Do you really need all that dental work?

adoptedbyhounds

This is a long but fascinating read from The Atlantic. It's a little like a detective story.


It begins with a dentist buying a practice from another dentist who is retiring. We learn that as the new owner begins seeing patients, he starts to suspect that many of them may have undergone procedures that were unnecessary. So he begins doing his own, meticulous detective work.


This article is not an attack on dentists, but rather a reminder that dentists are often seen as "authority figures." Few patients have the expertise to recognize anything is amiss when they're told they need a crown or a root canal. As a result of undeserved patient trust, and insufficient professional oversight, an unscrupulous dentist can spend an entire career under the radar while over treating and over charging patients. I hope some of you will enjoy this article as much as I did.


https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/

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Kathy

There is ideally and there is practical. We have to discern what is right for us personally.

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blfenton

My mom moved down to be nearer to her children and of course changed dentists. She was 86 at the time. When she went to a new dentist he gave her a list of work to the tune of about $3200 that HAD to be done. What he didn't realize is that I have a sister who is a dental hygienist and I gave the suggested work to her who discussed it with the dentist she works for. Her dentist said this was a make work project for the dentist she went to.

My mom went to the practise that my sister works at and she needed $400 worth of work done and a new bridge which wasn't mentioned.

What makes me angry is that this dentist is located in an area where a lot of elderly people live - a lot of apartments with all amenities within walking distance and on a busline. How many of their children check the work that is being "suggested" by this dentist.

Sorry, had to vent.

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AnnKH

My Mom's cousin was a dentist; even after I grew up and moved away, I went back to him for cleaning and exams.

When he retired, I had to find a new dentist, in my new city. I picked one at random; Hubby and I both saw him. We were both told that we needed a LOT of work - right away! Replace a filling, a crown here, another crown there. I thought "How big a boat did he buy?"

I asked coworkers for recommendations. The new dentist we chose examined us both, and said things like "Eventually you will need to have a crown here", and "Let's keep an eye on this filling; at some point it will need to be replaced." There was not one thing that needed to be done immediately; most of the things on the first dentist's list didn't need to be done for years.

I was thrilled to find a dentist that I trusted as much as my Mom's cousin.

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Kathy

If you have insurance they make sure to use it all every year.

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redsox_gw

Actually I have long suspected this. In addition, I find many doctors to prescribe beyond what is necessary. There are few doctors who will advise that you terminate a medication, such as omeprazole. I think "first do no harm" has morphed into "first make some money" for many.

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tony jelly

The worst thing about it is that there is no way you can check. No doubt there will be a few dentistry horror stories to follow, so here's mine.

Back in the day when gas was used a friend had a couple of teeth pulled, a wisdom tooth I think. And a couple of days later she was in a lot of pain so went to the hospital. After an X-ray, they found that she had a broken jaw.; it seems that the dentist had used her jaw to add leverage to pull her teeth.

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adoptedbyhounds

"We have to discern what is right for us personally."

You're right Kathy. That was one of the points the writer made. In general, patients don't have the expertise to challenge what they're told. As we've learned from responses here already, it can be very helpful to have access to a second opinion!

"I thought "How big a boat did he buy?""

LOL! You sound like my husband, AnnKH. One of the reasons this article caught my attention is because when our dentist became ill and died, our new dentist "found" a lot of "issues" in need of attention. We went ahead and spent the money, but after reading this article, I'm giving serious thought to looking around for a new dentist.

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terezosa / terriks

Years ago I had a dentist that said that I needed a couple of crowns. Before having that work done we moved a few hours away. My old dentist suggested that I go up for a day to his office to have the work done. I knew that I would need a new dentist in my new city, so I declined. My new dentist didn't see any issues, other than I needed to floss more often. :-D

It's been over 25 years now, and I've never needed those crowns.

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chloe203

25 years ago, I went to a dentist with a very posh office . The location was in an affluent area. His recommendation was $2500 of work for receding gums. I have really good teeth and so I was immediately suspicious. . I changed Dentists who confirmed there was nothing wrong. I went to him for 25 years. He just retired and the woman who bought his practice was really thorough on my first visit and commented that my gums were really healthy.

The dentist with the posh office didn't last very long . Moved on, I guess, to an area where it was easier to scam people.

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cattyles

I used to have a true dentist phobia. It was bad. As a child, I fell and broke a front tooth just as it was coming in and that has needed intermittent attention my whole life. About 15 years ago I decided to replace everything at once to have a better smile. It was a good decision.

Back in my early twenties my dental insurance filed a complaint against a dentist that messed up work on my front teeth. But I eventually found my current awesome dentist. He got me over my phobia and is a credit to his profession.

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marquest(PA zone 6)

I had a dentist say I needed work done on a tooth when he left the room the assistant told me the x-rays did not show his analysis. I told him I would make another appointment and just wanted a cleaning. I went to another dentist and she was right. You can and should get another opinion when dentist start recommending major work especially if it is a new dentist.

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rhoder551 zone 9b-10

Years ago I went to see a dental surgeon about a slight pain.. Yes, he gleefully informed me, a root canal was in order ( as he rubbed his hands together in anticipation of the 2500. payout, I'm not kidding about the hand rubbing) and he also wondered would I need any 'good' painkillers? Again with a gleeful smile and a twinkle in his eyes. I did go through with the root canal. There were several of us in the individual rooms and he shuttled back in forth doing a little here and there. Not only that, as I was waiting for him to come back I saw in front of me, his reflection in the glass of a framed poster... he was behind me and across the hall in a little utility room just cramming his mouth with food, gross. I would say he was running a root canal factory. He had been recommended by my regular dentist, who I liked and trusted...

Later I had to get it done again because he had left some root in the tooth causing me a lot of pain. I went to someone else for that procedure.

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carolb_w_fl_coastal_9b(zone 9/10)

Wow - that's some horrorshow - those poor patients!

My story: I went to one of those unscrupulous types for awhile before I finally figured out what he was doing. I found him in the Yellow Pages when I lost a crown on a holiday weekend, and kept having to return because it kept coming off, which he explained away as due to a water soluble cement, which I found questionable. Then he referred me to an office in the same office complex for a new crown, since the old one was poorly fitted and damaged, who, after squirting my teeth with ice cold air to 'test', told me I needed a root canal, badly. So fishy!

After that, I ghosted them, and the next time the crown came off (of course!) found another dentist, who charged me about 1/3 of what the first was taking for re-cementing, and the crown stayed on tight until they made me a new better one that has stayed on tight to this day. The second guy told me dentists can pretty much charge whatever they want & I most certainly did not need a root canal. I think his exact words were, "That tooth is still healthy and we want you to keep it as long as possible."

The first, shady guy also had a wall of photos of himself posing with all kinds of celebrities, and an eerily quiet office. I only ever saw 1 other patient there - ever, and the receptionist was his daughter.

The second place was always busy, very simply furnished and decorated, and also took Medicaid patients. That dentist is a retired Marine - a really nice guy.

And the dentist who first put in the problem crown is a whole 'nother story as well - a married pair with a super fancy office who were pushing implants. The woman just walked out of the room when I came to see her about the damaged crown.

I feel like I got off easy, compared to a lot of other people. I'm glad I walked away before anything worse happened. As it was, I was rooked out of maybe $1000 or so.

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tony jelly

cattyles: you had all your teeth pulled?

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cattyles

Oh Lordy, no! I’m sorry if I gave that impression. I needed to replace two crowns in the front and I replaced a bridge at the same time.

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tony jelly

There was an old lady in my childhood who would make us laugh when she made half he face disappear after she took her teeth out, and I had a flashback, I am glad I was wrong.

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cattyles

I can probably make you laugh, teeth and all.

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adoptedbyhounds

You made me laugh!


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tony jelly

This is the closest I could get on the internet.

It also reminded me of my grandson who thought he could hoodwink the tooth fairy and "make a bomb."


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catkinZ8a



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jerzeegirl (FL zone 9B)(9b)

I have found that there are different kinds of dentists. There are those who are expert at aesthetics and want to make your teeth movie star special. There are those who are into prevention and try to foresee problems that might arise (for example, wanting to remove old mercury fillings and replacing them). There are those who do the basics - you have a cavity and it gets drilled and filled - no more, no less. There are dentists who want to make sure their patients' gums are in tip top shape. Since I moved a lot I have actually experienced each type of these dentists. Only you will know whether you like the dentists' style.

I went to my current dentist just last week to have an old mercury filling removed which had expanded was cracking one of my teeth. I guess I could have said no and lived with the mercury filling and cracked tooth. Nothing hurt. But I felt that it made sense to have the work done.

I don't think the dentist in the OP was trying to fleece the woman. I think he was a perfectionist. Also, he really cannot say "you are too old to get a payback from getting this work done", can he? He needs to let the patient decide.

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floral_uk z.8/9 SW UK

I always used to go for 6 monthly checks. My husband never bothered. Eventually I stopped going too. Last year I had a bit of sensitivity from a receding gum. Made an appointment and just needed some sort of coating on a couple of teeth. As I left I asked when I was last there. 'Ten years ago' they said.....

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tony jelly

Ah, the British approach to perfect teeth

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tony jelly

I think I might watch the Marathon Man tonight.

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floral_uk z.8/9 SW UK

British teeth are a cliched running joke, I know. But many American teeth are equally ridiculous being completely uniform, dazzling white and utterly artificial looking. I'm not going to show you my teeth but they serve me well, have no issues and are all my own.

My kids have great teeth too, thanks to free treatment and free orthodontics. My daughter refused (free) braces because she wanted her own idiosyncratic teeth and not some idententikit ideal of what teeth should look like

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Zalco/bring back Sophie!

Twenty years ago American dentists would never have suggested the ridiculously un natural astro bright whites of today. It was literally unthinkable, and yet here we are with normal looking white teeth looking dingy compared to the fluorescent whites.

pro tip folks, veneers and bleaching are harmful to your teeth. Be careful.

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cattyles

I love this smile. Not big, opaque chiclets. Just nice teeth and healthy gums. Real or great cosmetic dentistry?

I used to participate in a dentistry forum so I could be an educated consumer after what happened in my 20s.


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carolb_w_fl_coastal_9b(zone 9/10)

Wait - what? Did you read the linked article, jerzeegirl?

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blfenton

One thing I did learn when dealing with my mom's dental care and doing research about good dental care in the elderly is that having good dental care is imperative for nutrition. If the elderly can't chew properly nutrition decreases. While this is certainly true for anyone it becomes more important for the elderly whose appetites are often dwindling anyway and so getting proper nutrition in smaller portions becomes important. The motion of swallowing and the act of chewing also remain necessary.

Gumming eggs and drinking protein shakes only goes so far.

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Prim Rose

If this op had been about ear, nose, and throat docs, I have some horror stories. Why that particular discipline has more mean-spirited, money grubbing, insensitive clods - I have no idea. But it does.

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cattyles

Yeah, the ENT guys made a ton off of my son.

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Jenn TheCaLLisComingFromInsideTheHouse(5)

The 'coating' that a previous commenter mentioned is undoubtedly what's referred to as sealant, it's applied most often to the deeply grooved back teeth to protect them from developing cavities as much as possible. I've had that done while I was still a kid but after my permanent adult teeth had all come in, so a few decades ago, and it's performed as intended - still there to this day. I got my first cavity when I was 27, a couple others by the time I was 30 and one crown are the only dental problems I've had other than requiring gum grafting by a periodontist on two upper sites around my canines(?) with the donor tissue taken from the higher side of my palate that was caused by sucking my thumb. I did that until I was 5 years old but it did have a beneficial impact in that the higher side of my palate made for an excellent gum tissue donor site which heals quickly because it's possible to be both protected and avoid irritation of surrounding tissue/edges of the site from the removable retainer I got when my braces were taken off. The retainer reduced the cost because most people have to have a mold made of just the roof of their mouth while I had something that worked even better because the way a retainer is designed with the metal wire kept it in place instead of shifting around and causing irritation (my braces were off at age 16, put on at 14 and 11 months right before my sophomore year in high school started - I have an August birthday)...I still wear my retainer at night, so my unnaturally straight teeth stay unnaturally straight. My mom had braces as a kid but had to have them removed before the course of straightening had been completed (due to the expense) so around the time I was in 8th grade she went to an orthodontist and started with braces again. Once hers were off she decided that my brother and I needed braces too, even though both of us had more or less straight teeth. But as an adult I've always been extremely thankful that my parents had very good dental coverage between the two of them, and that they made sure my brother and I had preventative care because it really does reduce how serious any future problems turn out to be in the long term. Which leads me to my 'horror story'...

My childhood best friend only went to the dentist when there was a problem causing pain until it had gotten unbearable enough to go in and have the dentist deal with. She didn't get braces - instead, she had these things that were called 'orthodontic appliances' which looked like regular retainers on steroids, and every so often a new one would be made. This continued from 5th grade, with her getting the last 'appliance' sometime during junior year in high school. Despite the time and expense, her teeth didn't really get straightened as they would with braces, but at least they did help some with the overbite. Lord knows how many cavities and root canals from childhood into her adult years, combined with smoking filterless cigarettes (I know! Yuck!) and poor dental hygiene like brushing/flossing/mouthwash for over a decade...resulted in her having all of her teeth, yes ALL of them pulled. She was 33 at the time. Without insurance to help with the cost, dentures were the only option for her, but I have to wonder if she'd made more effort with brushing/flossing/mouthwash all those years, would she have reached a point where her teeth were so badly decayed that pulling them all in her early 30's was necessary!?

I think that there's some variation in dental preferred aesthetics based on where you live. I lived in SoCal for more than 3 decades, at the very least the most recent 10 years has seen an increase in whitening and unnaturally straightening being extremely popular with the majority of the population. Somewhere between blinding and off-white is typical - if your teeth are yellowed you get the impression that you shouldn't even smile in a way that shows your teeth and continue that until you figure out a way to finance dental work including professional whitening options (custom trays, in-office express treatments with special gel and probably one of those weird handheld light things wielded by the dentist). Dental whitening strips that can be done at home and purchased at various retailers are 'okay' but they take longer to get a uniformly whitened appearance so most people use those for maintenance, in my experience. Now that we live in the Omaha area, NE, I haven't observed quite so many smiles that are so white I need my sunglasses on to avoid being blinded. My own teeth are relatively white thanks to the custom trays I had made in my early 20's, and as a soda/coffee drinker I've keep those trays around so that staining can be removed with just a phone call to our new dentist to request more of the lowest strength of whitening gel 'syringes' (they come in a package of three, the tips look like one of those irrigation syringes and give you a controlled amount of gel dispensed when the 'plunger' is pushed down into the tube itself). Yellowing of the enamel can be caused by antibiotics and some other medications, if it occurs in childhood and after permanent adult teeth come in, you're only going to be able to get your teeth whitened to a certain level and will need to keep your expectations within reason. I know that it can be difficult, when there's a steady bombardment of advertising that tells you your teeth should be impossibly and blindingly white - promising that they will be if only you buy a certain product. We've set standards for what is considered the minimum to be considered conventionally attractive - there are many who don't reach those minimums, and for whom it is impossible to achieve the standards without expensive, time consuming, complicated procedures. If your teeth aren't unnaturally straight and an imperfect shade of white, and it bothers you enough to do something about it - yippee, get down with your bad self! The process involved is way less expensive and far less invasive than say...a nose job, liposuction, injectable fillers, breast implants, etc. The impact of low self esteem can last a lifetime and if the person feels so terribly about their appearance, the lengths that they're willing to go to in order to change *everything* about what they look like - can be shocking.

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patriceny

That was a really good article. It helped me jell some thoughts that had been floating around in my head for awhile.

Same story as others above - had a good dentist, who retired. Tried a new dentist (who I knew socially, which is why I picked him) and he insisted I needed thousands of dollars of crowns. Didn't feel right, given that the "old" dentist had never mentioned crowns and I'd just seen him a few months before the new guy.

So found another new dentist to try, who said I absolutely did not need any crowns. That was over 20 years ago, and I still don't need crowns. I stuck with him for 20 years, and now he just retired and I'm on the hunt for someone I can trust once again.

It was a awkward because the guy who said I needed crowns was in the periphery of my social circle, and he definitely didn't like me after I never went back to see him again.

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Carro

It's hard to find a dentist who's trustworthy and won't rip you off.

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bob_cville

I recall reading a similar story that was even more horrifying. Where a dentist who would work on children who were being paid for through Medicaid would as a matter of course pull all of the kid's teeth and then install a mouth-full of implants, all simply to get as much money from Medicare as they were willing to pay. Oftentimes there was nothing wrong with any of the teeth in the first place.

I haven't been able to find that story, but this one is similar:


https://gawker.com/horrifying-dentist-allegedly-choked-kids-took-out-teet-1706062236

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jerzeegirl (FL zone 9B)(9b)

Wait - what? Did you read the linked article, jerzeegirl?

Sorry. I just realized I said OP when in reality I was responding to another poster.

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carolb_w_fl_coastal_9b(zone 9/10)

I wish they'd had those sealants when I was a kid! All my molars had/have huge fillings, which resulted in the lower ones cracking after many years, and necessitating the crowns.

What really ticked me off was the first crappy dentist (the married couple), who took over our excellent family dentist's practice when they retired, gave me a porcelain over metal crown on a back molar, which of course did not last very long. After the wife refused to even acknowledge my problem, I walked away from them as well.

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jerzeegirl (FL zone 9B)(9b)

Oh, me too!

I can't even figure out how they could do a porcelain over metal crown on you.

I had so many cavities when I was a kid. And my old-fashioned (decrepit) family dentist would fill them without novocaine. That traumatized me for the longest time. These guys were practicing before the notion of continuing education so the technology was ancient and stayed that way!

At least my current dentist makes the crown while you wait so you don't have to get a temporary and then come back for the permanent crown.

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JodiK

Personally, whether dentist or doctor, I am still the patient... I know what I need, generally speaking, because I've done my homework prior to having any actual work done. If I don't care for what I'm being told by the dentist or doctor, the deal is off. I'll go elsewhere. I won't pay for work I don't need.


Sometimes, it pays to obtain a second opinion.


Jerzee, novocaine is a must, as far as I'm concerned! There are too darn many nerves in the gum line and general mouth area! :-)



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terrene(5b MA)

Hi Jodi! Haven't seen you for awhile.


Ugh dentists! I loved candy as a child (and still do but don't eat much sugar any more), and also grind and clench my teeth during periods of stress so as a results have had lots of dental problems - tons of cavities, root canals, caps, and recently broke a tooth that required a dental implant. I have never had dental insurance (most jobs it wasn't even offered) and so have spent thousands. The implant and crown cost $4200 total!!

And I suspect the insurance companies are complicit in this price-gouging. I actually needed 2 caps and asked the dentist if he could discount the price if he did 2 at once. He said he couldn't do that because the agreement with the insurance company prohibited him from offering discounts or sliding scale prices for patients without insurance. They MUST pay full retail, which of course pressures people to obtain dental insurance. What a racket!

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rhoder551 zone 9b-10

Are there any honest dentists? I'm sure there must be but going to the dentist is kind of a krap shoot, seems like.

Perhaps there's something wrong with a culture that allows such abuse without comment and everyone acts like it's normal. And if you have a problem it's your fault for not doing your homework.


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Karen S. (7b, NYC)(NYC, zone 6)

If you're near big cities, try contacting your local University or look for the nearest dental school programs.

Being in NYC, that's how I've had dental work done for 20 yrs.+. Folks come from around the world to study dentistry at these 2 Universities. All student work is supervised at EVERY step. First, I used NYU's Dental School, where I was happy for 20 yrs, until they made me a defective denture (which dropped teeth). I had to switch to Columbia University's Dental School 2 yrs. ago; just finished getting a replacement denture. I've also had work done by Faculty (oral surgeon in my case), for some special cases.

Otherwise, I'd suggest asking your friends, neighbors, relatives, even doctors' offices for referral of dentists about whom they've heard good things.

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adoptedbyhounds

"Perhaps there's something wrong with a culture that allows such abuse without comment and everyone acts like it's normal."

Interesting point, rhoder. As the article says, few consumers have the expertise to know when their dentist is taking advantage of them. That's why more oversight might be a good idea. Dishonest dentists like the one in the OP can operate under the radar when there's nobody looking for them.

I want to go back to your excellent comment about culture:

"Perhaps there's something wrong with a culture that allows such abuse without comment and everyone acts like it's normal."

It got me to thinking about how often I see examples of that phenomenon. See something, let it pass without comment, and don't make waves.


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bob_cville

> That's why more oversight might be a good idea. Dishonest dentists like
the one in the OP can operate under the radar when there's nobody
looking for them.

Although wouldn't that be considered "regulation" and therefore be an unqualified bad thing and veritable anathema to Republicans?

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JodiK

I've had dental issues my entire life. I began getting cavities while quite young, and we grew up without candy or soda or other sugars in our household. And yes, we all were brushing and flossing and rinsing, with regular trips to the dentist. Sometimes, one just gets the crummy end of the genetic stick. I'm pretty sure having lupus hasn't helped.


Smoking, being a coffee-holic... these things also affect dental health... so some of it is my own fault. But I suspect my teeth wouldn't be much better even if I never picked up those habits. By the time I was 18, I'd already had a ton of fillings, and had to have a few root canals and corresponding caps. And those don't last as long as we'd like... although, for the price tags per tooth, one would expect a little more out of them, time-wise.


After a certain age, I just gave up getting such expensive work, that I couldn't afford, done. If a tooth keeps giving me issues, I have it yanked out. And one day, when I have some extra cash, I may think about getting dentures. In the meantime, the only thing affected is a big wide, white smile. Not a big deal.


Our country's medical and dental systems are not solely based upon helping people... only those who can afford to pay the exorbitant prices for that help. It's not normal by a long shot.

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haydayhayday

Buyer Beware!

It's that simple.

I love my dentist.


Some of my tales:

First off, I have a tip for you that I'm just now discovering. Worth your time to check out very carefully, I suspect.


Every year at this time, I get a script for Doxycyline to have on hand for prophylactic use in case I find a deer tick on me. It's good for Lyme disease. I won't go into the details here.


But, instead, focus on my buying the Doxy this week: I get a script and from my experience with another drug I made sure to check out this site before I go to pick it up at the pharmacy.


https://www.goodrx.com/doxycycline-hyclate


PRICE BREAKDOWN
Estimated Retail Price
$77.77
GoodRx Coupon Price
$19.38
Your Savings (75%)
$58.38

GET FREE COUPON

It's that simple.


Hay




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haydayhayday

Tales:

Another girlfriend in the medical field. She's 100% honest as a medical person, but somehow got invited to a gathering for a sales pitch and, thinking I'd be interested as an observer, invited me to join her. Just to see what it's all about.


What it was about is a gathering of crooked medical people, (mostly medical doctors), sitting there listening to a sales pitch with a "Vitamin Salesman" and there was no hiding what they were there for.


Spelled out quite clearly: It's junk medicine, but, if you can get your patients to subscribe to the program, we'll give you a huge kickback. It really was spelled out pretty clearly.


The point is, there are indeed crooked medical people just like any profession.


Buyer Beware!


Hay

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haydayhayday

I recently stopped going to a dermatologist for my yearly routine checkup. Two reasons:


The final straw: All those years I'd make an appointment. Show up on time and then sit in the waiting room for half an hour. And then in the exam room for another 15 minutes. I know that's to be expected and, if I didn't already dislike him, I'd probably have put up with it again, but, on that day, I'd had enough and walked out after half an hour. Hasta La Vista.


His routine. It NEVER failed that he'd find one little teeny, tiny "suspicious" something that needed to be snipped off and sent to the lab. Always came back as nothing. Always cost Medicare with more money in his pockets. Easy money. My body was becoming quite pockmarked.


My new Dermatologist looks over my skin, pats me on the back and sends me home.


Hay

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Cookie8

Me too Cattyles. I had the worst dentist growing up and couple that with the fact that I don't freeze well makes for horrific experiences. I went to a new dentist four years ago and was told I had to get x amount of fillings, a $5000 mouthguard and something else I can't remember. I allowed for 1 filling on one side of my mouth and she froze my eye open, hit a nerve and filled it incorrectly which I lived with for two years. It was painful the entire time. I never went back.

I had to face the fact it had to be corrected and went with a friend's recommendation. I actually cried when I called to make the appointment and I never, ever cry. I could barely do it. Weirdly, I was fine going into the office for the appointment though just the phone call was hard.

Turns out I only had one cavity and he fixed the filling that was messed up. Such a relief to find a dentist I can trust and is competent. Yes, I am an anti-dentite.

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JodiK

Speaking of ticks, Hay... it seems a little early in the season, but I found a rather large one crawling on my forehead yesterday. It hadn't bitten yet, so I grabbed it and cooked it with a bic lighter! One down... only a billion to go! I suspect I picked it up while throwing hay to my goats but who really knows.


My general outlook toward health and dental is... if it ain't broke, don't fix it. I can't afford to spend so much on tests and whatnot for things that aren't wrong. I think that after 60 years on this planet, I know when something's off... when I feel something's not quite right... especially after everything I've been through and have researched, not to mention everything we do holistically, and at home, ourselves.


Cookie8, I can sympathies... I once got a shot of novocaine directly in a nerve! I'm pretty sure my yell cleared out the waiting room of that dentist's office! ;-)

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Chi

When I was 22, and newly on my own, I went to the dentist and he said I needed a crown. Two other women I worked with (22 and 28) needed a dentist and since he was nice, I referred them. They both needed crowns too!

What are the chances that 3 healthy women in their 20's would all need crowns? I was young and naive and let him do it, and he did such a crappy job that it's had to be replaced 3 times at 1k a pop.

Now I'm a bit more suspicious about dentists but I have a wonderful one I've been seeing for a few years who I trust.

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Karen S. (7b, NYC)(NYC, zone 6)

Agreed, it does seem unlikely all 3 young women would need crowns.

Do you every ask WHY do you need a crown? Also, I've had a few, there's usually root canal work & a post done first.

If a dr or dentist can't or won't discuss & /or explain it to me I'm gone.

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Chi

I should have asked at the time but I honestly didn't know better. The root was totally fine. He just ground the tooth down almost to the gum and put the cap on, no root canal. There was really no reason that I can see other than he wanted my money.

I kept having to get his redone because he ground my tooth down so far that the crowns had a hard time sticking and kept popping off and sometimes breaking. My current dentist did a cerec crown that seems to be sticking better.

I definitely ask now! I've had a few more since then but with good reason, mostly old fillings leaking and causing the most painful abscesses ever.

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Cookie8

JodiK, the feeling really surprised me. I thought it was the solution spraying out the needle and burning my skin in a quick flash.

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catspa_zone9sunset14

I have been both fortunate and unfortunate. I have the worst teeth ever. A poor genetic background plus a series of very high fevers when I was young (chicken pox, measles of every sort, etc.) that weakened my teeth, smoking, and a long period of poverty left me with a ton of fillings when young and periodontal disease. Over the years, old, deep fillings progressed to abscesses, root canals, crowns, lost teeth, and two implants.

However, once we had money and insurance, I have had decent dentists (one exception, after we moved cross-country, and he lasted just one year - not only inept but greedy) and the work that done was pretty much the work that needed to get done. I always have them show me an x-ray and explain what they see and why particular work is needed. I lean toward being proactive, my experience being that, if a tooth can go bad, it will with me, and I hate suffering that pain. And, really, if a tooth abscesses, the solution is a root canal and crown, which is usually the situation I have been in (pain!). I have never (knock on wood) had a crown come off. Both my parents had dentures by their early thirties while I still have my own teeth into my sixties, except for two implants, largely due to the exceptional work done by periodontists and skilled dentists.

I am a great fan of the Columbia University dental school. When my husband was a graduate student there and we lived in utter poverty, I had three of my wisdom teeth pulled by their dental students for a fee of $7.00.


ETA my experience is that it does pay to be referred to the specialist -- not have the regular dentist do everything. If a root canal is needed, go to an endodontist, because that's all they do, all day long. Ditto oral surgery, etc. The only two root canals I've had that had to be re-done were done by regular dentists, in a pinch.

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JodiK

Given the often very small needle gauge used, Cookie8, pushing the plunger too fast, forcing the liquid through it, will cause a burning sensation as the needle, itself, heats up from such action. Anyone who gives injections on a regular basis, like a dentist, should know that much. The "novocaine" used is often actually lidocaine, which is the same thing. If I'm not mistaken, "Novocaine" is a brand name.


I once had to have 7 consecutive shots for a root canal, which caused half my face to numb, including my eyelid, which I ended up having to blink manually to keep my eye moistened! It was sort of humorous in a weird way!


But I can say, every root canal, filling or extraction I've gotten, I have needed. If a doctor or dentist won't explain in detail the how and why, I'm outta there before any procedure! Yes, I do want to see those x-rays... and yes, I do want to hear all about why I need something done and how they'll do it. And yes, if possible, I would like to remain awake throughout such things!


Three women all needing the same exact thing, referred to the same dentist, does seem hinky. The odds do not favor three exact procedures such as those crowns.


And the cost for some dental work... holy moly! I don't make my living by having a whitened, winning smile of perfectly spaced teeth, so... no, thanks! I'll pass on all that over priced stuff!




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catkinZ8a

Brushing of the teeth is a good thing.

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catspa_zone9sunset14

But even better to floss, at least, catkin. One study I read found that flossing was, by far, the more effective measure.

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Chi

A lot of it is just luck, too. I have good dental hygiene and have had many cavities. My good friend doesn't brush his teeth or floss (just uses mouthwash) and at 40 he has perfect, white teeth with no cavities ever.

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Prim Rose

That's pretty gross, Chi. I'm sure his gums are in bad shape.

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catkinZ8a

I love to floss..

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catspa_zone9sunset14

It is true that being in the lucky end of the gene pool helps with teeth, as it does with cancer. Many live "perfectly" and still get cancer and bad teeth.

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catspa_zone9sunset14

Another plus is growing up with fluoridated water or fluoride treatments. I grew up with spring water on a ranch, then well water in a suburb, neither fluoridated, nor did I get fluoride treatments ("good old days"). Later on, regular fluoride helped stem the tide of decay.

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Chi

Prim Rose, it certainly is gross! His gums always look healthy, his breath never smells and he says his hygienists compliment his flossing. It's very strange. We were roommates for a few years and shared a bathroom (never saw a toothbrush) so I don't think he's lying!

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JodiK

Some folks can brush and floss, or oil pull, or whatever dental routine they use, extremely scheduled and well, with the results still being teeth that crumble before their time. A part of it is just the roll of the genetic dice, something none of us has control over.


Extraneous forces can add to that losing roll of dice, like other health issues that can affect one's teeth or gums. We probably seldom think about how all the chemicals we consume from our general food source affect our teeth, hair and nails, not to mention other organs and whatnot, but over time... some of it might matter more than we think.


My Old Guy and myself are big believers in the adage, "we are what we eat". What we consume plays a large role in our health... and that would include dental health.





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Zalco/bring back Sophie!

With regular dental care, there should be no big dental problems. My grandfather was a dentist. He said there was zero excuse for having dentures in the 1970s.

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Joaniepoanie

Timely thread. Here's my story.

We had the same dentist for over 30 years. Crowns, etc were few and far between. He retires and sells practice to a young guy who tells me I have a condition. They take lots of xrays but can't get a good picture, they'll keep an eye on it.

Last year we move to a new state and two months later in July I experience increasing pain I can't ignore. I research and narrrow it down to 3 dentists. One was able to see me in two days. I need a crown and root canal, he sees no evidence of the condition previous dentist mentioned but endo can confirm when he does root canal.....nope, endo says no condition. Great.

DH goes for a checkup and cleaning in February. He's told he's grinding and needs a mouth guard. Gee....old dentist of 30 years never mentioned this. I check with SIL who's a hygienist who explains that protocols change and old dentist may have been using old guidelines. He's told from the xrays he needs a crown and goes ahead with both...mouthguard and crown.

I go for a cleaning and checkup this week. I'm told Im grinding, that half of his patients grind. And I need another crown. Now, he is showing me the X-ray and explaining why I need a crown. And even though the tooth is not bothering me I know it may complicate things if I wait until I am in pain. I decline setting up an appointment for now citing other expenses.

So I'm not sure what to make of all this. I will discuss with SIL when I get a chance but I'm thinking of going to another dentist in the fall when I'll need cleaning again and see what they say but I don't relish hopping around to different doctors.

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Jenn TheCaLLisComingFromInsideTheHouse(5)

Sealants have worked out great for me and I'm grateful to my parents for having dental coverage and ensuring I went in for preventative care on a regular basis.

The cement-stuff that is used for crowns hurts like a son-of-a...and I've only had one. :P

The oral surgeon who took my wisdom teeth out left bruising on both sides of my face in the outline of his fingers, had to break the lower ones into pieces to remove because if they came in they'd be horizontal and push my teeth out of place. After I came to I was all alone in the exam room, couldn't call out for anyone to come help me so I rolled myself off the chair and was crawling down the hallway towards the waiting room when that door opened so that another patient and a dental assistant had a clear view of what was probably pretty disturbing to see - totally out of it girl crawling towards the exit...:P

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arthurm2015(Micro-Climate, Zone 10b Sydney, Australia)

There is a Federal Election in Australia on May 18 and one of the parties seeking election in the Senate is the "Involuntary Medication Objectors (Vaccination/Flouride) Party"

Unbelievable!!

I grew up drinking water from a water tank and the diet wasn't all that great, so from the time I started work aged 15 I have been a Dentist's Gold mine.

They have been putting that "evil" Flouride in Sydney Water for a long time now and my Wife, and Children have pretty good teeth. Fillings as rare as hen's teeth and nil lost teeth.

Lucky that most of the teeth I lost were at the back.

Ironic, that part of the six monthly clean and check is the one minute Flouride teeth bath.

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Prim Rose

I had my wisdom teeth pulled during college. Didn't have a car - campus was very walkable - and doctors and dentists close by. So I took a bus to the dentist where he took out the teeth in pieces and sewed me up. I had two done at a time. On the way home, I got off the bus to stop at McDonalds for a strawberry shake and then walked back to my house.

It hurt, but I had a couple of pain pills. No drama, no helpless lil ole me.

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haydayhayday

My dental care is not covered by any insurance. The government is not involved.


My other medical care is covered nowadays by Medicare and the government is VERY involved.


Wednesday night I chomped down on some popcorn and a piece of some dental work chipped off. Thursday morning, first thing, I called my dentist..


"Can you see me?"

"Can you come in today at 12:40?"

"Yes, thank you."

...

"There, that'll get you through your weekend. We'll need to schedule something to fix it."


"How soon can you do it"


"Monday?"


Hay

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bob_cville

> They have been putting that "evil" Fluoride in Sydney Water for a long
time now and my Wife, and Children have pretty good teeth. Fillings as
rare as hen's teeth and nil lost teeth.

Several years ago I posted the following on GW:

My mother always railed against fluoridation of the Cincinnati area tap water on the grounds that she was allergic to fluoridated toothpaste, and therefore drinking fluoridated water would surely be bad for her. Further she would describe remembering when she was young that the very same fluoride-containing chemical that they proposed to add to the water was sold and used as rat poison.

She ended by saying something like "If you add fluoride to the water and if I then get cancer and die, I will sue you for every cent you have." They did. She did. and, of course, she didn't.

Later in college, I read a book by John Yiamouyiannis who was the father of a friend of mine, and who was widely regarded as the most prominent opponent of water fluoridation in the United States. As I recall that book asserted several claims:

  • Sufficiently high concentrations of fluoride leads to statistically significant increase in a rare form of liver cancer in rats.
  • Sufficiently high concentrations of fluoride in humans will discolor and weaken teeth, a condition called fluorosis.
  • Before convincing communities to add fluoride to drinking water, ALCOA had to pay to dispose of the chemical (which is a by-product of manufacturing aluminum). Afterwards they sold it to those cities for a tidy sum.

The book cast ALCOA as a profit-motivated, amoral corporation (which, of course, it is) duping well-intentioned, but hapless and witless local bureaucrats into buying poison and intentionally adding it to the communities drinking water, through emotional arguments that boiled down to "But think of the children!"

At first I was merely recounting my memories of my mother's anti-fluoridation stance and my college friend's father's book, but as I tried to refresh my mind about the book, and encountered many alarmist websites about the evils of fluoridation, I became alarmed. (Strange how that happens) As I read more it seemed at least some of their claims have merit and the issue isn't as clear and settled as I had long thought.

To me the most salient claims (on the alarmist website ) were:


11) Benefit is topical not systemic. The Centers for Disease Control and Prevention (CDC, 1999, 2001) has now acknowledged that the mechanism of fluoride’s benefits are mainly topical, not systemic. There is no need whatsoever, therefore, to swallow fluoride to protect teeth.

20) The highest doses of fluoride are going to bottle-fed babies. ... Even the American Dental Association (ADA), the most ardent institutional proponent of fluoridation, recommends that parents be advised that formula for infants should be made with “low or no-fluoride water.”

So while topically applied sodium fluoride does reduce cavities and is safe (as long as you don't swallow it). Adding fluoride to water only has benefit w.r.t reducing cavities for the brief time the water is sluicing over your teeth, and that on the whole the negative systemic effects of fluoride on a person's health aren't well tested but they likely outweigh the positive systemic effects (since there aren't any) So fluoridated water is beneficial and safe ... as long as you don't swallow it.

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Ziemia(6a)

Umm, topical is correct but the topical application is *not* from drinking fluoridated water.

"The primary and most important action of fluoride is topical, when the fluoride ion is present in the saliva in the appropriate concentration."

Found in multiple sources.

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arthurm2015(Micro-Climate, Zone 10b Sydney, Australia)

Sydney NSW, Australia current population approx 4 million has the water supply altered thus....

How much fluoride is added to the water?

In NSW fluoride is added to the water supply at a level of 1 milligram per litre (mg/L) in line with the National Health and Medical Research Council recommendations. One milligram per litre is 1 part per million. The National Health and Medical Research Council recommend a fluoridation range of 0.6-1.1 mg/L. This range is to allow lower fluoridation levels in warmer parts of Australia where a person’s water consumption may be higher and replicates a similar recommendation in the United States. The Australian Drinking Water Guidelines allows a maximum level up to 1.5 parts per million.

How long has NSW had water fluoridation?

Fluoride has been added to water supplies in NSW commencing with Yass in 1956. In NSW alone there are more than 50 years of experience providing effective and safe water fluoridation.

How many people in NSW have access to fluoridated water?

Approximately 96% of the NSW population has access to fluoridated water – one of the highest levels of fluoridation in Australia. (NSWHealth 2013) Not all councils or water utilities fluoridate their water supply and not all people in NSW have a reticulated (public) water supply to their home. For example, some people get drinking water from other sources such as water tanks and private bores.

...................................................

Back to the main topic of the thread. In the 60 or so years of supporting Dentists, I have had three and I am happy to say that none of them seemed especially dollar driven. The first two are in Dentists heaven and the latest one just every so often asks me if I have Insurance. Answer No.

There is universal health coverage here that doesn't extend to Dentistry.

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catspa_zone9sunset14

The Center for Disease Control recognizes fluoridation of water supplies as "one of the ten great health achievements of the 20th century." From their current site (and I wonder where the alarmist sites got their CDC "info"):


"Fluoride is a natural element found in rocks and soil everywhere,

in fresh water, and in ocean water. In fact, waters in and around

the United States have natural fluoride levels that range from 0.1

to more than 12 parts per million. The optimal level for preventing

tooth decay is a range from .0.7 to 1.2 parts per million.

Some communities are lucky enough to have naturally occurring

optimal levels of fluoride in their water supplies. However, most

are not. Adjusting the fluoride to an optimal level in the water

supplies of these communities can help prevent tooth decay.

Thousands of communities worldwide have reduced rates of tooth

decay and improved oral health among their residents through

water fluoridation.


Studies have shown that water fluoridation can reduce the

amount of decay in children’s teeth by as much as 60%. Today,

even with the widespread use of fluoride toothpaste, mouth rinse,

and professional fluoride treatments, fluoridation has been shown

to reduce tooth decay by 18-40% among children and by nearly

35% among adults."


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bob_cville

> "The primary and most important action of fluoride is topical, when the
fluoride ion is present in the saliva in the appropriate concentration."

I believe this is the specific claim that the (biased anti-fluoridation) website claims the CDC reports debunks:

"That by having fluoride in your system (from drinking fluoridated water) in sufficient concentrations, that your saliva would then have some lesser amount of fluoride ions in it that would then provide an ongoing "topical" effect, due to the "systemic" presence of fluoride ions. "

I cannot find those actual CDC reports, so it is quite possible that the (biased anti-fluoridation) website is misunderstanding those reports or even intentionally misrepresenting them.

Edited to add: Briefly looking I found this abstract for an article

https://www.karger.com/Article/PDF/259654

where it in part says:

"Children who consumed drinking water containing 1 ppm fluoride (Group 1)
showed a mean fluoride concentration of 0.009 ppm in parotid saliva.
Children residing in a community with less than 0.1 ppm fluoride in the
drinking water (Group 2) showed a mean concentration of 0.007 ppm."

Which seems to indicate that drinking fluoridated water has little effect on the fluoride levels in your saliva. ( but then I also noticed that that article seems to be dated 1970, so maybe it is long since debunked)

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