The Truth About Dentistry
April 17, 2019 6:51 PM   Subscribe

 
Today, an increasing number of dentists acknowledge that adults with good oral hygiene need to see a dentist only once every 12 to 16 months.

I KNEW IT!
posted by sallybrown at 7:27 PM on April 17 [14 favorites]


Is going to a physician and feeling better aftwards... really what's supposed to happen? Because I'm not convinced I've ever seen a medical professional, doctor dentist or therapist, and felt truly better afterwards.
posted by Mr.Encyclopedia at 7:34 PM on April 17 [19 favorites]


Little medical evidence justifies the substitution of tooth-colored resins for typical metal amalgams to fill cavities.

I mean, that’s for cosmetic purposes, surely? Nobody wants to have a smile like Jared Leto’s Joker in Suicide Squad.
posted by Secret Sparrow at 7:43 PM on April 17 [2 favorites]


Is going to a physician and feeling better aftwards... really what's supposed to happen? Because I'm not convinced I've ever seen a medical professional, doctor dentist or therapist, and felt truly better afterwards.

Is this a joke? Or maybe you are saying that you have never had a serious but treatable medical problem? Because if you, say, caught influenza, developed pneumonia as a secondary infection, spent several days delusional and feverish, and then a doctor admitted you to the hospital and administered IV antibiotics, would you say that medical care that kept you from dying perhaps made you feel better afterwards?

The comment isn't saying that every doctor visit magically changes your feelings, it is saying that medical treatment for illness is a thing.
posted by medusa at 7:45 PM on April 17 [11 favorites]


I honestly don't understand why dental care is so de-coupled from medical care.
posted by runcibleshaw at 7:50 PM on April 17 [72 favorites]


Got the the same philosophy for dentistry as medicine and mechanics. That is, I do the maintenance and only see professionals if there’s a problem. So I uh, I ended up not seeing a dentist for over 20 years, until a friend of mine was studying to be a dental hygienist and needed some volunteers to practice on. Got looked over by the school’s dentist before to make sure I was suitable, and she said “Great teeth! Keep doing what you’re doing.” So, I figure I’m good for another couple decades or so.
posted by rodlymight at 7:51 PM on April 17 [17 favorites]


It's gotten to the point that my parents specifically chose the dentist that gave them the most pain (and paid more for it), because they believed the pain meant the cleaning was done properly. It's a crazy perspective.
posted by meowzilla at 7:54 PM on April 17 [1 favorite]


Is going to a physician and feeling better aftwards... really what's supposed to happen? Because I'm not convinced I've ever seen a medical professional, doctor dentist or therapist, and felt truly better afterwards.

Is this a joke?


I mean, unless you're getting a boil lanced or something that will cause immediate, simple relief...yeah. You walk out with a prescription (to feel better later) or, with a therapist, something like a homework assignment (again, to feel better later).
posted by witchen at 8:06 PM on April 17 [7 favorites]


I am furious that he violated all those people and the DA charges him with insurance fraud. Why does a huge rich insurance company deserve protection from the state and those poor people with the damaged bodies and minds don't?
posted by fritley at 8:15 PM on April 17 [27 favorites]


Some parallels there with the physical therapy world which I discovered while studying pain science. Of course most branches of medicine struggle with the profit motive and inertia engendered by the egos of old practitioners.

Haven't been to the dentist in years (not that I recommend that) but the last guy I was going was of the opinion that an electric tooth brush twice a day is all most people need.
posted by MillMan at 8:16 PM on April 17


I'm feeling stuck with the dentist we've been going to for years. It's a big chain of clinics (their website shows 40+ clinics in my metro area), and while the work they do is fine, I definitely feel upsell pressure from time to time for unnecessary electives--a few years ago it was oral cancer screenings, and they always have posters for whitening and stuff like that. My wife has definitely had pressure for unnecessary treatment and they've been telling me for two years that I need a crown on a tooth I've had no problems with.

However, American culture being what it is, since the problems are fairly small and not egregious, I'm reluctant to roll the dice on trying a new dentist and getting someone truly awful.
posted by Ickster at 8:26 PM on April 17


My sister went to the dentist and he told her she had 17 cavities that needed filling. She doesn't have great teeth, but she also doesn't have a nightmare smile. She got a second opinion that was a lot less aggressive.

I've had to shop around for a dentist over the last few years (for various reasons). One thing dentists have started doing on the first visit is prodding the patient's gumline with a metal point, around and under each tooth, while assigning it a 1-5 health rating. It's not fun! The dentist I stuck with didn't do this. When I asked about my dental health, she basically said that my gums weren't bleeding and I wasn't in pain, so she didn't see a problem. (FWIW, my dentist was born -- and raised and educated -- in another country. I frequently have better luck with medical professionals who were educated outside of the US.)
posted by grandiloquiet at 8:38 PM on April 17 [2 favorites]


I get twice yearly cleanings for peace of mind (and because my unusually generous dental insurance covers it). I went through a autism-depression period where I couldn't brush my teeth for executive function and sensory reasons in my early twenties. Like *3 years* of no brushing or flossing except when I was basically forced to. It is a MIRACLE I don't have cavities, but I did have worn spots and stains and pre-cavities. Luckily my dentist is not an interventionist and he did not drill those spots just gave me a gentle lecture and a recommendation that brushing more regularly might help me feel better about myself and maybe a softer toothbrush wouldn't bother me as much sensory wise. And bobs your uncle it worked. I got a better diagnosis, I got a soft toothbrush and now I go in twice a year for cleanings basically so that if I have a bad sensory week and I can't brush it doesn't kill me plaque wise because twice a year I'm having cleanings. But the glory of my dentist is that he is fairly hands-off and doesn't push drillings and fillings. Considering the period when I didn't brush at all- I could have easily been taken advantage of by a less scrupulous dentist. I'm glad that guy got the hell sued out of him.
posted by Homo neanderthalensis at 8:40 PM on April 17 [8 favorites]


Is this a joke?

No, it's not a joke, and I'm at least glad Witchen gets what I was trying to say. Don't get me wrong, modern medicine is an indisputable good and saves countless lives ever year. At the same time I constantly see stories about how modern medicine fails people, especially marginalized people, so honestly I'm a bit bewildered by this kind of response.

In my experience I haven't seen much of a correlation between "receiving treatment" and "feeling good" but like you say I've been lucky enough to have never needed life-saving medical intervention. Maybe if a hospital saved my life I'd feel good? Or maybe I'd still feel like shit but at least living shit. If you've genuinely had an experience with a physician where you felt bad and they made you feel better then good on you. I simply haven't, which is why I asked the question to begin with. I probably just need better doctors.

Anyway, back to this topic, the branch of medicine least likely to ever make me feel better is dentistry. I think the only time it came close was boot camp where I was one of a select few in my division who was told I didn't need to have my wisdom teeth prophylactically removed. This made me feel good in the same sort of way being narrowly missed by a speeding semi truck would.
posted by Mr.Encyclopedia at 8:41 PM on April 17 [5 favorites]


I did not see a dentist for 14 years and he could not tell. When I told him he was like "guess you must not have a sweet tooth" and I nodded along, knowing full well I had just had a bowl of ice cream the night before. I think I've got lucky genetics or something since I've never even had a cavity but still. Is dentistry actually a science?
posted by dis_integration at 8:41 PM on April 17 [5 favorites]


At the risk of riding my hobby horse too hard, no field of medicine is a science. The training is different, the practice is different, and even the culture is different. And that's good! Medicine is respectable enough in its own right and I wouldn't want most scientists messing around with my health. But while medicine draws on science, and there are practitioners who do both to advance the field, it's quite different at heart.
posted by traveler_ at 8:53 PM on April 17 [12 favorites]


I'll send this article to my mother and see what she thinks. She was a practicing dentist in the Soviet Union, where it was a considerably less prestigious profession (her specialization was oral medicine, or stomatology, which is, I believe, a category of medical practice that doesn't map perfectly on to American dentistry). When we immigrated to the US, she learned that her credentials were not recognized here and that she would have to begin her education anew, starting with the BS. She didn't go on to dental school (for understandable reasons, I think), but did end up working as a dental hygienist. Given this family background, I harbor more than a little skepticism regarding the exacting scientific standards of American dentistry, but she is the professional, and it'll be interesting what she makes of the Atlantic piece.
posted by a certain Sysoi Pafnut'evich at 9:03 PM on April 17 [7 favorites]


Oh man, I've wondered for so long. One dental visit I had I knew I was being upsold on a procedure that probably wasn't necessary, and I passed on it. I have had no issues in 10 years after. Additionally, I'm pretty sure that the one filling I had in my life was not because I needed one, but because I came in for the procedures that the article indicates don't really make anyone money.

It's hard to refer to a "feeling" one has that they weren't dealt with honestly, but I think I've felt this more keenly at the dentist more than any other sort of health practitioner. There are quacks out there who are in certain "professions" who are well-intentioned but wrong, but there are also people who are wrong and know it. I feel as if I can tell this at times, but feeling as if I might not every time -- and don't have the time or energy for a second opinion -- keeps me from getting oral care as often as I should. (On the other hand, having my wisdom teeth out was one of the better decisions I've made in my life. Instant quality of life improvement.)

Truly, this applies not only to the patients in the story but to anyone who has been speculative about these kinds of things: "He damaged the trust I need to have in the people who take care of me." That's a hell of a thing.
posted by SpacemanStix at 9:04 PM on April 17 [1 favorite]


I don't know who needs to hear this, but: I used to have terrible dentist visits with multiple cavities every time and badly receding/bleeding gums. The dentist didn't believe that I brushed and flossed every day. Then — on a tip from the amazing older hygenist I saw once, who immediately knew what was up — I got a nightguard. I've had NO cavities since then, and my gums are now average-to-good.

I had the expensive custom guard at first (thanks insurance!), but after that one died I've just used the soft ones from the drugstore and they seem to work just as well. Seriously, it's $10 for 3 pack and you could possibly save yourself thousands of dollars.
posted by 100kb at 9:10 PM on April 17 [5 favorites]


This article was a frustrating read because it was like...yeah...I know...but what do I do about it? Because if you don't go see the dentist every six months they start looking extra hard for cavities to prove you aren't seeing them often enough, I imagine, whether that's their intention or not.

At least I didn't listen when I went to see a dentist at the age of 22 and she said I needed a crown. I was like "yeah, sounds great, I'll call to schedule, hey could I get those x-rays??" and ran as fast as I could with them to another dentist who laughed and laughed as his second opinion. 12 years later no other dentist has ever hinted I needed a crown.

My favorite dentist I ever had was trained in the military and had all these sorts of battlefield shortcuts. He was a huge believer in Recaldent and prescribed MI Paste to everyone, and was all about dabbing a little Chloraseptic on anything that hurt if your mouth "just to see if it went away and didn't come back". But the one filling he gave me, he didn't actually drill aggressively enough - the tooth remained sensitive, and the dentist after that said there was still decay and drilled out the filling and tried again, and I got relief that time. So I guess my favorite dentist wasn't so hot either. I don't trust my current dentist as far as I can throw her, but I don't really know how to find one in whom I'm able to have more confidence. I live in a pretty expensive area now and it seems like nobody who can afford to rent an office around here takes a conservative enough approach to dentistry to make me feel good about it.

Really, though, I want to see this same article about orthodontia. What a scam of a field that is. Six years in braces and the first time I saw a dentist afterwards you know what he said? First words?? "Boy, you want to get some braces on those teeth back there." I was like...BUD...ARE YOU KIDDING ME WITH THIS...literally, I had just got the damn braces off the previous week. And every cavity but one I've ever had was in a tooth that had a band on it. You try keeping your teeth clean with braces on them for six years.
posted by potrzebie at 9:36 PM on April 17 [4 favorites]


Yeah I never know if they're telling me the truth but I'm so bad at brushing (I brush in the morning but can't make myself do it at night, I hate the sensation) that I don't doubt they're riddled with new cavities. I can only afford to go every few years because I can't tolerate how much any of it hurts. Even just the cleaning. I think because they started putting epinephrine in the Novocain. It made my heart race which gave my brain the idea that it's a dangerous situation and now every time they start poking around in there my brain says "Oh, I remember this, this is where your heart always started racing, this sucks and hurts, let's start crying til someone comes and helps us". So now I need full sedation which isn't covered by insurance and is so expensive.
posted by bleep at 9:46 PM on April 17 [1 favorite]


oooh braces is the other reason I see my current dentist religiously. A) I have staining issues and enamel issues due to the braces themselves and B) this dentist was hyper-honest with me. I had been told by my ortho that besides my janky teeth looking janky the real reason 12 year old me needed braces was because IF I DIDNT GET THEM I WOULD NEED JAW SURGERY OMG IT IS AN EMERGENCY YOU MUST GET BRACES and of course my loving mother bought it. But my dentist (same guy still) after the fact at like 16 took a look at my old x-rays and called extreme bullshit. Pointed out exactly why my teeth would have been fine without braces, just janky and said I never would have needed jaw surgery without braces. So his radical honesty about how my ortho lied coupled with my issues remembering to brush have me coming back to him.
posted by Homo neanderthalensis at 9:49 PM on April 17 [2 favorites]


So I had an excellent dentist out here, recommended by a friend who worked at Stanford Medical as the one she and all her colleagues went to. Always happy to detail what he was doing, loved gadgets where he could show you what he saw in your mouth, gave you realistic estimates about whether you really needed to have work done or it could wait for a few years. Even did a couple of fillings for the cost of materials when I was unemployed.

But then he retired and sold his practice, and while the first new set were okay, they sold it on to a guy who tried to up-sell me for *three* different things on my first visit. Which was the sign to go, and I did. I know Yelp is evil in a lot of ways, but it turned out to be great for finding a new dentist, because you could look for one that had reviews where they talked about how detailed and non-pressure the appointments were and avoid the ones where it was all about whiter teeth. I don't love my new one quite as much as my last, but she's in much the same vein. Though I admit I find the gum checks somewhat annoying as well.

To me, the reaction when you push back on a suggested treatment is the key to telling whether you are being falsely up-sold. Are they willing to detail the issues they see, and back them up with x-rays or tests? Do they give you a realistic sounding estimate of what the consequences of waiting would be, or do they try to pump up the terror? Mostly, do they try to sell you harder, or do they accept it and say "well, we can see how things look next year" or suggest a less drastic alternative?
posted by tavella at 9:49 PM on April 17 [1 favorite]


Please tell me, all you people who visit dentists on a decade-long schedule, that you at least floss and brush religiously. Or that you do not eat any carbs. How are you so cavalier about your tooth care? Have you not had the kind of toothache that makes you count the minutes until your dentist appointment or makes you consider using a chisel and hammer yourself? I spend the time I get my teeth cleaned twice a year thinking about the ancient bridal present of having your teeth banged out all at once to spare the agony of them rotting out.
posted by Camofrog at 9:58 PM on April 17 [1 favorite]


I will never, ever forget the sign I saw on the side of a bus once. "Any tooth removed, only $99!"

This is the state of health care in America—dentistry is in its own little world, so people line up days in advance for free clinics, make their own teeth out of plastic they buy on Amazon, and brute tooth removal is the only treatment for some because dental care is an extra hit on your paycheck.

I didn't go for many years due to extreme phobia (this article REALLY needs a content warning, BTW) and as a result I've had to have massive amounts of work done. I went six times last year for a chipped tooth, a crown, and three cleanings. Not everyone is lucky to grow up with good water or winning the genetic lottery for enamel strength and tooth shape.
posted by fifteen schnitzengruben is my limit at 10:30 PM on April 17 [7 favorites]


I feel fairly sure that tooth health is largely genetic and that explains why some people have a horrible time while cleaning the shit out of their mouths and others don't give a shit but end up with no problems. I luckily fall into the second category, although I do floss now, but only because food gets stuck between my teeth more than it did when I was younger. My wife on the other hand can't catch a break. She brushes faithfully after everything she eats and still has tooth issues.
posted by Literaryhero at 10:42 PM on April 17 [17 favorites]


I think when you've been physically hurt and tortured repeatedly as a child by multiple dentists and orthodontists, leaving your teeth filed, chiseled, hammered, and "fixed", only to see your teeth fail on you as a young adult anyway, it makes nothing but sense to avoid all things dentistry for at the very least several decades.

Maybe (??) American dentistry no longer traumatizes its young patients, but make no mistake it did for ages and avoiding those sadistic assholes made and makes sense, because at least in my case they did far more damage than they could ever do healing.

In short: Fuck dentists and orthodontists! Yeah I said it, it feels good, and bully for you if you love yours.
posted by riverlife at 10:48 PM on April 17 [8 favorites]


The article is two stories: one is about a dentist and fraud, the other is about how little is known about proper dentistry. That second story is maybe more important than the first.
posted by CCBC at 10:57 PM on April 17 [14 favorites]


I guess I'm the exception here, to have had mostly good experiences with dentistry with pretty crappy teeth. Though the more I think about it, maybe it's not so great after all.

All the usual circumstances: stable household, constant employment for all (so far, knock on wood).

When I first came to the US and with a mouthful of cavities, my parents, paid under the table, paid the dentist for those fillings in cash. It was a lot of cavities -- the grandparents who raised me didn't really do toothbrushing. But now considering it, did I really need baby teeth filled? (A quick search says 'yes', but most sources seem to be from dentists.)

After that, since my mother's insurance paid for four cleanings a year, she decided that I should have them. I went to the same dentist through college. They moved offices and got a Keurig machine; I usually liked these visits, especially when I got them done before picture day. I got a filling once in a while.

On the orthodontic front, I still feel that mine set my teeth in a position that I can't really bite in, so I do take some umbrage at that.

As an adult, I went to a dentist whom a friend said was very conscious of insurance / the fact that the operations she proposes costs money. I only get two free cleanings a year, so I do that, and I get a filling once in a while. Her office is really pleasant, and I think the hygienists are told not to nag too hard about my uh, lax flossing cadence. That seems to make business sense to me; unpleasant cleanings = no return visit = no payout.

Yesterday, actually, I'd been on the second day of intense face pain. I've had sensitive teeth on and off, but this pain was getting to the point that two ibuprofen weren't helping and it was hard to fall asleep. I got a reminder email saying that I had a cleaning coming up, and I decided to call asking if they could get me in earlier.

They could; I went in today, got my mouth stones scraped, and the dentist did her exam. She said that I'd chipped a filling, and it would have to be shored up at a later appointment.

"So you're not going to do anything now? I get waves of pain in both my upper and lower jaw even though the bad tooth is on top."

She put her loupes and mask back on, made a scrap of cloth extremely cold, tried it on a good tooth (yelp), tried it on that tooth -- nothing. Sheepishly she sent me to the endodontist for a same-day root canal ("necrotic pulp"): he squeezed me in at the end of the day, did two of the roots, and had me make an appointment for the following week to do the last root. None of this hurt (yet, lol).

This is going to cost me > $700, despite insurance. (Should have loaded up that FSA this year!)
posted by batter_my_heart at 11:50 PM on April 17


I'm sorta wondering about the 'new teeth in a day' things now. Rip them all out at once and replace. It's a bit of a leftover from my cyberpunk days way back when and being all cool with replacing frail biological parts, and a good bit of having three wisdom teeth that grew forwards instead of up (that no dentist ever actually warned me about) that ended up pretty much crushing the back of my mouth. I sorta want to just get it over with and just do dentures like my parents and grandparents. I sorta get the feeling that all of those dentist looked at the x-rays and saw future $$ signs in their eyes and sent me on my way. It wasn't until a wisdom tooth erupted sideways into my cheek that they deemed it time to take them out and by then the damage was done. Graar, dentists.
posted by zengargoyle at 12:14 AM on April 18


(now having read the article)

On the plus side, I definitely walked out feeling better than I walked in! This was, guaranteed, not a gratuitous root canal. (My dentist also does not fill minor cavities, but instead puts a watch on the tooth, and a lot of them do go away)

Unfortunately it seems that root canals have risks and complications ;_; I hope I'll be one of the lucky ones!
posted by batter_my_heart at 12:22 AM on April 18


It's genetics too. My biological kid has the best tooth care from birth of my children and a fantastic paediatric dentist who did the protective sealants. She's had multiple fillings already, maybe six or seven in her baby teeth. My older kids have beautiful straight teeth and barely any cavities except for one with specific teeth-trauma. Even that kid has amazing teeth now. My dentist refused to do whitening or veneers for me because he said it was basically not worth the additional damage for my teeth. We just had a dentist charged with using dental insurance fraud for about a quarter of a million over a few patients as well!
posted by dorothyisunderwood at 12:33 AM on April 18


Nthing that genetics is relevant. I eat carbs, drink juice and wine and coffee and brush once a day. I don’t floss and I get my teeth cleaned every 12-18 months. I once went for about 5 years without going to the dentist for reasons. And hygienists keep telling me that I have hardly any plaque. I also don’t find it painful, just uncomfortable and I have one filling, in a baby tooth (I am 41). That tooth didn’t have a cavity, I bit into a nut and a bit broke off. They tell me I‘ll need an implant to replace that tooth eventually. Now my younger brother has always had problematic teeth. Even when we were in pre-school, had the exact same diet and brushed our teeth side by side he ended up with cavities in his baby teeth and I didn’t. He is somebody who would need to be very diligent in his dental care. But as he is at least as negligent as I am, he has a lot of problems.
posted by koahiatamadl at 3:06 AM on April 18 [1 favorite]


Wow, American dentistry sounds very different than the Canadian variety, even though it's not covered by our socialized medicine plans. I cannot imagine being updos anything I didn't ask about in the first place.

I used to live near a dental school a few years ago and apparently the new hotness in the field is laser dentistry, which is absolutely delightful in comparison to the old methods.
posted by peppermind at 3:15 AM on April 18 [1 favorite]


Oh man, I had a dentist like this once. When she heard that I hadn't seen a dentist in a couple years, you could practically see the $$ light up in her eyes. After 30 years of good oral hygiene (ok, I'll cop to skipping flossing at times) and never any tooth issues, I suddenly had 8 cavities that had to be filled ASAP, needed all my wisdom teeth pulled out, Invisalign braces, jaw surgery to correct my overbite.... I politely said I'd need to schedule all that later, paid my bill for the cleaning, and never went back.

My current dentist seems a lot more reasonable. He still does recommend the biannual cleaning schedule, but doesn't upsell, which seems as good as it can get in the current world of dental care. And no, I never had any cavities.

Honestly, though? This is what happens when you introduce the profit motive into medical care -- and yes, dental care is medical care. As the article points out, most dentists are solo practice or small group practice, essentially small business owners who have to pay their staff and their office rent and whatever professional organization dues/continuing dental education requirements they have. Get rid of the profit motive and you'll get rid of a lot of this bullshit upsell.
posted by basalganglia at 3:56 AM on April 18 [5 favorites]


If this article makes you angry, please remember to direct your anger at the right people, and not at receptionists and dental hygienists.
posted by Rock Steady at 3:57 AM on April 18 [5 favorites]


When I was just a little kid, the dentist my parents took me to was horrible. Not only did he "drill, baby, drill" at almost every opportunity, he did so without any local anesthetic. On a kid! That torture made sure, later in life, that I never saw a dentist unless I definitely had a problem.

I don't recall the proliferation of dentistry upsells (and, honestly, price escalation) until schemes like CareCredit hit the market, making it "easy" for patients to pay for expensive services.

I think all you need to know about dental care in America is that the largest chain of "dentist" offices, Aspen Dental, is primarily focused on selling dentures.
posted by Thorzdad at 4:26 AM on April 18 [2 favorites]


Let me just say this: if your dentist is working out of any kind of chain office, run the fuck away and find someone more reputable. Those fuckers are evil incarnate.

I was literally made to wait 30 minutes in agonizing pain, having already seen the dentist and already with a not-yet-filled prescription for painkillers in hand, for what I was given the impression was more results from the dentist. Instead, it turned out that was the time they needed to put together a pitch to right then and there, as I was again sitting there in excruciating fucking pain, try to sell me on signing up (complete with "easy" down payment) for over $20,000 worth of dental work they claimed I needed.

These assholes were so excited at the possibility of making money from me that they made me sit around in pain, delaying getting my prescription and thus relief, so they could organize strongarm tactics to try to get me to sign anything just to get the fuck out of there.

I did not sign. I got the fuck out. I never went back.

Big shock: at a reputable dentist, literally none of the work they claimed was needed was identified as needed. None of it has ever been an issue in the 15+ years since.
posted by tocts at 4:32 AM on April 18 [8 favorites]


Also, I don't mind naming and shaming: this was of course at an Aspen Dental. One opened up in my town years later, and every time I drive by I idly think about whether I could get away with firebombing it.
posted by tocts at 4:33 AM on April 18 [7 favorites]


Agree with tocts. I have a dentist brother and he has warned me to steer clear of huge national chains like Aspen, which are, according to him, are chop shops that upsell you on unnecessary procedures, and actually exploit their employees (including dentists) with a ridiculously burdensome workload and absurd "production" goals
posted by shaademaan at 5:05 AM on April 18 [1 favorite]


It’s not just (some) dentists that do unnecessary procedures, medicine is also full of doctors who went into the field to make money. Colonoscopies every 3 years (!), echocardiogram every 6 months, etc. etc. Always get a second opinion.
posted by sudogeek at 5:15 AM on April 18


I did once have an encounter with a dentist who insisted I had a cavity and it would need a crown, but my employer changed dental plans and I went to a different dentist 6 months later who looked and said "eh, there's a weak spot there, but if it's not bothering you, we'll just keep an eye on it." I am convinced that the one guy needed to make a boat payment.
posted by coppertop at 5:17 AM on April 18


I had such a horrific experience at one dental chain/hmo, I staggered out and never returned. They had one dentist on duty; she was Russian and had little English. She had patients in three rooms, and they had her literally running between us patients, starting a procedure on one, dashing off to another to perform the next stage on that victim, running to the third to work on him. Because she was in such a hurry, she was rough. I hadn't had such painful dental work since my childhood, and I had never had a procedure take so long, because of course I had to lie there and wait (Novocaine wearing off) while she worked on patients 2 and 3 before coming back to me.

Fortunately, I found the classic little neighborhood dental office within walking distance from my house. The dentist lives in my neighborhood, he's kind, professional, unpretentious, and knowing his patients as neighbors, he often discounts his services or performs another procedure at no additional charge. He and I are both approaching retirement age. I dread having to start with a new, unknown dentist in my senior years.
posted by Lunaloon at 5:21 AM on April 18 [1 favorite]


> “I honestly don't understand why dental care is so de-coupled from medical care.”

The reason dentistry and all other medical practices are separate is largely because, historically, a barber or blacksmith took care of your teeth and a physician handled everything else. Dental care was viewed as a grimy, lower-class practice by doctors ever after. It’s quite a damaging separation.
posted by thoroughburro at 5:26 AM on April 18 [5 favorites]


> “At the risk of riding my hobby horse too hard, no field of medicine is a science. The training is different, the practice is different, and even the culture is different. And that's good!”

Dentistry is separated, both in education of practitioners and their practices, in a way different from all other medical science. It’s due to historical anomaly being perpetuated long past its sell-by date. See again the link above, but there is no shortage.
posted by thoroughburro at 5:33 AM on April 18


A caution about genetics... I seem to have fortunately inherited my father's constitution, but not all of his habits. He had one cavity when he was in the army, and one in his 80's, IIRC. But he didn't drink gallons of Mountain Dew. I also neglected to go to the dentist from around ages 19-26. The dentist I went to then was excellent, and I have no reason to doubt anything he did to fix me up, even if it did take 15-20 visits.
Moved to another city, got another dentist. This one I would describe as good, but not excellent. He was a real nice guy, and he freely dispensed nitrous oxide, which increased the likelihood of my going back for more services. It also made me comfortable with most dental work. I did not doubt his work at all until this article. I had a bunch of crowns in 20 years of going to him, but it seemed like that was a result of keeping up the work done in my 20's (while maintaining my soda habit). Now, not sure, but I'll give him a pass thanks to the nitrous.
My dentist in Vermont is excellent. I trust her implicitly, my only concern there is that since she wrote a best-selling novel, she might retire before I die. I have switched to sugar-free soda and bought an electric toothbrush, but I am still amazed when they say everything looks great.

I did go to Aspen a few times when I was between cities, and the dentists were mostly foreign, and mostly really, really good. My only worry was the older white guy. I thought 'What did you do that made you wind up here?'

My biggest horror story was going to an endodontist who had a TV attached to the equipment stand. I can understand that patients might want to watch while they wait, but the dentist was watching, and he was watching some Sally Jessy- type show, and arguing with it. [That wasn't the horror part, but I would not have made it through that procedure without nitrous)
posted by MtDewd at 6:17 AM on April 18 [2 favorites]


I went to a dentist in California once where everyone in the office has Invisalign guards on and - guess what? - they tried to sell me on Invisalign too, despite having straight teeth and a good bite. I might need a night guard eventually, but there's a *really* big difference between even a custom night guard and, essentially, braces. I did not go back, and neither did my wife. (My wife is a whole other story, with possibly-unnecessary jaw surgery as a teenager that has given her chronic problems ever since, and they sold her on a ridiculously expensive piece of bullshit that I would have absolutely vetoed had she gotten a chance to ask me about it before handing over her credit card.)

My dentist back in Austin was fantastic - total dentistry nerd, and had a couple of firmly-held opinions that I defer to her on, such as only using baby toothbrushes (you don't need firm bristles, they're hard on your gums, and the smaller head lets you get all the way back to your molars) and ditching the Tom's of Maine (which she said correlated with bleeding gums in her experience - I'm back on standard non-whitening Crest) and did a fantastic job on all the minor work I needed done. But she retired early and I live elsewhere anyway, and my current dentist is... fine I guess? But I don't trust him and I probably shouldn't. They're good with my wife's special needs, though, so I guess I'll live with him. (She gets cleanings four times a year because she can't keep her mouth open comfortably for long enough to do a deep cleaning - see above, re: jaw surgery.)
posted by restless_nomad at 6:21 AM on April 18 [1 favorite]


Please tell me, all you people who visit dentists on a decade-long schedule, that you at least floss and brush religiously. Or that you do not eat any carbs

Nope. I eat carbs religiously, brush daily, floss never, and my record is seventeen years between visits. Never a cavity. Both my parents went through various dental nightmares, so it wasn’t genetics.

What was it? I lucked out with a childhood dentist who believed in fluoride tablets every morning and parents who agreed to them. Took them every day with breakfast until around puberty.

Still have a goofy gap in my upper front teeth and a single crooked lower one, because the same dentist said it wasn’t worth getting braces for two minor cosmetic quirks. I wonder what became of that guy and his radical ounce-of-prevention approach?
posted by armeowda at 6:24 AM on April 18 [1 favorite]


The no-longer-my-dentist arm-twisted me into a flapper (cosmetic fake tooth that needs to be removed for eating or sleeping) on a tooth where I explicitly said I was getting the post for an implant. Flapper won't fit over the post, wtf?

I have crummy teeth, am the 7th of 8 pregnancies, 5th of 6 kids. My poor younger brother has it worse. Had the same dentist for 30 years until he retired. I think one of his kids' years of college should have been dedicated to me. But he didn't do unnecessary stuff.
posted by theora55 at 6:27 AM on April 18


A few years out of college, living on my own, finally got dental insurance with a new job and went to a local dentist--one of those ones who'd been well-reviewed in a local newspaper's 'best of' list. Where I was told that not only did I have a whole bunch of cavities that needed filling, my teeth didn't line up properly and would need cosmetic reshaping, and they would have to do something about the horrific staining. I freaked out not only because I had never had a cavity but also because I couldn't afford thousands of dollars of dental work. My mom got in touch with my childhood dentist, I got the shady local dentist to send their x-rays (which my childhood dentist said were terrible quality), but she not only looked them over but CALLED ME to tell me that my teeth looked fine. I found a new dentist a little while later and they were like, yup a few watch spots but no big deal and otherwise my teeth look great. And did you know that my back molars are discolored but that was probably something that happened in utero or infancy?
posted by carrioncomfort at 6:52 AM on April 18 [1 favorite]


I still have all my wisdom teeth and my test when I go to see a new dentist is whether or not they tell me they should come out. One dentist told me I should take out the bottom ones "to make room" (my wisdom teeth are not impacted.) For what, I don't know. Maybe his boat?
posted by Automocar at 6:57 AM on April 18 [1 favorite]


I don't know who needs to hear this, but: I used to have terrible dentist visits with multiple cavities every time and badly receding/bleeding gums. The dentist didn't believe that I brushed and flossed every day. Then — on a tip from the amazing older hygenist I saw once, who immediately knew what was up — I got a nightguard. I've had NO cavities since then, and my gums are now average-to-good.

Samesies with me, except what I did was get diagnosed with sleep apnea and get a CPAP. Besides the improvement in my sleep quality, energy, immune system, you name it - my oral health improved tremendously as well. Breathing through my mouth every night dried it out and ruined my gums and teeth. Thanks to my CPAP, I no longer do that, and my gums have improved tremendously, as has my tooth sensitivity, and susceptibility to cavities.

This says to me that oral health really is not separable from the rest of the body. (Neither can brain health, for that matter.) Treating my sleep issues improved my mouth issues...so my dream for health science is that all categories would be integrated in a way they are not now.

BTW, I had dental phobia for years (thanks, bad childhood dentists and orthodontists and parents who didn't give a shit how I felt) and now I have a wonderful dentist with wonderful staff and, yes, nitrous, which helps tremendously.
posted by Rosie M. Banks at 7:03 AM on April 18 [6 favorites]


My mother has always said that you have to be skeptical of dentists.

I had been with one dentist for more than ten years when one day, I went in for a scheduled appointment and found the office locked with a ton of missed delivery notices stuck to the door, and a full voice mailbox. I later discovered that my dentist had come out of the closet late in life, fell in with a bad crowd, and started abusing his prescription pad, eventually leading to losing his license. So that was fun.

My next dentist was fine, but very utilitarian, which in retrospect might have been a good thing. Eventually a friend of mine enticed me to change to his dentist, who has several beautiful offices. I feel very comfortable and well-taken care of there, but I've already been talked into spending several thousand dollars on an orthodontic appliance and have now been referred for gum surgery. So I dunno whether I'm getting great care, or a shakedown.
posted by sevenyearlurk at 7:07 AM on April 18


seventeen years between visits. Never a cavity.

Might be the fluoride tablets, might be diet, might be oral/endodontal flora, might be roll of the dice. I'm not sure we know enough to say exactly why some people get cavities despite being meticulous and some people can apparently do almost literally nothing and be fine. Although those towns filled with dumbfucks who are taking fluoride out of the water are providing us a nice experiment.

There are a lot of things wrong with dentistry in the US, but hollll-yeee-sheeet if you've ever had a problem where you need a dentist and can't find one promptly, it sucks. There's a reason why people used to let other people rip their bad teeth out with pliers and chisels and stuff. Anything to make the pain stop seems like a good idea.

But yeah, the for-profit piecework model leads to a tremendous amount of unnecessary procedures. Unnecessary wisdom teeth removal in the US almost certainly kills young people who would otherwise be alive—there's a nonzero risk of death associated with oral surgery, and yet lots of endodontists push wisdom teeth surgery as a "routine" thing, not dissimilar to how tonsillectomy used to be pushed in the 1950s. Tellingly, the procedure is far less common in countries where the surgeon isn't making money off of every tooth ripped out, and are on salary instead. But this is America, and that's obviously socialism. So open up, kids! Those extra teeth are where Communism lives!

Also, I loled a bit at this Twitter post from Dan Sheehan:

> According to most health insurance companies, teeth are luxury bones that I must pay more to continue enjoying
posted by Kadin2048 at 7:09 AM on April 18 [8 favorites]


I feel fairly sure that tooth health is largely genetic

The nature of your saliva, what kinds of microflora live in your mouth, the strength of your tooth enamel and its resiliency against acid, whether you grind your teeth, how your teeth fit together, how your jaw works, the resiliency of your gums, etc. all have a huge influence on the extent to which you develop dental plaque and tartar, cavities, etc. I believe this is magnified by the quality of your dental prophylaxis as a young person. I come from a family with good teeth, but I also grew up in a city with fluoridated water, my mother made us drink powdered milk (more fluoride!) and we got awful-tasting fluoride treatments at the dentist who we saw regularly. As a result I have had practically no dental problems as an adult, and my dental hygienist said my teeth looked fine and only needed light cleaning even though it had been a decade since my last cleaning. On the other hand, I have a friend whose dietary and tooth maintenance habits are effectively the same as mine and who also hadn't had a cleaning in a decade, and she had to schedule a follow-up appointment to complete the cleaning due to the accumulation of dental plaque. And, of course, I have friends who brush and floss fastidiously after every single meal, and whose teeth are a wreck.
posted by slkinsey at 7:24 AM on April 18 [3 favorites]


Man, now I'm wondering about my first adult dentist who immediately diagnosed six cavities in my rear molars that my prior dentist hadn't. I mean, at the time I wrote it off to a gap between visits after I aged out of my parent's plan and I started going on my own plan, but now I'm not so sure. I think I've had one or two more in the 20-some years since, but if six of the sixteen molars are already amalgam, well...

I'm quite happy with my current dentist - he inherited his practice from his father when he retired (and his dad was a good guy, too), so he didn't have a huge initial investment to pay off. Sure, all his gear is a little older, his xray is from the 60s and looks it, but it's more than sufficient for regular cleanings and maintenance. He mostly seems content doing what he does, and it might be a quirk of our insurance, but he's happy to hand us off to in-network specialists for more expensive services like extractions or root canals. Or maybe he just likes doing what he knows he's good at, and he can keep the business afloat without branching into trying to be more sales oriented.
posted by Kyol at 7:29 AM on April 18 [2 favorites]


“He damaged the trust I need to have in the people who take care of me,” Cordi says. “He damaged my trust in mankind. That’s an unforgivable crime.”

I really feel for this person. By the time I mastered my dental avoidance, I was in bad shape with periodontal disease, and I have had some heavy work done. Extractions, laser surgery, bridges, crowns. I really, really, really need to trust my dental care professionals (and I do) - if I found out that they had been telling me to have procedures I did not need, I'd be very traumatized.
posted by thelonius at 7:35 AM on April 18 [4 favorites]


lots of endodontists push wisdom teeth surgery as a "routine" thing, not dissimilar to how tonsillectomy used to be pushed in the 1950s

Okay, so this is a tangential story, but it's too good not to share: My father and his cousins grew up in rural Texas during the Depression and war years. One day when they were young boys his cousin Ed got tonsillitis, and a message went out to an "itinerant surgeon" who agreed to swing by their dusty little west Texas town with his tank of ether. As he discussed the procedure with Ed's parents, he mentioned that Ed hadn't yet been circumcised and offered to go ahead and do that too while Ed was under the ether (male circumcision was commonplace in America at that time). That sounded okay to them. None of this was discussed with Ed, because that was not the done thing in those days. Needless to say, Ed emerged from the ether to quite a surprise. Not too long thereafter one of Ed's friends in a nearby farm started getting a sore throat, and Ed showed him what happens when you get your tonsils out. The surgeon showed up, but somehow the boy was nowhere to be found. He never did get his tonsils taken out and, according to legend, when he greeted his maker many decades later he still had his tonsils.
posted by slkinsey at 7:38 AM on April 18 [15 favorites]


Count me in as suspicious of dentists. I had always had good teeth (one cavity lifetime) until I started going to a new dentist in my late twenties. And suddenly I had a cavity to fill every time I saw him. I figured out there was a problem when he told me I needed a root canal on a tooth where I had no pain, and he was pointing to a spot on an xray where I couldn't see anything.

Because I am a bit of a nutcase, I stalked out without getting it done, but then got blocked on ever going back to a dentist and didn't see one again for five or six years. The tooth that 'needed the root canal' was fine. Since then, the only problems I've had have been gaps around the fillings he put in -- a bunch of those have needed (maybe? how would I know?) to be replaced.

I would think of a doctor who was knowingly and intentionally doing unnecessary, damaging procedures to make money as an incredibly bizarre freak: I fundamentally trust doctors. Dentists, I think your odds of running into a crook who will do permanent damage to you for profit are fairly high.
posted by LizardBreath at 7:38 AM on April 18 [1 favorite]


I typically feel better after I see a dentist so I don't find it to be a big deal to get cleanings every 6 months, but then again I see it as completely normal to go many years between seeing one too. I went a solid 10 years if not longer without ever going to the doctor. Same thing. Sometimes you get lucky.
posted by The_Vegetables at 7:44 AM on April 18


I read an article a few years ago - I think it was in Reader's Digest - by a reporter who had gone to about 50 different dentists, all around the country, for an evaluation and "second opinion". He got everything from "well, there are one or two areas I want to keep an eye on, but everything is basically OK" to $20k "treatment plans" calling for multiple root canals, crowns, etc.
posted by thelonius at 7:44 AM on April 18


Please tell me, all you people who visit dentists on a decade-long schedule, that you at least floss and brush religiously. Or that you do not eat any carbs.

Nope and nope. I brush once a day, and I do it “wrong” (I do the circles thing instead of the approved ‘fling toothpaste and spit onto the bathroom mirror, walls, and ceiling’ method), and floss when I have something stuck in my teeth (flossing is bullshit, anyway). Eat and drink many, many carbs.
posted by rodlymight at 8:04 AM on April 18 [1 favorite]


I had some medical neglect as a kid and part of that was having braces put on, the process nearly completed, and then not maintained. By the time they were removed I hadn’t seen a healthcare professional for three years.

By some miracle, my teeth are straight. But I am in the chair every six months to deal with slight gun recession and sensitivity caused by the ordeal. I don’t floss as well as I should and I have to set a timer for my brushing because thirty seconds sure feels like two minutes.

I have worked in dental offices. Some are nightmare pits of upselling and scammers. I suggest folks get a second opinion on all major work. I’ve got a tooth that ‘needed a crown’ 15 years ago. I insisted to every new dentist we baby it along and talk about it next year. My current dentist is 100% in support of my plan and worked very hard to rein in some serious sensitivity in that area. I love my dentist. If you’re in NYC, go see Dr Hamidi in Tribeca. Patient, kind, gentle, believes me when I tell him I can feel what he’s doing instead of charging ahead and telling me that’s not possible with the amount of medicine he’s injected. Because it takes me a while to get numb and I don’t reliably stay numb, we don’t do much in any one visit and he’s never made me feel bad about any of it. He’ll be my dentist as long as I’m in New York and he’s in business.
posted by bilabial at 8:42 AM on April 18 [4 favorites]


God, this article makes me nervous.

I saw the same family dentist through my early 20s, when I was on my own insurance for the first time. I'd had maybe 3 cavities up until then. I saw a new dentist who started spitting out numbers and promptly scheduled me for 8 fillings in my back molars. I was stunned and went with it, but decided to go to a different dentist after that experience. For three years, everything was fine.

Then I moved to Florida, new insurance again, it had been about 9 months since my last cleaning. Find a new dentist. He recommends expensive onlays because he says my back molars are covered in cavities. I'm skeptical, get a second opinion. The second opinion dentist says it was too extensive of a treatment plan, but that I certainly did have cavities--like a dozen of them! I get them all filled with him, but in the process, two teeth get infected--the most painful experience of my life--requiring root canals. I'm about twenty-five at this point. My mom's like, when you're home visiting NJ, come back to the family dentist. So I start doing that, for the next decade. We live in Florida, Virginia, and New York state but like clockwork I go back to my childhood dentist every six months. One filling falls out and needs to be replaced, and I get one cavity beneath some dodgy filling material that I KNEW I couldn't floss correctly. One of the root canals, which never felt right, gets infected again and requires being redone.

But I need no new fillings.

As of November I was still seeing this dentist, driving two hours for appointments, and I really like him and his assistant. His office is old and shabby but I trust him. He also barely charges me because he says we're like family--for years I paid only $50 for cleanings and x-rays and when i did need work done he never charged me more than that. But he's 70, close to retirement, and more importantly, I'm now estranged from my mother so going back to my hometown is a huge anxiety trigger and he and the hygienist keep cheerfully asking me if I've seen my mother lately, and how recently, and I get the feeling she's said shit to them about it and I just can't deal.

So I really need to look for a new dentist but god damn it, I'm scared to. To this day I'm not entirely convinced that I needed any of that dental work in the first place. I always, always floss and brush. But I have no idea what a new dentist might pressure me into.

Also I do think my braces--maybe unnecessary, and i think in retrospect if I'd had any say in it, I wouldn't have gotten them--have a lot to do with it. I've been told that my gums look like the gums of someone who had braces, whatever that means.

My daughter has crappy teeth--definitely had early childhood caries in her front teeth--but we've found a good pediatric dentist who just put a ton of fluoride on them and they've been stable for 4 years now and are falling out. I pay quite a bit of cash to see him, when my daughter is covered on medicaid, but I've researched and read that pediatric dentists who accept medicaid do wildly more invasive treatments. So no way.
posted by PhoBWanKenobi at 8:57 AM on April 18 [2 favorites]


If you don't trust dentists, you could always go the Bob Mortimer route.
posted by MartinWisse at 9:04 AM on April 18 [1 favorite]


I do love dentist stories. Here are mine:

Dentist 1: A fraternity brother of my father's. Practiced out of a house in a fancy neighborhood. Neutral visits where he mostly talked about his daughter's soccer team and caught up on gossip with my mom. Dental health is a social event!

Dentist 2: I guess I had fallen through the cracks when my parents got divorced, because I wound up in another town for college not having seen a dentist for about a decade. The guy--who, somehow, was supposed to be dating my mother--told me I needed eleven fillings. A good thing is that he let me take my Discman into our sessions and listen to Joni Mitchell while they drilled.

Dentist 3: Back in my hometown, and my dad has moved away from his frat bro and onto a super cool lady dentist who used to work for NASA. She was the best. THE BEST. God, I loved that office. If you need a recommendation for Raleigh, NC, go to Beverly Thurmond.

Dentist 4: I'd just moved and I had a broken tooth, so I went to the "urgent care" office. It was located around back on the basement level of a run-down shopping center. The office was messy, with file folders all over the place, no order or rhyme or reason to any of it. The staff looked like a real ragtag group. The equipment was weirdly old and out-of-date; I remember thinking it had a Soviet vibe? While also looking like old-timey "country doctor" equipment. There was a spit sink finished in chipped enamel. I left without any treatment. I got a bill in the mail for $12.51 and never paid it, (correctly) assuming they'd never notice or care.

Dentist 5: Reasonable, sensible, nice. I try to get care from female practitioners only, and it's easy to do with my current office. It's not really remarkable, and that's pretty much ideal.
posted by witchen at 9:15 AM on April 18 [2 favorites]


i'm just angry about the thousands of dollars my parents spent on braces for me. when the braces came off i had those white circles on all my teeth where the brackets were and i'm STILL (25 years later) having problems with all the teeth that had BANDS on them. huge fillings, multiple crowns, multiple root canals. and, because i haven't worn my retainer in 20 years because i HAVE to wear a night/bite guard, my teeth are moving back to their shitty position. it's complete bullshit.

my childhood dentist was awful. pulled teeth without enough anesthesia and didn't believe me when i needed more. from college on though i have picked my own dentist and all have been good, tho some do try to upsell. i just say no.

i'm also angry that crowns are only good for 10-15 years. i've had some crowns replaced already. so, say i'm going to live another 40 years, and i have 5 crowns now. at 1200-1600 a crown now (more as time goes on) that's just so much fucking money. i don't have that kind of money.
posted by misanthropicsarah at 9:26 AM on April 18 [3 favorites]


I remember thinking it had a Soviet vibe?

The guy I know with the worst dental trauma got it in the USSR. They filled several teeth, no anesthesia, just guys holding him down in the chair. I think he was about 9 or 10 years old.
posted by thelonius at 9:27 AM on April 18


Here's a shout out for modern pediatric dentists. We chose the one for Little Purr based on some research, but it was newly opened and near the pediatrician's office, so it seemed good enough to start. The dentist and hygienists are AMAZING. Giving kids cool sunglasses for the lights, showing every single instrument, and explaining what they do (sometimes on the kid's hand, so they know the feeling). The facility is bright and airy, with a forest motif and toys on the side for siblings to play while they wait. Little purr had been getting checkups since they were 2 years old, and always seemed very calm and happy about going.
....
so when I called them one afternoon in a panic because LP had bashed in two baby teeth on the playground, they calmly told me they'd fit me in, bring in the kid, and did x-rays, consultation and advised me to remove the two teeth (now sideways) and gave me the costing form in about half an hour. I signed some forms, and they did laughing gas, Novocaine, a netflix show on the ceiling, and pop! the two teeth were out. I was probably more traumatized by the whole situation than my kid. The trust that they had already built up with Little Purr meant that they were fine with the needle and the extraction. The dentist also wrote down the medications used so we could give the ER physicians when we went in for the stitches on the lip.

So in this case, we definitely had a "feeling bad in, feeling good out" situation with the pediatric dentist.
posted by Hermeowne Grangepurr at 9:45 AM on April 18 [4 favorites]


All y'all with orthodontic issues, I got you all beat - my orthodontist literally lost his mind midway through my treatment. I had braces for 4 years, and then was meant to have a retainer for another short while, but it wasn't doing anything. Over the next two years he kept coming up with weirder and weirder ideas, each with their own recommended treatments; I think by the time I was 16 he had diagnosed "tongue thrust", which he described as a habit of pressing my tongue against the backs of my front teeth and knocking them out of alignment. I was supposed to get some kind of retainer with little spikes fitting over the back of my front teeth to train me not to do that.

That's the point that my mother finally got a second opinion for my teeth, and the second orthodontist took one look at me and said "a retainer isn't going to fix this, only breaking your jaw and re-setting it would. How the hell did he miss that?" They added that it would only be a cosmetic improvement, though, as I seemed to be eating and chewing okay, so I could stop altogether if I wanted, my parents and I said "fucking yes" and that was that.

But yeah, teeth seem to be a bit of a crapshoot anyway. I've only been to a dentist for major problems over the past several years, and same too with my parents - and we've only had a few cavities and that's it. I did have one root canal way in the back, but the worst part of that was that I have a really strong gag reflex (probably why I had the trouble initially, since choking made me skimp on brushing back there) and the dentist I saw that time put down in the chart that I was a "very difficult patient". ...Yeah, sorry my choking made your work tough, doc.
posted by EmpressCallipygos at 10:03 AM on April 18 [2 favorites]


This thread is reminding me of one of James Herriot's stories, about when he was enlisting in the Royal Air Force. There was a mandatory dental inspection, and the military dentist had a terrible reputation as a brutal sadist. So Herriot goes to his local guy in advance, who gives him a filling or two and otherwise a clean bill of dental health. As a result, he's quite smug when he turns up at the air force dentist... and then shocked and dismayed when that guy tells him he needs an extraction.
posted by sevenyearlurk at 10:21 AM on April 18 [2 favorites]


All y'all with orthodontic issues, I got you all beat - my orthodontist literally lost his mind midway through my treatment.

This is similar to a story my S.O. told me about one of her childhood dentists (in central California) - that he was a guy who considered himself to have been on the cutting edge once, and that as he got older he started pushing weirder and weirder ideas for procedures.
posted by atoxyl at 10:49 AM on April 18 [1 favorite]


sevenyearlurk, you left out the best part! After a harrowing hammer-and-chisel based extraction, Herriot remarked that he had also removed teeth in the same manner. When asked if he was a dentist he replied, no, he was a vet. (Maybe that was in the third book?)
posted by wintermind at 11:39 AM on April 18 [1 favorite]


In my defense, it's probably been 20 years since I read those stories! :)
posted by sevenyearlurk at 12:07 PM on April 18


I wouldn't want most scientists messing around with my health

I got suspicious when they wanted to test my brushing technique by brushing only left-side teeth for six months, keeping the right side unbrushed as a control group.
posted by justsomebodythatyouusedtoknow at 12:19 PM on April 18 [2 favorites]


"say i'm going to live another 40 years, and i have 5 crowns now. at 1200-1600 a crown now (more as time goes on) that's just so much fucking money. i don't have that kind of money."
Merida, Mexico. The best dental care I've ever had. $280 per crown, I shit you not. MeMail me
posted by Floydd at 3:10 PM on April 18 [2 favorites]


To follow up on Floydd's comment, I've commented on AskMe before that we also got excellent care at a highly reduced price in Tijuana MX. The dentist is a member of the ADA, and even took our insurance. The total price was about 1/5 the price that we were quoted in the US, and the out-of-pocket price was almost too good to be true but it's been several years and the dental work has held up beautifully.
posted by vignettist at 4:10 PM on April 18 [1 favorite]


I've said this here a few times, but when I left to go to university, my childhood dentist told me to try to go to a dental school.

I took his advice when I went to grad school and started seeing dentists at the dental faculty practice, and they've been super duper honest and by the book that it verged on ridiculous (You are moving away? You will of course need this giant packet of dental records which we have helpfully printed for you.). When I moved away for a few years, the next dentist was OK, but the hygienist was super up-selly (You should have your amalgam fillings drilled out and replaced with composite/have you considered teeth whitening/your wife could use veneers and braces we don't do payment plans but you could put it on a CareCredit card at 20% interest!).

When I was in Denmark, I had a root canal fail and everybody kept telling me that I would have to pay the dentist when I saw them! And that it was going to be very expensive! So I took out like $300 in kroner, and some very nice Australian lady told me I had beautiful teeth, gave me antibiotics, and took an x-ray. $50.
posted by Comrade_robot at 2:55 AM on April 19 [4 favorites]


sevenyearlurk: "Eventually a friend of mine enticed me to change to his dentist, who has several beautiful offices. I feel very comfortable and well-taken care of there, but I've already been talked into spending several thousand dollars on an orthodontic appliance and have now been referred for gum surgery. So I dunno whether I'm getting great care, or a shakedown."

I mean, it sounds to me like you're paying for those beautiful offices. Personally I'm always suspicious of medical places that are too nice -- shabby and older but clean and well-maintained is what I'm looking for.
posted by crazy with stars at 10:52 AM on April 19 [3 favorites]


sevenyearlurk: "Eventually a friend of mine enticed me to change to his dentist, who has several beautiful offices. I feel very comfortable and well-taken care of there, but I've already been talked into spending several thousand dollars on an orthodontic appliance and have now been referred for gum surgery. So I dunno whether I'm getting great care, or a shakedown."

I once went to a dentist with a noticeably nice office on a recommendation from my boss. They told me, a 23-year-old with perfect teeth and no pain, that I needed a gum graft. Be wary.
posted by momus_window at 3:18 PM on April 19


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