[HN Gopher] I went to 50 different dentists: almost all gave a d...
___________________________________________________________________
I went to 50 different dentists: almost all gave a different
diagnosis (2022)
Author : mgh2
Score : 495 points
Date : 2023-08-06 15:20 UTC (7 hours ago)
(HTM) web link (www.rd.com)
(TXT) w3m dump (www.rd.com)
| lacrimacida wrote:
| Just like car mechanics:)
| bluescrn wrote:
| If you take a car to a mechanic, the upper limit anyone will
| likely pay for repairs is the value of the car.
|
| If you take a human into the healthcare system, there is no
| upper limit.
| doubled112 wrote:
| A couple of my coworkers were paying up to the limit of their
| insurance and just leaving the rest.
|
| I think that's probably even worse.
| thedanbob wrote:
| If anyone is in my situation where you need dental work but can't
| afford it and have some time/availability, see if there's a
| dental college nearby that has a student care program. The one
| I'm going to is costing me about 40% of the quote I got from a
| regular dentist for the same work. (The downside is it takes a
| _lot_ longer.)
| esafak wrote:
| But don't sign up for any experimental procedures that they
| want to test on you. Also, be prepared for more pain since
| they're inexperienced.
| ustamills wrote:
| I know my comment is anecdotal but for me it's relevant.
|
| I'm 60 years old. Up until about 25 I just listened to dentists.
| They drill-and-fill and I went along. No longer. In 35 years I've
| had one problem. I broke a tooth biting on a hard seed in some
| Indian food. I got a crown for that. A few years later the crown
| came off. I haven't bothered getting it replaced.
|
| I don't have tooth pain. My teeth have not shifted. I still eat
| what I want. I'm careful with Indian food. :)
|
| My takeaway? I'm not seeing the dentist until I'm in pain or
| something breaks. No one is drilling on X-ray shadows again.
| wccrawford wrote:
| I felt the same way as you do, and didn't go in until I knew
| there was a problem... Turns out I had quite a few hidden
| cavities, and at least a couple were severe enough to be
| worried about. I found myself wishing I'd gone in at least once
| in a while for a checkup, even if I didn't actually get a
| cleaning. I'm sure I would have gotten occasional or regular
| cleanings as well, though, and I'd probably be better off for
| it.
|
| In short, I'd do it differently if I were doing it again. But I
| certainly would never take it to the level that most people do.
| shagie wrote:
| Setting aside the drilling on shadows...
|
| There are studies that link gum disease to dementia.
|
| https://www.nia.nih.gov/news/large-study-links-gum-disease-d...
|
| > The mouth is home to about 700 species of bacteria, including
| those that can cause periodontal (gum) disease. A recent
| analysis led by NIA scientists suggests that bacteria that
| cause gum disease are also associated with the development of
| Alzheimer's disease and related dementias, especially vascular
| dementia. The results were reported in the Journal of
| Alzheimer's Disease.
|
| Going to the dentist for cleaning may be a good thing for those
| with less than ideal dental hygiene habits - even if no
| suggestions of cavities are ever drilled.
| appplication wrote:
| I go for a cleaning at least twice a year even though I brush
| thoroughly. The dentist will always be able of clear out
| plaque you can't. That said, there might not be much reason
| to listen to them beyond that.
| lost_tourist wrote:
| Yeah no way you don't go to the dentist for 20 years and
| not have a few millimeter thick worth of plaque on plaque.
| I brush and floss before I go to bed and go to the dentist
| every 9 months. I haven't had a cavity since I was 15 and
| my sweet tooth kind of faded out after that for some
| reason.
| notdang wrote:
| Haven't we read here on HN that there are studies that coffe
| might help with dementia (or Alzheimer?), so they should
| level up.
| kowalej wrote:
| CBC Marketplace in Canada has done a couple similar assessments
| over the years where they have someone go to different dentists
| after an initial diagnosis by independent experts. They saw
| basically the same thing as this article, huge differences in
| opinions where clearly some practices were trying to scam money
| by doing unnecessary work. This is why I drive over an hour to
| visit my same dentist after moving house, they guy only does work
| if it is actually in my best interest.
| the-alchemist wrote:
| I know HN will have the answers if no one else will:
|
| Anyone have links to good studies (or even RCTs) about flossing,
| different kinds of toothpaste, etc.?
|
| I don't wanna open up the whole fluoride debate, but it seems
| _stannous_ fluoride is more effective than _sodium_ fluoride. The
| mouthwash I bought stained my teeth (can't find the link, but you
| had to dilute it with water. Something like [0]).
|
| I remember reading a study that pulling wisdom teeth was
| unnecessarily common. I can attest that, as the best dentist
| actually compared two X-rays six months apart to see whether they
| moved.
|
| P.S. Castle Dental is the worst. They quoted me for almost $3k
| worth of work! A second opinion told me I just needed a cleaning
| and maybe a filling.
|
| [0]: https://www.amazon.com/3M-ESPE-PerioMed-Stannous-
| Concentrate...
| dawnerd wrote:
| I switched to importing novamin based toothpaste from Canada
| and it's greatly improved my teeth. Used to be sensitive when
| chewing and it's all gone now until I run out and have to use
| normal toothpaste.
| zackmorris wrote:
| My dad was a dentist and I've never had a cavity. TBH any
| fluoride is fine, so other preventative care should take
| priority. The idea being that with proper technique, and
| barring other health conditions like dairy allergies, nobody
| should experience tooth decay. This is anecdotal, but ranked
| from highest to lowest (top 3-5 especially!), I'd say:
|
| * Brush teeth morning and night with any name brand fluoride
| toothpaste, replacing toothbrush often like every 6 months
|
| * Use a floss pick morning and night, and preferably on any gum
| pockets after meals, since cavities form where the tartar is,
| where the food sits, which can be revealed by using disclosing
| tablets periodically
|
| * Use a water pick morning and night
|
| * Get fluoride treatments from the dentist every 6 months until
| adulthood, after that is too late except as maintenance, but
| continue that schedule for checkups
|
| * Sleep with mouth closed at night using nasal strips and
| optionally taping mouth in an x-shape to not stretch philtrum,
| because dry mouth causes gum disease
|
| * Avoid sugar and foods like potato chips which stick to roots
| and cause tartar, or brush afterwards
|
| * Drink milk until adulthood and continue until intolerant,
| also eat leafy green vegetables and other high-calcium foods
|
| * Eat whole fresh firm foods which develop the jaw and teeth,
| especially in youth while still growing
|
| * Exercise, especially weights and athletic movements that
| exercise the face and jaw to promote development and encourage
| blood flow
|
| * Work on head/neck posture and sit upright in chair while
| working, since mouth breathing is caused by poor posture that
| narrows the throat's air supply, which causes dry mouth which
| leads to bad breath and tooth decay
|
| * Don't smoke and avoid excessive alcohol
|
| * Consider orthodontic treatment if bite is off, since once
| enamel is worn, it takes too long to redeposit before the tooth
| wears to the point of failure, but get multiple opinions and
| avoid all extractive dental work and/or headgear, since
| orofacial myofunctional exercises accomplish the same thing and
| can have better long-term results
| PaulHoule wrote:
| When I first went to Ithaca I went to a quack dentist who charged
| me a lot for unnecessary diagnostics. I did not see a dentist for
| two years, then I got a referral to my current dentist where the
| whole family gets a cleaning twice a year. My wife thinks the
| exam with the dentist after seeing the hygienist is a scam, I see
| the dentist only if there is evidence of a problem. In that time
| I got a referral to extract one of my rear teeth (could have
| gotten an implant but decided against it.). My dentist gave me
| recommendations for sensitive teeth (saltpeter toothpaste and an
| electric toothbrush which was cheap when I got one that uses
| rechargeable AA's) and a brace for tooth grinding which focalized
| my TMJ symptoms (shoulder, back, neck pain and headaches) to
| something which is somewhat annoying occasionally. I am
| satisfied.
|
| I hear though that a lot of dentists get into scams like Amway
| and Scientology.
| evmar wrote:
| (Wife is a dentist.) There are a lot of immoral people out
| there, but "see the dentist only if there is evidence of a
| problem" is a bad strategy.
|
| Tooth decay is a slow process and the treatments slowly ramp up
| in invasiveness: when it's minor you can use sealant (like
| painting over it), if it progresses you get a filling (with
| some minor drilling), if that progresses you get a root canal
| (drilling out the whole nerve and replacing the bulk of the
| tooth). You may only reach the threshold of feeling pain at the
| point of needing a root canal when it can be preventable
| earlier.
|
| (I do suspect hygienists are capable of spotting most of this
| but my impression is they're not licensed to diagnose.)
| bigmattystyles wrote:
| It was so jarring coming from France in the late 80s to the US
| and going to the dentist. In France, the dentist's office was one
| woman, was the dentist and ran her office (Scheduling, seeing
| patients, etc...) She had modified her house so she ran her
| practice from a wing of her house. It was modern at the time,
| sanitary and she was a very nice dentist, but no assistants or
| anything. It was very much 1 patient at a time, you waited in the
| waiting room. At the time, though I was a child, I don't remember
| cleanings being a thing, just an occasional visit (maybe every 2
| years for adults) or you went if something hurt. My family had
| means but we would still pay partially with mutuelle coupons
| everyone was given by the government. (Not sure how this works, I
| was young)
|
| Moved to the US in the early 90s, the dental practice in the US,
| holy moly! TVs with cartoons mounted to the ceiling, a bunch of
| staff from office workers dealing with insurance and scheduling
| to dental assistants. Then 1 or 2 dentist moving from patient to
| patient sequentially. It was a business first.
|
| I don't know what it's like in France now, this was in the north,
| in a traditionally not affluent area (though my family was by all
| standards affluent). Has it become more like the US now? I don't
| which one is best, I do know all my grandparents (who were not
| affluent) had full dentures by the time they were 60.
| Izkata wrote:
| > At the time, though I was a child, I don't remember cleanings
| being a thing
|
| Dentist cleanings are to remove tartar buildup, which even if
| it was a thing you may not have needed (depends on diet and how
| good you are at cleaning your own teeth).
| [deleted]
| glimshe wrote:
| Diagnostic from 2 dentists for me: 3 crowns vs no cavities. Just
| like every profession, doctors and dentists can be criminally
| immoral or incompetent.
| xchip wrote:
| make sense, they are very biased towards the treatment most
| expensive
| kwanbix wrote:
| What I don't understand is why dentist work is not better
| regulated and covered by health. I can get a heart operation
| covered but if I have to do an implant I have to pay for it. I
| mean, I understand if you charged me something as a punishment
| (lets say 100/200 dollars), but I don't get why is not covered.
| We can even make it an additional monthly payment or something.
| But it is crazy that there is no coverage for most things, as if
| one could go on with his life without teeth.
|
| Side Story: in my home country, Argentina, you can get national
| or imported screws/implants. The difference for doing one over
| the other is like 3 times. So let's say 500 dollars vs 1500
| dollars (those are not the actual number), but I am friendish
| with a dentist, and he told me that the actual difference between
| a national vs imported screen is no more than 50 dollars.
| OfSanguineFire wrote:
| Dental work beyond tooth extraction is generally not covered by
| health because it is viewed as a cosmetic procedure. From a
| purely health perspective, a person can go on with their lives
| without teeth by installing dentures, and millions of people do
| so.
| kwanbix wrote:
| But that is not the truth. The impact in your life if you
| lose a tooth, and you cannot replace it, is horrible.
| Mentally it could have much more impact that many things that
| are covered.
| rincebrain wrote:
| I can't speak to historically, but my understanding is
| currently, in the US, dental coverage was excluded from a lot
| of "this is insane, not allowed" provisions in the ACA as a
| compromise, so all the fun things you loved seeing go away in
| health insurance like lifetime maximums on coverage are still
| around.
| delfinom wrote:
| >What I don't understand is why dentist work is not better
| regulated and covered by health.
|
| If you read into the history, it's because the doctors of the
| past didn't consider dentistry to be a real field (basically
| considered it more cosmetic), so the early pioneers of
| dentistry profession formed their own club.
|
| And now that there's so much money in keeping the peasant
| bloodsucking machine known as healthcare going in the US,
| nobody is going to alter it to even include dentistry. For fear
| of losing out money.
| zeroonetwothree wrote:
| Wouldn't covering it more just exacerbate the problem of
| overcharging and doing unnecessary work? Not sure this really
| helps.
|
| The real problem is that dentists business model assumes they
| will do a lot of restorative work but people's dental health
| has improved so it's far less necessary than before.
| kwanbix wrote:
| You should justify the need and you can be audited.
|
| Also, I do a tooth cleaning, 1 hour work, 100 euros. I do an
| implant, also 3 hours of work. 1800 euros. What is the
| reason?
|
| Wouldn't make more sense to do 10 implants at 800 than do 1
| or 2 at 1800? I don't get it.
|
| One of the dentists I used to go told me that he was no
| longer doing implants because people won't pay for them. Of
| course!
|
| If it is a full minimum salary for 3/6 hour of work. Charge
| something reasonable and people would do it.
|
| We are in 2023, a dental implant can no longer be considered
| a luxury. It is crazy.
| alainchabat wrote:
| My initial Invisalign treatment consisted of approximately 30
| trays (invisible aligners) for a total of $5,000, covering all
| expenses. However, after completing the 30th aligner, my dentist
| determined that I required additional aligners. Today,
| approaching my 45th aligner, but it didn't incur any additional
| charges for the extra aligners. I'm curious about the reason
| behind not having to pay more.
|
| During each monthly visit, the dentist evaluates my progress by
| conducting scans (done by the intern) and occasionally cleaning
| my teeth. The process was quite straightforward, and appears to
| be much simpler compared to making adjustments for traditional
| braces.
|
| I'm interested in finding real cost for Invisalign trays and what
| share get the dentist
| Aeolun wrote:
| Why does this say 2022 when the original article is claimed to be
| from 1997? That kind of makes a difference.
| abeppu wrote:
| I'm guessing this can't happen for institutional reasons, but
| given that dentists are using x-rays + cameras, and apparently
| even sending people home with copies of images, is there room for
| a standardized ML-based "check" which could help catch cases
| where individual dentists are recommending something well outside
| some consensus/standards of care? If everyone could easily check
| their images against the same bot, and pool information, one
| could identify dentists who regularly recommend unnecessary work.
| Or we could normalize the idea of getting the exam done by
| dentist A, and getting the work done by some other undisclosed
| dentist B, so they're not incentivized to give bogus
| recommendations?
| seventytwo wrote:
| This article is originally published in 1997, btw.
| Invictus0 wrote:
| (1997)
| throwawaysleep wrote:
| I asked my dentist about this (someone who has never done any
| major work on me despite 20+ years of the option to do so) and he
| said that insurance reimbursements are such that you need to do X
| amount of work per Y patients to make money.
|
| With him, I pay a 50% premium on the regular dentistry, well
| above what insurance will pay. Worth it, but makes sense.
| baby wrote:
| My experience with dentists in France has always been good, but
| as I moved to the US I noticed that suddenly I was having
| cavities, suddenly floss was important (when studies say that
| they don't add any value), suddenly I had to take X-rays every 6
| months, suddenly I was being pushed on doing aesthetic changes,
| suddenly I was seeing insane bills that had no connection with
| the service I was getting.
|
| I'm convinced that regulators should take a look at
| (ortho)dentists in the US, it's one of the most scammy group of
| people.
|
| Also, I'm so happy that invisalign is being disrupted by all
| these online companies like
| SmileDirectClub/Byte/NewSmile/Candid/etc. It's literally the
| exact same service but you'll find plenty of FUD online about it.
| Can't wait for invisalign to die.
| i_like_apis wrote:
| I have always agreed with Vinod Khosla about doctors. Much of
| what they do today should be replaced by AI.
|
| My own opinion: their arrogance is the most offensive part of the
| situation. There are plenty of great doctors and surgeons out
| there, don't get me wrong. But the majority seem to think they
| are a superior species.
| dclowd9901 wrote:
| No doubt an artifact of their cult like educational experience.
| The whole system should be uprooted.
| ravenstine wrote:
| There's a lot of perverse incentives baked into dentistry. This
| is true of allopathic medicine was well, though I think it can be
| more difficult for someone to dispute a diagnosis from a dentist;
| who are you to say that little dot on your X-ray isn't serious
| enough to be drilled? It wouldn't surprise me if there are many
| fill-n-drill dentists out there. I knew people whose oral hygiene
| and diets were far worse than mine and yet they almost never were
| told they had cavities, and then there were those who ate
| properly who have had root canals and crowns.
|
| In my experience, and in my own opinion, the industry of
| dentistry would be nowhere near as necessary as it currently is
| if people largely gave up consuming too much carbohydrates and
| sugar, which feed the bacteria that are ultimately the root cause
| of tooth decay. Acidification of saliva is of course an issue as
| well, but I think the whole "drinking cola will rot your teeth"
| thing is an exaggeration and a sort of red herring. It's not the
| soda per se, or so much the acidity of carbonated water, but the
| fact that you're feeding bacteria which colonize in the crevices
| and pores of your teeth, forming biofilm, creating isolated
| pockets of acid that wear holes in teeth. If it was all about
| exogenous acid, then the entire tooth would be rotting evenly,
| but that's usually not what you see.
|
| My teeth aren't perfect. In fact, there's some decay that I've
| let sit there for nearly two decades now. Ever since I cut sugar
| from my regular diet, any caries I had either reversed (when
| extremely early) or stopped progressing. I do plan on seeing a
| dentist soon to actually address the decay, because it's silly to
| leave it there, but I'm confident that I otherwise stopped it in
| its tracks. My gums don't bleed, and I've seen no meaningful
| changes to my teeth in all that time. If my hypothesis is
| correct, then there's a real conundrum because the most
| affordable food available to people also tends to promote more
| tooth decay; dentistry largely exists to compensate for the fact
| that the cheapest available energy for humans comes with negative
| side effects.
| pests wrote:
| I had a rough life when I was younger. I went to the dentist
| maybe 7-10 years ago and they told me they wanted to pull over
| 10 teeth. Probably closer to 14. I was shocked and shaken. They
| were even talking dentures. I couldn't believe I was going to
| be basically toothless. I never went back and it ored dentistry
| for years.
|
| I just switched dentists last week. One cavity and they want to
| fix an old crown.
|
| I never had one of those teeth pulled.
| manmal wrote:
| Having had 4 root canals (even though not consuming much
| sugar), I got kinda obsessed over oral health and looked for
| options beyond brushing multiple times a day and flossing. In
| case anyone's interested, here are some, ordered descendingly
| by perceived helpfulness:
|
| - Vitamins K2 and D3 halted further decay it seems. For a few
| years I took only those and things plateaued mostly (but not
| entirely).
|
| - Chewable digestive enzymes - not much research on this, but
| eg bromelain destroys biofilm, exposing pathogens to other
| interventions. This eliminated sensitive gums and remaining
| pains quickly for me.
|
| - Oral probiotic chewables (Salivarius K12) every now and then
| reduced the occasional pain in root canals. I also slept
| better, probably because they reduced throat swelling too.
|
| - Intranasal pathogen interventions (nasal rinse with NAC, tea
| tree oil etc) and L. Sakei colonization were actually meant to
| improve nasal breathing (they did), but also helped oral
| health.
|
| - Organic silica (liquid MMST in my case, but chOSA should work
| too) - has made my enamel look more solid.
|
| - Tooth paste (chewable actually) containing baking soda,
| reducing acidity. This helped reduce pain greatly when one of
| the root canals got inflamed.
|
| Oh and really do take care of inflamed root canals. Those are a
| major health risk. Look into getting the roots cut off and
| sealed - it's gruesome but could save the tooth with relatively
| low cost.
| dctoedt wrote:
| Never ask a barber if you need a haircut.
| esafak wrote:
| So whom would you ask if you need oral surgery if not a
| dentist?
| jbrowning wrote:
| > This article originally ran in the February 1997 issue of
| Reader's Digest.
| phyzome wrote:
| Tangential anecdote: I needed a crown some years ago, and did
| some research on what materials to go with. It turns out gold is
| more biocompatible, safer for the opposing tooth, and will last
| something like twice as long. It's not much more expensive, even
| as the price of gold increases.
|
| But the first dentist I talked to wanted to do some kind of
| ceramic, and didn't even suggest gold. The second one, I said I
| wanted gold, and he seemed relieved, saying that was the far
| better choice, but that he basically never brings it up any more
| because it has gone out of style.
|
| ...it really bothers me that neither of them would have mentioned
| the safer, superior, more durable option even as just that, an
| option. :-X
|
| I wonder if this might be an interesting litmus test.
| intrasight wrote:
| I went to 50 different software engineers: Almost all give a
| different refactor suggestion.
| rsync wrote:
| Some easy heuristics that will save you:
|
| - shower curtains instead of glass doors: subpar airbnb
|
| - Kikkoman soy sauce: probably not the best sushi
|
| - teeth whitening services: dentist not optimizing for dental
| health
|
| The problem is that _they all push teeth whitening_ ... but it 's
| a strong signal if you find one that doesn't.
| LegitShady wrote:
| Free whitening kit with your cleaning!
|
| means they're charging you enough for both in the fees.
| soared wrote:
| Isnt kikkoman one of the only mainstream brands that makes soy
| sauce the traditional way?
| Ekaros wrote:
| I probably don't agree with Kikkoman one. Maybe with sushi, but
| other Chinese food here it is more premium brand. Many others
| are cheaper and worse.
| freitzkriesler2 wrote:
| Man I had a really serious overbite as a kid and had a lot of
| orthodontia work done. I'm obsessive with my teeth now because of
| it. I'm also the child of doctors and coincidentally, when you're
| the child of medical professionals, other medical professionals
| treat you very very well.
|
| I had stellar dentists up until I moved to a new city and had my
| first experience with a bad dentist. Never again.
|
| Now I'm old enough to know better and here's my advice: brush and
| floss once a day before bed. Don't eat anything after you do so.
| If you want to get rid of "morning mouth", rinse your mouth using
| diluted hydrogen peroxide. Put a very gentle amount of pressure
| on the teeth using the brush. You don't need to scrub them.
|
| If you can get a descaling from a dentist, take advantage of it.
| Ask the hygienist to use a local numbing agent on your teeth
| before cleaning (the gel not the injection). They'll know what
| this is. It makes the descaling far less painful and sort of
| pleasant.
|
| When it comes to procedures like crowns or wisdom teeth, only
| deal with it if there is pain. I had my wisdom teeth removed and
| I disagree that it was medically necessary. They would have come
| in normally.
|
| And if you know a medical professional, ask them who their doctor
| is and then ask that doctor who their dentist/doctor/eye
| doctor/etc is. Go to the medical professional other medical
| professionals go to if your insurance allows for it.
|
| Good luck fellow HN friends.
| unshavedyak wrote:
| > I had stellar dentists up until I moved to a new city and had
| my first experience with a bad dentist. Never again.
|
| Is the only way to determine a bad dentist by going to many? I
| am in need of _lots_ of work, but the thought of going to a ton
| of car-salesman-esque "medical professionals" to pick the
| correct one .. is terrifying.
| cudgy wrote:
| The above advice seems sound. Find out who your doctor(s) use
| as their dentist. Ask other people too like neighbors,
| coworkers, and friends. Google Reviews can be helpful in some
| cases like when there are a reasonable number of reviews from
| legitimate looking reviewers.
|
| Be wary of pushy dentists that are unwilling to treat you
| unless you agree to their "plan". I once was told by a
| dentist as a new patient that they would not perform a
| standard cleaning until they could do a more extensive, more
| expensive, not covered by insurance cleaning. Immediately
| left that office and found another dentist. Turns out I did
| not need that cleaning.
| avodonosov wrote:
| I believe for a long time already, that for any serious medical
| question it's better to hear at least 3 doctors.
|
| Visited several dentists recently, all gave me different
| diagnosis and recommendations. My mother also visited four
| dentists recently, all gave her different recommendations.
|
| When I say different, there is overlap between them. But also a
| significant difference.
|
| That's not only dentists. I have several examples in my family
| when non-dentist doctors give directly opposite opinions.
|
| Also a well known fact: surgeons always recommend to cut.
| mildavw wrote:
| I have a good friend who is a hygienist for two dentists. One is
| completely inept and the other an outright scammer.
|
| The inept guy generates business by doing such a poor job with
| fillings that crowns and root canals are always eventually
| needed. And he does such a poor job with those that bridges and
| implants are then needed. He's a master bullshitter and most
| patients trust him (a few catch on, and a few have sued). My
| friend keeps records for the lawsuits, covers her own butt, and
| discreetly encourages some patients to go elsewhere.
|
| The fraudster puts everyone on "perio" schedules (cleanings every
| 3 months instead of 6) whether they need it or not. And also
| bills insurance for treatment he didn't do. His actual dental
| skills are decent, however.
|
| We laypeople assume we can trust these "experts" with degrees and
| white coats when we really have no clue if what they're doing is
| legit.
|
| Next time you get your teeth cleaned, ask the hygienist if they
| themselves (or their family -- kids, parents) use the dentist
| you're about to see. My friends says that this is the question
| with the most valuable answer. She wouldn't let either guy within
| 100 miles of her teeth or her kids' and will happily tell people
| where she goes if they ask.
|
| This is assuming the hygienist isn't crooked too. In the US,
| hygienists are typically paid hourly but with "production"
| bonuses, meaning they get a cut of the dentists fees for
| treatment beyond cleaning. So beware that they're incentivized to
| do more treatment than necessary too. In my friend's case, the
| bonuses are a small %, so it's not a huge incentive.
|
| She stays because they pay well, give her the hours she needs as
| a single mom, and likes her co-workers. But the patient care and
| outcomes do take moral toll on her.
| rossdavidh wrote:
| At the very end of the article: "This article originally ran in
| the February 1997 issue of Reader's Digest."
|
| Surely this should be noted in the HN title?
| csomar wrote:
| I am guessing today the prognosis will be different and all
| dentists will give him the same diagnosis. The sub-title will
| be
|
| > From all dentists, I got a quote of $29,850!
| mortenjorck wrote:
| Wow, seeing this headline brought back a faint memory of
| reading a similar story in a Reader's Digest at my
| grandparents' house decades ago. Apparently it's the same
| story!
| MattRix wrote:
| Hah, that explains why all the quoted prices seem low compared
| to what they are now.
| mingus88 wrote:
| I caught that too...after I had already shared this with my
| wife
|
| But it still feels relevant. I had a dentist that wanted to
| drill cavities out with every visit, regardless of how often I
| flossed and brushed
|
| Been to four dentists since and haven't been told anything bad
| at all. There absolutely still exist dentists who are cashing
| in on us.
| appplication wrote:
| I used to be told I had cavities all the time when I was
| younger, despite religious brushing. Since moving elsewhere,
| no cavities ever. I did have one dentist who insisted on
| redoing almost all of these fillings (~8-10 over a few
| visits). I now rarely stick with the same dentist for long,
| oftentimes it's clear they have some upsell. One recently
| tried to convince me I'm grinding my teeth At night. Having
| had multiple sleep studies done that have not noted this, and
| no other dentists corroborating this opinion, it's clear it's
| just a way to sell their fancy laser-fit mouth guards.
| danbmil99 wrote:
| That would explain the absurdly low cost for a crown. I just
| wish I could pay $500 for a decent crown but they're more like
| $1500 to $2,000
| tedunangst wrote:
| Oh, I thought somebody repeated the experiment. I remember this
| was a classic article.
| constantly wrote:
| Oh wow thanks for posting this. I read this and was thinking "I
| feel like deja vu from an article I was reading in a physical
| copy of RD from like 20 years ago" but the bottom seemed to
| indicate it was originally posted in 2020.
| [deleted]
| verisimi wrote:
| Dentistry has improved in leaps and bounds since 1997 - as the
| monetary incentive to over-prescribe treatments has now gone,
| right? /s
| rossdavidh wrote:
| Yeah, agreed, I totally don't believe this problem has gone
| away. In fact, it is still a noteworthy article for the very
| reason that it was 26 years ago but sounds like it could have
| happened yesterday. But, it should be noted in the HN title.
| superkuh wrote:
| The current trend is for the remaining independent dentist
| (vets, pharmcies, etc) practices to be bought up by
| international private equity and enshittified.
| jbgreer wrote:
| I note that one of the few dentists he mentions by name as
| providing a diagnosis consistent with his panel and a
| reasonable estimate is still practicing: Dr. Henry Wah in
| Marion, AR, apparently still has a good reputation and has been
| joined by other family members: https://wahfamilydentistry.com/
| kevinmchugh wrote:
| Another read on dental overdiagnosis and outright fraud:
|
| https://www.theatlantic.com/magazine/archive/2019/05/the-tro...
| jzl wrote:
| Beat me to it. This is a superb article and I highly recommend
| that everyone read it in full.
| pragmatic8 wrote:
| The dental and vision "care" industry is rife with fraudsters to
| the extent that they are more akin to rackets.
| CommieBobDole wrote:
| I've posted this before, but I went to a new dentist one time and
| though I'd never had a cavity, the new dentist said I had nine,
| some of which were pretty bad and needed immediate treatment lest
| they require a root canal. I didn't have any money or dental
| insurance at the time, so I didn't go back and just worried about
| it a lot for a while.
|
| That was twenty-five years ago. Haven't been to a dentist since.
| My teeth are fine, and always have been.
|
| Funny story about the 'no cavities' thing - when I was maybe 12 I
| went to a new dentist who found a cavity in a molar, drilled it
| out, and filled it with some sort of 'invisible' polymer filling
| and charged a whole bunch of money for it. Next dentist I went
| to, I mentioned the cavity and he said nobody had drilled on the
| tooth and there was no sign of a cavity or a filling of any type
| there.
|
| Some years later, I was reading somewhere online and found out
| that the dentist who "filled" the "cavity" was a subscriber to a
| dental practice management program run by the Church of
| Scientology that, in part, taught that it was OK to rip off
| patients who weren't Scientologists. A few years after that, the
| dentist got arrested for molesting children and is probably still
| in prison.
| pedalpete wrote:
| Similar experience with an extra twist.
|
| I hadn't been to a dentist in 10 years, not even for a
| cleaning. I chipped tooth and went in to get it fixed.
|
| The dentist tried to upsell me on a ton of things that needed
| to be looked at.
|
| Never once mentioned that it looked like I hadn't had a
| cleaning in a while.
|
| I got my tooth fixed (just a bit of bonding), never had any of
| the other work he recommended done.
|
| I went to a new dentist a few months ago because I was starting
| to get some sensitivity and exposure at a gum, which I thought
| was really bad. He said it wasn't a big deal, fixed it up, but
| then says he wants to cap all of my teeth!
|
| Happy to be reading this and think I'll wait on getting any
| more work.
| leoqa wrote:
| I had a similar experience, got up sold on more frequent
| cleanings and they always found something to iterate on. I took
| their offer once to fill a "potential infection" and then
| recognized the pattern. They probably legitimately think the
| tooth may decay further - it probably won't and you probably
| don't need pre-emptive correction but they make more money and
| "fix" the problem for you so they may not see the ethical
| issue.
| danieldk wrote:
| Frequent cleanings are nice though. As an avid tea drinker
| it's nice to have white teeth again once or twice a year. The
| insurance covers most of the cost, so -\\_(tsu)_/-.
| lost_tourist wrote:
| once or twice isn't "frequent" in the USA. I'd guess you're
| in another country? Most Dentists here say 2 times a year.
| I had one who suggested every 4 months and I refused. I go
| every 9 months now, to split the difference between 6 and
| 12
| danieldk wrote:
| We go twice a year (NL). But we also lived in Germany for
| a while where it was once a year and they wouldn't do the
| extra polishing/whitening unless you paid a lot extra.
| But I think for a long time you also had to pay extra in
| Germany to get white composite filling, insurance would
| only cover amalgam fillings.
| stevehawk wrote:
| well.. "twice a year".. but your insurance policy
| probably says 1 every 181 days.. just to rob you of the
| actual twice a year.. #america
| pb7 wrote:
| There are 365.25 days in a year so insurance policy is
| quite generous in fact.
| phonon wrote:
| Ummm...a year is longer than 2 x 181 days...so what is
| being robbed exactly?
| kortilla wrote:
| The comment was actually a critique of the US education
| system :)
| brewdad wrote:
| It is just another "gotcha". Oh you wanted to do your
| visit the week before vacation rather than when you get
| back? Sorry, that was only 179 days between visits, so
| your coverage is denied.
| strokirk wrote:
| Wow. In Sweden, "frequent" would be every second year.
| kccqzy wrote:
| What? My dentist told me teeth whitening is not part of
| regular cleaning, and I'd pay extra for whitening.
|
| I also drink a lot of tea and coffee, and unless I pay
| extra, I don't get any whitening.
| delfinom wrote:
| They are referring to the fact that drinking tea often
| stains your teeth and pretty easily. Black teas are heavy
| in tannins which do all of the staining.
|
| I found that getting the fluoride paste applied at the
| end of each cleaning actually helps reduce the tea
| staining. (My teeth used to stain pretty bad)
| brewdad wrote:
| My hygienist recommended the Crest 3D White toothpaste to
| help with my staining. I've been using it for about nine
| months now . I didn't solve things completely but my
| teeth definitely look better and my last visit was at
| least ten minutes shorter.
| programmertote wrote:
| Same thing. I am always good with flossing twice a day,
| brushing teeth twice a day (in fact, I spend ~10 mins brushing
| teeth gently and carefully every day). But the dentist in SF I
| visited 10 years ago "saw" 4 cavities and he showed me the
| X-rays, which I didn't know better I should have looked at
| carefully. But I got 4 fillings. Credit to him, those fillings
| never had any issue for the last 10+ years.
|
| But I went to a new dentist in FL a few months ago, and that
| guy told me to refill them because according to him, they are
| starting to crack (not sure how he saw them in grainy X-rays;
| he tried to show me one, but I couldn't see it) :D Anyway, I
| agreed to have them refilled since it's been a while and the
| cost was reasonable. Now one of the fillings he redid in my
| molar makes me feel uncomfortable when I chew things with it.
|
| I wrote up a more detailed experience about this in another
| comment in this post. I hope people see it and learn from it to
| not trust their dentists easily (esp. the ones you are visiting
| for the first time).
| istjohn wrote:
| If you tell them it makes you uncomfortable when you chew,
| they will probably grind down the filling for you at no
| charge--at least mine did.
| 2-718-281-828 wrote:
| the dental elephant in the room is that our body can heal
| cavities to some extent. especially if you change your dental
| hygiene and diet. (also your dentist might have tried to scam
| you, of course)
| hinkley wrote:
| There's a process that is approved in Europe but not in the
| US last I looked. Involves UV light (or was it ozone?) and a
| bag over your tooth full of intense fluorine to first kill
| the cavity and then remineralize it. No drill.
| peteradio wrote:
| Nuh uh! - your dentist probably
| hinkley wrote:
| Are you me? Was this dentist in Fremont, WA?
|
| I finally found a good dentist, but it was after I chipped one
| during the pandemic. It was never was done right in the first
| place, or the second place when I had it fixed. Lost that tooth
| unfortunately.
|
| But after ten years with no dentistry, I had only one other
| cavity, and of course some light gingivitis. They did not have
| an idea I hadn't been for over ten years.
|
| I had great insurance at the time, and I was so shocked that I
| didn't get a second opinion. After many years of retrospect, I
| have deep fissures which I got sealed years ago, and I suspect
| this hack saw shadows and assumed cavity instead of looking,
| because almost of the cavities she found were in the molars.
|
| If the news is awful always get several opinions. One person
| may know better ways to handle it.
| JeremyNT wrote:
| To back this up, I used to go to the dentist regularly as a
| child. I got the regular cleaning and such until I went to
| college and had to pay for things myself. I didn't have any
| dental insurance so I stopped going around then.
|
| Maybe 10 years later, after countless people warning me that I
| was gambling with my health by never going to a dentist, I
| thought I'd try again. I went to the local university dental
| school, where they need problems to work on.
|
| They told me I was totally fine.
|
| I haven't been to a dentist in the maybe 15 years since that
| experience. It turns out there is almost no evidence to support
| routine cleanings or consulting with a dentist.
|
| HN anecdotal data is not medical advice - but if you aren't
| suffering from any dental issues, it could be worth your time
| to do some research before you schedule your next dental
| appointment, and if you get a diagnosis of an issue it might be
| worth a second opinion. I highly recommend checking to see if
| your local dental school is taking appointments, because they
| have no incentive to push additional procedures on you (they
| can always find somebody who really needs it).
| somenameforme wrote:
| It's so weird, as I had a very near identical experience. I
| went through a cursory checkup then they sat me in some waiting
| room with a video on all sorts of dental diseases, apparently
| all of which I had. They needed to drill out some half dozen
| cavities, carry out a root canal, and I cannot even remember
| all what else. I noped out without even asking for a quote, and
| started skipping my annual exams.
|
| Some 20 years later I finally went to a dentist again, in a
| developing country no less, because I had a visible cavity - my
| first ever. It was quite scary given the elapsed time. $15
| dollars, and about as many minutes, later all was said and
| done, with no other issues present.
| Traubenfuchs wrote:
| Went to a new dentist after moving. She found two "small spots
| that could go bad if left untreated!" and "should be drilled
| and filled!". A year later I am still in pain some time.
|
| Dentists are fucking psychopaths and we are literally cattle at
| their mercy. I have no idea how to continue, how to find a
| dentist I can trust with my stupid teeth. I am terribly afraid
| of them now.
| voisin wrote:
| Did you have the work done? I suspect you should go to a
| different dentist based on reviews from people you know.
|
| Also, try oil pulling and get some good higher end
| toothpaste. I had some sensitivity and after doing both
| everything is great.
| hinkley wrote:
| God the heat and cold sensitivities from that crank's
| fillings bugged me for ten years before they settled down.
| delfinom wrote:
| Find a dentist that'll actually do x-rays and show you the
| cavity on them. Mine does that. The cavities show pretty
| relatively easily on x-rays because the tooth density is
| compromised.
|
| If you are in pain, they either damaged the nerve which is
| bad as that could require a root canal eventually. Or they
| failed to clean out the cavity and it's infected. Either way,
| you should experiment with finding a dentist, perhaps go in
| for a cleaning every 6 months to check a dentist out.
|
| At not point are you obligated to do a cavity filling unless
| you are comfortable with it. Just decline any additional
| services beyond the cleaning.
| Traubenfuchs wrote:
| Yeah next time I will get a second opinion. My old family
| dentist said everything was fine after I went back to her,
| so I don't think there is infection, also, my CRP is very
| low.
| taocoyote wrote:
| Similar experience but I was in the military and I didn't have
| a choice to say no. I have 5 fillings. They wanted to schedule
| 2 more but I was due to be reassigned overseas. They tried to
| delay my reassignment over it. Eventually, they cleared my
| paperwork but made it clear I was to see the dentist at my new
| base as soon as possible.
|
| My new dentist says there is nothing wrong with my teeth
| whatsoever.
| j45 wrote:
| What's the saying.. At every meeting something is sold, either
| a reason why you're buying, or a reason why you're not buying.
| quitit wrote:
| No one becomes a dentist because they're keen to pull shards of
| chalk-soft teeth from senior's mouths or enjoy dealing with the
| scent of rot from infection. It's a career for the money and
| it's rather easy to find dentists which are optimising for
| that.
|
| In medicine you treat the patient, not the picture. If your
| teeth seem fine, they probably are fine.
|
| You will always hear a lot of differing opinions about this
| from health care professionals and there are of course
| exceptions, but exceptions are exceptions. You must keep in
| mind that HCPs are people that see a disproportionate number of
| very unwell people and they are not immune to bias.
|
| Because of this bias, a common phrase in medicine is if you
| hear hooves, think horses, not zebras. It's a way of saying
| that most symptoms you see will be from ordinary ailments. I
| can think of too many cases where patients went through
| needless testing and anxiety only to eventually discover that
| it was all for nothing.
| pcurve wrote:
| Some of these dentists should either have their license revoked
| or prosecuted for malpractice. I can believe what I just read.
| rthfnbbgedfgery wrote:
| (Throwaway account)
|
| I can only say, avoid dental chains at all costs and only go to
| trusted dentist owned clinics if possible.
|
| I'm from EU and I got a yearly review + professional cleaning in
| a chain for my first job more than 15 years ago. The first time I
| used it they diagnosed me 4 or 5 caries that needed treatment,
| they said it was just a "beginning" but that it should be treated
| soon.
|
| I ignored it and left it untreated for 1 year. My family never
| had problems with caries and before that time I was going to a
| public dentist who never identified any problem.
|
| Next year I used the professional cleaning again but I went to a
| different clinic. They identified again 4 caries but in
| completely different teeth! Since that day I don-t trust any
| dentist that need an insurance to get patients or is managed by a
| profit-oriented chain. Note that in my country a lot of dentists
| don't work with insurance but that might not be the case in other
| places.
|
| It's not like the dentists shouldn't earn good money, but they
| the ones that have their own clinic earn more than enough to not
| have to scam their patients. And even these can be greedy, but at
| least they are not pushed by a manager with monthly goals, so the
| chances are lower.
|
| Fast-forward I met my now wife who is actually a dentist. 10
| years later after my fake 5 caries she didn't find any.
|
| When she finished her studies, she had to work for a few chains
| as well. What she saw there is terrifying.
|
| The 1st job she was fired after 4 days because she was asking for
| autoclave sterilized material for every patient. First they tried
| to push back saying that ultrasound and chemical was enough, but
| she was having any of it.
|
| Later the same week, she had a family with 3 kids, and she also
| requested sterilized tools for each of the 5 patients. They were
| telling her that sharing tools with the same family is totally
| fine. She was ready to leave the job the next day but they were
| faster and fired her. I guess she was starting to raise ideas to
| the young assistants.
|
| After that she still worked in a few more places before she could
| find the right family owned clinic first and later start her own
| clinic.
|
| During this period, she saw multiple malpractices and the
| authorities are not checking anything until somebody is badly
| hurt: Non-graduated dentists doing full-licensed dentist
| procedures, low quality materials and tools from Aliexpress that
| shouldn't be used for any medical procedure, patients coming from
| other clinics where after checking the history of x-rays she
| could see the dentist "planted" the root canal treatment
| (difficult to 100% proof of course), dentists invoicing for
| things that they didn't really do, and the list goes on...
|
| Just please, be very careful when choosing your dentist. Some
| people can save tons of money and a lot of teeth if they have a
| knowledgeable and honest dentist.
| iamapot wrote:
| Are you from Portugal? Can your recommend a good dentist in
| Lisbon?
| m3kw9 wrote:
| Dentist can overtreat/under treat/aggressive/conservative(let's
| not drill that cavity if we don't have to). All depend their
| hungryness for money or morals. Some dentist can remove teeth for
| the smallest thing which could be borderline valid, but they get
| paid much more than saving the teeth
| shipscode wrote:
| There's a reason that the dentistry model is Drill, Fill, and
| Bill.
| prepend wrote:
| This is the one place I like insurance because it at least gives
| some cost conscious perspective to proposed procedures.
|
| My insurance sucks but at least it's useful that insurance
| considers optional what my dentist says is essential. For
| example, my dentist only does tooth colored fillings and my
| insurance doesn't cover them. My dentist says the covered ones
| are unsafe.
|
| It's a weird situation. My last dentist said I needed an
| "emergency crown" because my tooth would shatter at any moment.
| It was $3000. My insurance covered $600. The dentist said it was
| because my insurance was terrible.
|
| Another dentist said the crown was optional and would cost $1800.
| That's almost a 100% price difference.
|
| And my most recent dentist says I don't need a crown at all and
| it's been two years since the "emergency."
|
| I'm not sure what's going on, but of course it's impossible to
| compare prices when choosing dentists and I don't trust new
| dentists at all.
| pryelluw wrote:
| It's at the point where I'm saving up to get my dental work in
| Mexico or Colombia. There's no point of doing it in the states.
| I paid $6k for one implant. Ridiculous.
| packetlost wrote:
| The thing about teeth and crowns is, it's fine until it isn't.
| I've actually had a molar collapse while eating almonds. It's
| honestly more traumatic than you'd think. Anyways, as a result
| I did a bunch of research and it turns out that crowns are
| important for reducing further damage to the root. A split down
| the the root is it for a tooth, and prosthetics are not a great
| replacement. My dentist gave me a price breakdown between
| extraction or root canal and crown both as valid options. Just
| because they say it's optional doesn't mean they're trying to
| price gouge you (though clearly the former was).
| prepend wrote:
| I understand how crowns work.
|
| My issue is that one dentist thought it was an emergency and
| it obviously isn't. It's not the optionality, it's that one
| said it was not optional.
|
| And that one dentist charged $3000 and one $1800. And they
| don't have options. That is the only price they charge.
| danieldk wrote:
| Hmpf, this is probably in the US? I always got the composite
| filling and it cost me almost nothing. The insurance pays most
| of it and the cost is not that high anyway.
|
| We all go to the dentist every 6 months, let them do whatever
| they need to do (a good cleaning every visit, X-Ray every two
| years), etc. And it doesn't cost a lot.
|
| (Western Europe)
| karaterobot wrote:
| > Others wanted ten, 20, even 50 times that amount.
|
| I am excited to see an article using AP style. Maybe it's because
| it's from 1997, back when there were copy editors.
| morningsam wrote:
| Rule of thumb from my anecdotal experience: If the dentist's
| office looks all fancy and feng-shui, they're usually the kind
| that does pointless work (which is where the money for the fancy
| office comes from). You can't turn this around and say that any
| dentist with a humble office will be honest and only do what's
| necessary, but the likelihood is higher.
| imperfect_light wrote:
| It's because in many of these fields (medical, dentistry etc)
| professionals are making decisions based on intuition and what
| they learned in school (which may or may not considered accurate
| anymore).
|
| They should be consulting a formal decision tree based on latest
| research, but many doctors consider that to be insulting, much
| like they pushed back on check lists when they first became a
| thing.
| bluescrn wrote:
| 'While you've got good insurance, we can upgrade all your teeth
| now, before they get bad'?
|
| There may be stereotypes about the British having bad teeth, but
| I've never had a dentist try to milk my wallet like that despite
| a poor diet having done a fair bit of damage over the years.
|
| Dentistry here seems much more about doing the minimum necessary
| work to save teeth and relieve pain. The thought of getting
| crowns done en-masse is terrifying, I've only had one done, and
| it wasn't a fun experience - it's something I see as a last
| resort to save a tooth, certainly not something I'd want to go
| through for cosmetic improvements.
| unshavedyak wrote:
| > I've only had one done, and it wasn't a fun experience - it's
| something I see as a last resort to save a tooth, certainly not
| something I'd want to go through for cosmetic improvements.
|
| What was "unfun" about it? I'm familiar with what they are, but
| not the pain-points (in the non-literal sense lol) of getting
| them.
| bluescrn wrote:
| In my case, it was just discomfort rather than pain, the
| worst bit was having a metal 'temporary crown' that
| felt/tasted uncomfortable and wouldn't stay in place over the
| mostly-drilled-away tooth for a week or more while the crown
| was being manufactured. And I couldn't stop myself from
| constantly probing it with my tongue. (This was over a decade
| ago, maybe the process is quicker, or they have better
| temporary crowns?)
|
| But the tooth had had a root canal done some years before the
| crown, so there was no nerve to cause pain when/after much of
| the tooth was drilled away to prepare for the crown. Not sure
| what the process is if the tooth is healthier/more sensitive
| to begin with.
|
| End result is good though. Just not something I'd choose to
| go through it if was mostly cosmetic rather than to save a
| tooth.
| doubled112 wrote:
| For me at least, I've had freezing fail many times.
|
| Once they begin, I believe you're pretty much stuck there
| until the dentist is done, and that's a lot of drilling.
|
| Not looking forward to ever needing anything like that.
| ttymck wrote:
| What is freezing? Anesthetic?
| doubled112 wrote:
| Yes
| [deleted]
| [deleted]
| electrondood wrote:
| I've never had cavities. No problems. Went to a new dentist and
| they told me I had two, and needed fillings. Went back to my
| usual dentist and they said there was some slight enamel erosion,
| but that I didn't need fillings.
|
| This article is right on the money.
| Waterluvian wrote:
| My son when 3 had a fall and a few teeth were bent. Went to our
| local dentist who mostly had a wait and see opinion. But then
| calls a day later and says they've decided they should just come
| out. Two top front teeth. Would have no top front teeth for
| years.
|
| I went into engineer mode and while I acknowledged I didn't have
| domain expertise, I asked questions and probed the whole
| situation. Very unsatisfactory, meandering answers.
|
| This was a deeply distressing experience. For the first time ever
| I did the "call in a personal favour" thing and asked my dad to
| reach out a family friend, a former cosmetic dentist and former
| head of the province's dental association for a second opinion.
|
| He saw my son a few hours later and he was just _livid_ about the
| diagnosis. That it was possible they'd have to come out but it's
| impossible to know this for at least a few more weeks or more.
|
| In a few months the teeth returned 100% to normal and firmed
| right up as the ligaments healed.
|
| I'm not a conspiracy nut. I believe in listening to experts (but
| ultimately making an informed decision). I believe in modern
| medicine. But that experience shook me and forever changed my
| trust in the dental industry.
|
| My feeling is that the nature of dentistry leaves a lot of room
| for subjectivity and COVID left a lot of dental chairs empty.
| gitfan86 wrote:
| 90% of dentistry revenue is a scam.
|
| But at the same time it is very important to brush you teeth
| twice a day and floss weekly. You should also avoid sugary food
| as much as possible.
|
| Dentistry is much like Realtors, they like to take credit for
| very little actual work.
|
| "If I'm not here to confirm people are brushing regularly
| everyone would lose all their teeth"
|
| "I'm so glad I could sell your house for 500k. Without me you
| may have never sold it"
| ballenf wrote:
| The sugary foods advice is true if you're talking about
| refined sugars, but I recall a study showing that raisins,
| e.g., are much better than refined flour in terms of damage
| to teeth. Despite having much higher sugar content.
|
| Here's an article about the study:
| https://nutritionfacts.org/blog/raisins-and-dental-health/
| jzawodn wrote:
| You know what flour turns into very, very quickly in you
| digestive system?
|
| Sugar.
| eropple wrote:
| The comment was about teeth, though, and flour/meal _is_
| abrasive, though. Not to the degree it was in prehistoric
| times--dental health went to hell during the transition
| to sedentarism, thought mostly to be due to milling
| introducing rocks etc. to the meal--but, setting aside
| that both are nutritionally probably not great, it stands
| to reason that the stuff mentioned in that blog post
| (mostly grain-derived) have more ways to stick to the
| surface of teeth and hang around to mess up mouth pH.
| benjaminwootton wrote:
| Surely floss daily should be the advice? It only takes an
| extra minute when you are brushing so there's no reason not
| to.
| jnwatson wrote:
| For the same reason you don't brush 10 times a day. It
| isn't significantly more effective than once a week and we
| all have better things to do.
| the-alchemist wrote:
| Was wondering if you knew any RCTs or solid studies...
| ProjectArcturis wrote:
| Dentistry in general seems averse to doing RCTs.
| smallerfish wrote:
| > floss weekly
|
| For me daily makes a big difference. If I leave it until
| weekly my gums will start to suffer for it.
|
| I use the little floss picks, as they're much easier to
| manage for me than floss, and - here's something - they're
| reusable. Rinse them off like you would your toothbrush and
| you can keep those suckers going for a long time. You can
| also get them made from bio-plastic, so that they'll degrade
| once they go to landfill.
| yikes_42069 wrote:
| Do you get those ones that are thinner than normal floss?
| Because it won't be as effective if so. Tried the Listerine
| ones but I'm curious which brand you get that has
| bioplastic
| smallerfish wrote:
| This is not the brand, but they look a lot like this.
| https://www.amazon.com/Natural-Dental-Floss-
| Picks-200/dp/B08...
|
| The double string ones are really good, as they catch a
| lot of gunk in the gap between them.
| kypro wrote:
| The same is true for healthcare generally in my experience.
| Very bad advice is often given.
|
| I can't really common about the US, but here in the UK the
| quality of healthcare is shocking bad. Although we may have the
| opposite problem, where instead of doing unnecessary procedures
| to increase costs, the NHS generally tries to avoid doing
| anything unless you're dying.
|
| I had some pain in my abdomen a few years back and had
| persistently elevated liver enzymes. My doctor told
| continuously told me not worry about it and would say the pain
| was probably because I was sitting funny and other nonsense. In
| their opinion I was too young to have liver problems so there
| was no point in doing any further tests.
|
| Fed up, I decided to do my own research and pay for my own
| tests. From this I found out that I have a fairly rare generic
| condition which makes me highly predisposed to liver disease
| and NAFLD. Certainly not the end of the world, but it pissed me
| off a bit because the disease could have progressed had I taken
| their advice and simply ignored it.
|
| Around this time I also had a family friend who was the same
| age as me. She went to the doctors repeatedly over the course
| of a year describing several symptoms she was experiencing just
| to be dismissed. Turns out she actually had cervical cancer,
| but they never ran any tests and kept telling her it was
| probably nothing to worry about. By the time she found out she
| had cancer it was stage four and she died a few weeks later.
| She was 28 and had two kids.
|
| Like you I believe in listening to experts. Most experts know
| what they're talking about and generally give good advice, but
| it's important to keep in mind the conditions experts operate
| in. Here in the UK the NHS has neither the time or money to
| give you high quality healthcare. It doesn't really matter if
| you see the best doctor in the world, if they can't spent the
| time and money running the tests you need you're not going to
| get a good diagnosis.
| basisword wrote:
| >> It doesn't really matter if you see the best doctor in the
| world, if they can't spent the time and money running the
| tests you need you're not going to get a good diagnosis.
|
| Everyone in the UK should get to experience a private
| consultation just once. The difference between the rushed
| 10mins you get with the NHS and the considered 30mins you get
| private is amazing. You leave feeling like you've been taken
| care of and all your questions have been answered. It's only
| when you see this you can see just how bad the quality of
| care in the NHS is at the moment. We need to stop equating
| the NHS with the people that work for it and start calling it
| out for how god awful it is. We've made it a dirty that can't
| be criticised properly when it sorely needs to be.
| pablobaz wrote:
| >The difference between the rushed 10mins you get with the
| NHS and the considered 30mins you get private is amazing.
| You leave feeling like you've been taken care of and all
| your questions have been answered.
|
| This is true for fairly simple cases. But when something is
| complex or very serious you want a true multidisciplinary
| team that sees the most cases per annum - that is the NHS.
|
| A private consultant in a nice office with a very nice
| efficient secretary is great for their particular expertise
| but outside of that poor. This is based on more experience
| personally and with family than I would wish anyone to
| have.
| noelwelsh wrote:
| I believe the NHS is seriously under-funded, the Tory
| government is responsible, and healthcare is suffering as a
| result.
|
| However, I do want to provide an anecdote to illustrate
| that private healthcare is not perfect. I had some
| persistent pain in my foot. Realized I wouldn't get
| anywhere with the NHS so I went private. The person I saw
| had an excellent manner. They suggested some fairly gnarly
| surgery. Said I should think about it and in the meantime
| they gave me an anti-inflammatory injection. My problem
| cleared up in about two weeks. What was wrong: I have
| really really wide feet (seriously; they are wider than the
| widest setting on the foot measuring device they use at
| shoe shops.) I didn't know this. I was wearing Chuck
| Taylors, which are very narrow, and they were pinching my
| feet. I didn't wear my Chucks over the two weeks and I
| figured out what was wrong in that time. What I learned:
| everyone has a toolbox they want to reach into. In this
| case I was seen by a surgeon so they of course turned to
| surgery as solution. Always be your own advocate, to the
| best of your ability, in healthcare. (I thought the surgeon
| might have said something about the width of my feet given
| they spent so much time looking at feet.)
| actionfromafar wrote:
| These feet looked like the nicest weekend ever, probably.
| (To the surgeon.)
| segh wrote:
| As a percentage of GDP, the UK has the 6th highest
| healthcare spending of OECD countries, on par with
| Switzerland. The UK is not an outlier in terms of
| spending.
|
| https://stats.oecd.org/Index.aspx?DataSetCode=SHA
| iancmceachern wrote:
| >The same is true for healthcare generally in my experience.
| Very bad advice is often given.
|
| I have seen this in my personal life time and again. I have
| seen it in my professional life time and again.
|
| The only way though the mine field is to take personal
| ownership over your Healthcare, you need to learn more about
| what ailes you than the doctors know. You need to be
| confident in this knowledge enough to challenge them and walk
| out to receive better care at any moment. This is why people
| say that healthcare us such a trap in the US particularly. If
| you are injured and incapacitated you can't advocate for
| yourself, and if you don't have the support infrastructure in
| place in your personal life we are just one medical event
| away from financial and physical ruin.
| User23 wrote:
| This is true for every kind of professional including
| realtors, lawyers, and financial advisors, just to name a
| few. At the end of the day everyone you hire is just doing
| a job, and it's on you to learn enough to know that they
| are doing it to your satisfaction.
| tonyarkles wrote:
| [Canadian here, for context]
|
| > The only way though the mine field is to take personal
| ownership over your Healthcare
|
| Shortly after graduating from university, when I no longer
| had access to student health, I started hunting for a
| regular family physician. The guy I found... my first
| "let's get to know each other/annual physical" kind of
| appointment he said "Look, I don't know if you noticed but
| there are a lot of people out in the waiting room. My staff
| here is great, but things happen. Maybe they call you with
| test results and you miss the voicemail. Maybe the lab
| forgets to send the results. Maybe the fax from the lab
| gets stuck to another piece of paper. We're all human here,
| and I try really hard to treat each one of my patients as a
| real human and not just a list of symptoms on a page. If
| I'm going to be your doctor, there's only one thing I ask:
| be your own advocate. If you're expecting to hear back from
| us and you don't, or if you feel like we've missed
| something, or you have questions, or... anything really,
| please don't hesitate to follow up. I promise I'm going to
| do my best to look after your health, but you care about it
| more than anyone else in the world. Does that work for
| you?"
|
| He was, by far, the best damned doctor I've ever had. And
| then, apparently, one day he had a serious family emergency
| back home and vanished, never to return :(.
| samtho wrote:
| > From this I found out that I have a fairly rare generic
| condition which makes me highly predisposed to liver disease
| and NAFLD. Certainly not the end of the world, but it pissed
| me off a bit because the disease could have progressed had I
| taken their advice and simply ignored it.
|
| I was diagnosed after a blood test (in the US) but they just
| put me on a statin (high cholesterol medication) that fixed
| only what the blood test showed and did not treat the
| problem. Now I'm having to, with 10 fewer years than when
| learned it, drastically adjust my life and diet to ensure I
| won't develop additional complications.
|
| Why are we so hilariously bad at treating chronic problems?
|
| Btw through generic genealogy, I've managed to pinpoint which
| branch of my family that this comes from and they're all from
| Yorkshire. Given how rare it is, there is a nonzero chance we
| are cousins of some sort if you have semi-recent ancestral
| origins there.
| esafak wrote:
| Statins reduce cholesterol production. What were you hoping
| for?
| liamconnell wrote:
| I lived in Argentina for a few years. There are plenty of
| problems with their public healthcare system that pretty much
| mirror any country with a troubled economy, but one day a
| work colleague recommended I visit the Favoloro Institute.
| I've never seen such an impressive healthcare organization in
| my life.
|
| They time their appointments ever 2 minutes so you're
| expected to arrive early. Once you start, they wiz you around
| to about a dozen tests including getting hooked up to
| electrodes while running on a treadmill. After less than an
| hour you see a doctor who goes through everything for about
| 15 very detailed and thoughtful minutes.
|
| The entire thing is FREE! Completely publicly funded.
|
| I don't know much about healthcare but this type of thing
| always struck me as a missing apparatus of healthcare in the
| US. Although apparently Favoloro (who invented some kind of
| bypass surgery) founded the Institute after being inspired by
| the Cleveland Clinic.
|
| Would love to hear other people's thoughts on this because I
| tell that story all the time!
| culiao wrote:
| Interesting. I too lived abroad in argentina for a few
| years... the healthcare there is actually pretty
| impressive. I had my tonsils removed, I had a crown put on
| my molar, dermatolgist appointments, etc. Even a podatrist
| and custom orthotics... From now on... anything major - I
| am flying back to get things done.
|
| USA healthcare system burns me out.
| gochi wrote:
| That sounds like what private clinics offer around here,
| certainly not for free, but they tend to perform an
| onslaught of tests.
|
| I don't know how effective it is, and how much of it is
| theater.
| 2-718-281-828 wrote:
| > I'm not a conspiracy nut
|
| where would be the conspiracy in your experience anyway?
|
| > But that experience shook me and forever changed my trust in
| the dental industry.
|
| don't trust any industry. industry is always about making money
| and keeping a comfortable status quo. sometimes this is
| achieved through conspiracies.
| basisword wrote:
| >> I'm not a conspiracy nut. I believe in listening to experts
| (but ultimately making an informed decision). I believe in
| modern medicine. But that experience shook me and forever
| changed my trust in the dental industry.
|
| Ask anybody who's experienced a "chronic" illness about the
| "experts" and they'll tell you a tale or two. The experts are
| great until they have a case that is unusual. The don't have
| the time or knowledge to treat you properly. You get passed
| from "expert" to "expert" each time having your hopes dashed.
| You start feeling like a conspiracy nut chatting with other
| patients online sharing what's anecdotally helped. After
| running into this issue more than once I've lost all blind
| trust in medical experts. I'll verify what they tell me as best
| I can and get second opinions if necessary. In one case I was
| passed up the chain of experts until I finally found the right
| one myself after a year, and it still blows my mind that this
| wasn't the first referral. The system is at the same time
| incredible and awful.
| mapt wrote:
| House, MD was a fictional show on how the medical system is
| supposed to work, with abundant detective work and testing of
| hypotheses and pursuing a solution until one is found.
|
| On the other hand, from the administrator's perspective:
|
| "Your team of four people treat about one patient a week, why
| am I paying your salaries again?"
|
| In our universe, I probably won't receive that much medical
| care in my lifetime.
| cancerhacker wrote:
| If you ever get cancer... Maybe it's just that I lucked
| into getting the most aggressive oncologists, but on more
| than one occasion I was sent to get an MRI or CT on the
| spur of the moment. There were times when it was scheduled
| out as well - but along the lines of "come back in six
| months; we'll schedule the CT for the week before".
|
| (But I know I was lucky - my oncologist could order a river
| to reverse itself and it probably would.)
| tomcam wrote:
| Your profile and your user name seem to imply you've
| changed the direction of your career? Glad you're alive,
| by the way.
| jasonwatkinspdx wrote:
| This is very true. I had a SO with severe chronic gastric
| pain and they got passed around by doctors for years. One
| jerk wrote "drug seeking behavior" into her file and that
| made things even worse. Finally someone took her seriously,
| got imagery done, and discovered surgery was necessary.
|
| In US healthcare you have to be your own advocate and be
| willing to push. The system breaks down if you don't have a
| routine and obvious illness.
| smsm42 wrote:
| It's not specific to the US. It's the problem of doctors
| seeing every particular patient for literally minutes and
| having zero incentive to dig deeper. 90% of the problems
| are of the nature that is either covered by standard
| remedies or will pass by itself with time. If you have one
| of the 10%, you need to have good luck to encounter an
| extra-ordinary doctor that would take personal interest in
| your problem, usually while all incentives point to "give
| the standard answer and move on" behavior.
| kortilla wrote:
| >extra-ordinary
|
| It's just "extraordinary".
| TheOtherHobbes wrote:
| I once had extended work done at a dentist. It took a few
| hours, some of which involved sitting around and waiting
| for things to happen.
|
| It gave me a new perspective on that kind of work. From
| my/our point of view, I was the most important person in
| the room and my problems really really matter.
|
| From the doctor or dentists POV, I'm one a long long list
| of people they're seeing that day. It's a health care
| production line, and even if they have the inclination to
| be equally caring about everyone - which is a rare
| quality, because a good medical professionals are only in
| it for the money - they just don't have the time.
|
| This is not an excuse unprofessional behaviour. But it
| made me realise that self-advocacy works because you're
| asking - maybe demanding - more than the production line
| gives you by default.
|
| Also, medicine is incredibly complicated. And the
| research is often very low quality.
|
| And that's not taking into account Big Pharma trying to
| tout its products, whether or not they're suitable or
| effective.
|
| The most depressing thing recently has been the
| professional response to Covid. In the UK countless
| doctors have aggressively given up masking, even in
| settings with immunocompromised patients.
|
| It's really made it obvious that some doctors are just in
| it for the money, a good few are phoning it in,
| surprisingly many have quite irrational beliefs, and the
| caring expert professionals are much rarer than they
| should be.
| webmobdev wrote:
| That sounds very much like someone I know. She had pain in
| her stomach that doctors in the US just refused to examine
| in depth. One prescribed her pain-killers and another
| steroid. She asked more tests but they declined. Her father
| is a doctor in India and when she finally told him (after a
| few months of suffering) about her ordeal, he asked her to
| come immediately to India. After some reluctance, she flew
| down, and the first thing they did after reviewing her
| reports was a simple ultrasound. They discovered a tumour
| in her stomach. Operated and removed it and luckily it was
| not cancerous. The irony is that when her father asked her
| to come down to India, she refused initially arguing that
| the US was at the forefront of medical science in the
| world. She now understands that doctors matter too. (And
| unfortunately doctor behaviour in the US is very much
| influenced by insurance provider policies).
| Etrnl_President wrote:
| Now imagine doing this on Canadian healthcare, having to
| wait months or years for each appointment, and nowadays
| they try to talk you into MAID to save resources...
| littlestymaar wrote:
| Favorably comparing the US health system to the Canadian
| one is an interesting take indeed...
| momirlan wrote:
| Absolutely true, and that is if you even have a family
| doctor to refer you to a specialist. For those who had
| the luck to lose their family doctor (mine through
| retirement), it is impossible to find one that takes new
| patients. Many retired during covid, many more only work
| part time. The Canadian health care is a disaster at this
| point, and those who have a family doctor have no clue
| how awful this is.
| smsm42 wrote:
| In the US it's not easy to find a primary care provider
| also. When we moved couple of years ago and called a
| local medical center to establish a primary care
| provider, we were given answers like "we have the nearest
| appointments in 6-8 months". If you have something
| urgent, there's telemedicine line where you can talk to
| advice nurse or if there's something really urgent, get
| an appointment with an urgent care doctor. But all
| primary care providers seem to be booked solid for
| months. And given how many patients they'd have and how
| often they see each one, establishing any kind of
| personal care relationship is out of the question. How
| personal can it be if you can see you doctor twice a year
| for 20 minutes? I think the only solution is go get rich
| enough so you can afford personal concierge doctors or
| however it is called (no idea since I'm not rich enough).
| mynameishere wrote:
| _rich enough so you can afford personal concierge_
|
| A few minutes research suggests it's not that expensive.
| (As little as ~2000/year).
| 20after4 wrote:
| For most people, that's expensive.
| wredue wrote:
| This is not true.
|
| I mean, the wait times sometimes are, but they vary by
| province. More conservative provinces have worse wait
| times. That is not surprising given that the provincial
| conservative government are all actively attempting to
| sabotage public healthcare so we can move to an American
| style system. A system where we will all pay more, and
| still see similar wait times anyway.
|
| MAID is not actively proposed as a way to save resources.
| jasonwatkinspdx wrote:
| Yeah that's a hyperbolic exaggeration.
| mikeyouse wrote:
| I know HN is a privileged place but people should
| recognize that the "worst case" of Canadian/European
| healthcare wait times is already the reality for many if
| not most Americans.. You shouldn't base your
| understanding of American health care on personal
| experience if you work for a big company that provides a
| nice health insurance plan.
| ROTMetro wrote:
| I have jank government insurance and this is not true.
| When I got out of prison and had no insurance I went to
| the city's clinics. Wait times have never been an issue
| (at most was two weeks for specialist). The doctors in
| the clinic were also friggin amazing doctors/people. I
| had a ton of shame around getting out of prison, some
| much shame about needing to get tests ran for HIV/Hep
| from being in prison but they were so good about it all
| (all came out negative so woohoo).
|
| Now dentists...when we had money we went to a family
| friend. He still totally f'd us and did unnecessary work.
| It's only now that I have a cash only country dentist
| that I trust my dentist again. Crazy part is the cash
| only dentist ends up being cheaper than my previous
| copay/premiums insurance dentists.
| tyg13 wrote:
| I'm always surprised when people leave comments like
| these, based on nothing but N=1 anecdata. You don't have
| any authority to say something like "this is not true"
| with regards to the whole of the American healthcare
| experience. Compared to my own personal experience, yours
| was uncommonly-good. Wait times for specialists for my
| SO's heart condition are routinely several months out.
| zdragnar wrote:
| What this demonstrates is that wait times are widely
| variable by specialty and region. Arguments like "for
| most Americans" are wrong on their face, because most
| Americans don't live in the same area or have the same
| issues.
|
| My wife and I have both had to see various specialists.
| Some had very long wait times, many didn't, and of those
| that did, we were (fortunately) able to call around to
| different clinics to find one that wasn't too bad.
| formerly_proven wrote:
| > In US healthcare you have to be your own advocate and be
| willing to push. The system breaks down if you don't have a
| routine and obvious illness.
|
| 100% the same thing on this side of the pond, US healthcare
| isn't special here.
| danielfoster wrote:
| How is this problem specific to the US? I live in Germany
| and hear exactly the same problem of needing to be your own
| advocate in northern Europe.
| emerongi wrote:
| Also in Europe and most doctors just want to get you out
| of the office. I've met only a few doctors who actually
| care and will work with you to figure out the issue. The
| equivalent in software engineering would be waiting for
| my client to tell me what line to change in what file.
|
| To be fair, doctors are usually overworked and on a human
| level I understand that the system is a bit broken, but
| it's still infuriating when it's your health that is
| suffering.
| NovaDudely wrote:
| The internal term is "Treat and street". Get them out on
| the street as quick as possible .
| colordrops wrote:
| This whole fear of being labeled a "conspiracy nut" for
| exploring less trodden paths needs to end. Calling people
| conspiracy nuts for looking behind curtains they shouldn't
| was a good tactic by various entities to cover up secrets and
| misdeeds, but it has spilled over into the non political
| arena and poisoned everything.
|
| Humans don't have a full understanding of everything, and in
| fact it's quite the opposite, in that we don't understand
| almost everything. Almost all paths are untrodden. It's fine
| to look where others haven't and come up with your own
| theories and ideas, as long as you retain a healthy
| skepticism and back things up with data as much as you can.
|
| Science and exploration should not use fear of social
| reprisal as a guide.
| ryandrake wrote:
| I'm torn about this now. I used to cautiously support the
| practice of double checking your doc, but not
| wholeheartedly because of all the various quacks: essential
| oil moms, natural/spiritual healers, psychics, supplement
| sellers, crystal therapists, "old school" (pre-COVID)
| antivaxers and so on, muddying the water.
|
| Until COVID came around and unearthed the absolute hoards
| of dO yOuR oWn ReSeArCh imbeciles. Now the sensible
| practice of getting a second opinion and exploring other
| options/doctors has been mixed up with the kooks: extreme
| politics and actual conspiracy theories, to the point where
| it's hard to take any of it seriously.
|
| When someone now says they don't trust doctors, you have to
| dig deeper to understand if it's someone genuinely seeking
| out other options, or if it's one of Those People who've
| gone off the deep end.
| felipeerias wrote:
| The pandemic revealed the degree to which any respectable
| field can harbour extremely dangerous kookery without
| realising it.
|
| For example, Western health authorities used to be
| absolutely certain that viruses could not be airborne
| (outside of very specific medical procedures), even
| though they did not have any good reason or evidence to
| back that up: it was just an old idea that happened to
| fit in with their priors, so generations of experts kept
| parroting it until horror unfolded.
| wredue wrote:
| The earth is not 6000 years old
|
| God didn't do it
|
| Gravity is the curvature of spacetime
|
| Things are not attracted to the planet through static
| electricity
|
| Covid is real
|
| Vaccines work
|
| Rich mother fuckers do NOT have our best interests at heart
|
| Intelligent aliens have not visited earth
|
| People are called conspiracy nuts for being conspiracy
| nuts. Not for "taking less trodden paths". Getting real
| tired of the HNs new "wahh wahh, we're such major victims
| for believing stupid shit and being called out on it!" And
| just trying to paint it as "less trodden paths".
| colordrops wrote:
| You are arguing with a straw man. Nothing in my post
| suggested support for any of those things. That's why I
| included the terms skepticism and data.
| wredue wrote:
| [flagged]
| lannisterstark wrote:
| Not OP, but if you have nothing to contribute but
| vitriol, maybe do not comment, and move on.
| chrismarlow9 wrote:
| Same experience here. My analysis is it's a money milking
| scheme between groups of doctors. Pass you around so everyone
| gets a cut and they cross refer people to scratch each
| other's backs. Surgeon refers you to pain management and pain
| management refers you to surgeon. Add in a physical
| therapist, testing facility, and chiropractor and you got a
| pretty lucrative meshnet of referrals going.
| darkerside wrote:
| Hanlons razor
| maeil wrote:
| While this might happen, it's certainly a tiny minority of
| cases. In most cases it's just too big of an ego to admit
| that they really don't know, and not willing (private
| practice) or unable to (employed by a big hospital) spend
| the large amount of time needed to raise the chance of
| finding the cause from 0% to maybe 2%.
|
| Truth is that modern medicine still knows much less than is
| often assumed, let alone individual doctors. There's an
| absurd amount of potential for LLMs here.
| newaccount74 wrote:
| I was with you until the last sentence:
|
| > There's an absurd amount of potential for LLMs here.
|
| The problem is not that doctors are stupid, the problem
| is that a lot of ailments are just not easily diagnosed.
| Even if the doctor has one (or more) suspicions what the
| red rash on your skin is, there just aren't any tests for
| many conditions. Many diseases are only diagnosed by
| symptoms and the underlying cause is unknown.
|
| And even if you get a diagnosis, there is often nothing
| you can do.
|
| LLMs are not going to magically come up with cures.
| mapt wrote:
| > Even if the doctor has one (or more) suspicions what
| the red rash on your skin is, there just aren't any tests
| for many conditions.
|
| There aren't any tests that the doctor has on hand,
| because the doctor is a unit in the medical system
| designed to provision affordable care instead of a
| scientist attempting to cure you. It would be too
| expensive to test you, especially for something that will
| probably go away on its own.
| palata wrote:
| Is LLM the new web3, where people just keep throwing it
| as a solution for every problem they encounter? Seems
| like it... Maybe soon they will throw LK-99 at every
| problem?
| arolihas wrote:
| LK-99 is already on the blockchain
|
| https://coinbrain.com/coins/bnb-0xb131f5e8ec273af4652eecd
| d87...
|
| This will change everything
| Retric wrote:
| People always default to whatever the new thing is being
| somewhat magical. Radiation as a medical cure all didn't
| age particularly well, but it's not like the same people
| are falling into the trap. It's been common across many
| generations and cultures, I doubt it's going to change
| any time soon.
| Etrnl_President wrote:
| Read HIPAA when you get the chance; Specifically how to
| calculate cost.
|
| Everyone who talks to the patient, who touches them, and
| who is consulted by the doctor, gets to charge. Yup, that
| means if another doctor happens to walk by, and confirms
| what he just told me, he gets to charge me again (double).
|
| Feels like theatre every time I go to the doctor, so I just
| tell the secretary "I'm talking to you and Doc, no one
| else", and just quietly stare at anyone else who pops in.
|
| Usually insurance covers this stuff, but I was uninsured
| when I discovered it .
| basisword wrote:
| Tbf in my case this was NHS so no money to be made by
| referrals afaik. It mostly seems to be a lack of up-to date
| knowledge paired with a reluctance to take the initiative
| and research the latest information for a specific case. As
| a substitute they refer you up the chain where the same
| problem also exists.
| wizofaus wrote:
| > NHS so no money to be made by referrals afaik
|
| I wouldn't assume that - just because the money isn't
| coming from your pocket directly, it's inevitable there
| are doctors that milk the system. But you'd think
| bureaucrats whose job it is to assess the legitimacy of
| requests to the NHS (or equivalent institution in your
| own country) for payment might be harder to swindle than
| your typical patient.
| ransom1538 wrote:
| "The experts are great until they have a case that is
| unusual. "
|
| I was so pissed by this I created a way to find experts.
| People that actually studied the issue, have actual publish
| papers on the topic. What I found was no one cared. No one
| wanted "experts" - they want a specialist that is in their
| network and close.
|
| Example of searching for mohs surgury. https://www.opendoctor
| .io/research/?research_papers=mohs&zip...
| ambicapter wrote:
| If this is in the US it would make sense that people are
| really bound by their insurance provider as to who they are
| allowed to see cheaply.
| basisword wrote:
| Interesting service, thanks for sharing. I think most
| people are looking for their GP to be able to refer them to
| the correct specialist which seems fair. It shouldn't be on
| the patient to try to find them. But good website
| nonetheless! (FYI it doesn't display great on mobile Safari
| - content too wide so there is horizontal scrolling).
| atlas_hugged wrote:
| Wow this is awesome. You should post this as it's own show
| HN thingy.
| jcborro wrote:
| This is great, thank you.
| x86x87 wrote:
| 1000% they have optimized for the things that they see often
| and most of the times they don't even consider what else
| could be going on (even if they maybe know about it).
| Ultimately it's on you to understand what they are saying and
| to decide if what they're saying makes sense. When in doubt
| you should never ever be afraid to ask for a 2nd, 3rd, 4th
| and so on opinion.
|
| Don't even get me started on diseases where we have
| medication that sort of works with tons of side effect where
| no significant progress has been made for decades. If you're
| alergic to the said medication or your side effects make it a
| no go, tough luck!
| svara wrote:
| > I'm not a conspiracy nut. I believe in listening to experts
| (but ultimately making an informed decision). I believe in
| modern medicine. But that experience shook me and forever
| changed my trust in the dental industry.
|
| To be fair, in your story the "former head of the province's
| dental association" apparently did know his craft, indicating
| that competence is rewarded in dentistry also...
|
| There are a lot of doctors and dentists, and as in any field,
| mastership of a profession is rare. So you did the obvious and
| correct thing of finding someone more competent when you had
| doubts.
|
| That would honestly have reinforced my trust in medicine more
| than do the opposite...
| lowkey wrote:
| > I'm not a conspiracy nut
|
| I think that term has lost all meaning. A more appropriate term
| for someone who no longer blindly trusts expert consensus
| without question is an inquisitive skeptic who takes in expert
| opinions and applies reason, judgement, analysis and data to
| determine a course of action.
|
| It's becoming more and more recognized that expert consensus
| has become highly politicized and that the problem with blindly
| following the science is that science often follows the money.
| NullPrefix wrote:
| >For the first time ever I did the "call in a personal favour"
| thing and asked my dad to reach out a family friend, a former
| cosmetic dentist and former head of the province's dental
| association for a second opinion.
|
| Why aren't you using connections on a daily basis to get
| reliable services?
| xyzelement wrote:
| Good for you figuring this out. I always point out to my wife
| that an expert with a financial benefit in the advice they are
| giving you is potentially more dangerous than an amateur.
|
| If you are a dentist, "more dentistry" is likely to resonate
| with them as a solution, especially if that means they charge
| for doing the work. No different than if you ask a software
| developer if you should hire them to automate some process. A
| true pro may say "nah it's not worth it for you" but that's
| rare...
|
| It's fashionable to dunk on folks who "do their own research"
| but I admire that more than those who are proud of
| unquestionably taking direction from vested parties.
| Al-Khwarizmi wrote:
| _> I always point out to my wife that an expert with a
| financial benefit in the advice they are giving you is
| potentially more dangerous than an amateur._
|
| Indeed. In my country we have a public healthcare system. I
| also have private insurance, which I use sometimes because
| you can get consultations and tests much faster; but I
| wouldn't do anything invasive with the private insurance
| before getting an opinion from a public doctor first. The
| incentives aren't well aligned in private healthcare. For me,
| the combo (trust diganoses from the public system more, but
| use private when convenient) seems to work well.
|
| Public healthcare doesn't cover dentists, though, and to be
| honest, from other people's experience, I don't trust them
| much. I haven't visited one in over 20 years, and so far I
| haven't experienced pain or any other annoying symptoms other
| than some slight gum bleeding once per year or so which seems
| to resolve by itself by brushing and flossing more thoroughly
| than normal for a few days. I know it's risky and this may
| come to bite me later. Fingers crossed.
| Waterluvian wrote:
| I think the "do your own research" label conflates two
| categories: people who are shopping for a comforting answer,
| and people who want to be informed and make conscious
| decisions. I don't have to be a dental expert to know that
| something isn't adding up and to seek a second opinion.
| steveBK123 wrote:
| It strikes me as unfortunate that for a lot of things like
| home repairs/renovations its pretty normal to get 3+
| different opinions/bids.. but for our health its usually
| your regular doctor, and at most a 2nd opinion in some
| cases.
|
| We'll make life changing decisions based on the
| opinion/advice of 1 individual, while shopping around on a
| home project or car repair that's +/- $5k.
|
| It seems again like a combination of shortage of medical
| workers and the indirect nature of medical payment. If I
| knew up front that walking in and getting 3 medical
| opinions would cost me X, and I didn't need any pre-
| approval from insurance, or risk denials.. I'd just go do
| it more. But the system is so opaque that I don't know I
| can get those answers readily, or believe the numbers are
| real and won't result in random bills later.
|
| Further, the next step after figuring out the cost of
| getting options would then e getting a quote for the actual
| resulting medical care recommends is opaque due to
| differing payment %s & co-pays by procedure, etc.
| bombcar wrote:
| My go-to question isn't "should I do X" but more like
| "would you do X if this was you" - with good providers it
| gets closer to the heart of the matter.
| pathartl wrote:
| Something your comment overlooked is the overall
| availability and the required timeline for something
| health related is usually quite different than home
| maintenance or car troubles.
|
| I had a really bad sprain about two years ago to the
| point where my partner had to help me on and off the
| toilet. Eventually I took off work, went to urgent care,
| and paid $200 for them to basically say "well it's not
| broken, we could do an MRI otherwise we don't know what
| you want us to do". Booking an appointment with a GP
| would have taken around a month. They won't be able to do
| anything long term but will recommend a physical
| therapist. All said and done it's probably a $5-10k
| ordeal and weeks until I could actually see any progress,
| plus work time missed. Big surprise, I didn't actually
| end up going to see a doctor. Recovery sucked and some
| movements still aren't quite right.
| tyrfing wrote:
| In an ideal world, what would you say should have
| happened?
| ryandrake wrote:
| > Further, the next step after figuring out the cost of
| getting options would then e getting a quote for the
| actual resulting medical care recommends is opaque due to
| differing payment %s & co-pays by procedure, etc.
|
| There's nothing more quintessentially American than "not
| knowing how much you are going to pay for something until
| you owe it." You go for a hospital visit and nobody has
| even a remote, order-of-magnitude idea of what you are
| going to pay. But you have to sign a doc right away that
| says "you agree to pay whatever number we eventually come
| up with!" And then you slowly get dozens of bills from
| individual doctors and hospital workers over the next 4
| months. It's absurd.
| hunson_abadeer wrote:
| I think it's easy to come up with such delineation after
| the fact, but OP _was_ looking for a more comforting
| answer. By the sound of it, they just didn 't like the
| implications of the initial diagnosis. It wasn't about
| facts not adding up.
|
| The reality is that modern medicine is absolutely amazing,
| but there are also many interventions backed by shoddy
| science or no science at all. Sometimes, "doing your own
| research" exposes such lapses. Sometimes, it sends you off
| the deep end and you end up chasing ghosts. To allow the
| former, you need to tolerate some of the latter.
|
| And yeah, sometimes the shoddy science involves
| interventions so basic and so common that you'd _think_
| they 're sorted out. Consider that Europe and the US take
| wildly divergent views on topics such as wisdom teeth,
| colonoscopies, or the value of flu vaccines.
|
| "Science literacy" doesn't shield you from being wrong.
| Maybe it helps, but there's no shortage of Nobel laureates
| who believe in conspiracy theories or promote dubious
| medical treatments. Talking about "science literacy" is
| usually just how geeks convince themselves that their
| beliefs can't be wrong.
| [deleted]
| Waterluvian wrote:
| It's funny how every generation of modern medicine acts
| like this time they know 100% what the correct answers
| are while we all scoff at how wrong they got it just a
| few decades ago.
|
| Every generation the advice on which way to put your kid
| to sleep flip flops.
|
| It would be shamefully foolish to disregard all the
| incredible advances and technologies that modern medicine
| offers. It would be equally shamefully foolish to think
| it's not still deeply flawed.
| bombcar wrote:
| This is true across more domains than medicine -
| especially in IT, the absolute assurance that those
| idiots 5 years ago were brain dead but now we've solved
| all the things.
| j-krieger wrote:
| Similar story here. I went to a dentist, who with a sad look
| told me that all my wisdom teeth needed pulling. She
| recommended me to an oral surgeon who agreed and wanted to do
| the surgery, but not without first handing me a letter to sign
| which stated that I would not sue her if I lost feelings in my
| face or developed some kind of permanent pain.
|
| Seemed fine to me, but my father insisted to ask a friend of
| his who is a dentist. Turns out my wisdom teeth were completely
| fine and none needed pulling. My pain just stemmed from me
| grinding my teeth at night.
| cies wrote:
| > grinding my teeth
|
| For which magnesium (try different types of Mg-salts) helps
| many! (never heard that from a dentist, again, possssibllyy
| because the solution is not sold in their shop)
| dublo7 wrote:
| My kids had insurance through their mom, because she made
| shitty pay, but good benefits. She lost her job and put them on
| state medicaid plan. Suddenly my son who has never had a cavity
| in his life needed _6_ fillings.
|
| I took him to my dentist who found a single tooth that may have
| a cavity but it's too early to be sure. A year later he's had
| one filling. And that one was not any of the teeth the other
| dentist wanted to drill. He flosses in public bathrooms.
|
| They obviously was a cash grab and were going to just drill the
| fuck out of his mouth to maximize medicaid payments.
| whynotminot wrote:
| Was military in the past, so on tricare. Base dentist was
| busy so they referred me off base to a local dental clinic
| for my regular cleaning.
|
| That local dentist I guess saw a blank check when I walked in
| the door and tried to convince me I had 5 cavities that
| needed filling. I told him to finish just the cleaning and
| I'd check back in with my military dentist.
|
| Military dentist later looked me over again and said I had
| one slowly developing potential cavity to keep an eye on.
| That's it.
|
| A lot of dentists are apparently unethical hack shops.
| throwaway290 wrote:
| Once I had bad pain and went to a dentist, he pulled out a
| tooth. Later I heard it's absolutely last ditch and replacement
| teeth are finicky and will make your life much more
| problematic.
|
| Thankfully it's just enough to the side to not be visible so I
| am getting away without one. (Though I think it's also
| problematic long term, because remaining teeth would shift.)
|
| Never again to trust a dentist, no matter if it's a private
| clinic in developed country with supposedly great healthcare.
| Always talk, discuss and research and ask around enough to make
| own judgement...
| dawnerd wrote:
| I'm missing quite a few teeth not mostly biologically but had
| two that grew in weird and had to be extracted. Found an
| amazing dentist that's on the local board and they're not
| pushy about implants but does say don't wait too long since
| it'll end up costing more if the other teeth move. He's also
| managed to save a tooth my last dentist absolutely demolished
| trying to put a crown on it.
|
| It's hard to shop around for dentists but when you find a
| good one it's life changing.
| nick__m wrote:
| Dental implant while costly are wonderful if you have
| sufficiently dense jawbone, they feel like a real teeth.
|
| My dentist also told me that tooth extraction is a last-ditch
| effort. But that come sooner than you would like; after one
| rounds of antibiotics, if the pain come back but there are no
| apparent mechanical defect in the tooth yet the roots are
| blurry on the x-rays, the probability that a root canal
| treatment would be successful is quite small and extraction
| followed by an implant is your best bet.
| throwaway290 wrote:
| Thank you for insight. Perhaps I heard or understood wrong.
| Almost sure I was not prescribed antibiotics before
| extraction that time but to be fair I may be forgetting, it
| was 4-5 years ago. I guess an implant becomes difficult
| after so long but I should look it up and see what dentists
| around say probably.
| varjag wrote:
| D students have to work somewhere too.
| ornornor wrote:
| I feel like dentistry in particular is one of the least
| rigorous of medical sciences.
|
| From my point of view (patient), I feels like dentists base
| their treatment recommendations on how much kickback they're
| getting from medical corporations (Invisalign anyone?) and
| biased papers.
|
| I wonder why dentistry is so far removed from the rest of the
| medical profession on this. Not that MDs are immune to the
| above but it feels to me like it's not as bad as in dentistry.
| gochi wrote:
| I don't feel the same, a lot of other medical professions are
| very similar to dentistry. Deal with a chronic plantar
| fasciitis and you'll see exactly what I mean, clueless
| experts everywhere with nowhere near the amount of rigor you
| would expect.
|
| Anyways beyond that, dentistry sits in a very interesting
| position where there isn't a whole lot that can be done
| (without major breakthrough). It's why so much is based on
| preventative measure. It's also why the field feels
| "antiquated" in a way, we're still using simple instruments
| to scrape the teeth (or inside the tooth when it comes to
| root canals), or yanking the entire tooth out. We haven't got
| much farther than cavemen using stones to clean plaque in
| that way, besides the pain mitigation.
|
| It's the one field that is ripe for revolutionary
| improvements if it weren't for corporations constantly
| pushing their garbage studies.
| dsugarman wrote:
| I think in general it's safe to take a cynical view on every
| vendors aptitude. Many, if not most, people are terrible at
| their jobs and it's your job to find the good ones and hold
| onto them
| umvi wrote:
| It's not just the dental industry that's like this. A lot of
| medicine is subjective, and a lot of doctors have poor
| "debugging" skills and do the equivalent of print statements to
| try to diagnose an issue (guess and check).
| darkerside wrote:
| Sometimes that's the best and cheapest way to diagnose.
| benjaminwootton wrote:
| I also found this with accountants. My tax affairs are semi-
| complicated, and every accountant I speak with has a totally
| different approach and advice. I think if I went to see ten,
| none of the advice would overlap.
| GartzenDeHaes wrote:
| I think that's more in the domain of tax attorneys than
| accountants.
| heavenlyblue wrote:
| print statements are not a bad practice
| psd1 wrote:
| I might expect more when it comes to my health, though
| AQuantized wrote:
| I saw a private dentist for the first time roughly a year ago.
| I was under the impression that I had 10+ fillings, and prior
| to lockdowns a dentist had told me I needed at least 2 more,
| which I assumed would still be the case.
|
| He said he could see no indication of decay that would need
| treatment, and all the 'fillings' I had were more like sealants
| in the enamel, none of which reached the dentin, and any of
| them could have been avoided by a more wait and see approach.
|
| I saw 5+ dentists on the public health system that all had the
| same cavalier approach, and it's hard to assume it wasn't to
| line their own pockets.
| EGreg wrote:
| If you realized this about the dental industry, just wait until
| you learn about the psychiatry industry. They overdiagnose so
| many disorders... antidepressants (1 in 5
| middle aged women) opiates (mostly an epidemic for
| men) amphetamines for ADHD (adderal, ritalin)
| autism (this increase may actually be the most legit)
| gender dysphoria (5% of young adults now)
|
| https://www.pewresearch.org/short-reads/2022/06/07/about-5-o...
|
| DSM-5 has made it easier to diagnose someone with these things,
| boosting recurring revenues for the psychiatry and pharma
| industry.
|
| And then look at the Tax Preparation industry, which always
| lobbies to keep things complex and perpetuate the individual
| income tax. If there was ever something that marched Graeber's
| Bullshit Jobs essay, it's that.
| mrwnmonm wrote:
| I read a book by psychiatrist, can't remember it's name
| now... he was saying, I explained the serotonin reuptake
| process to one of my patients, then the patient said...
| great, but how do you know that this applies to me
| personally?... he said I couldn't respond.
|
| Also, there are many antidepressants... I don't think there
| is a solid ground for why they describe a specific one for
| certain patients.
|
| Check these too:
|
| https://webcache.googleusercontent.com/search?q=cache:https%.
| ..
|
| https://webcache.googleusercontent.com/search?q=cache:https%.
| ..
| x86x87 wrote:
| Normally they try multiple antidepressants or combos until
| one works. Nobody tells you about the side effects -
| especially long term side effects
| x86x87 wrote:
| I know at least a handful of people that ended up gaining
| weight and developing diabetes (or they are close to
| diabetes) as a result of antidepressants. It's super
| depressing: you are trying to cure one thing and trigger
| another one. This is double bad in cases where you didn't
| need the pills in the first place.
| creata wrote:
| > gender dysphoria (5% of young adults now)
|
| In no country is it true that 5% of young adults have been
| diagnosed with gender dysphoria. The Pew Research article
| that you linked only looks at how people identify themselves.
| EGreg wrote:
| Right, but why has it been normalized? This is a _disorder_
| according to DSM V, and the word "dysphoria" also suggests
| profound discomfort and unease. Like "body dysmorphic
| disorders" like anorexia (another issue for young girls).
|
| Perhaps people are trivializing the actual affliction and
| are "appropriating" the identity the way it has been done
| with blackface or wearing drag for the fun of it etc. I
| actually _hope so_ since the opposite would imply a lot of
| psychological torment. But regardless, we must once again
| look at society and upstream issues.
|
| For example, if a girl preferred traditionally male
| activities, today that is 1 of 2 criteria she needs to be
| considered as having gender dysphoria, while in the past
| she'd be called a Tomboy before. That was a normal
| acceptable category for explaining her tendencies. It
| didn't come with an assumption that she is "REALLY" a boy
| inside and should make a decision on whether to take
| advantage of the latest technology to physically transition
| her gender before she hits puberty. And to be fair, the
| amount of people undergoing hormone blockers or surgeries
| is still low compared to the number of young kids who
| identify as trans. But if the capitalist psych and pharma
| industries have their way, they'll push it to increase.
|
| Most tomboys eventually changed as they got older, it was a
| phase, and it was contextualized differently by society.
| Also they had a mom at home, raising them, etc. Today both
| parents are away. School administrators cover their butt
| and say the parents can't be notified and even if they do,
| they have no say. A lot of the industry increasingly is
| pushing ONE interpretation on all cases. An interpretstion
| that didn't exist even 10 years ago. This is an experiment
| in novel interpretations and it's not working well so far
| in terms of mental health outcomes.
|
| Many times throughout history we had such interpretations
| (eg Hysteria for women, or chemical castration for gays) it
| turned out that the problem was societal.
| gochi wrote:
| Curious why you feel autism is the most legit here when it's
| the one that's been expanded on the most due to the DSM. They
| all make statistical sense to me given the rising acceptance
| of mental health being a real thing in the first place, no
| longer dismissed as "just work harder".
| EGreg wrote:
| I could be wrong. There has been an uptick in all of them,
| but I thought autism had less of an uptick, and there have
| been new _biological_ environmental factors that may make
| autism something from birth, whether heritable or not.
|
| Whereas something like, say, gender dysphoria has
| positively exploded in diagnoses. It's a worrying disorder,
| which (eg unlike autism) studies show leads 30-50% to
| attempt suicide. So any increase in its prevalence to 5% of
| the emerging US population is worrying. If this was, say, a
| coronavirus with that kind of risk to life, we'd all be
| worried.
|
| I want to be clear - I am _not_ saying that the symptoms
| aren't real and that "this is all in their head", or that
| we need "conversion therapy" or something. I an saying the
| major systemic problems are upstream and by changing THE
| SYSTEM we will reduce the incidence instead of only
| focusing on medical interventions downstream as bandaids.
|
| As an analogy -- if we addressed antibiotic overuse on
| factory farms and sugar and high fructose corn syrup and
| pink slime, fast foods etc. we could address the epidemics
| of obesity and diabetes, including in children. But instead
| we focus on inventing new ways to medicate them!
|
| And when the coronavirus comes around, instead of
| recognizing that these very same factors (obesity and
| diabtetes) are highly correlated with morbidity and
| mortality with that virus, we once again look for vaccines
| against the virus and once it subsides we continue to
| IGNORE all the systemic upstream factors in the underlying
| chronic epidemics in USA.
|
| Autism could very well be yet another one, maybe it is like
| autoimmune diseases that are related to microplastics,
| maybe they affect hormones like aestrogen and testosterone.
| We need to LOOK UPSTREAM.
| chpatrick wrote:
| What's the right level of diagnosis for these?
| EGreg wrote:
| [flagged]
| anonacct37 wrote:
| I found your comment a bit hard to follow. Did you just
| blame "ganst" (sic) rap for the increase in diagnosis of
| gender dysphoria?
|
| How does that work?
| eropple wrote:
| For those reading who may be unfamiliar, "gangsta
| rap/drill music" is a common conspiracy-theory
| shibboleth. Has been for the last ten (drill) to thirty
| (rap) years.
|
| Between that and the water-carrying for anti-trans
| bigots, this has no place here.
| EGreg wrote:
| On the contrary, discussing institutional dogma has a
| major place on HN because the hacker ethos is to question
| authority and the official narratives of the dominant
| system we are embedded in. Or at least it used to be...
| now a larger number of people on HN support centralized
| power in the form of corporations, state governments,
| CBDCs, etc. while also bitterly complaining about the
| downstream results of their exercise of that power.
|
| Just because people are being systematically squelched
| for questioning gangsta rap or giving amphetamines to
| kids doesn't mean they are "bigots". They may care more
| about individuals than the people who view the kids as
| just a cog in a machine, and the administrators who cover
| their butt and barely know anything about the kid.
|
| I believe that water-carrying is being done in the other
| direction far more -- the capitalist industries that make
| a profit.
|
| Check out the following issues and ask yourself whether
| all they have in common is "conspiracy nuts", or whether
| on the other side they have a highly organized
| cooperation to push a change through, and to deplatform
| and delegitimize anyone -- even previously respected
| experts or people whose job it is to deal with these
| issues - who dares to make too much noise or criticize
| whatever agenda is pushed:
|
| Weapons industry / military industrial complex -- the
| latest being the war in Ukraine, but previously in Iraq
| etc.
|
| Plastic - recycling (later revealed to be a scam)
|
| Depression - I saw lots of pushback right here on HN when
| questioning SSRIs and imbalance theory, but since the
| 2022 meta-study that died down
|
| Vaccines - we are all aware of how pervasive the push for
| censorship was, just look at the latest revelations out
| of FB, Twitter
|
| (CBDCs and National IDs - coming soon)
|
| Gangsta Rap - anyone speaking against it or its misogyny
| is attacked
|
| Trans activism - anyone voicing any concern for
| overdiagnosis, or the economic system that separates kids
| from both their parents, or even continues to use the
| psychiatric perspective of a disorder or dysphoria out of
| a concern for children, is shamed as "on the wrong side
| of history".
|
| BLM - Anyone discussing any other killings other than by
| cops of unarmed Black men was systematically attacked
|
| MeToo - Men told to be quiet, listen and not be part of
| the conversation. Once again rape is very important
| topic, but the concept got "overdiagnosed" and stretched
| to the point where someone like Matt Damon making a
| nuanced distinction becomes persona non grata
|
| To be clear, a man disagreeing with the following tweet
| is not the same as normalizing rape, but look how quick
| one side (the water-carrying one, in my opinion) is to
| paint the other as an "antisemitic/racist/white
| supremacist/misogynist/putin-supporting/bigot" for merely
| speaking up and voicing different opinion: https://twitte
| r.com/driverminnie/status/941905518284566528?s...
|
| There are groups who pounce on anyone attributing
| disparities in economic outcomes to any other factors
| than the one-dimensional explanation of systemic sexism,
| racism, etc. It is like when some Zionists explain
| criticism of Israel purely in terms of systemic
| antisemitism, or some anti-Zionists navel-gaze at Israel
| call it the world's worst violator of human rights and
| hurl epithets at anyone who mildly disgrees. When you
| have an agenda you tend to do lots of adhominems. It
| shuts down the conversation and prevents real discussion
| exploring other factors. Because institutions have an
| agenda and they co-opt people into enforcing it. Whether
| it's regular Han Chinese in China supporting the locking
| up of Uyghurs for the "greater good". Or Sunni/Shiite
| proxy wars in Yemen. Their "solutions" are invariably
| worse than the problem, which in any case is upstream and
| probably due to the very institution and government
| working together to create it.
|
| The well-meaning activists who carry water for these
| industries and agendas do not engage in good faith. They
| are so convinced they are morally superior that they
| simply insinuate you're a bad person and then respond in
| passive-aggressive one-liners!
| eropple wrote:
| Thank you for demonstrating my point.
| EGreg wrote:
| You've just demonstrated mine! Ironic.
| EGreg wrote:
| No, I think you made a wild connection.
|
| I said the systemic causes of problems are upstream. I
| named several of them: A, B, C that exacerbates X, Y, Z.
| That doesn't mean A causes Z.
|
| Gangsta Rap may be responsible for a totally different
| phenomenon than gender dysphoria: namely, the increase in
| violence, misogyny etc. in some Black communities. With
| the rise of Black music moguls it became essentially
| self-blaxploitation:
|
| https://m.youtube.com/watch?v=Pr6gb1w72xA
|
| And also influenced a lot of bad memes among many Black
| youth:
|
| https://en.m.wikipedia.org/wiki/Acting_white
|
| https://en.m.wikipedia.org/wiki/Sagging_(fashion)
|
| This in turn hurt their economic chances as a class, to
| get high-paying jobs.
|
| This shares elements with other similar examples, which
| are nevertheless distinct. For example, TikTok and
| Instagram harming the psyche of young teen girls, with
| one in three attempting suicide:
|
| https://www.chconline.org/resourcelibrary/teen-girls-
| report-...
|
| That's insane! This was NOT the case in previous
| generations. But notice how few people in mainstream
| media talk about the upstream causes, and how they mostly
| discuss medicating this newfound problem away.
|
| Similarly with diabetes, very few people talk about the
| prevalence of sugar in so many plants we eat (fructose in
| fruits for instance) or the government actually
| supporting high fructose corn syrup and genetically
| modified crops with sugar... or factory farms and so
| on...
|
| https://weather.com/news/news/2018-10-03-fruit-so-sweet-
| zoo-...
|
| Once you see it, you can't unsee it:
|
| https://magarshak.com/blog/?p=385
| Waterluvian wrote:
| I think that's part of the problem. Because of long-
| standing systemic issues with statistical medicine, it's
| all but impossible to say "that number is too high or low."
| The tail can wag the dog if it so chooses.
| [deleted]
| jokethrowaway wrote:
| My son had cavities at 3, likely resulting from a lack of
| minerals and breastfeeding until 3.
|
| UK NHS diagnosis was to pull 4 front top teeth out. I asked a
| relative (a doctor working in a public hospital but not a
| dentist) who advised to absolutely don't do that without even
| seeing him in person (COVID lockdown BS).
|
| A local private dentist agreed and wanted 5k to fix his teeth
| (remove cavities, put fillings under general anesthetics).
|
| In the end we went to Russia and got it done for 1k.
|
| That's public healthcare for you!
|
| His teeth have been fine for years, not long until he loses
| them naturally.
| seanmcdirmid wrote:
| Did you consider seeing a doctor? Dentists are sort of doctors,
| but MDs with teeth specialties could be better, I'm sure your
| GP could have given you a rec.
|
| (Edit: it turns out orthodontist is not like ophthalmologist).
| joe5150 wrote:
| All of the orthodontists I quickly searched in my area have
| DMDs from dental schools.
| calderwoodra wrote:
| Where did you hear that? Most Orthodontists do not have
| MDs...
|
| Did you mean an oral surgeon?
| seanmcdirmid wrote:
| Ugh, probably.
| ArisakaDJB wrote:
| I'm not from the U.S. but I was that kid. I broke my teeth when
| I was 6. My dad took me to the local dentist who told me to
| "leave him as it is" for a decade.
|
| Except my teeth were my second teeth, and they were half
| broken. I was walking around with half-blackened by the rot
| teeth, which caused all sorts of health problems on top of all
| the bullying and the first kiss kids tend to take came to me
| after I fixed the teeth.
|
| And don't get me started with my chronic illness that I've been
| looking for diagnosis for the last 10+ years.
| redeeman wrote:
| the dentist regularly examined you and doubled down on "leave
| him as it is" thoughout a decade?
|
| while a dentist should of course make sure to double check if
| its the permanent teeth and all that, I feel that your dad
| did not really fulfill his role as a proper parent here
| cies wrote:
| I have a tooth with a root-canal treatment that I dont trust.
| But several dentists say all is fine.
| phpisthebest wrote:
| >>I believe in listening to experts (but ultimately making an
| informed decision).
|
| The problem for the most part in all industries is we have
| moved from a system of experts to a system of credentials. Now
| one would say that in order to get a credential in something
| one must be an "expert" but this is far far from the truth,
| there are all kinds of competing incentives to ensure an ever
| increasing supply of "credentialed" professionals that have
| nothing to do with validation of their expertise in a given
| field or subject.
|
| It does not matter if it something like an electrician, or
| brain surgeon, from teaching, to physics, and everything in
| between including medicine, we favor credentials now not
| expertise
|
| Largely the consumer public simply looks to see if this person
| as the correct credential. license, etc for the given job...
| Consumers often lack the resources, information, or decisions
| tree in most instances to look for any indicators of actual
| knowledge in the field beyond that credential
| tomsmeding wrote:
| > Consumers often lack the resources, information, or
| decisions tree in most instances to look for any indicators
| of actual knowledge in the field beyond that credential
|
| This is true. I have no clue how to check the expertise of my
| dentist, apart from using my own mental bullshit detector (of
| limited use here) and reading reviews by others (also of
| questionable use, because who reviews their dentist? And
| where?).
|
| The analogous problem exists for certain kinds of expensive
| products with the property that they usually work well, but
| sometimes become flaky. Think a washing machine. Who posts a
| review about their washing machine four years post-date that
| it's still going strong? And absence of base rate information
| makes absolute numbers of bad reviews mostly meaningless.
| phpisthebest wrote:
| >>expensive products with the property that they usually
| work well, but sometimes become flaky. Think a washing
| machine.
|
| that is a different problem, consumerism killed that. There
| used to be several media companies that focused on long
| term durability of "durable goods" like washing machines
| and such
|
| But today most people buy new appliances not when they fail
| but when they need to upgrade to the latest technology, or
| because new government regulations makes them unfeasible to
| use / service, or because the Calendar function on their
| smart fridge does not work with google cloud anymore (true
| story), etc...
| gorbachev wrote:
| That may be true for a lot of folks, but that's not the
| only issue.
|
| From my experience, the biggest issue is that a lot of
| the appliances and other gadgets we have these days are
| very complex. You have to be an electrical engineers,
| software engineer and a mechanical engineer, or a big
| service company that employs all three, to be able to fix
| anything.
|
| Additionally it's sometimes really difficult to find
| service manuals for a lot of these things. If your doodat
| is flashing error code E-71-X1-C and the user manual you
| have just says "call for service", what are you going to
| do about it? You typically need pretty serious google-fu
| magic to find enough information to start figuring out
| what's wrong.
|
| When my dryer broke several years ago I think I found the
| proper service manual for it on a site that looked
| exactly like a SEO spam site and seriously sketchy.
| Downloading the PDF I was praying my anti-virus
| application was up-to-date.
| krisoft wrote:
| > If your doodat is flashing error code E-71-X1-C and the
| user manual you have just says "call for service", what
| are you going to do about it?
|
| Call for service.
| api wrote:
| Systems of experts are hard to scale since you need experts
| that you know are experts to vouch for experts. Systems of
| credentials that are at least theoretically assigned by
| experts are the next best thing, but obviously not ideal.
|
| It's at least better than the populist solution of anti-
| experts chosen on the basis of charisma or "truthiness."
| phpisthebest wrote:
| your last part is a false dilemma, because there are
| methods that do not required a system of credentials and
| also do not require populism
|
| Your first part is more challenging because what you find
| is the people with true expertise in their field are often
| far to busy and/or have no interest in validating other
| experts so the people doing the validation at best are on
| the lowest end of the spectrum of "experts" which naturally
| causes the spectrum to expand.
|
| Further you will find in many many many fields the method
| of obtain a credential is has no connection to another
| expert vouching for you, it is matter of simply passing
| some kind of standardized test, and completing a required
| amount of training
|
| For example one that has been in the recent news is Airline
| Pilots where you have to have a fix number of flight hours
| to be a commercial pilots, many pilots get those hours by
| fly pipe or other utility line check operations which is
| done a clear day, fixed altitude, fixed path and with
| limited deviation. So the value of those hours would be far
| less than the same person flying in varied conditions, in
| varied locations, etc.
| wouldbecouldbe wrote:
| I have learned from personal experience to never take
| healthcare medicals for their words.
|
| Always do your own research. Ask them consequences and how sure
| they are.
|
| And take into consideration the impact of treatments and
| diagnosis to the life quality of yourself or loved ones. At
| times can be hard for doctors and others to look beyond their
| own worldview.
|
| Personally I've had this eczema where I found the correct cream
| by reading the research on it, and later found out this is also
| the official advice. Most doctors here just prescribe an old
| cream out of habit, that contains hormones and often creates
| worse side effects.
|
| But a bigger diagnosis mistake was a close family member
| diagnosed with a very bad gen defect that would cause liver
| failure within a few years. He wanted the kid to start taking
| unpleasant medicines to be sure. He told us to get bloodwork
| done (without mentioning the costs) but in the end couldn't
| find enough genes that had the mistakes. He wanted to do even
| more bloodwork being convinced there needed to be 2 genes with
| the defect, but I clearly told him he was going in uncharted
| territory, after doing the extra bloodwork he had to come back
| and agree he was wrong.
|
| One defect gene was found and in extreme health circumstances
| liver values were found that matched the pattern of a certain
| disease. Which is why he was convinced it was wrong.
|
| He was a well intentioned doctor, but these academics doctors
| get obsessed with analysing and diagnosis without always
| understanding the costs for the patients. Although they try to.
| In the meantime our family thought the kid was going to die for
| months and made significant unnecessary costs.
| NovaDudely wrote:
| Oh yeah I had really bad skin flaking, they would orescibe
| all kinds of hormone or steroid based creams that would next
| to nothing.
|
| One search on Reddit and many people just said to use
| petrolium gel. Bam fixed it up in two days! Costs me about $3
| a year to control this now.
| slim wrote:
| the whole discipline is based on interpretation of symptoms.
| the job of a doctor is _exactly_ like debugging a live system
| except when it crashes you don 't get to restart it. they
| actually investigate by testing their suspected diagnostic on
| you. they literally give you a medicine and don't know if it
| will work. that's their normal process.
|
| I think what happened to that dentist is he changed his
| diagnostic because of an external factor, like realising that
| removing the teeth is less risky with regards to getting sued
| by you.
| TimTheTinker wrote:
| Should say (1997) - this was a reprint in 2022
| zw123456 wrote:
| OK, throwing my dental horror story on the pile. About 15 years
| ago I bit on something in a wrap, and it hurt like heck, and I
| went to the dentist, and he said I needed an implant. $3000
| later, I had a cool fake tooth. Then a few years later, something
| similar happened but this time I decided to try another approach.
| I used my water pick and sonic toothbrush and just kept after it
| while taking naproxen to deal with it.
|
| Guess what, the tooth healed up and stopped hurting and stopped
| wiggling in there. that was about 10 years ago, and it's been
| fine ever since. Now, I use the water pick 3 times a day and
| brush at least the same number of times or more. And I have not
| been back to the dentist since. I just keep everything nice and
| clean in there. I am not a doctor and blah blah warning. Just my
| personal experience.
|
| Chiropractor == Dentist (IMHO)
| swe_dima wrote:
| When I was in beginning of my 20s I would put blind trust in
| doctors.
|
| Unfortunately I had a ligament tear in my knee and after 4
| surgeries I developed some pretty bad pains.
|
| I took a vacation and scheduled visits to 10 orthopedic surgeons
| who had some of the highest medical credentials in the country.
|
| Everyone told me that pain was caused by a different thing and
| dismissed ideas of other doctors.
|
| The confidence with which they told me the reason would have
| convinced me have I not visited other doctors.
|
| Later I had similar experience with doctors from other health
| areas.
|
| Essentially, in medicine they can only diagnose the most typical
| stuff, for anything else it's just a bunch of wild guesses.
| EMM_386 wrote:
| I've been told I'd have to have my wisdom teeth extracted by
| every dentist I've seen. Over 10 of them as I've moved around.
| Oral surgeons saying the same thing.
|
| The first one to recommend this was _35 years ago_.
|
| I still have them, and the last dentist I saw says they are in
| good shape. The first one ever to tell me this. I've never had an
| issue with them.
|
| Go figure.
| ilaksh wrote:
| I had a problem with a single wisdom tooth (around 12 years
| ago? don't remember). I don't remember but I think it was
| starting to be impacted or something. It was quite sore and
| obviously needed to be removed. I don't remember the cost but
| it was something I could just manage to afford at the time
| (probably around $500 or something including the cleaning).
|
| The dentist said I really needed to have the other three
| removed also. I can't remember why exactly they claimed I
| needed to do that. But it ballooned the cost up well over $1000
| (maybe $1500, don't remember). When I said no the second time,
| they had the very pretty receptionist (/model?) come into the
| room and sit right next time me and explain again why I needed
| to have them out.
|
| All told, I had to explain at least three times how I was
| definitely too broke to consider removing the other teeth. They
| didn't believe me and even asked again what my job was or
| something (was a low-paying job).
|
| The other wisdom teeth never caused a problem like that one I
| had removed. Or any other problem that I am aware of. I
| actually haven't been to the dentist since. Not aware of any
| teeth falling out or anything obvious like pain. I think it
| would be good to get them cleaned one of these days though.
| whack wrote:
| I've had a similar experience with tax preparers. I once decided
| to hire two different tax preparers, both of whom had good
| reviews and strong credentials. I naively assumed that I would
| spend an hour tops comparing the two returns side-by-side, and
| examining any small differences between them.
|
| What ended up happening was that both returns were so
| dramatically different, along many different dimensions. It took
| me nearly 40 hours to catalog all the different decisions made by
| each preparer, and which of the two decisions is the better one.
| Through this exercise, I realized that both preparers had made
| some major errors - and by reconciling them, I ended up saving
| more than $10,000, while also making my tax returns more
| resilient if audited.
|
| I'm convinced that for any non-trivial decision in any field, the
| best way to make them is to hire multiple independent
| professionals, and cross-check their independent recommendations.
| And yes, this applies to software engineers as well.
| dclowd9901 wrote:
| I've always suspected this was the case, but this result is kind
| of astounding. I would expect, generally, dentists agree on mouth
| health. Indeed, the ones he sees initially that lack financial
| motive have general agreement on his treatment plan.
|
| A very generous interpretation of the results here are that none
| of these dentists have a good context for the reporter's overall
| dental health, hence such variation, but I suspect it is the far
| more banal profiteering that is driving the differences.
|
| My own experiences mirror this when I go to a dentist. A gleaming
| office with several very expensive cars parked out front makes me
| immediately suspicious.
|
| This industry had better tighten up or it's going to have real
| problems with trust.
| bagacrap wrote:
| [1997]
| chriscjcj wrote:
| From the bottom of the article:
|
| > This article originally ran in the February 1997 issue of
| Reader's Digest.
|
| > [Stock photo of people shaking hands]
|
| > Originally Published: November 18, 2020
|
| Is the 1997 date a printed issue and the 2020 date an online
| posting? Weird. Either way it's very old. It would be nice to
| know if the situation is as bad now as what was portrayed in
| the article.
| PointyFluff wrote:
| [dead]
| gooseyman wrote:
| This article was run in 1997. It reads exactly like what a modern
| dental experience is.
|
| If dentists want to start drilling, capping, or pulling. Go get a
| second opinion.
|
| I was referred to the Otho within my dentists office to look at
| my wisdom teeth. I was not in pain, they weren't impacted,
| instead I was told "It's a standard practice just to check." It
| was supposed to be a consultation, but the ortho wanted to rip
| them out right then and there. He was frustrated at my insistence
| that we understand the total cost after insurance. I was awake
| for the procedure, local anesthetic only.
|
| My dentist at the next visit looked at my X-rays and asked why I
| got my wisdom teeth out. The ortho was no longer with them.
|
| Good riddance
| criddell wrote:
| > get a second opinion
|
| This guy got 50 opinions and 12 of the dentists gave reasonable
| treatment plans. At least one dentist said there was nothing
| wrong.
|
| I'm not sure two opinions is enough really.
| nmz wrote:
| If anything it seems the only ones to trust are the students.
| evmar wrote:
| My wife was shocked to learn in dental school how many people
| were there focused on the money. From her experience I learned
| that dentistry in particular is a profession that has a low
| investment / high payoff ratio. Relative to medical school dental
| school is easier to get into and shorter, and unscrupulous
| dentists can extract a lot of money out of patients.
|
| PS: I feel compelled to share her best advice re oral hygiene:
|
| "You only need to floss the teeth you want to keep."
| fakedang wrote:
| Reminds me of that argument scene between Capt. Holt and the
| dentist from Brooklyn 99.
| whatever1 wrote:
| Ok sample of N = 1, but here it goes.
|
| Flossing daily was the single thing that imroved my dental
| hygiene more than anything else. Brushing, mouthwash, fluoride
| treatment, gum laser treatment, regular dentist visits, nothing
| worked. Still had bleeding gum, pain here and there, bad smell,
| unstopabble tooth decay.
|
| In my mid 20-s I started flossing daily (even multiple times
| when I feel like food is stuck). Really my mouth problems all
| went away.
|
| I wish someone had shown me in an earlier age the benefits. I
| would have saved a lot of my teeth.
| toxik wrote:
| Have you tried a waterpik? Considering an investment there
| myself.
| tiahura wrote:
| Got one a year ago. They _seem_ effective, however they
| make a huge mess - it's a pressure washer in your bathroom.
| criddell wrote:
| I just had a checkup and they mentioned Water Pik and
| recommended a cordless model you can use in the shower.
| lost_tourist wrote:
| Flossing&brushing is better than a waterpik, any dentist
| worth their salt will tell you that. I think it's a money
| grab. You don't need it.
| wccrawford wrote:
| I've never used one for its intended purpose, but my wife
| has one. I recently had some food stuck in my gums behind
| my back tooth, and it got infected. I was able to use the
| waterpik to remove the food when I wasn't able to get
| into a dentist for a cleaning right away, and by the time
| I got the cleaning, between the waterpik and the anti-
| viral medicine the dentist prescribed, the infection was
| gone. Having it around saved me quite a bit of pain over
| a few days.
|
| But I still haven't actually used it for cleaning what
| it's supposed to. :D
| leviathant wrote:
| My parents had a Waterpik in the 80s - it was okay, I
| guess, but my go-to are Plackers, have been for years. I
| can get to every little nook and cranny with those things.
|
| Ultimately, whatever you're using, I think the important
| part is that you're doing it daily, and being thorough.
| leviathant wrote:
| +1
|
| My gums had been bleeding enough during brushing that I
| decided to break my 14 year run without a dentist visit and
| get things checked out, but felt shame about the state of
| things, so I gave myself a month or two of runway - and
| adopted a daily flossing and mouthwash routine.
|
| By the time I got to the dentist, my gums were in good shape.
| They removed _lot_ of plaque, but underneath, my teeth were
| pristine. In the 14 years since I 'd been to the dentist,
| either the tools had become much more humane, or I just
| happened to be surrounded by sadists in the late 90s/early
| 2000s.
|
| Upgrading to an electric toothbrush was another revelation,
| and I also learned that a tongue scraper is the solution to
| tonsil stones.
|
| Genetics play a part, for sure, but flossing daily has been a
| total game changer.
| positr0n wrote:
| My huge dental hygiene improvement anecdote is switching to
| an electronic vibrating toothbrush.
|
| My gums were always bad so I thought I needed to floss more.
| But once I started using an electronic tooth brush all my gum
| problems are gone.
| wahnfrieden wrote:
| just don't use floss with PFAS / microplastics
|
| eg Oral B Glide tests at 248,900 ppm / 25% of volume for PFAS
| jandrese wrote:
| I wonder if this is the reason dentists seem to be kooks more
| often than other types of doctors?
| alwa wrote:
| I do think this is a (1997) rather than a (2022), judging by the
| line at the bottom where it says that's when it was originally
| published. Also, language in the piece--selecting dentists at
| random from 28 cities' Yellow Pages, the claim that "the average
| income for dentists in private practice for 1994, the last year
| for which figures are available, was $117,610"--seem to support
| the idea that these figures are from 26 years ago rather than
| last year.
|
| And if those prices were in 1997 dollars, I can't imagine they'd
| be anything but much higher in 2022.
| pierat wrote:
| Unfortunately I have an anecdote, but is also a concern.
|
| I had a tooth pulled. Could have been a root canal, but whatever.
| (Insert sob story)
|
| The real problem was that this dentistry was quietly affiliated
| to the local university's dental school. Many of the students end
| up here. The problem, is that the dentistry IS NOT UPFRONT this
| is a teaching business, and not actual professionals.
|
| I found it out when I was digging through unrelated records in
| GIS, and found they were legally registered as a school. Dug
| deeper, and they're basically misrepresenting and lying to the
| public.
|
| So yeah, keep this scam in mind as well. (I call it a scam cause
| I wasn't getting student rates, and they did their damndest to
| hide that.)
| ahelwer wrote:
| That's just... all of medical care. The procedures are almost
| all done by residents and, yes, med students under supervision
| of a full doctor. How do you think we get new doctors? Nobody
| wants to be the person who is used for teaching new doctors but
| that's how it is.
| adamredwoods wrote:
| I have many dentist anecdotes (I switch dentists often), and
| generally don't believe what dentists tell me. My first suspicion
| began when one told me to floss more, so I flossed daily for an
| entire year. When I went back in after six months, they told me
| to floss more. I told then I had flossed daily for an entire year
| and they did not believe me. I went to another dentist and they
| were impressed by my teeth from my flossing! I was more happy
| with the second dentist for noticing!
|
| I had another one tell me I had a 'dead' tooth and it needed
| extraction as it would rot my mouth. I saw a different dentist
| and I asked about my 'dead' tooth. They responded I had no dead
| teeth and weren't sure what I was referring to.
|
| Another anecdote: My child's teeth were coming in crooked, and
| had some late adult teeth. The first orthodontist suggested a
| spreader (a common procedure where your palate is split and made
| wider), followed by braces. The second said that they could also
| suggest an alternative, with only braces.
|
| End result-- the dentists that give options are the better ones
| (IMO). If they give only one option, I am cautious. In general,
| get a second opinion.
| UniverseHacker wrote:
| I went to one dentist that said I had over 20 cavities. I didn't
| believe them and went to a second dentist that said I had none,
| but one spot was eroded and would soon become a cavity. I waited
| a full 10 years without doing anything and then went to a 3rd
| dentist, that said I have no cavities.
|
| I'm convinced dentistry is a total scam. I'm the only person in
| my friends group that has never had a cavity or dental work, and
| I strongly suspect it's not because there's anything special
| about me, except that I don't go to dentists as often as most
| people do.
| moomoo11 wrote:
| Doctors are just people. I personally don't trust a single one
| and why I always get multiple opinions.
|
| The sooner they're replaced by automation that's far superior in
| terms of accuracy and diagnosis, the better.
|
| Just a hundred years ago doctors were doing wack shit like
| chopping off limbs and giving people toxins or cocaine. Maybe the
| cocaine isn't so bad.
|
| Today they give us SSRIs and opioids.
|
| They are given far too much credit imo when they're just
| mechanics. Just like you can get into an accident because brakes
| failed or something and you're left with pain and suffering or
| you die.
|
| I've had a misdiagnosis before. It has left me with continued
| pain and I do thank the second doctor who realized the former
| doctors mistake and did his best to make me as whole as possible.
|
| I don't trust doctors. And I don't think that highly of them
| either.
| esafak wrote:
| Would a robot change much? The company that makes or leases it
| is still going to make more money when it is used.
| kashunstva wrote:
| > The sooner they're replaced by automation that's far superior
| in terms of accuracy and diagnosis, the better.
|
| I assume you are not referring to the procedural specialties of
| medicine. My spouse does complex aortic surgery; I don't think
| most of her patients would consent to seeing her replaced by a
| robot. But who knows, techno-dystopias have a strange appeal
| for some.
| thenerdhead wrote:
| The reputation of these noble jobs are going straight out the
| window. The same that happened to "an honest mechanic" when
| that used to be a thing.
|
| https://en.wikipedia.org/wiki/Iatrogenesis is absolutely a
| thing and is likely how many of these industries work. The
| excess activity causes more problems for others to solve.
| smallerdemon wrote:
| Yeah, if you find an honest dentist in 2023 in the United States,
| never, ever go to anyone else. Thank GOD I found one recently.
| After a cross country move I put off going to the dentist for
| FIVE years because my previous dentist was amazing. The first one
| I tried was a bizarre Christian cult with a bunch of chi-chi crap
| in the lobby, and contemporary Christian music that -the dentist
| hummed along to while working on my teeth-. And then the calls
| started "You need X, Y, Z and probably A, B and C." and I was
| like "Nah. Fuck right off." Two more years without, and FINALLY
| found a guy who was like "You're teeth are fine. We'll keep an
| eye on some of these, but only worry about them if they cause you
| pain or have sudden changes." Guy is a gem.
| jeffmcmahan wrote:
| Took my 7 year old daughter to a dentist. 8 cavities. Gotta get
| em right away! Went to another one. All good - zero cavities.
|
| Many dentists are criminals willing to drill holes in children's
| teeth in order fraudulently take your money.
|
| She's now 15. Never had a cavity ever.
| hahamaster wrote:
| I think the majority of these people are despicable individuals
| who damage children's teeth for profit. But some are just plain
| incompetent. My son doesn't have a single cavity but there were
| cases when dentists at his school (who visit once every few
| months) "detected" cavities which were later proven to be
| simple food stains.
| thenerdhead wrote:
| Seeing that this article ran in 1997 originally, someone ought to
| build a website that lists this type of information or
| experiences for the type of care you're looking to get in your
| area.
|
| I've had similar experiences that make me never want to go to a
| dentist again because these new practices are so detached from
| reality. They only care about what is covered by your insurance
| and will deceive you with non-answers to maximize it.
|
| I've also had experiences where one dentist will tell me I have a
| cavity and I'll get it checked out by another dentist who cannot
| confirm. These types of things need some type of tally from the
| public so others don't let these money-grabbers get off scot
| free.
| charles_f wrote:
| This resonates so much. I have had some heavy dental work in the
| past because of actual problems that got my mouth (or rather both
| the issue and it's fix) published, but then I moved far away and
| had to change dentists. And since then...
|
| > Your dental work is lousy
|
| This makes me fly away faster than anything else.
|
| > Some of your crowns have jagged edges and need immediate
| attention. They will trap food and cause decay
|
| I've also heard this one for the first time from a dentist that I
| thought I could trust. She initially said the previous work was
| nicely done, but one day, curiously while she started renovation
| work in her office, this became a problem that "she wasn't
| comfortable with anymore"
|
| This is to the point that I switch dentists often and only get
| cleanings, reject everything they propose. Nothing they recommend
| ever align, and I'm quite open to them about that, and they still
| go ahead and affirm that the previous one was wrong and they know
| their shit.
|
| > what I really ought to do, he said, would be to crown all 28
| teeth
|
| How can you reasonably be comfortable proposing that to someone?
| I can't begin to imagine all the problems you're gonna create for
| your customer at this stage.
|
| Incentives for dentists are built in a way that only a very
| strong ethical sense will make them do the right thing. And since
| the standard is so low, of course things are going this way.
|
| Unless ethical boards are made to be more independent and get
| much stronger on this kind of malpractice, or you reform training
| so that dentists don't start with huge student debt, there's no
| good way out.
| jph wrote:
| How to add a date to HN title? The post says "This article
| originally ran in the February 1997 issue of Reader's Digest."
| Madmallard wrote:
| Where do you get the most trustworthy or realistic dental
| diagnosis and advice? Dental schools?
| laserDinosaur wrote:
| There's an episode of Marketplace in Canada[1] where they found
| similar results themselves:
|
| "By the end, the dentists had recommended treatments covering 19
| different teeth, ranging from nighttime mouth guards to veneers
| promising a "complete smile makeover," with cost estimates
| ranging from $144 to $11,931."
|
| When they asked for answers they were told "Dentistry is more of
| an art than a science". I damn near fell out of my chair when I
| heard that.
|
| [1]https://www.cbc.ca/news/canada/dentists-vary-widely-on-
| diagn...
| kentonv wrote:
| A couple years ago my dentist sold her practice to a new dentist.
|
| Before I had an appointment with the new dentist, my wife had an
| appointment, and he told her she had gum disease with bone loss
| and needed a deep cleaning and to go on a "periodontal schedule"
| where she would have to come in every three months instead of
| six. (Note: My wife and I have different last names and separate
| insurance, so he wouldn't have known we're related.)
|
| When I went in, the hygenist measured my pocket depths, and I
| noticed she seemed to be adding 1-3mm to what I remembered the
| measurements being every time I had that done in the past. The
| dentist then came in and gave me what sounded like a rehearsed
| speech concluding in the same diagnosis he had given my wife.
|
| I told him I'd like to think about it and could he please send me
| the records they based this on. They proceeded to rush me out of
| the office, outright refusing to do the regular cleaning.
|
| I went to another dentist and only told her I left my previous
| dentist because he gave me bad vibes. She started off with the
| pocket measurements which were magically back to normal! She said
| my teeth looked great. Then she asked about my previous dentist
| and I told her what happened. She said: "I suspected it was
| something like that."
|
| So... yeah... what an industry...
|
| ETA: Although now in my paranoia I wonder if the new dentist
| somehow knew the previous dentist's diagnosis and realized the
| way to keep me as a customer would be to tell me they were wrong.
| But they shouldn't be able to get my past records unless I
| authorize it, right?
| leptons wrote:
| Some dentists are the worst - they're no better than used car
| salesmen, and sometimes they are worse than that. Just shady
| and questionable businesses that try to extract the most money
| possible from you, and in some cases they will lie to do it.
|
| I moved cities a few years ago, about an hour south of where I
| used to live, and I changed my doctor, my mechanic, but I kept
| my dentist even though it's a 1.5 hour drive in rush hour
| traffic. It's worth it. There's plenty of dentists around my
| new house, and I tried one of them and it was awful. I went
| back to my beloved dentist in the old city and I'll never look
| for another one. They don't ever try to recommend work I don't
| need, they find and fix real problems not made-up problems, and
| the prices are very reasonable.
|
| Once you find a good dentist, keep them forever if you can.
| It's too bad your old dentist sold the business, that would be
| devastating for me.
| meindnoch wrote:
| Oh, first I thought "measuring your pocket" meant that they
| somehow gauged your financial status.
| rmwaite wrote:
| Oh, believe me - they most certainly are. :-)
| davedx wrote:
| Yeah, our dentist sold the practice and the new one gave me a
| (unnecessary?) filling that is so painful I can't eat properly
| on one side of my mouth anymore.
|
| Of course, I now don't want to go back to the new dentist, I
| want to find a new one that isn't going to screw up the first
| time they touch me, but that's a minefield too (finding a new
| dentist). So I've dealt with the pain for like 4 months
| already.
|
| Sigh.
| hetspookjee wrote:
| Just take the leap with a new one that gives you good vibes.
| Skipping one side entirely is also a recipe for worse things
| to come. So, the longer you wait the worse it'll probably
| get.
| kvmet wrote:
| Many dentists ago for me but they got a new contraption that
| could measure enamel thickness. They waved this wand around in
| my mouth and told me that I was in need of (4) fillings. Now I
| have always had thin enamel so it's not unusual to need some
| fillings but I didn't trust this process at all so I told them
| I'd mull it over and call back. Waited 6 months for next
| cleaning and mysteriously I didn't need any fillings at all
| despite having no work done.
|
| I don't think it is necessarily done intentionally, but it's
| good to be a tiny bit skeptical especially when new factors are
| involved.
| sjackso wrote:
| Similar experience here. I went to a new dentist who had one
| of those machines and he told me I needed at least nine
| fillings. I declined and found someone else. Over 16 years
| and multiple moves/new dentists since then, maybe three of
| those teeth have actually needed fillings.
| elteto wrote:
| I had the same exact thing happen to me and my wife. We've
| learned since then that this is a common scam by dental
| clinics.
|
| Did they try to sign you up for a "care" credit card too?
| ourmandave wrote:
| I remember a story of a fraudulent dental service that were
| telling parents they needed all their children's baby teeth
| pulled. They were finally busted because parents got second
| opinions.
|
| I googled trying to find it and pulled up a bunch of other
| stories of dentists performing unnecessary procedures on children
| to defraud medicaid.
|
| F'ing monsters.
| can16358p wrote:
| "You do not have access to www.rd.com. The site owner may have
| set restrictions that prevent you from accessing the site."
|
| WTH?
| tamimio wrote:
| Sometimes healthcare systems feel like it's run by Mafias, hell,
| even Mafias have code of ethics.
| aj_nikhil wrote:
| Its an old article "This article originally ran in the February
| 1997 issue of Reader's Digest."
| duffpkg wrote:
| Wrote Hacking Healthcare, healthcare executive for 20+ years...
|
| About 10 years into my career we had already been managing some
| very large hospital groups but ended up with a mangement contract
| for a diverse group health system that through accidents of
| history including some dental clinics. ~50 suites across several
| sites/brands. I had had some exposure to dental clinics and
| generally had not been impressed but not overly concerned either.
|
| First meeting we had with the senior staff across the clinics set
| my hair on fire. It was one of the most callous, fraudulent and
| shocking things I had ever seen in my career. Dentistry does not
| have a notion or ethical obligation of "first do no harm...". The
| entire agenda of the strategy setting meeting was how to trick
| "patients" into unecessary procedures, generally defraud
| insurance companies (especially breaking things across many
| visits that could easily be done in one) and every other
| deceptive way to inflate profit at "patient" expense that could
| be conceived. There were quotas for procedures, something
| unimaginable and defacto illegal in a healthcare setting.
| Needless to say we divested the dental clinics as soon as
| possible. I came to find in later years that those modes of
| operation are more or less commonplace in the industry.
| crakhamster01 wrote:
| Can the HN title be updated? Read this whole article thinking the
| numbers were from last year, not 1997...
| moshegramovsky wrote:
| I eventually found a great dentist. The first time I went to his
| office, it was extremely obvious that he was a Christian. Did
| that make me trust him more? Yes it sure did, but only because he
| was young. I would also trust an Orthodox Jewish dentist, but
| there aren't any here in Seattle that I can find. If I needed a
| lot of really expensive work, I would probably just go to a high
| end place in Mexico.
| carabiner wrote:
| I've used the same dentist in Bellevue for 4 years and he's
| never had me do anything besides my 2x a year cleanings. Never
| tried to sell me anything but tells me to floss. He's not
| noticeably Christian.
| kashunstva wrote:
| I don't understand how the religious inclinations of the
| dentist have anything to do with their trustworthiness in terms
| of their diagnoses and treatment recommendations.
| ilaksh wrote:
| Because many dentists are fraudulent. Morality is a big part
| of many religious doctrines. So they might be less likely to
| lie about unneeded procedures. But overall I agree that it's
| not in any way something you could rely on.
| moshegramovsky wrote:
| Note that I am not religious. The last religious thing I did
| was my bar mitzvah, which was like 35 years ago.
|
| I felt like my dentist was morally upstanding.
| prmph wrote:
| Does anyone know the best way to get proper diagnostics care for
| a possible tooth fracture without being given the run around and
| ripped off by dentists?
|
| Whilst extracting my last wisdom tooth (in the US) the dentist
| must have made a bad mistake, because right after the procedure I
| couldn't bite down properly on the affected side on my mouth.
|
| I went for years with this situation, and started experiencing
| occasional pain on that side. Whilst a teaching assistant the the
| University of Washington (UW), I used to visit UW Medicine for
| faculty, telling the dentists that I suspected a fracture (based
| on my research). However they would invariably just throw me off,
| claiming it was very hard to identify such cracks, it might not
| actually be a crack, etc.
|
| Eventually I lost that tooth, almost certainly due to the
| widening crack, as I suspected.
|
| Now back home in Ghana, another tooth seems weak when eating
| certain very hard foods, and again I suspect a crack. Again,
| dentists in general seem unwilling to really address it,
| halfheartedly trying various diagnostic procedures that do not
| actually uncover the problem.
|
| One was quick to propose a root canal, which seemed weird to me
| as the first line option to address something like that. This
| dentist describes himself as a root-canal specialist, and it's
| not a stretch to assume that he sees every dental problem in
| terms of root canals. Another dentist suggested it was a small
| cavity, and did her drill and fill routine, which has done
| nothing at all to alleviate the problem. Yest another dentist
| claims I need some tooth tissue filed away to correct the
| problem.
|
| So now I'm not sure what to do. It seems cracks are hard to
| identify; I'm not sure why dental imaging cannot help much here.
| I'd like to know if there are better options than dealing with
| lazy dentists who just want your money.
| [deleted]
| ridiculous_fish wrote:
| What are some techniques to find dentists who do not engage in
| such aggressive over-treatments?
|
| Asking friends for recommendations is the best approach I've
| found - are there others?
| JulieCat757 wrote:
| [flagged]
| entropicgravity wrote:
| If you have an ongoing problem of plaque/tartar build up on your
| teeth then this BBC article[1] could be a life changer for you.
| It was for me. After a year of doing it right my gums are now
| close to perfect.
|
| I notice though that neither my hygenist's or my dentist's office
| has been handing out information about this approach. Not good
| for business perhaps. I believe this technique works via abrasion
| so toothpaste is a must. I use a Braun 4000 but any sturdy
| electric toothbrush should work.
|
| [1]https://www.bbc.com/future/article/20220718-the-best-way-
| to-....
| elteto wrote:
| Holding at 45 degs is what the instructions in my electric
| toothbrush recommended, so it seems it is commonplace now.
| shrimpx wrote:
| So it's just holding the electric brush at 45 degrees against
| the gum?
| prakhar897 wrote:
| I really lucked out that Indians families push for
| Doctor/Engineer career so hard. My family has dentists, surgeons,
| general practice doctors etc. This gives me immense leverage as
| trusted second opinion is just a call away.
|
| Also, Can anyone tell why don't more people fly to other
| countries for these procedures? Paying something like 6k$ for a
| crown is pure extortion. In India, a decent one (with quality
| equivalent to US) costs around 60$. That a difference of 100x.
| solardev wrote:
| Medical tourism is totally a thing, but it's harder when you
| don't know the other country's culture and/or language and
| can't tell a good doctor apart from a bad one.
|
| It's a lot easier when you have family and referrals in the
| other country who can point you at a trusted source.
|
| Just like most outsourcing, I suppose.
| [deleted]
| PopAlongKid wrote:
| >What, then, can Americans do to protect themselves from
| overtreatment and overcharging? Says the ADA's Dr. Seldin, "We
| encourage patients to seek out--certainly if there's a lot of
| work to be done--second or third opinions so they can have
| comfort with the practitioner's recommendations."
|
| Actually, the article already identified the prime protection
| mechanism -- insurance. The data in the article is nearly
| meaningless, because in each case it was presented as "I will get
| reimbursed for whatever you charge me".
|
| Having said that, you also need to get quality insurance, not the
| kind that limits you to the local "Smiles" dental franchise
| office.
| solardev wrote:
| Isn't dental insurance kinda a scam itself? They pay for a
| couple cleanings and give you maybe a slight discount on major
| work, but the payout limit is so low that you might as well pay
| out of pocket for all of it (and just save your premiums for
| operations) or use the clinic's own subscription program.
|
| When would dental insurance actually be cost effective for any
| major operations?
| PopAlongKid wrote:
| I wouldn't say it's a scam, but yes it is in many cases just
| pre-paid expenses. If all you need is cleanings and periodic
| x-rays, it might end up a wash against the cost of premiums.
|
| I recently went through a transition from employer-provided
| group dental insurance, to the basic Medicare Advantage
| dental offered through Kaiser, and had to pay out of pocket
| for some major work that couldn't wait (root canal). Since
| then I have found an affiliation-based group plan that costs
| a little more but results in much lower amounts charged by
| the dentist for non-routine work. The quality of the dentists
| in the network is much higher, in my limited experience.
| justinator wrote:
| If you think dentists are bad, go to a doctor about a sprained
| ankle.
| fferen wrote:
| My tentative advice would be to find the one with the best
| reviews. Only pay attention to the lowest reviews, even a few
| 1-stars are informative.
|
| My story: I brush and floss every single day. At my regular
| checkup, the dentist measured 2-5mm gum depths, and insisted on
| doing a deep cleaning, which involves anesthesia and multiple
| visits. I argued that the 5mm depths were borderline, and could
| very well be 4mm with measurement error. (They did seem to be
| pushing rather hard.) They also pointed out some tiny supposed
| "pockets" on the X-ray that looked like just imaging blur or
| something. Feeling very suspicious, I left, and found another
| dentist with, surprisingly, zero bad reviews on Yelp. They
| measured 2-4mm gum depths, and did a much less aggressive
| cleaning.
| superb-owl wrote:
| Year should be 1997 based on the disclaimer at the bottom. Cc
| @dang
| programmertote wrote:
| I went to a new dentist after moving to FL. Pines True Smile is
| their name. The dentist and cleaning hygienist keeps selling me
| this Invisalign despite me being 40 years old with teeth in great
| condition (I have two front buck teeth, which are just 3mm ahead
| of others around them). The hygienist even said because of those
| two front teeth, the air gets into my mouth and the rest of the
| gum will be eroded by bacteria more (kind of like a scarce tactic
| to make me go through with their Invisalign procedure, which
| would cost me $2-300 out of pocket). I refused because I never
| had any issue with my teeth and have great set of teeth (my
| previous dentist and hygienist in NY would always praise how well
| I maintain my oral hygiene). I even joked them that I'm happily
| married and don't need to look dapper anymore. Then the dentist
| (who's the owner of that clinic) started giving me an attitude.
|
| He then told me I need to extract a wisdom tooth that never came
| out. I saw the X-rays and it is not touching/hitting other molar
| like some of the nightmare wisdom scenarios that I've seen on the
| internet. It just didn't come out of the gum and it wasn't
| hurting me for the last 20 years of my life. So I refused saying
| because it never give me a problem, I'll leave it at that. My
| worry was that once it's taken out, it would give more space for
| the molar and other teeth nearby to start shifting, and my teeth
| spacing will become sparse (thereby, needing Invasilign for
| real). Then he started talking to me impatiently.
|
| Finally, he suggested I redo the fillings, 4 of them total, that
| I had done ~10 years ago in SF. I never had any discomfort and
| there is no stain or sign of old-age in these fillings. The
| dentist didn't show me any picture of these fillings and why they
| need to refilled. But given that I have read about fillings
| needing to be redone every decade or so before, I said alright.
| Then he did it in 20 mins. Now one of the molars that he refilled
| has been giving me some uncomfortable sensations occasionally
| when I chew something with it.
|
| This is not to mention that because I mentioned that the last
| time I went to a dentist was 1 year ago (I was busy from moving
| to FL), they suggested me to a deep cleaning. Turns out, that
| deep cleaning was quoted to be $2592 on paper and cost me $237.80
| out of pocket (plus $569.20 paid out by my dental plan). The
| fillings cost $384 on paper and $36 out of pocket (plus $225 paid
| out by my dental plan). The worst was that the "deep cleaning"
| they gave me was EXACTLY the same that I got every six months
| from my NY dentist, who I had been seeing for 4-5 years.
|
| Basically, my conclusion is that the dentist and hygienists
| decided to extract (pun intended) as much money out of me as
| possible because it was my first visit and my teeth are in good
| condition, so they realize if they couldn't scare me with mis-
| aligned teeth, closeted wisdom teeth, etc. then they might as
| well make up some excuses to charge me as much money as possible
| for "deep cleaning" and refillings. The clinic still made
| $237.80+$569.20+$36+$225=$1068 for a total of maybe 20 mins with
| the dentist and 25-30 mins with the hygienist.
|
| Needless to say that I refused to schedule bi-annual (every 6
| months) visit with them this July. The point I'm trying to make
| is that in this day and age of profit-oriented healthcare, we, as
| patients, cannot trust doctors and dentists without questioning
| (yet, some doctors and dentists don't like us questioning their
| judgment/recommendations because they are the ultimate
| authorities).
| akakakak677 wrote:
| I spent 25 years with face pain. Saw more than 50 doctors in my
| lifetime. Finally, by chance, I was referred to a dentist that
| diagnosed me with TMJ. I'm wearing a plaque (or whatever it's
| called) and have zero pain now.
|
| I'm done all kinds of exams you can think of and it was just me
| pushing my teeth all the time.
| Xcelerate wrote:
| Might as well add my anecdote to the fray: no cavities for
| decades, perfect teeth. I move and get a new dentist. Suddenly I
| have a cavity! She "fixed" the back molar and it has given me
| nonstop pain ever since then.
|
| Like someone else mentioned on here, I'm disinclined to believe
| in conspiracy theories, but I do believe there is a massive
| amount of incompetence and irreproducibility in the practice of
| medicine. It's not rigorous science by any stretch.
| gumby wrote:
| I had the same experience in the last two weeks!
|
| I hadn't been to the dentist since covid. My gf convinced me to
| try her dentist -- I left with a $6000 proposal to fix all sorts
| of problems (including the one that sent me there -- a lost
| filling).
|
| So I went back to my old dentist; she identified the missing
| filling and a couple of holes "worth keeping an eye on" with a
| total projected cost of... $300.
| siva7 wrote:
| That's extreme but getting different diagnoses isn't unheard of.
| Always take a second opinion in case of a delayable invasive
| procedure. You'd be surprised how many times there is an
| alternative. Medicine is all about probabilities, not an exact
| science.
| prepend wrote:
| This is 50 diagnoses with extreme variance. It's an issue of
| too many alternatives and having a hard time choosing the
| correct path.
|
| I don't think this is a function of medicine but a function of
| poor ethics in dentistry.
| commiepatrol wrote:
| I had a very similar experience at the dentist.
|
| Top of my crown cracked and I went to a new dentist(because we
| recently moved) to check it out. They told me that I need to get
| an implant and that implants are much better than real teeth
| anyway and it would only cost me $6k. The crazy part is they also
| had a foot massage place inside the office that was free after
| your procedure and you also get a free fresh cut rose when you
| come in...weird.
|
| Anyway, so I went to a different place for a second opinion and
| they told me the crack is superficial and unless I'm concerned
| with the way it looks I can just ignore it. Which I did. This was
| about 3 years ago and I've been going to the second dentist ever
| since.
| lost_tourist wrote:
| This was my experience. I had been going to a dentist around 8
| years. Regular cleanings, a couple of fillings. Then they got a
| new hygienists who was -very- judgmental, I was of course like
| WTF. Then my dentist comes does some hmmms and ohhhhhs and
| suddenly I need root clean (forget the name exactly) and 5
| crowns. This was mind you 6 months after my last cleaning/x-ray.
| Naturally I was suspicious and told them "I'll call and schedule
| with you, work is crazy". I then go to another dentist, and he
| says my teeth looked great, and he'd like to take out one wisdom
| tooth for $120 because it was awfully out of place. So I switched
| and have been happy with him for a few years now.
| deagle50 wrote:
| A few months ago my gf went in for a 6 month cleaning (to her
| regular dentist office of several years) and they told he she had
| 4 cavities, after having none 6 months prior. She got a second
| opinion and the diagnosis was zero cavities. She called the
| original office to see what their angle was and they said
| something to the effect of "ok, no problem. See you in 6 months."
| They were so used to getting away with fraud (or worse), they
| didn't even blink.
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