximum amount of information available to make a decision.
“Don’t get that “unnecessary” test, it might give you a result that might lead to treatment you don’t need” — hearing this blows my mind every time.
The unnecessary test, leading to an unnecessary intervention, which gets you unnecessary long term issues is a real risk in many cases. It's not just a matter of doing a bonus blood test here or there.
If there were a risk free button that you could click to see a full breakdown of all illnesses no more how early stage, would you click the button?
It would include a report of cells that may eventually turn into cancer (or may not).
It would include things like polyps, and every other diagnosable condition.
Do you avoid pressing the button? Why?
TIL of that theory: https://en.wikipedia.org/wiki/Radiation_hormesis
The most fascinating example of hormesis I can think of is that after the atomic bombing of Hiroshima, some people who would've received a relatively small dose of radiation seemed to have a slightly lower cancer risk than people who wouldn't have received any additional radiation.
https://pmc.ncbi.nlm.nih.gov/articles/PMC6937943/
I'm sure there is plenty of debate about these studies and their methodology, but I have some suspicions. There seems to have been a lot of handwaving and intentional omission to explain away or ignore why LNT didn't seem to match reality. Radiation hormesis may be an illusion itself, but as it stands it appears LNT is unable to explain experimental evidence sufficiently. We're clearly missing something, and there is a lot of potential conflict of interest, especially given the obvious incentives for the energy sector...
But also, I just read Wikipedia and watch YouTube causally, so hell if I know.
" In light of the results of this comprehensive literature search and critical analysis, it is concluded that a routine instruction to use floss is not supported by scientific evidence."
On the 'dentists don't really know what they're doing' front, my kid's orthodontist ($$$$) describes himself as a "fencing contractor". Conversely, I got the water flosser tip from an Indonesian dentist who I hired opportunistically on holiday for a clean; he turned up in flip-flops but decanted to bare feet during operating and gave the most sage advice I've ever had in 40+ years of dentists: BUY A WATER FLOSSER. Terimakasih, Doktor!
If I don't floss my breath smells terrible because of bacteria and bacteria causes tooth decay. I'm pretty certain I'm not special.
Some people get lucky, and even with low brushing, won't get cavities.
It is not sugar that causes dental caries, but bacteria. Flossing that old food out from between teeth is guaranteed to cut down bacteria growth!
Furthermore, my new and wonderful dentist and his hygienists wholeheartedly recommend and encourage the practice.
So perhaps you can excuse me for ignoring a singular “research study”.
> The evidence was limited in applicability and was incomplete. The included studies only presented data on gingivitis, plaque, and adverse events; most did not measure or report other important outcomes such as periodontitis or interproximal caries. … Additional use of floss or interdental brushes compared to toothbrushing alone may reduce gingivitis or plaque, or both, and interdental brushes may be more effective than floss. The evidence is low to very low‐certainty, and the effect sizes observed may not be clinically important.
Private equity affiliation among dentists increases: https://adanews.ada.org/ada-news/2024/august/private-equity-...
When Private Equity Firms Acquire Dental Practices, Patients Pay the Price: https://truthout.org/articles/when-private-equity-firms-acqu...
Dental offices acquired by private equity firms tended to shift from diagnostic and preventive procedures to generally higher reimbursement restorative, specialty, and surgical procedures: https://pubmed.ncbi.nlm.nih.gov/41367221/
The dentist office I went to switched my dentist, and suddenly, I had a cavity in almost every tooth, and he recommended drilling on the spot.
Went to a different dentist. As expected they said I do not have any cavities.
It's kind of interesting that nothing will happen as a result of that.
IMO this is a good litmus test for choosing a dentist.
A dentist with nuanced and honest judgment will identify questionable spots, probe them, ask you about your experience (“does it hurt”), and explain the difference between something to watch and when it is actually problematic.
A lazy dentist trying to make a buck will take a quick look and tell you that you have a bunch of cavities that need to be addressed now.
Just like software engineering, there’s always the guy who will recommend kubernetes for every problem, and then there’s the guy who says “ah yeah, you can just do this with a shell script until you need more”
If you live in the US you can report them to your state’s board of dentistry. Not sure how responsive they are in your particular state but in mine they take that stuff seriously.
At my last visit, the new doc who took care of me for my third cleaning said: "Oh, by the way, we have these cavities we've been watching that need filling." It was never mentioned to me that they were keeping an eye on anything. I just had to wonder if every patient's third visit calls for a filling!
I used to be very regular with dental visits, and have had an enormous amount of work done over the years. Then I went to my first PE owned dentist (by accident) and it was such a horrific experience I've basically avoided dentists since.
There used to be some reasonable balance between the dentist wanting to make money and wanting to build a secure custommer base/happy clients. PE dentists are just money extraction machines with little to no concern for how much pain is caused getting money out of your wallet.
(Just avoiding going to the dentist is pretty extreme tho - probably reasonable to get them looked at at least yearly?)
Same guy expects me to handle the pain of all four of my wisdom teeth being removed with literally one 12 pill vial of Vicodin. Acts like I'm doctor/pill shopping.
Reported him to my stats dental board, they get back to me with "well homeopathic remedies can't hurt you either, so we won't do anything to him!"
Dentists are the scum of reality, and their usage as traditional fronts for organized crime is done on purpose and as a trope in media it is sadly true.
Wage war on them as an economic group. They are almost as bad as chiropractors. Also a traditional occupation of corrupt state legislatures/senators.
Are narcotics normally required to handle that?
I also had my gallbladder out via laparoscopic surgery with the same as pain relief. It's possible we just don't feel pain the same.
Going every six months for a checkup is really nice, because thing rarely get out of hand (+ you have whiter teeth after cleaning, which is especially nice for tea addicts like me :)) and they x-ray every two years or so.
The only person you consult with is the doctor/surgeon, who has all the incentive to downplay the risks. Their benefit is both financial and ramping up their resume
Don't know how much effect it would have, but it should cut down the suspicion.
I don't think anything stops dentists from working like this today?