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Dentistry technology seems similar to battery technology in that these developments never seem to filter down out of the lab, ever. The only thing new that's be
by sli 9y ago
Dentistry technology seems similar to battery technology in that these developments never seem to filter down out of the lab, ever. The only thing new that's been added to my dentist visits is that little graduated paperclip looking thing that measures depth between your teeth and gums. Other than that, every dentist visit I've ever been to has been basically identical, as far as technology goes.
I get that much of it works, so there's not a lot of need to throw it out, but where's the progress? My eye doctor visits add new technology regularly. Not often, to be sure, but still regularly. My eye doctor visits now are quite a bit different in many ways than they were when I first got glasses.
There's a point where I started to wonder if dentists in general are worried about becoming obsolete. That's conspiracy theory, of course, so I don't take it seriously. But I do wonder all the same.
- vkou 9y ago> Dentistry technology seems similar to battery technology in that these developments never seem to filter down out of the lab, ever. What? Batteries have made enormous strides in the past two decades. Surely, you remember the days of almost everything running off AAs, which took hours to recharge (If they were even rechargable), and tended to leak their contents at the slightest provocation. Or, alternatively, you could shell out large amounts of money for lithium-ion batteries, which wouldn't hold half a charge after ~50 cycles, and which would be at 1/6th their original capacity after ~100 cycles. If anything, battery technology has been a monumental success story. No, we don't have batteries based on unicorn farts that charge in 20 seconds, and hold more energy then gasoline. But what we do have is pretty damn amazing.
- plushpuffin 9y agoBatteries have seen incremental yearly improvements of a few percent in capacity, recharge time, cost, weight, and number of recharges, which looks impressive over several years. GP is talking about the articles that come out every month or two saying "new battery with nano-particles/graphene/etc has 20x the capacity of LiOn [in the lab]."
- wmeredith 9y agoI also found this to be a puzzling analogy. Battery is improving at a blistering pace, but then again so is dental tech, so ¯\_(ツ)_/¯
- sambe 9y agoMost people's primary experience of lithium-ion batteries is in their mobile phone. From that point of view, they were already cheap and commonplace at ~the turn of the millennium. Most people's perception is that in the last 18 years they've got substantially worse. Obviously, the power and capability of the phone has gone up dramatically, but it's pretty obvious where the perception has come from. I'd think the secondary experience is in laptop batteries, and I'd hazard a guess that there's a similar but less extreme story: perception is similar battery life (perhaps because most life extensions come from low-power modes, so anyone actually using their laptop doesn't reach the claimed numbers for modern laptops?). Of course, a third major factor is that people tend not to notice incremental improvements as much as step changes, and tend not to "upgrade their battery" in a comparable way. All told, in relative terms there's probably some truth to it; other technology has progressed faster. But I wholeheartedly agree things have got better.
- jstanley 9y agoI lost one of my front teeth and now have a titanium bolt threaded into the tooth socket, with a ceramic tooth screwed into the titanium bolt. https://en.wikipedia.org/wiki/Dental_implant https://en.wikipedia.org/wiki/Dental_implant There was a CT scan of my mouth, and then a bolt was selected and a ceramic tooth created that would accurately fill the gap. It works just like a real tooth, except it is slightly chunkier (but it's chunkier in the direction that points inside my mouth, so I'm the only person who can tell). It felt pretty high-tech to me, although the article mentions that the first titanium dental implant was placed in 1965.
- suryamp 9y agocan you use MRI machines?
- jstanley 9y agoI believe so, yes.
- CognitiveLens 9y agoProbably not, actually - I have a similar thing and was told that although the MRI machine won't rip the metal out of your jaw like it would for ferrous metals, the titanium will essentially act like a little antenna and obliterate the image
- cperciva 9y agoI have a titanium implant and have had MRIs. It might be a problem if you wanted an MRI of your teeth, but anything else is fine.
- ricardobeat 9y agoApparently implants have been made for over 100 years, even before titanium was 'discovered' in the 60s. The best bet we have to replace that are root-analogue implants [1] - essentially a physical 3D-printed copy of the whole tooth, including roots. Unfortunately information is scarce (as you can see in that wikipedia page), it's not even mentioned in the main 'Dental implant' article. There is a single dentist in the entire world [2] actively offering these implants, and going at it for 20 years. [1] https://en.wikipedia.org/wiki/Root_analogue_dental_implant https://en.wikipedia.org/wiki/Root_analogue_dental_implant [2] http://www.bioimplant.at http://www.bioimplant.at
- ChrisClark 9y agoWhen I had braces as a kid, after they glued them on I had to sit there with air blowing on them for a long time to dry/set the glue. Nowadays they just shine a near-UV light on them for a couple seconds and it's done.
- wlesieutre 9y agoThat one's been around for at least 15-20 years. Are people still getting braces glued on is it going the way of the molded clear plastic things? They were the hot new item being advertised back when I was getting my teeth fixed.
- ChrisClark 9y agoI guess I'm just older than I thought. :) Yeah, I'm not sure about braces now. I do hear ads for that invisalign product, or something close to that. So that's probably what's being used now.
- wlesieutre 9y agoWas curious and googled it, Invisalign has some limitations (mentioned in "Not ideal for") like moving teeth vertically and rotating canines or premolars. So even aside from the price tag (which I assume used to be even higher) it wouldn't have worked for me. Would've loved to do without the wires popping out and stabbing me in the mouth, it wasn't a favorite part of my childhood. So much orthodontia. Would be great if you're doing it as an adult, I wonder how most kids would do with the "must wear 22 hours a day" part. If I could've taken my braces out I probably would have. OTOH I had a couple other removable mouth appliances and managed with those, so maybe it's just because braces are awful that I wanted to get rid of them. https://happytoothnc.com/braces-vs-invisalign/ https://happytoothnc.com/braces-vs-invisalign/
- SN76477 9y agoinvisialign is for shifting, not really for repositioning.
- juancampa 9y agoOne counter example to this argument is Invisalign. 3D printed braces.
- deleted 9y ago[deleted]
- BugsJustFindMe 9y agoI don't see how something for sale in the US since 1999 is a counterexample. That was 19 years ago.
- gldalmaso 9y agoMy wife made a partial tooth implant a year or so ago, the implanted tooth was 3D printed.
- Kluny 9y ago> There's a point where I started to wonder if dentists in general are worried about becoming obsolete. That's conspiracy theory, of course, so I don't take it seriously. But I do wonder all the same. If they are, someone should hold their hands and reassure them, or something. I haven't been to a dentist in about 6 years, mostly due to procrastination - though I can afford to have work done, I don't have coverage for it. I'd be a lot more enthusiastic about going if I thought they could actually fix something, instead of announcing that they want to drill more holes in my teeth every time.
- wmeredith 9y agoIf you want dentists to stop drilling holes in your teeth, you should go more often and take care of your teeth.
- vinceguidry 9y agoYou need to stop putting this off and just get in there. If you let it go long enough, then your teeth and gums will become permanently damaged and you'll need cleanings every 60 days instead of 120, for the rest of your life. If you hate going into the dentist now, just wait until you're on that schedule. I narrowly escaped this fate, but it happened to our project manager. If you have a lot of cavities to fill, I would advise knocking it all out outside the country. I went to a dentist in Medellin that did an amazing job, basic cosmetic and restorative work on my whole mouth plus the plane tickets and a 21 day stay in an AirBnB totaled out cheaper than my Atlanta dentist wanted for one inlay.
- wingworks 9y agoYeah you really should go, you have to have these teeth till the end, best to look after them the best you can. I was kinda like you, I hadn't gone to the dentist for maybe 2-3 years, and have just gone and have gotten 1 filling that had half fallen out, re-done and another new hole fixed. And was told to switch to an electric toothbrush as I was brushing away my gums (which I highly recommend, if anyone is still using the hand brushes), which is kinda irreversible and potentially really bad if it goes too far. And there are a tonne of other things your dentist will be checking each time. Paying ~$100 a year is a small price to pay to keep your teeth healthy.
- lanius 9y agoNot sure if this is considered part of dentistry, but when I got consultations for jaw surgery, they used some sort of wand with a camera to build a 3D model of my mouth. I thought that was pretty high tech.
- Zaak 9y agoWhen I was getting a dental implant to replace a badly decayed tooth (protip: get broken teeth fixed), my dentist used the same sort of thing.
- jccalhoun 9y agoI think it depends on how often the dentist updates the office equipment. I'm sure that stuff isn't expensive and why upgrade when what you have works? I've gone to dentists in totally new buildings and saw some things I didn't see at my old dentist who had been there for years.
- bbatha 9y agoYou also have to factor in familiarity, ie does it make sense for a dentist to pick up a new tool with slightly better outcomes if they’re going to make more mistakes while they learn on it?
- hugh4life 9y agoHmm... could be an complete apples and oranges comparison but I remember waiting on my brother do his root canal for a couple hours in the 90s and around 2012 or so it too me 15 minutes.
- ricardobeat 9y agoI guess that has nothing to do with tech. I had a canal treatment a couple years ago that took almost two hours, fully modern clinic (own cerec mill and all).
- hsod 9y agoFifteen minutes? I got one last week (USA) and it took over an hour.
- wmblaettler 9y agoMy dentist, a younger generation who took over the practice from a retiring dentist, has installed a Cerec crown milling machine. It was amazing to see the tooth modelled in 3d using a series of photos, then I watched my dentist raise the ridges of the tooth to create what would become the crown. After a few clicks he sent it off to be made - in the next room! In literally 10 minutes he had a crown milled from a block of dental porcelain or some kind of hard ceramic, ready to be fitted in my mouth. See a video of the process here: https://www.youtube.com/watch?v=ajj4zkXHe6U https://www.youtube.com/watch?v=ajj4zkXHe6U
- HorizonXP 9y agoI had a crown put in two years ago, and my periodontist and I were talking about how this would be the next step. He had already done detailed 3D modelling of my jaw, mouth, implant site, and had a 3D model from my existing teeth that were removed. Glad to see it actually happening!
- tinbad 9y agoYes! My dentist back in the Netherlands had this technology in 2004 and both of my crowns were made that way. When I came to the US in 2011 and had to go through the ‘old way’ of getting a temp crown, sending mold off to lab, coming back 2 or 3 times over the course of a month I was genuinely amazed it hadn’t caught on here. I finally found a dentist in the Bay Area with new technology.
- greglindahl 9y agoUSB x-ray detector. Think about that for a second -- a chip that can reliably send USB signals despite being bombarded with x-rays.
- mrits 9y agoMy dentist usually breaks out photoshop in my visits. He makes his crowns in-house right in front of me with 3D imagining tech he helped develop. One time he let me mess with it and that's when we found a bug in the undo feature...he had to start a 20 minute process over. He breaks out so much new tech when I visit my friends and family think I'm crazy for going to him. I refer to him as my mad scientist.
- wmeredith 9y agoDentists can already easily be rendered obsolete by regular brushing and flossing-which all of them recommend constantly.
- athenot 9y agoMaybe for us on the younger side but I guarantee there are many ways teeth/gums/bone fail with age, no matter how well you brush and floss.
- privacypoller 9y agoI assume you're being facetious, this just isn't true. Brushing and flossing won't re-align teeth, correct major problems for which you have a genetic disposition, address factors beyond your control like the chemistry in your mouth, extra or absent teeth, dry mouth or physiological factors like how you sleep or the impact of respiratory considerations. Sure, brushing and flossing helps, but to say it eliminates dental professionals is absurd. That's like saying a healthy lifestyle means you'll never need a doctor or visit a hospital.
- dennisgorelik 9y agoGood dental hygiene cannot fully replace dentists, but it can reduce need for dentists ~10x.
- balnaphone 9y agoDo you have scientific evidence (or "proof") of this claim, assuming you're referring strictly to dental caries, and perhaps receding gums? I don't believe it, whatsoever. In fact I challenged some friends (a dentist, an orthopedic surgeon, and a biochemist -- all researchers affiliated with prestigious institutions) to provide that scientific evidence, and after a year they all concluded that standard dental advice is simply wishful thinking. Since it is the recommendation of dental associations, a practicing dentist must give this advice, but that doesn't make it true.
- kaybe 9y ago
- aaavl2821 9y agoFrankly I think a lot of it has to do with money. Not sure exactly what ophthalmology tech you're referring to, but when I go to the eye doctor they have a few machines that offer additional services for an additional fee. The doctors buy these devices in the hopes they will collect enough additional "per click" rev to be profitable. A lot of ophth, as well as derm, is cash pay, so companies can develop and sell these products to doctors who then market them to patients for a relatively low cost and avoid having to get insurance coverage to pay Dentistry has these things too. I think some whitening products are an example. Turns out you don't actually need to be a dentist (from a technical / clinical knowledge perspective) to sell these products, so a lot of random retailers started selling them for a lot cheaper. Dentists got mad, and in these situations the ADA or regional dental associations can drive legislative change. Not saying this always happens, and it certainly isn't unique to dentistry, but these economic issues often dictate what tech gets marketed and what doesnt. If the tech offers a real and meaningful clinical improvement however (whitening does not count) then the tech gets to the market eventually The issue I see with this approach is that 1) the risk / benefit is not super great, and not better than standard of care from what I can tell. Fillings work pretty well, and if there is any risk you can get cancer or other bad things happen from this regenerative med, it wouldn't be responsible to prescribe it. Further, marketing this would require expensive clinical studies, and you'd never be able to charge enough to recoup this cost. Unless there is a significant clinical benefit, no insurance company would pay for an expensive med vs a simple filling. This is why most drug developers using cutting edge tech target areas of significant unmet need, like late stage cancer. If it works, you really provide a ton of value to patients (extending health span and life), so insurers will pay you for that value. If you are offering a "cooler" alternative to something that pretty much works, not so much
- deleted 9y ago[deleted]
- cptskippy 9y agoMy experience with dentists is that they're less about preventative care and more about expensive procedures. It's unfortunate that our health care centers are profit focused.
- cag_ii 9y agoI'd expect preventive care is a lot more about ones own routine vs. what the dentist does.
- privacypoller 9y agoPlus the never-stated but not-quite-secret that uncontrollable factors like genetics and mouth chemistry dictate a lot of what's going to happen, regardless of how well you care for your teeth...
- ericd 9y agoI think mouth chemistry is at least somewhat controllable, via what you eat. It'd be nice if dentists knew more about that aspect, so that they could advise about it beyond "don't eat too much sugar".
- deleted 9y ago[deleted]
- privacypoller 9y agoI don't mind profit motivation, but (at least in Canada) it's combined with all sorts of protections that lead to zero competition and dramatically different costs across jurisdictions (which is Provincial). I'm in Alberta and a lot of procedures from check-ups to fixes cost 2x as much as next door in BC. A few years ago I "shopped" some dentists looking for rough estimates on a general visit (with the provision I wasn't going to hold them to a quote, just wanted to know how much I should be prepared to spend) and most looked at me like I was crazy. Profit-driven without competition is the worst of both worlds.
- jcadam 9y ago
- nextos 9y agoThe paperclip to measure gum pockets is a bad idea. These paperclips have the potential to infect healthy gum tissue with nasty anaerobic bacteria from pockets that are already infected. Unless you use one clip per pocket, of course. If you want good measurements of disease progression, it's much better to use e.g. a BANA test that estimates pathogenic bacteria counts. Or if you are really fancy, sample some gum pockets and get a bit of 16S sequencing done with a MinION.
- russdill 9y agoIt's not a paperclip thing and it's not new. It's a sterile instrument specifically intended for that purpose. https://en.wikipedia.org/wiki/Periodontal_probe https://en.wikipedia.org/wiki/Periodontal_probe
- geoelectric 9y agoHe's saying you can autoinoculate the patient from one pocket to another by using the same probe across your mouth without sterilizing between teeth. It might hasten the spread of periodontitis to areas of the gums it might not have spread to otherwise. Translation only, I have no data here aside from that my hygienist does seem to use the same probe without doing much between teeth when my gums are measured this way.
- russdill 9y agoIt's been researched: http://www.rdhmag.com/articles/print/volume-24/issue-9/columns/periodontics/moving-bacteria-around.html http://www.rdhmag.com/articles/print/volume-24/issue-9/colum... Bacteria already have a great chance to move around the mouth. Healthy pockets are healthy not because they haven't been exposed to bacteria, but because they are place bacteria can't get a foothold.
- agumonkey 9y agoAfter being interested about material science I also realized that a lot of dentist techniques aren't that complex. Mold, UV cured resin... I believe the medical glow makes it appear more sophisticated than it appear, justifying the high costs.
- samstave 9y agoDentistry is a weird field. It takes a certain type of personality to become a dentist. im sure that everyone can do their own thinking on that subject. but I have had the gamut oof good to bad dentist experiences; good: father in law (who was a dentist) was a great man bad: dentist accused me of having braces (I have perfect teeth - never had braces) -- then charged my insurance for a bunch of procedures which werent performed (I only had a cleaning)
- ryen 9y agoMany of Invisialign's patents ran out last year [1] and there have been a few 'startups' cropping up in this space doing discounted Invisialign-like work. https://www.forbes.com/sites/michelatindera/2017/04/25/out-of-silicon-valley-a-billion-dollar-orthodontics-business-built-with-plastic-and-patents/#4676b94130c2 https://www.forbes.com/sites/michelatindera/2017/04/25/out-o...
- ern 9y agoI went to a dentist after many years (no good, I know) and ended up getting some fillings. I was surprised by how much more pleasant the experience was than the last time I had them put in, in the 1990's. The ceramic fillings seem to be a remarkable improvement over amalgam ones. There were also little things, like having a TV, and a pair of glasses to protect my eyes from the glare of the lights.
- wingworks 9y agoI've heard people complain about the lights before, but have no idea what they're talking about, my dentist uses these lights that seem very directional, they don't shine on my eyes at all, I just need eye protection from stuff that gets flung out of my mouth while they're doing there work.
- WalterBright 9y agoWhen I was younger, I got mercury fillings. Those weaken the teeth, need regular replacement, and I suspect are marginally toxic. When they were literally crumbling away later in life, the dentist told me to wait before replacing them, as new filling materials coming down the pike. So I did, and got all the old fillings drilled out and replaced with epoxy ones that match color with my teeth, will last the rest of my life, and hold the weakened tooth together. I wish I'd had that paint available these days when I was a kid, that is painted on the tooth and prevents decay.
- boobsbr 9y agoChanges I've been able to see: * the evolution of dental curing lights from cumbersome, active refrigerated, and wired into really light, portable, wireless flashlights/pens * the introduction of sodium bicarbonate jets for cleaning, polishing and whitening teeth * the introduction of the ultrasonic scaler * the change from dental amalgam (mercury-based), for fillings, to cast resin or ceramic * the introduction of whitening treatments * the changes from really bulky braces to relativevly slim ones, transparent and low-profile brackets, new techniques that do away with external head-gear for a lot of cases
- letsgetphysITal 9y agoI'll add digital on-site radiography processing, i.e. an x-ray is taken by the dentist, the film is processed and scanned in the next room over, and available on the touchscreen in the dentist's room 5 minutes later. That was a week's return by mail 15 years ago. I've also heard of crowns being 3D imaged and milled from a ceramic blank while the anesthetic takes effect, but only from one person.