4 ms·

Routine wisdom teeth removal, male genital mutilation, dentists giving fillings far before they are required, causing toothaches and sensitivity... But these a

Routine wisdom teeth removal, male genital mutilation, dentists giving fillings far before they are required, causing toothaches and sensitivity... But these all turn out to be easy money for someone, for some odd reason.

bsanr 6y ago
I imagine that this gray area is where a lot of "unnecessary surgery" comes from. The vast majority of people have no medical need for circumcision (but some do). A lot of people don't need their wisdom teeth removed (but many probably should). You might need a filling eventually (just not now). Where do you draw the line, in a world where setting up studies to find conclusive evidence for binary medical decision-making ("Should this ever be done in the presence of x, or should it never be done?") is hard enough? I had two surgeries in 2019; in both cases the consulting doctor told me that it was 50/50 if I actually needed them or if they'd actually fix the issues that might have been associated with them. One was a pretty smashing success, the other (ironically more expensive) one was a 4-figure wash that had the surgeon dodging my inquiries as to what went wrong. Unfortunately, it turns out that medical decision-making entails taking a holistic view of the situation and giving advice that the doctor then has to take responsibility for. Good luck achieving that on a systemic level within the ever-dysfunctional structure of American healthcare.
jessaustin 6y ago
I've assisted on numerous third molar extractions, on patients up to sixty years old. None of those people were glad they had neglected to get the work done in their twenties. If you're not sure about a recommended dental filling, just go to a different dentist for a second opinion. By the time a cavity causes you pain you'll need a root canal and possibly a crown.
- hnuser123456 6y ago
  I got all mine out at ~18 for no discernable reason. Earlier in the year, got a filling despite visible substantial enamel. Was fine before, but I could barely handle drinks colder than body temperature for about 6 months. I think it could've waited.
- worker767424 6y ago
  > If you're not sure about a recommended dental filling, just go to a different dentist for a second opinion. This happened to me, probably twice. The first time I got rushed through the fillings and had them the same appointment as a cleaning because they were minor (they were). I still felt abused by it. A few years later, the same dentist found something else. I got a second opinion this time. It was basically that an aggressive dentist might reasonably want to fill it, but the second opinion was "don't bother." Five years and on a new dentist and it hasn't been so much as mentioned by the new dentist. Unless something is obviously wrong or you have a known history of cavities, I'd always get a second opinion.
- klenwell 6y ago
  In my early twenties, I was scheduled to get my wisdom teeth removed. It was going to cost me the equivalent of about a couple week's wages at the time. If I did it without general anesthetic it would be significantly cheaper. The oral surgeon to whom I was referred said I could do it either way, it was my choice. He did mention that, on a scale of 1-10, he would estimate the difficulty of removing my teeth at a 9. In x-rays, a couple looked like they were coming in upside-down. After calculating the number of hours of work the anesthetic would cost me, I decided to bite the bullet of go with a local anesthetic. (My dad was also tough-guying me to skip the general anesthetic.) So I called the surgeon's office to make an appointment. When I mentioned that I would be opting opt of general anesthetic, the receptionist paused and asked me to hold. When she came back, she said that the doctor specified that general anesthetic would be necessary. I mentioned the conversation I had already had with him. She again asked me to hold. When she returned, she said it was no longer an option. I put off the appointment. Miffed, I decided to take a closer look at the practice. This was pre-internet so I went to my local public library. I tracked down a British NHS study that suggested extraction was over-prescribed in the US in part due to the private insurance system. (I guess you can insert your tired joke about British teeth here.) One NHS study coupled with my incipient suspicion of the American medical system was enough for me. Plus all the money I was going to save. I decided to forego the surgery. Almost 30 years on and I can say I have no regrets. (Yet?) My third molars are still buried in my gums. A few years ago, the bottom right one partially broke through the gum. It was irritating at times but never really painful. I take care to floss and brush it with my other teeth. It seems to have come to rest. If I remember correctly, the study stated that after age 30 or 40, most people's wisdom teeth will have settled. One internet commenter's tale backed by one study for which I no longer have the reference.
  - antisthenes 6y ago
    > When I mentioned that I would be opting opt of general anesthetic, the receptionist paused and asked me to hold. When she came back, she said that the doctor specified that general anesthetic would be necessary. I mentioned the conversation I had already had with him. She again asked me to hold. When she returned, she said it was no longer an option. That's a very strange outcome indeed, I wonder if you could have pushed for it anyway. My wisdom teeth were also impacted (nearly buried in gums, horizontally aligned), and I also opted for a local anesthetic. The worst part of the procedure was seeing the size of the syringe. They really didn't spare any anesthetic for it. I felt numb all the way to my neck and ears. To my surprise the whole procedure took less than 40 minutes from start to finish, including cutting the gums, sawing the impacted teeth in half (the noise and smell is not for the faint of heart), and then putting sutures in. Personally, I don't regret getting rid of them either. Made hygiene slightly easier and no risk of inflammation where the wisdom teeth were breaking through the skin.
- mypalmike 6y ago
  Yeah getting my wisdom teeth removed in my 40s seemed like 20 years later than optimal. They always seemed to take up too much space in my mouth, were hard to brush (which led to them eventually needing removal), and contributed to canker sores and other routine pain and irritation. After they were removed, my mouth felt so much healthier, easier to keep clean, and free of miscellaneous pain.
- voxl 6y ago
  The entire point of this discussion is that you are biased. What you need is scientific evidence to back it up. Finding water for your patients is not a good way to view the world.
pstch 6y ago
This is exactly what I thought 3 years ago when a dentist told me that it was very important for me to get rid of my wisdom teeth, because loss of enamel meant that they were very likely to decay quickly even with proper hygiene. Other dentists told me that it was not necessary, and could be done later if the teeth ended up decaying too much. Now the teeth are completely decayed, I've started to feel severe pain, and since I've developed severe thrombopenia (<20 G/L), I can't get them extracted easily (couldn't find any dentist willing to take that risk), so since six months, I have to take anti inflammatory drugs for the pain and antiobiotics to limit the infections, as well as the folic acid and corticosteroids needed for ITP, and I have no idea when will this end. It's very difficult to differentiate important advice from "easy money" advices, especially when this advice stems for a principle of precaution. Most peoples don't develop severe ITP, but if they do, getting wisdom teeth removed before they can cause problems can be very important.
- giardini 6y ago
  This is a long shot but some claim that vitamin K-2 can regenerate teeth to some degree. It might get your teeth in good enough condition to remove. I had started taking K-2 (Jarrow MK-7 menaquinone-7 FWIW) for other reasons but when my semiannual dental checkup came due, both the technician and dentist kept marveling about how pristine and healthy my teeth were. They credited it to my brushing and flossing habits, which had not changed. I took the praise but was puzzled until I remembered that the K-2 might be helping my teeth.
ThePadawan 6y ago
> Routine wisdom teeth removal That one is new to me. My dentist took X-rays at that point in puberty where it would become obvious if the wisdom teeth were obviously and majorly deviating (thus requiring removal). The X-ray came back somewhere between "inconclusive" and "too early to tell", so I still have my wisdom teeth.

bsanr 6y ago

I imagine that this gray area is where a lot of "unnecessary surgery" comes from. The vast majority of people have no medical need for circumcision (but some do). A lot of people don't need their wisdom teeth removed (but many probably should). You might need a filling eventually (just not now). Where do you draw the line, in a world where setting up studies to find conclusive evidence for binary medical decision-making ("Should this ever be done in the presence of x, or should it never be done?") is hard enough? I had two surgeries in 2019; in both cases the consulting doctor told me that it was 50/50 if I actually needed them or if they'd actually fix the issues that might have been associated with them. One was a pretty smashing success, the other (ironically more expensive) one was a 4-figure wash that had the surgeon dodging my inquiries as to what went wrong. Unfortunately, it turns out that medical decision-making entails taking a holistic view of the situation and giving advice that the doctor then has to take responsibility for. Good luck achieving that on a systemic level within the ever-dysfunctional structure of American healthcare.

jessaustin 6y ago

I've assisted on numerous third molar extractions, on patients up to sixty years old. None of those people were glad they had neglected to get the work done in their twenties. If you're not sure about a recommended dental filling, just go to a different dentist for a second opinion. By the time a cavity causes you pain you'll need a root canal and possibly a crown.

hnuser123456 6y ago
I got all mine out at ~18 for no discernable reason. Earlier in the year, got a filling despite visible substantial enamel. Was fine before, but I could barely handle drinks colder than body temperature for about 6 months. I think it could've waited.
worker767424 6y ago
> If you're not sure about a recommended dental filling, just go to a different dentist for a second opinion. This happened to me, probably twice. The first time I got rushed through the fillings and had them the same appointment as a cleaning because they were minor (they were). I still felt abused by it. A few years later, the same dentist found something else. I got a second opinion this time. It was basically that an aggressive dentist might reasonably want to fill it, but the second opinion was "don't bother." Five years and on a new dentist and it hasn't been so much as mentioned by the new dentist. Unless something is obviously wrong or you have a known history of cavities, I'd always get a second opinion.
klenwell 6y ago
In my early twenties, I was scheduled to get my wisdom teeth removed. It was going to cost me the equivalent of about a couple week's wages at the time. If I did it without general anesthetic it would be significantly cheaper. The oral surgeon to whom I was referred said I could do it either way, it was my choice. He did mention that, on a scale of 1-10, he would estimate the difficulty of removing my teeth at a 9. In x-rays, a couple looked like they were coming in upside-down. After calculating the number of hours of work the anesthetic would cost me, I decided to bite the bullet of go with a local anesthetic. (My dad was also tough-guying me to skip the general anesthetic.) So I called the surgeon's office to make an appointment. When I mentioned that I would be opting opt of general anesthetic, the receptionist paused and asked me to hold. When she came back, she said that the doctor specified that general anesthetic would be necessary. I mentioned the conversation I had already had with him. She again asked me to hold. When she returned, she said it was no longer an option. I put off the appointment. Miffed, I decided to take a closer look at the practice. This was pre-internet so I went to my local public library. I tracked down a British NHS study that suggested extraction was over-prescribed in the US in part due to the private insurance system. (I guess you can insert your tired joke about British teeth here.) One NHS study coupled with my incipient suspicion of the American medical system was enough for me. Plus all the money I was going to save. I decided to forego the surgery. Almost 30 years on and I can say I have no regrets. (Yet?) My third molars are still buried in my gums. A few years ago, the bottom right one partially broke through the gum. It was irritating at times but never really painful. I take care to floss and brush it with my other teeth. It seems to have come to rest. If I remember correctly, the study stated that after age 30 or 40, most people's wisdom teeth will have settled. One internet commenter's tale backed by one study for which I no longer have the reference.
- antisthenes 6y ago
  > When I mentioned that I would be opting opt of general anesthetic, the receptionist paused and asked me to hold. When she came back, she said that the doctor specified that general anesthetic would be necessary. I mentioned the conversation I had already had with him. She again asked me to hold. When she returned, she said it was no longer an option. That's a very strange outcome indeed, I wonder if you could have pushed for it anyway. My wisdom teeth were also impacted (nearly buried in gums, horizontally aligned), and I also opted for a local anesthetic. The worst part of the procedure was seeing the size of the syringe. They really didn't spare any anesthetic for it. I felt numb all the way to my neck and ears. To my surprise the whole procedure took less than 40 minutes from start to finish, including cutting the gums, sawing the impacted teeth in half (the noise and smell is not for the faint of heart), and then putting sutures in. Personally, I don't regret getting rid of them either. Made hygiene slightly easier and no risk of inflammation where the wisdom teeth were breaking through the skin.
mypalmike 6y ago
Yeah getting my wisdom teeth removed in my 40s seemed like 20 years later than optimal. They always seemed to take up too much space in my mouth, were hard to brush (which led to them eventually needing removal), and contributed to canker sores and other routine pain and irritation. After they were removed, my mouth felt so much healthier, easier to keep clean, and free of miscellaneous pain.
voxl 6y ago
The entire point of this discussion is that you are biased. What you need is scientific evidence to back it up. Finding water for your patients is not a good way to view the world.

pstch 6y ago

This is exactly what I thought 3 years ago when a dentist told me that it was very important for me to get rid of my wisdom teeth, because loss of enamel meant that they were very likely to decay quickly even with proper hygiene. Other dentists told me that it was not necessary, and could be done later if the teeth ended up decaying too much. Now the teeth are completely decayed, I've started to feel severe pain, and since I've developed severe thrombopenia (<20 G/L), I can't get them extracted easily (couldn't find any dentist willing to take that risk), so since six months, I have to take anti inflammatory drugs for the pain and antiobiotics to limit the infections, as well as the folic acid and corticosteroids needed for ITP, and I have no idea when will this end. It's very difficult to differentiate important advice from "easy money" advices, especially when this advice stems for a principle of precaution. Most peoples don't develop severe ITP, but if they do, getting wisdom teeth removed before they can cause problems can be very important.

giardini 6y ago
This is a long shot but some claim that vitamin K-2 can regenerate teeth to some degree. It might get your teeth in good enough condition to remove. I had started taking K-2 (Jarrow MK-7 menaquinone-7 FWIW) for other reasons but when my semiannual dental checkup came due, both the technician and dentist kept marveling about how pristine and healthy my teeth were. They credited it to my brushing and flossing habits, which had not changed. I took the praise but was puzzled until I remembered that the K-2 might be helping my teeth.

ThePadawan 6y ago

> Routine wisdom teeth removal That one is new to me. My dentist took X-rays at that point in puberty where it would become obvious if the wisdom teeth were obviously and majorly deviating (thus requiring removal). The X-ray came back somewhere between "inconclusive" and "too early to tell", so I still have my wisdom teeth.