Posted on 10/17/2024 9:49:46 PM PDT by ConservativeMind
A series of recently published opinions and letters present varying perspectives on the current state of US dental care all emphasize the need for evidence-based practices and changes in economic models.
The conversation kicked off when Paulo Nadanovsky, DDS, Ph.D. and colleagues presented "Too Much Dentistry," arguing that dental diseases and procedures are highly prevalent, costly, and often exceed spending on other major health conditions such as diabetes and hypertension.
They suggest that dental care in the U.S. is driven more by economic pressures and patient trust than clinical evidence, leading to excessive diagnoses and interventions.
Examples offered include the treatment of noncavitated caries lesions (white spots) and routine fillings in children, practices that lack substantial evidence of benefit in preventing pain or infection.
The collective viewpoints acknowledge themes of overdiagnosis, the influence of economics on dental practices, and the urgent need for basic evidence-based guidelines.
Another way of phrasing that is, yes, the current state of US dental practice is a somewhat of a scam with some really good outcomes. While perceptions of dentistry often come down to patient confidence and trust in the profession, I offer a few anecdotal tales from the ever-skeptical author of this article as examples.
I was once told that I had eight cavities and was handed a detailed schedule of the order in which the dentist would recommend addressing them. A visit to a new dentist for a (blinded) second opinion revealed that I had zero.
When my oldest daughter was three, a dentist took X-rays that revealed five cavities. When I looked at the X-rays, I couldn't see anything. I was told it was because I wasn't a dentist. The new dentist she visited later found none.
The implications of oversight for dental practices and health care policy are significant.
(Excerpt) Read more at medicalxpress.com ...
My mother looked at me mad, knowing the financial burden I was causing them, and through her red face, gritted teeth, said to get them done.
I have never had a cavity, then, or ever. Those same fillings are still in place.
If the man was still alive, I would entertain giving him a similar set of issues, in return.
It was outright fraud.
Xylitol.
I’ll bet you money that most of this dental quackery occurs in predominantly blue cities.
We don’t have this issue in small town Texas — and I’d put the quality of our dentists up against anyone’s.
My dental plan at work covers a couple of cleanings a year. I pay for a third cleaning out of pocket - it isn’t that expensive and there’s evidence that gum disease and inflammation can trigger heart disease. Cheaper than paying for a stent or a bypass later.
Don’t get me started on Mouth Mechanics. My wife had to see 1 dentist and 2 oral surgeons to finally determine she needed an implant. All the dentist could do was drill and fill. The first oral surgeon said he did root canals but not extractions. The second could do the extraction and implant base, but the dentist had to set the implant. Each dentist/oral surgeon needed new x-rays. Apparently, they could not share pics. Scammers! My dad always said that dentistry could be completed with a 1 year correspondence course.
>> It was outright fraud.
Definitely
>> I pay for a third cleaning out of pocket
I do quarterly cleanings and I pay out of pocket for all of them. I agree with you, it’s money well spent; oral health impacts whole body health, as you point out.
Plus, with four annual professional cleanings, I don’t need to brush or floss.
(j/k)
Who can afford it anymore?
The flip side is that dentistry is now good at treating and repairing actual cavities and other issues. Soon, special mouthwashes will become widely available that implant and foster the growth of genetically modified bacteria that displace the acid generating species of bacteria that cause cavities and gum disease.
That’s pretty much the case with me. In 1968-69 as I was getting ready to be shipped out overseas, this new dentist from the Ga Dental School....a butter bar said, “you’re going to Viet Nam and won’t have any dental care out there so I’m gonna fill in all the deep fissures in your teeth. He drilled and poked stuffed and pushed that amalgam on my whole set of upper teeth. ALL damned day long. He said to make an appointment the next week for the bottom set. I never went back.
Since then, EVERY filling fell out and nearly all the big teeth cracked down to the root and had to be pulled. The bottom teeth are still good. I dearly wish I could get my hands on that ass.
I would agree with this. The local small-town dentist I see here knows me personally. He's been practicing for almost forty years, up on all the latest dental procedures, including cosmetic dentistry, takes his time, and not once has he ever hurt me. He owns the practice and has other excellent dentists and assistants working under him. But, he is damn expensive. However, you get what you pay for.
Real piece of work, your mother.
Regards,
To me another interesting thing is that an emergency room refuses to have anything to do with dental. I know a man who was living very close to the line, and had no dentist. He had very quickly developed a raging very painful tooth infection and went to an ER. They turned him away without even starting an antibiotic.
A tooth infection is lethal and they let him walk out the door without the slightest effort.
They will crack open your chest and do emergency surgery for a bullet or heart attack. They will amputate a leg if they must. They will call in a neurologist for emergency brain surgery.
But pulling a tooth or trying to stop an infection somehow eludes them. I’m not talking crowns, fillings etc. But it’s odd they will do their best and call in specialists for every part of the body.... except for teeth.
I don’t know about other States, but in Oklahoma, Medicaid will pay virtually nothing on adult teeth, but will pay for crowns on children’s teeth, so that many dentists are actually putting crowns on baby teeth! To me, this is a huge scam and malpractice, and if I had children on Medicaid, I would not allow this practice! I don’t know if my dentist takes Medicaid, but he is a very upright man, and I am sure he does not crown baby teeth.
Chronic inflammation of the gums can lead to heart disease. Everyone needs to visit a dentist at least once a year. Just make sure it’s a good dentist.
I would have been interested in the author addressing this latest push towards caps and crowns.
I keep being told I have a couple cracked morals that need caps or crowns as over a grand a piece because *IF* one of them should crack even more, it could be a costly, time consuming, painful procedure to endure.
I was told that fillings don’t work so well and the teeth cannot be bonded with something that could hold them together.
If I were much younger, I’d maybe consider it. But at almost 70? Nah, not worth it for the few years I have left.
And, take the time to floss between teeth.
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