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In a few years I think we will look back on how today's dentists look after teeth with shock, similar to how we do now knowing that they used to treat depressio

In a few years I think we will look back on how today's dentists look after teeth with shock, similar to how we do now knowing that they used to treat depression with a frontal lobotomy. "They used to DRILL your teeth? And if that didn't work they yanked them out of your jaw?" It all seems so low tech.

pavel_lishin 11y ago
No need to wait. A few decades ago in Russia, anesthesia wasn't used during dentistry. That was a fun time period to grow up in.
- wanderingstan 11y ago
  No need to even go that far, in 2006 I had a root canal in Germany with no anesthesia or pain killers given. Made worse by the fact I didn't understand what it was being done. My German was terrible and the dentist's English was worse.
  - pavel_lishin 11y ago
    That's terrifying; I'm guessing that the language barrier resulted in a serious miscommunication?
  - merpnderp 11y ago
    How was it possible to hold still while having a large nerve drilled out?
    - Jtsummers 11y ago
      I can't speak to dental stuffs, but some local anesthetics don't work on me. I found it remarkably easy, though extraordinarily painful, to maintain stillness while having my foot stitched back together. The grip I had on the bedframe, however, I'm surprised I didn't break it or tear something apart in my arm. I can't really say how I did it, because I'm not sure. I just knew I had to and didn't move.
      - pavel_lishin 11y ago
        I feel like dental work is harder. I've had an ingrown toenail worked on, and every painkiller injection was a) incredibly painful, b) barely useful for dulling the pain. After about seven shots, I decided that the knife-work on my toe was going to be less painful than subsequent injections, and toughed it out. It's much harder when having dental work done; I've had painkillers not-quite-take, and I always ask for additional injections, unless they're minutes from being done.
        merpnderp 11y ago
        Holy crap am I glad I'm extra sensitive to painkillers' effects. For tooth work, I can easily get by on half a shot.
        pavel_lishin 11y ago
        One thing few writers focus on, in terms of the post-apocalypse, is dental care. A cavity can literally kill you if it progresses far enough. David Brin actually addressed this in The Postman; maybe this is why everyone in post-apocalyptic television and most films has shiny white teeth - they know!
        merpnderp 11y ago
        Whenever I read or hear about "preppers" or people preparing for a catastrophe, I've always wondered what their plan was for dental care. When I was in my early 20's, my wisdom teeth became impacted. My only symptom was a horrible upper respiratory infection that turned into pneumonia. Without antibiotics and then surgery to remove the teeth, I probably would have died. And The Postman was a wonderful book.
        Jtsummers 11y ago
        So far for dental work anesthetics have always taken for me (or I've been knocked out, like when my wisdom teeth were pulled). I only brought it up because the foot happens to be another particularly sensitive area of the body. It's possible to get by without anesthetics, and you may (though I hope no one here ever has to find out) surprise yourself by how much you can tolerate while still remaining still for the procedure. But in general, I think you're correct that dental work is harder. A bunch of stitches on the bottom of your foot, however, is still some sort of torture. The ones I've had on my head or arms or torso with other non-functioning anesthetics were far easier to take.
    - Eldarrion 11y ago
      The way root canals were handled is by usually killing the nerve via opening up the nerve, putting arsenic in and sealing it with a temporary filling for 2-3 days. After that's all done, there's very little pain felt except when the doctor goes far enough to poke at the gums. The procedure does take longer than with anesthesia in that you need two visits for the whole process, but that's how they did it.
      - Karunamon 11y ago
        That explains a lot. I had one of these improperly done on a molar about 10 years ago. After the anesthetic wore off from the first visit, the pain slowly grew over the next few days until it was of brilliant, blinding, bang-head-against-hard-object make it STOP!! intensity. After they took off the temp filling, the smell was nauseating. Apparently it wasn't cleaned very well. Never went to that guy again.
        Turing_Machine 11y ago
        The foul odor may well have been from an infection.
        pavel_lishin 11y ago
        That is absolutely not normal.
      - spyder 11y ago
        Arsenic? So they not only using mercury in fillings but arsenic too for killing the nerve, nice :(.
  - vectorjohn 11y ago
    This can't be real. I've had a couple root canal procedures done, and even with local anesthesia, sometimes a jolt of pain comes through. It would be impossible to take, I would think.
    - jacquesm 11y ago
      I've had one done without. It's definitely not pleasant.
    - takeda 11y ago
      It really matters at what stage the tooth is in. If the tooth is dead (e.g. you have pain that intensifies to heat, and cold helps)[1] then anesthesia won't make much difference you won't feel a thing anyway. If you're getting root canal, because cavity is close to the nerve and your dentist don't want to use amalgamated filling then you will need anesthesia, because the nerves are alive. [1] It gets a bit complicated with molars, which have multiple nerves, if one nerve dies, you'll still need anesthesia for the remaining ones, and you do need root canal, since you can't save part of the tooth and you do need anesthesia, because the tooth is not completely dead yet.
      - vectorjohn 11y ago
        Hmm. Both of mine were on molars and certainly alive, so that explains that. But I don't know how a dentist could possibly tell the nerves are dead before drilling in. And the way they know is that you say ouch that fucking hurts.
        etcet 11y ago
        They do hurt you but they don't use a drill at first. I had a root canal done recently and the dentist briefly touched a piece of dry ice to my tooth. He did to a an undamaged tooth first, I guess to see if I could feel pain?
        pnathan 11y ago
        Correct. The doc did it to me. I had a very dead tooth, and a very alive tooth. Worked like a charm.
  - Luc 11y ago
    Are you talking about anaesthesia in the sense of general anaesthesia (loss of consciousness and all that)? Because that's really not needed for a root canal. I've had many and generally the dentist will make an injection to numb the nerve, have you wait 15 minutes, and start working. In case of discomfort they'll give an extra injection.
  - derriz 11y ago
    Must be a thing in German speaking countries? Last year i was asked if i wanted local anesthetic when the dentist was about to drill a back tooth for a crown in Zurich. I blinked with incomprehension - I couldn't believe anyone would NOT want anesthesia. But apparently I had understood correctly and according to the dentist quite a few ask to forego it.
    - __david__ 11y ago
      My dad doesn't do anesthesia when getting fillings (we're in the US). He doesn't like the numbness afterwards and the pain doesn't bother him too much, I guess. I tried it once and made it through, but it was a pretty miserable experience.
    - jacinda 11y ago
      They may have asked because having dental insurance isn't as common in Switzerland (medical/accident insurance is mandatory, but not dental), so many people pay for everything out of pocket. They might opt-out of the anesthetic to save money.
    - legulere 11y ago
      Drilling and getting a filling isn't that painful and for some people getting a shot is less pleasant. There even are some dentists in Germany that drawing teeth without anesthesia, but with the help of hypnosis.
      - tripzilch 11y ago
        Indeed, some people are way more afraid of needles. And the pain (for drilling+filling a regular cavity) really isn't that bad. The biggest unpleasantness about it is that it's in a weird place, at the back of my tooth, and that it happens at pretty much random intervals beyond my control. Most of the time you don't feel a thing, until the dentist "hits a nerve", sharp pain, but also subsides within the second. And as far as I've understood they don't actually hit the nerve with the drill, just that the tooth locally heats up from the drill friction, which the nerve feels as a sharp pain, anyone know if that is actually right? I just ... read it somewhere :) I used to do without (it wasn't offered, I was young and didn't ask either), but nowadays I usually opt for the anaesthetic, I don't mind needles at all, and there's no downside to it, afaik.
- amelius 11y ago
  At least there was vodka :)
  - pmoriarty 11y ago
    The problem is that the anaesthetic dose of alcohol is close to the lethal dose.
- outworlder 11y ago
  What the hell? Frankly, I would consider foregoing anesthesia if they wanted to hack one of me members with a kitchen knife. But would never, ever, opt out of anesthesia for dental work. Those tooth nerves seem to have realtime priority or something. These things HURT, and I haven't even done anything other than wisdom teeth extraction and normal cavity drilling. I cannot imagine a root canal therapy done without at least local anesthesia.
- roel_v 11y ago
  Today if you go to the dentist in the Netherlands they'll ask you whether you want anesthesia. At first I was like 'wtf, is that even a question' but it's not that bad. It just compresses discomfort into a smaller time window. I'd estimate the 'total' discomfort to be the same. Only have experience with fillings, btw. I guess extracting a healthy molar (e.g. to make room for other teeth), or a wisdom tooth, would be significantly more uncomfortable when done without anesthetics.
- anonymfus 11y ago
  It's still not used by many poor/old patients here because mandatory insurance don't cover it.
  - pavel_lishin 11y ago
    That's terrifying; isn't it just discouraging people from going to the dentist? How much can dental anesthetic injections cost, anyway?
    - anonymfus 11y ago
      About few hundreds of roubles.
atom-morgan 11y ago
People still get their wisdom teeth taken out without being put under. I heard one person describe the process inside your mouth sounding like a tree trunk being snapped in half.
- digitalengineer 11y ago
  That would be Europe. Sounds awful indeed. Especially if they won't budge and an extra tool is placed under the wisdom-tooth to be used as a lever… Root canal is done with local anesthetics as well by the way...
  - falcolas 11y ago
    US as well. I was able to be put under for my most recent extraction, but only after shopping around and strong and continual insistence on my part.
  - djfm 11y ago
    Where I live in Europe dentists are pretty effective, I got 2 wisdom teeth pulled out under local anesthesia and truly did not feel a thing. Was even able to eat a light meal a few hours after.
- PuffinBlue 11y ago
  Huh, that's actually pretty accurate. In fact, 'normal' molars sound the same. In a former life, a nice American chap yanked one of mine out whilst in Kandahar and it sounded like that - only he also broke a part off the jaw too, so that could have been some part of the sound. He informed me with a slightly embarrassed: "I'm sorry but I think I just broke your jaw bone." In a later development, the bone began to be rejected by my gum and was pushed up and out. Broken bone is surprisingly sharp and rather than carry around the little calcium razor one of my Corporals kindly volunteered to pull it out with a pair of needle nose pliers. Happy to say the latter operation was a complete success.
- cguess 11y ago
  I had mine removed and opted out of being put under. I get pretty nauseous coming out of general anesthesia. Local anesthesia and very loud Flogging Molly did the trick for me (and a lot of patience, it took awhile). Didn't really feel anything.
vdnkh 11y ago
It is all low tech. I've been undergoing significant dental work over the past year and I always come back to this same thought. The reason the "brutal" techniques works is because of the amazing resiliency of the mouth. Wounds heal quickly, and teeth are rooted so deep they take a ton of punishment before giving out. I've been lucky to find an orthodontist whose not afraid to do something advanced. Previously, I had 5 or 6 consultations from different orthodontists who, in some cases, wanted me to return within the hour to install metal braces.I knew that my mouth was a bit of a special case (impacted canine), but I refused to believe that metal was the end game. I always asked for Invisalign, but they all said it wasn't possible - until I met my current orthodontist. After a quick consultation, he comes back saying "we're going to try something different". The man is a genius, as far as I'm concerned. He proposed a solution to straighten my teeth with Invisalign while making space to pull the canine into place with a cantilever. The cantilever is hidden behind my teeth, attached to my molar and secured with trans-palatal arch. He actually bent the wire around the top of my mouth to minimize its obstruction of the tongue. Painful, simple, but effective. I barely notice it. He cuts my Invisalign retainers by hand so they still fit in. In the dental world, this is really advanced. I had to repeat the procedure several times to my oral surgeon (who did great work) before he understood that the chain pulling my tooth into place isn't destined for a metal bracket, and must be sutured to my gum pending installation of the cantilever. Quick call to my ortho cleared everything up. Likewise, my dentist was equally surprised. Both said it was a great idea. According to my orthodontist, my treatment would be the subject of a paper, if he was still inclined to write them. None of it seems very modern to me.
- sevensor 11y ago
  I had the same diagnosis 20 years ago. And I had the old-fashioned treatment for it: oral surgery to expose the tooth, metal braces, canine winched into place by means of weekly tightenings over several months. Glad to hear things are beginning to improve.
  - kbutler 11y ago
    And sad that the improvement won't become common practice because the practitioner doesn't feel the need to publish it...
santaclaus 11y ago
I dislocated a limb, once, while playing some sports ball. The fix at the ER? A heavier doctor wrapped some ropes around me and leaned back with all of his weight, while the other doctor grabbed my limb and pulled really damn hard. Some medical treatments feel absolutely medieval...
- raverbashing 11y ago
  Well, there's no modern way of solving what's essentially a misplacement of your limb It's going to involve pulling and readjusting
mikeash 11y ago
At least dental techniques work, even if they might not be very sophisticated or pleasant. Lobotomies just destroyed people. They were only successful in that they made the victims more compliant and less of a hassle for their caretakers, they didn't actually fix the problems.
- Bluestrike2 11y ago
  When you get a chance, take a look at a photo of an orbitoclast (think ice pick). Hammer it in behind the eye socket, give it a good whack, and swing it around a bit. Walter Freeman, the asshole who invented the device, used to drive around the country in his little van performing lobotomies for $25 a pop. He had a nasty tendency to kill his patients; he even killed one when he stopped to have his photo taken with the pick in the patient's brain and accidentally rammed it in a bit too far. These things, of course, happen when you can't see what you're doing. http://projects.wsj.com/lobotomyfiles/?ch=two http://projects.wsj.com/lobotomyfiles/?ch=two https://40.media.tumblr.com/995323300444f99ee37ffffaa834cfb1/tumblr_nim4uz0TDA1qa8kcao1_500.jpg https://40.media.tumblr.com/995323300444f99ee37ffffaa834cfb1... http://www.sculptorshop.com/oddities/lobotomy-walter-freeman.jpg http://www.sculptorshop.com/oddities/lobotomy-walter-freeman...
  - mikeash 11y ago
    People like to say that "learning is fun," but I find that with the internet this is often not true.
    - Bluestrike2 11y ago
      All too true at times.
kobayashi 11y ago
Comparing frontal lobotomies (FLs) with cavity fillings is not an appropriate comparison, IMHO. FLs were always quite controversial because of the serious impairment side-effects and the danger inherent in the procedure (5% death rate during procedure). The operation caused serious brain damage to most - that was its modus operandi. On the other hand, drilling holes in teeth seems like a low-tech solution (though I suppose that humans from years past would view it as a marked improvement from tooth-pulling), but it ultimately gets the job done, more or less, with minimal negative side-effects.
marincounty 11y ago
The way they treat depression is still very low tech. They make it sound modern, but electroshock therapy still has the the highest rates of remission. I'm a nobody, so listen to your psychiatrist though. I do agree they have a long way to go in dentistry. A year ago, I was browsing a scientific grant site. They still don't know why fluoride ions seem to protect teeth. As to keeping your teeth as long as possible, I'm an old dude who's missing one tooth. It could be genetics, or luck, but here's my regimen. Brush with a electric tooth brush(the original one, that one that vibrates. Get in the habit of using tooth picks. I'm a former smoker, so the habit came easily. (Don't throw the tooth picks on the ground. Birds can swallow them, and other trash concerns. I won't mention a company. They are all the same.) Try not to eat sugary stuff before sleeping, even napping. Buy a few dental scraping instruments. (if you are somewhat coordinated, you can scrape your teeth. You can even get 1 to 2 mm below the gum line. Because you are doing this extra work, just believe you are saving your teeth. (Yea, why not use the placebo effect on your own body?). Drink tap water. When I was younger, I looked into making chewing gum, but with a safe substance in it that would neutralize the acids on you teeth. Never got around to it. I recall a French company hit the market with a gum like the one I wanted to make, but unsure if it was successful, or even worked. There's a part of me who believe's tooth decay is more about enzymes, and immunity, but who know?
Justsignedup 11y ago
Yep yep yep yep. The fact is that this will "heal" the tooth rather than effectively putting a cork in it. This will also eliminate root canals because rather than a cork pushing against the nerve, you will have calcium replacing lost... calcium. Boom. Real healing. Remember when a bad cut = cut the arm off? Now we have so much treatment that it is very rare to remove healthy tissue. Similar things are coming with that new artificial eye lens. "Why would we cut off healthy tissue, when we can just replace the bad tissue"
smacktoward 11y ago
The problem with new techniques is that, being new, they are (1) hard to find and (2) more expensive. Combine that with miserly dental insurance and it's hard for advances to get traction. I actually have an example of this from my own life. I grind my teeth while I sleep, apparently, and since none of the dentists I saw during the first 30 years of my life ever figured that out (grr) my teeth are pretty ground down. These days I wear a dental appliance while I sleep to reduce the damage, but it is only a case of "reduce", not "prevent." The teeth are still getting worse, just not quite so fast. The word I'd gotten from several dentists was that this was as good a solution as I could realistically hope for. But last year I switched to a new dentist, and when I was telling him all this his eyes got all big, like I was telling him that the plan had been to drill a hole in my head to let out the Evil Spirits. Modern dentistry, he told me, actually had a way to stop the grinding altogether using a course of mild, painless electrical stimuli. Do a few rounds of that, he said, and it'd be problem solved. Which sounded great! Except that my dental insurance refused to cover even one dollar of such a procedure, which meant it would have cost me about as much out of pocket as a small car. And I, being a layman, have no way to tell if this one dentist is really right, or if all the other ones were and this one is peddling snake oil. So I ended up not doing it, out of fear of a worst case scenario where I went broke paying for treatments that didn't actually do anything. This outcome is sub-optimal for everybody -- even the health insurance company, since the more I grind my teeth down the more often they'll end up having to pay for extractions, root canals and the like as the teeth crack and fail. But combine lack of information with high costs and change-averse insurance, and it's difficult to see how you get to any other outcome.
grumblestumble 11y ago
Stents and angioplasty are pretty low tech, too, in much the same way. Bodies are messy.
saidajigumi 11y ago
> It all seems so low tech. This is because the alternative is very high tech. A living part of the body that isn't self repairing needs to be regenerated somehow. The tooth -under the enamel- is a complex living structure that doesn't self-repair. Much of our medical practice, esp. w.r.t. trauma, is based on the premise that the body can repair itself if perhaps given some assistance. But that premise fails with cavities. At first blush, I was hoping that this work was going to be an advance that would promote repair in the deeper layers of the tooth. Sadly, we're not there yet.
bluthru 11y ago
More than anything it shows how terrible a lot of modern diets are for health. Virtually no one would go around eating lemons, but we've found a way to combine it with sugar to create the worst of both worlds for our teeth. Sugar isn't easy to come by in the natural world but it's in so many foods now that bacteria in the mouth never go hungry.

pavel_lishin 11y ago

No need to wait. A few decades ago in Russia, anesthesia wasn't used during dentistry. That was a fun time period to grow up in.

wanderingstan 11y ago
No need to even go that far, in 2006 I had a root canal in Germany with no anesthesia or pain killers given. Made worse by the fact I didn't understand what it was being done. My German was terrible and the dentist's English was worse.
- pavel_lishin 11y ago
  That's terrifying; I'm guessing that the language barrier resulted in a serious miscommunication?
- merpnderp 11y ago
  How was it possible to hold still while having a large nerve drilled out?
  - Jtsummers 11y ago
    I can't speak to dental stuffs, but some local anesthetics don't work on me. I found it remarkably easy, though extraordinarily painful, to maintain stillness while having my foot stitched back together. The grip I had on the bedframe, however, I'm surprised I didn't break it or tear something apart in my arm. I can't really say how I did it, because I'm not sure. I just knew I had to and didn't move.
    - pavel_lishin 11y ago
      I feel like dental work is harder. I've had an ingrown toenail worked on, and every painkiller injection was a) incredibly painful, b) barely useful for dulling the pain. After about seven shots, I decided that the knife-work on my toe was going to be less painful than subsequent injections, and toughed it out. It's much harder when having dental work done; I've had painkillers not-quite-take, and I always ask for additional injections, unless they're minutes from being done.
      - merpnderp 11y ago
        Holy crap am I glad I'm extra sensitive to painkillers' effects. For tooth work, I can easily get by on half a shot.
        pavel_lishin 11y ago
        One thing few writers focus on, in terms of the post-apocalypse, is dental care. A cavity can literally kill you if it progresses far enough. David Brin actually addressed this in The Postman; maybe this is why everyone in post-apocalyptic television and most films has shiny white teeth - they know!
        merpnderp 11y ago
        Whenever I read or hear about "preppers" or people preparing for a catastrophe, I've always wondered what their plan was for dental care. When I was in my early 20's, my wisdom teeth became impacted. My only symptom was a horrible upper respiratory infection that turned into pneumonia. Without antibiotics and then surgery to remove the teeth, I probably would have died. And The Postman was a wonderful book.
      - Jtsummers 11y ago
        So far for dental work anesthetics have always taken for me (or I've been knocked out, like when my wisdom teeth were pulled). I only brought it up because the foot happens to be another particularly sensitive area of the body. It's possible to get by without anesthetics, and you may (though I hope no one here ever has to find out) surprise yourself by how much you can tolerate while still remaining still for the procedure. But in general, I think you're correct that dental work is harder. A bunch of stitches on the bottom of your foot, however, is still some sort of torture. The ones I've had on my head or arms or torso with other non-functioning anesthetics were far easier to take.
  - Eldarrion 11y ago
    The way root canals were handled is by usually killing the nerve via opening up the nerve, putting arsenic in and sealing it with a temporary filling for 2-3 days. After that's all done, there's very little pain felt except when the doctor goes far enough to poke at the gums. The procedure does take longer than with anesthesia in that you need two visits for the whole process, but that's how they did it.
    - Karunamon 11y ago
      That explains a lot. I had one of these improperly done on a molar about 10 years ago. After the anesthetic wore off from the first visit, the pain slowly grew over the next few days until it was of brilliant, blinding, bang-head-against-hard-object make it STOP!! intensity. After they took off the temp filling, the smell was nauseating. Apparently it wasn't cleaned very well. Never went to that guy again.
      - Turing_Machine 11y ago
        The foul odor may well have been from an infection.
      - pavel_lishin 11y ago
        That is absolutely not normal.
    - spyder 11y ago
      Arsenic? So they not only using mercury in fillings but arsenic too for killing the nerve, nice :(.
- vectorjohn 11y ago
  This can't be real. I've had a couple root canal procedures done, and even with local anesthesia, sometimes a jolt of pain comes through. It would be impossible to take, I would think.
  - jacquesm 11y ago
    I've had one done without. It's definitely not pleasant.
  - takeda 11y ago
    It really matters at what stage the tooth is in. If the tooth is dead (e.g. you have pain that intensifies to heat, and cold helps)[1] then anesthesia won't make much difference you won't feel a thing anyway. If you're getting root canal, because cavity is close to the nerve and your dentist don't want to use amalgamated filling then you will need anesthesia, because the nerves are alive. [1] It gets a bit complicated with molars, which have multiple nerves, if one nerve dies, you'll still need anesthesia for the remaining ones, and you do need root canal, since you can't save part of the tooth and you do need anesthesia, because the tooth is not completely dead yet.
    - vectorjohn 11y ago
      Hmm. Both of mine were on molars and certainly alive, so that explains that. But I don't know how a dentist could possibly tell the nerves are dead before drilling in. And the way they know is that you say ouch that fucking hurts.
      - etcet 11y ago
        They do hurt you but they don't use a drill at first. I had a root canal done recently and the dentist briefly touched a piece of dry ice to my tooth. He did to a an undamaged tooth first, I guess to see if I could feel pain?
        pnathan 11y ago
        Correct. The doc did it to me. I had a very dead tooth, and a very alive tooth. Worked like a charm.
- Luc 11y ago
  Are you talking about anaesthesia in the sense of general anaesthesia (loss of consciousness and all that)? Because that's really not needed for a root canal. I've had many and generally the dentist will make an injection to numb the nerve, have you wait 15 minutes, and start working. In case of discomfort they'll give an extra injection.
- derriz 11y ago
  Must be a thing in German speaking countries? Last year i was asked if i wanted local anesthetic when the dentist was about to drill a back tooth for a crown in Zurich. I blinked with incomprehension - I couldn't believe anyone would NOT want anesthesia. But apparently I had understood correctly and according to the dentist quite a few ask to forego it.
  - __david__ 11y ago
    My dad doesn't do anesthesia when getting fillings (we're in the US). He doesn't like the numbness afterwards and the pain doesn't bother him too much, I guess. I tried it once and made it through, but it was a pretty miserable experience.
  - jacinda 11y ago
    They may have asked because having dental insurance isn't as common in Switzerland (medical/accident insurance is mandatory, but not dental), so many people pay for everything out of pocket. They might opt-out of the anesthetic to save money.
  - legulere 11y ago
    Drilling and getting a filling isn't that painful and for some people getting a shot is less pleasant. There even are some dentists in Germany that drawing teeth without anesthesia, but with the help of hypnosis.
    - tripzilch 11y ago
      Indeed, some people are way more afraid of needles. And the pain (for drilling+filling a regular cavity) really isn't that bad. The biggest unpleasantness about it is that it's in a weird place, at the back of my tooth, and that it happens at pretty much random intervals beyond my control. Most of the time you don't feel a thing, until the dentist "hits a nerve", sharp pain, but also subsides within the second. And as far as I've understood they don't actually hit the nerve with the drill, just that the tooth locally heats up from the drill friction, which the nerve feels as a sharp pain, anyone know if that is actually right? I just ... read it somewhere :) I used to do without (it wasn't offered, I was young and didn't ask either), but nowadays I usually opt for the anaesthetic, I don't mind needles at all, and there's no downside to it, afaik.
amelius 11y ago
At least there was vodka :)
- pmoriarty 11y ago
  The problem is that the anaesthetic dose of alcohol is close to the lethal dose.
outworlder 11y ago
What the hell? Frankly, I would consider foregoing anesthesia if they wanted to hack one of me members with a kitchen knife. But would never, ever, opt out of anesthesia for dental work. Those tooth nerves seem to have realtime priority or something. These things HURT, and I haven't even done anything other than wisdom teeth extraction and normal cavity drilling. I cannot imagine a root canal therapy done without at least local anesthesia.
roel_v 11y ago
Today if you go to the dentist in the Netherlands they'll ask you whether you want anesthesia. At first I was like 'wtf, is that even a question' but it's not that bad. It just compresses discomfort into a smaller time window. I'd estimate the 'total' discomfort to be the same. Only have experience with fillings, btw. I guess extracting a healthy molar (e.g. to make room for other teeth), or a wisdom tooth, would be significantly more uncomfortable when done without anesthetics.
anonymfus 11y ago
It's still not used by many poor/old patients here because mandatory insurance don't cover it.
- pavel_lishin 11y ago
  That's terrifying; isn't it just discouraging people from going to the dentist? How much can dental anesthetic injections cost, anyway?
  - anonymfus 11y ago
    About few hundreds of roubles.

atom-morgan 11y ago

People still get their wisdom teeth taken out without being put under. I heard one person describe the process inside your mouth sounding like a tree trunk being snapped in half.

digitalengineer 11y ago
That would be Europe. Sounds awful indeed. Especially if they won't budge and an extra tool is placed under the wisdom-tooth to be used as a lever… Root canal is done with local anesthetics as well by the way...
- falcolas 11y ago
  US as well. I was able to be put under for my most recent extraction, but only after shopping around and strong and continual insistence on my part.
- djfm 11y ago
  Where I live in Europe dentists are pretty effective, I got 2 wisdom teeth pulled out under local anesthesia and truly did not feel a thing. Was even able to eat a light meal a few hours after.
PuffinBlue 11y ago
Huh, that's actually pretty accurate. In fact, 'normal' molars sound the same. In a former life, a nice American chap yanked one of mine out whilst in Kandahar and it sounded like that - only he also broke a part off the jaw too, so that could have been some part of the sound. He informed me with a slightly embarrassed: "I'm sorry but I think I just broke your jaw bone." In a later development, the bone began to be rejected by my gum and was pushed up and out. Broken bone is surprisingly sharp and rather than carry around the little calcium razor one of my Corporals kindly volunteered to pull it out with a pair of needle nose pliers. Happy to say the latter operation was a complete success.
cguess 11y ago
I had mine removed and opted out of being put under. I get pretty nauseous coming out of general anesthesia. Local anesthesia and very loud Flogging Molly did the trick for me (and a lot of patience, it took awhile). Didn't really feel anything.

vdnkh 11y ago

It is all low tech. I've been undergoing significant dental work over the past year and I always come back to this same thought. The reason the "brutal" techniques works is because of the amazing resiliency of the mouth. Wounds heal quickly, and teeth are rooted so deep they take a ton of punishment before giving out. I've been lucky to find an orthodontist whose not afraid to do something advanced. Previously, I had 5 or 6 consultations from different orthodontists who, in some cases, wanted me to return within the hour to install metal braces.I knew that my mouth was a bit of a special case (impacted canine), but I refused to believe that metal was the end game. I always asked for Invisalign, but they all said it wasn't possible - until I met my current orthodontist. After a quick consultation, he comes back saying "we're going to try something different". The man is a genius, as far as I'm concerned. He proposed a solution to straighten my teeth with Invisalign while making space to pull the canine into place with a cantilever. The cantilever is hidden behind my teeth, attached to my molar and secured with trans-palatal arch. He actually bent the wire around the top of my mouth to minimize its obstruction of the tongue. Painful, simple, but effective. I barely notice it. He cuts my Invisalign retainers by hand so they still fit in. In the dental world, this is really advanced. I had to repeat the procedure several times to my oral surgeon (who did great work) before he understood that the chain pulling my tooth into place isn't destined for a metal bracket, and must be sutured to my gum pending installation of the cantilever. Quick call to my ortho cleared everything up. Likewise, my dentist was equally surprised. Both said it was a great idea. According to my orthodontist, my treatment would be the subject of a paper, if he was still inclined to write them. None of it seems very modern to me.

sevensor 11y ago
I had the same diagnosis 20 years ago. And I had the old-fashioned treatment for it: oral surgery to expose the tooth, metal braces, canine winched into place by means of weekly tightenings over several months. Glad to hear things are beginning to improve.
- kbutler 11y ago
  And sad that the improvement won't become common practice because the practitioner doesn't feel the need to publish it...

santaclaus 11y ago

I dislocated a limb, once, while playing some sports ball. The fix at the ER? A heavier doctor wrapped some ropes around me and leaned back with all of his weight, while the other doctor grabbed my limb and pulled really damn hard. Some medical treatments feel absolutely medieval...

raverbashing 11y ago
Well, there's no modern way of solving what's essentially a misplacement of your limb It's going to involve pulling and readjusting

mikeash 11y ago

At least dental techniques work, even if they might not be very sophisticated or pleasant. Lobotomies just destroyed people. They were only successful in that they made the victims more compliant and less of a hassle for their caretakers, they didn't actually fix the problems.

Bluestrike2 11y ago
When you get a chance, take a look at a photo of an orbitoclast (think ice pick). Hammer it in behind the eye socket, give it a good whack, and swing it around a bit. Walter Freeman, the asshole who invented the device, used to drive around the country in his little van performing lobotomies for $25 a pop. He had a nasty tendency to kill his patients; he even killed one when he stopped to have his photo taken with the pick in the patient's brain and accidentally rammed it in a bit too far. These things, of course, happen when you can't see what you're doing. http://projects.wsj.com/lobotomyfiles/?ch=two http://projects.wsj.com/lobotomyfiles/?ch=two https://40.media.tumblr.com/995323300444f99ee37ffffaa834cfb1/tumblr_nim4uz0TDA1qa8kcao1_500.jpg https://40.media.tumblr.com/995323300444f99ee37ffffaa834cfb1... http://www.sculptorshop.com/oddities/lobotomy-walter-freeman.jpg http://www.sculptorshop.com/oddities/lobotomy-walter-freeman...
- mikeash 11y ago
  People like to say that "learning is fun," but I find that with the internet this is often not true.
  - Bluestrike2 11y ago
    All too true at times.

kobayashi 11y ago

Comparing frontal lobotomies (FLs) with cavity fillings is not an appropriate comparison, IMHO. FLs were always quite controversial because of the serious impairment side-effects and the danger inherent in the procedure (5% death rate during procedure). The operation caused serious brain damage to most - that was its modus operandi. On the other hand, drilling holes in teeth seems like a low-tech solution (though I suppose that humans from years past would view it as a marked improvement from tooth-pulling), but it ultimately gets the job done, more or less, with minimal negative side-effects.

marincounty 11y ago

The way they treat depression is still very low tech. They make it sound modern, but electroshock therapy still has the the highest rates of remission. I'm a nobody, so listen to your psychiatrist though. I do agree they have a long way to go in dentistry. A year ago, I was browsing a scientific grant site. They still don't know why fluoride ions seem to protect teeth. As to keeping your teeth as long as possible, I'm an old dude who's missing one tooth. It could be genetics, or luck, but here's my regimen. Brush with a electric tooth brush(the original one, that one that vibrates. Get in the habit of using tooth picks. I'm a former smoker, so the habit came easily. (Don't throw the tooth picks on the ground. Birds can swallow them, and other trash concerns. I won't mention a company. They are all the same.) Try not to eat sugary stuff before sleeping, even napping. Buy a few dental scraping instruments. (if you are somewhat coordinated, you can scrape your teeth. You can even get 1 to 2 mm below the gum line. Because you are doing this extra work, just believe you are saving your teeth. (Yea, why not use the placebo effect on your own body?). Drink tap water. When I was younger, I looked into making chewing gum, but with a safe substance in it that would neutralize the acids on you teeth. Never got around to it. I recall a French company hit the market with a gum like the one I wanted to make, but unsure if it was successful, or even worked. There's a part of me who believe's tooth decay is more about enzymes, and immunity, but who know?

Justsignedup 11y ago

Yep yep yep yep. The fact is that this will "heal" the tooth rather than effectively putting a cork in it. This will also eliminate root canals because rather than a cork pushing against the nerve, you will have calcium replacing lost... calcium. Boom. Real healing. Remember when a bad cut = cut the arm off? Now we have so much treatment that it is very rare to remove healthy tissue. Similar things are coming with that new artificial eye lens. "Why would we cut off healthy tissue, when we can just replace the bad tissue"

smacktoward 11y ago

The problem with new techniques is that, being new, they are (1) hard to find and (2) more expensive. Combine that with miserly dental insurance and it's hard for advances to get traction. I actually have an example of this from my own life. I grind my teeth while I sleep, apparently, and since none of the dentists I saw during the first 30 years of my life ever figured that out (grr) my teeth are pretty ground down. These days I wear a dental appliance while I sleep to reduce the damage, but it is only a case of "reduce", not "prevent." The teeth are still getting worse, just not quite so fast. The word I'd gotten from several dentists was that this was as good a solution as I could realistically hope for. But last year I switched to a new dentist, and when I was telling him all this his eyes got all big, like I was telling him that the plan had been to drill a hole in my head to let out the Evil Spirits. Modern dentistry, he told me, actually had a way to stop the grinding altogether using a course of mild, painless electrical stimuli. Do a few rounds of that, he said, and it'd be problem solved. Which sounded great! Except that my dental insurance refused to cover even one dollar of such a procedure, which meant it would have cost me about as much out of pocket as a small car. And I, being a layman, have no way to tell if this one dentist is really right, or if all the other ones were and this one is peddling snake oil. So I ended up not doing it, out of fear of a worst case scenario where I went broke paying for treatments that didn't actually do anything. This outcome is sub-optimal for everybody -- even the health insurance company, since the more I grind my teeth down the more often they'll end up having to pay for extractions, root canals and the like as the teeth crack and fail. But combine lack of information with high costs and change-averse insurance, and it's difficult to see how you get to any other outcome.

grumblestumble 11y ago

Stents and angioplasty are pretty low tech, too, in much the same way. Bodies are messy.

saidajigumi 11y ago

> It all seems so low tech. This is because the alternative is very high tech. A living part of the body that isn't self repairing needs to be regenerated somehow. The tooth -under the enamel- is a complex living structure that doesn't self-repair. Much of our medical practice, esp. w.r.t. trauma, is based on the premise that the body can repair itself if perhaps given some assistance. But that premise fails with cavities. At first blush, I was hoping that this work was going to be an advance that would promote repair in the deeper layers of the tooth. Sadly, we're not there yet.

bluthru 11y ago

More than anything it shows how terrible a lot of modern diets are for health. Virtually no one would go around eating lemons, but we've found a way to combine it with sugar to create the worst of both worlds for our teeth. Sugar isn't easy to come by in the natural world but it's in so many foods now that bacteria in the mouth never go hungry.