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  • FLP: Not a fan of dentists

    Today Fatlittlepig found himself in an unfamiliar situation, he was in a dentist chair, a place he has not been for many years: Fatlittlepig does not think highly of our dental colleagues, he feels they are largely business people upcharging for unnecessary procedures and x-rays (that being said Fatlittlepig isn’t much of a fan of seeing doctors either) however Fatlittlepig did develop some tooth pain a week
    ago which prompted today’s visit by the time of the appointment the tooth pain has resolved.

    Fatlittlepig then had his entire oral cavity thoroughly irradiated (I counted over 10 xrays) included the panorama X-ray radiating the entire lower skull. I was then prepared for the inevitable look at what we found on your xrays...

    Voila there happened to be a large cavity (not in the tooth that had pain) that needed a semi urgent root canal, and another tooth (again not the tooth that had pain) that also needed a root canal because he determined it was “dead”. On top of that, no dental cleaning was done because it was determined Fatlittlepig needed dental scaling and cleaning which turns out to be another two separate visits and places you on a schedule to have special gum work every 4 months. That being said I did determine that this dentist seems to be a trustworthy person but do I really need dental scaling which does not seem very appealing...

    got to love our dental colleagues, providing us such joy and happiness.

  • #2
    correction:

    Everyone: Not a fan of dentists

    Comment


    • #3
      I’m not a dentist, but maybe some of this would not have happened if you visited one for routine care on a semiannual basis instead of waiting until you had tooth pain. I feel like even with good personal oral care (brushing/flossing) getting routine cleanings and check ups is beneficial.

      Comment


      • #4
        Originally posted by fatlittlepig View Post
        On top of that, no dental cleaning was done because it was determined Fatlittlepig needed dental scaling and cleaning which turns out to be another two separate visits and places you on a schedule to have special gum work every 4 months. That being said I did determine that this dentist seems to be a trustworthy person but do I really need dental scaling which does not seem very appealing...
        Roughly 60% of the adult population in the United States has some stage of periodontal disease. Given that you blew off routine exams and cleanings and you work in a somewhat stressful profession, it doesn't seem at all unlikely that you need scaling and root planing.

        As to the endodontic treatment and the periodontal disease, I suppose you could ignore it and see if it gets better on its own. However, if you've found a decent dentist he or she would probably like you to get healthy and keep your natural teeth as long as possible. The interaction between periodontal disease and cardiac disease makes another good case for getting the scaling and root planing done and sticking with the recommended perio maintenance schedule.

        Comment


        • #5
          I used to read some FLP posts to my dentist wife as she was entertained by a troll. Reading this led to a nice breakdown by her with some not living room friendly terms. She’s pretty used to hearing paranoid nonsense like that, just not from a physician.

          Preventative care is a good thing. Surely FLP knows better. Hank already covered the major points.

          Comment


          • #6
            To play the devil’s advocate, and please any dentists here correct me if I’m wrong, but as far as I know there is no evidence based study that shows that regular scale and polish treatments are more effective in preventing gum disease that no treatments at all. Since I’m a family physician, I’m all for preventive care, but without evidence that what FLP is doing is wrong, I can’t really fault him.

            Comment


            • #7
              Originally posted by fatlittlepig View Post
              Today Fatlittlepig found himself in an unfamiliar situation, he was in a dentist chair, a place he has not been for many years: Fatlittlepig does not think highly of our dental colleagues, he feels they are largely business people upcharging for unnecessary procedures and x-rays (that being said Fatlittlepig isn’t much of a fan of seeing doctors either) however Fatlittlepig did develop some tooth pain a week
              ago which prompted today’s visit by the time of the appointment the tooth pain has resolved.

              Fatlittlepig then had his entire oral cavity thoroughly irradiated (I counted over 10 xrays) included the panorama X-ray radiating the entire lower skull. I was then prepared for the inevitable look at what we found on your xrays...

              Voila there happened to be a large cavity (not in the tooth that had pain) that needed a semi urgent root canal, and another tooth (again not the tooth that had pain) that also needed a root canal because he determined it was “dead”. On top of that, no dental cleaning was done because it was determined Fatlittlepig needed dental scaling and cleaning which turns out to be another two separate visits and places you on a schedule to have special gum work every 4 months. That being said I did determine that this dentist seems to be a trustworthy person but do I really need dental scaling which does not seem very appealing...

              got to love our dental colleagues, providing us such joy and happiness.
              Please provide data that dentists are largely up charging for unnecessary procedures and xrays.

              Hmmm...do you know of another way to effective obtain a full mouth xray exam? If you do, please let us know.

              Pain may not be a result of a tooth that needs a root canal and it's pretty simple to see if there is a "dead" tooth.

              Scaling is not a routine cleaning.

              Looks to me that you didn't take care of yourself well. Time to pony up. Glad you are a physician and can afford it.

              And physicians provide such joy and happiness. Cancer, heart disease diagnoses.

              I happen to be both a dentist and a physician. I practice medicine now and know what I speak of.

              Maybe try to be thankful that there are people, dentists in this case, who have gone to great lengths to train, learn and become experts. They can make your life better.

              Best.

              Comment


              • #8
                I look forward to the FLP post in 3 years about the up charge for dentures.

                Comment


                • #9
                  I'm sympathetic to the pig on this one. The number of stories I've heard from friends who suddenly needed 8 fillings after switching dentists, or who needed a crown at every visit but then switched dentists and need nothing anymore... I confess utter ignorance of the field, but the variation in the "standard of care" just seems dramatically more broad in dentistry than what would be seen in most of medicine. I recently moved and had a new dentist tell me I needed work on multiple teeth. I went to an older dentist whose office wasn't plastered in ads for veneers, dermal fillers, and botox, and he said (after panorex and exam) there was one small enamel defect that should repair with fluoride and no abnormality that he could find with any of the other teeth in question. I don't know who is right. But, that two people could look at the same teeth and images and recommend such different treatment makes me distrustful of the field.

                  FLP, you can always get a second opinion. Even if the outcome isn't different, you might sleep better having heard it twice.

                  *Expert tip: Pocket the Rolex before your next dental exam.

                  Comment


                  • #10
                    Sounds like someone should spend more time brushing and flossing and less time typing.

                    Comment


                    • #11
                      We already had the anti-dentist thread here that got quite ridiculous, don't need another.

                      Go get a second opinion.

                      I'm sure there is NOTHING that you do in medicine that is subjective/qualitative.

                      Comment


                      • #12
                        Originally posted by ticker View Post
                        I'm sympathetic to the pig on this one. The number of stories I've heard from friends who suddenly needed 8 fillings after switching dentists, or who needed a crown at every visit but then switched dentists and need nothing anymore... I confess utter ignorance of the field, but the variation in the "standard of care" just seems dramatically more broad in dentistry than what would be seen in most of medicine. I recently moved and had a new dentist tell me I needed work on multiple teeth. I went to an older dentist whose office wasn't plastered in ads for veneers, dermal fillers, and botox, and he said (after panorex and exam) there was one small enamel defect that should repair with fluoride and no abnormality that he could find with any of the other teeth in question. I don't know who is right. But, that two people could look at the same teeth and images and recommend such different treatment makes me distrustful of the field.

                        FLP, you can always get a second opinion. Even if the outcome isn't different, you might sleep better having heard it twice.

                        *Expert tip: Pocket the Rolex before your next dental exam.
                        Like finding a honest car mechanic.. If you can find a good dentist who believes less is more, isn't interested in milking you or your insurance for unnecessary treatments keep them...

                        as for the tooth he strongly recommended getting a root canal, I will proceed to do so, as even I could see the large lucency on the radiograph which looked pretty close to the nerve root. The other tooth which he said was dead and probably should get root canalized at some point, I'll treat that recommendation as a "class 2A" recommendation, and I translate that into I probably don't really need to worry about that for a while. As for dental scaling, deep cleaning, that's kind of tricky because the way they operate is that you don't get a regular cleaning if they categorize into the dental scaling subgroup of people, so i may be stuck with it.

                        Comment


                        • #13
                          Once I lost my dental insurance I started going to the local dental school, where I get seen mostly by students. They say my oral care is great and don't try to upsell me anything. Works for me.

                          Comment


                          • #14
                            My dentists have been hit or miss (like any other occupation). The issue with dentistry is that there's such a paucity of research when compared to medicine. It's tough to tell whether the recommendation is a good thing or not. Like most interactions in life, you need to find somebody you are comfortable with and can trust.

                            Comment


                            • #15
                              Originally posted by ticker View Post
                              I'm sympathetic to the pig on this one. The number of stories I've heard from friends who suddenly needed 8 fillings after switching dentists, or who needed a crown at every visit but then switched dentists and need nothing anymore... I confess utter ignorance of the field, but the variation in the "standard of care" just seems dramatically more broad in dentistry than what would be seen in most of medicine. I recently moved and had a new dentist tell me I needed work on multiple teeth. I went to an older dentist whose office wasn't plastered in ads for veneers, dermal fillers, and botox, and he said (after panorex and exam) there was one small enamel defect that should repair with fluoride and no abnormality that he could find with any of the other teeth in question. I don't know who is right. But, that two people could look at the same teeth and images and recommend such different treatment makes me distrustful of the field.

                              FLP, you can always get a second opinion. Even if the outcome isn't different, you might sleep better having heard it twice.

                              *Expert tip: Pocket the Rolex before your next dental exam.
                              I agree with sentence #2 and some of the rest including a 2nd opinion. However, it's no different than going to various physicians who have a different way of treating the same problem, some aggressive, some not. We are imperfect people in an imperfect world.

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