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FLP: Not a fan of dentists

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  • #16
    Here we go, again......


    • #17
      I have multi-generations of dentists and endodontists in the family, so I'm not anti-dentist by any means. But now more cautious about seemingly good advice regarding root canals and crowns.

      In a new city, newish dentist did 2 fillings and afterwards my pain was awful. I waited months for it to diminish, it barely budged, sent to endodontist. He gave it a few more months then said root canal x2. Wasn't excited about mummifying 2 more teeth so a few months later got a couple other opinions (at same time a old filling cracked on other side of mouth, one doc said crown other said replace filling. I chose replace filling). Both of the other dentists checked the originally pained teeth (which was diminishing slowly with time) Both said based on xrays filling were superficial, no exposed nerve. I have really sensitive teeth, ok to continue watch/wait. 2 years later, no pain and saved 2 root canals. Who knows if I did the right thing in the end -- but I'm happier, and so far everything's been fine no dead teeth yet.

      No worries, get another opinion, it's just your time/$. --but get emailed copies of all those Xrays and bring them with you to or else you'll overcharge dental Xrays for the year.

      Sometimes watch/wait isn't the worst policy, particularly in medicine this occurs weekly that I'm talking patients out of me doing unnecessary or what would likely be multiple surgeries on them.

      Good luck!! PS. FLP - you're in the Bay I know a reputable dentist on the peninsula if you're interested PM me.


      • #18
        Been going to my dentist for 20 years. I've always had mildly inflamed gingiva. No treatment was ever recommended. Surprisingly, it resolved after I started daily fasting.


        • #19
          When I was a teenager I went to a new dentist and he told me I needed 8 fillings. I was 100% asymptomatic. What did I know, I was just a kid, so I let him do his thing. Looking back, I would bet a million dollars that the SOB was drilling healthy teeth just for the cash.


          • #20
            I do the basic dental care and there is never anything wrong with my teeth. My wife and kids put in 5x the effort and end up with problems all the time. Same dentist.


            • #21
              Originally posted by CordMcNally View Post
              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.
              why do you think that is?


              • #22
                As someone alluded to in a different thread I think there’s is a high level of interoperator variability, diagnostic skill, and practice style which is coupled with a fee for service model which is based entirely on trust - this situation I suspect leads to the wide range of experiences that many of us have witnessed.


                • #23
                  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.
                  Today orthodds found himself in a familiar situation. FLP is making himself look like an idiot by sharing how irresponsible he has been with his own dental/oral hygiene and then ignorantly blaming his problems on a dentist.

                  Here are a few basics to keep in mind, FLP:

                  1. Every patient, every tooth, every dentist is different. Treatment recommendations might vary because of that. This happens all the time in medicine as well.
                  2. Endodontic problems are not as simple as they might appear at first glance. Many teeth die a silent death, meaning the pulp tissue inside the tooth can become necrotic without eliciting any immediate symptoms such as pain, swelling, radiographic findings etc. Without pulp testing to find out if the pulp is dead one can't know for sure. For example, you can hit your front tooth on a chair at age 14 but not have symptoms appear until age 18. So thinking your dentist is dishonest because he says you need root canal treatment when you aren't experiencing any symptoms just shows you don't know what you're taking about. Eventually a necrotic tooth will "blow up" and cause problems. When this happens just hope you have access to a good dentist (think Tom Hanks in Castaway). A tooth might look like its dead on a radiograph (maybe a periodical radiolucency) but this doesn't mean the tooth is dead. It could be the radiolucency is the result of an abscess associated with a necrotic adjacent tooth or some other lesion. A clinical exam, radiographs and pulp testing as needed is the way to diagnose what's going on.
                  3. Periodontal problems are also rarely symptomatic in terms of pain or other immediately noticeable symptoms. Bone can melt away due to chronic inflammation around the roots of the teeth and the patient might not know what's happening until the teeth become loose. Scaling and root planing, antibiotic treatment, surgery might be needed to address the problem. And yes, all of these things have been shown to be beneficial in maintaining and improving soft tissue attachment and bone levels in those with perio disease.
                  4. Radiographs are needed in order to evaluate structures not readily observed by other means. Crazy, but true. Those little bitewings that irradiated your head (four of them) gave you a whopping 0.005 mSv of radiation. Ouch! I hope youre doing ok after that. I'm guessing your salivary glands and thyroid are toast.
                  5. I'm always entertained by physicians who think dentistry is so simple, and yet when the topic comes up they show off their ignorance to such an embarrassing level it surprises me.
                  6. Some dentists are better than others, just like in medicine or any other job in the world. Put in the effort to find a good one and then regularly follow up with that dentist, ask questions along the way and take responsibility for your own dental/oral health. Don't be like the patients you deal with who won't do their part but then show up in your office expecting you to solve their problems with a wave or your wand.


                  • #24
                    Originally posted by Jim View Post
                    When I was a teenager I went to a new dentist and he told me I needed 8 fillings. I was 100% asymptomatic. What did I know, I was just a kid, so I let him do his thing. Looking back, I would bet a million dollars that the SOB was drilling healthy teeth just for the cash.
                    Right! Because carious lesions are always symptomatic.


                    • #25
                      Originally posted by HikingDO View Post
                      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.
                      Yes. You're wrong. There are lots of studies that demonstrate this link in various ways.

                      It makes me wonder if there is a study that shows it's safer to drive with vs without a blindfold. If there isn't any good research on this then I might try the blindfold. Plaque is a film of bacteria that has been shown to metabolize carbohydrates and release acid into the immediate area as a byproduct of that metabolism. The acid has been shown to cause an inflammatory reaction in the adjacent gingival tissues and to decalcify the adjacent enamel. Flouride has been shown to strengthen enamel by replacing some of the OH ions in the hydroxyapatite (F is more electronegative than an OH ion so it binds more tightly). Tartar has been shown to harbor bacteria and plaque. Do you need a prefect research project to help you reach a reasonable conclusion? Yes, most of this can be done at home (brush, floss and use fluoride-containing toothpaste). If you don't have much tartar buildup and you do a great job of brushing and flossing then it's probably not much of an issue. If you're FLP then you need all the professional help you can get in order to save your teeth. Every patient, every tooth is different.


                      • #26
                        I rarely post, but I will for this. I agree that in medicine and dentistry,i is as much of an art as it is a science. Of course, there will be differing opinions. However, I personally noticed much greater variability in dentistry. A lot of practices are heavily focused on the business aspect. This is all personal experience and experience of family members.

                        It seems that the number of cavities I have seem to correlate with the numbers or text and calls I incessantly get to remind me if my appointment and how shiny the advert at the front office is. And the need for dental x-ray and panorex seems to correlate to how often my insurance is willing to pay for it. This coming from someone who is a patient, who has immediate family who is a dentist, has many dentist friends, and in a specialty that shares a lot of patients with dentist. Don't get me started on laser frenectomy.

                        To the OP, I switched to the low income community health dental group recently and I am very happy. It's not shiny, it's not new, you won't have Netflix streaming or warm blankets, you might have to wait a while, but it's straight forward and frank. I'm happy to use my very good dental insurance there.

                        BTW, ask me to name some crummy medical docs and I'll give you a list. But at least they made the news or the state medical commissioner radar.


                        • #27
                          I feel like more doctors are running away from the business end of the job these days.


                          • #28
                            I've had good luck with dentists and growing up long ago, in a small town with no fluoridation, I certainly needed their help. My current general dentist does a lot of cosmetics but only had to say once that I had no interest and that was the end of that. Have had one root canal over the years and that tooth wound up eventually needing an implant. My generalist referred me and the specialist that did it didn't charge me full freight for it. A couple of months ago I cracked a pre-molar that needed another implant with the same specialist. Cost was very reasonable. I had f/u appointment yesterday and they took a couple of x-rays to check alignment and bone level - I was leaving and asked the front desk if I owed them anything and receptionist said no charge. Have been impressed with how pain-free almost all dental work is these days. A funny note was that the tooth that needed the root canal acted up when I was in Africa and I had a British dentist look at it. His laughed at how 'beautiful' all the fillings in my mouth were and that they were more into functional than art in the UK.

                            Have been happy with dental care for the 4 kids too. Thankful to have access to modern dental care and for the kids - fluoridation.


                            • #29
                              It's crazy I have parents going out of their way to avoid fluoride still....


                              • Lordosis
                                Lordosis commented
                                Editing a comment
                                Do you know a better way to avoid the government mind control?

                            • #30
                              Originally posted by Peds View Post
                              It's crazy I have parents going out of their way to avoid fluoride still....
                              Seriously? You have parents that believe in chemtrails as well?

                              Although I suppose if someone has drunk the anti-vaccine Kool-Aid, it's not really that big a leap to move on to other conspiracy theories...