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Well it's only anecdotical of course, but I had a similar experience a couple of years ago that made me very confused about dentistry in general. At the time a

Well it's only anecdotical of course, but I had a similar experience a couple of years ago that made me very confused about dentistry in general. At the time a had a small tooth ache so I was planning to visit a dentist to check it. I was living in Switzerland, where dentist costs are very high, but I was about to go on holiday to Tenerife, where prices are much lower. So I checked on the Internet and chose the dentist with the best reviews near my holiday resort. When I was there and had explained my problem, the dentist said he'd like to do a full check of my teeth. He did that with a little camera so I could see my teeth on a screen as well. Next he went past all my fillings. I had quite a few of them, and for every one of them his comment was the same: 'decay'. He said they were old, or didn't fit properly, so around the edges decay had started. And indeed the image on the screen showed some brown edges. In the end he offered to replace all of them with some modern alternative. The treatment would cost a couple of thousand euro and would take my entire holiday week. I didn't entirely trust him so I said I needed some time to think about it. Back in Switzerland I went to my usual dentist. I didn't tell him about the Tenerife episode but just explained about my complaint and asked him to check. He concluded that there was not really any problem, it might be my gum was infected and this gave me some pain. Then I told him the diagnose of his colleague in Tenerife. I expected that he would be shocked but he wasn't: he asked how much the guy was charging and just said it wasn't a bad price. I then told the story to a friend whose both parents were dentists. He wasn't surprised either and he explained like this: he said dentists were like car mechanics. When a car mechanic is checking your engine and some parts were a bit worn out, some would say they should be replaced, but others would say they are still working so let's only replace them when they break. It's 5 years later and all those 'decayed' fillings haven't given me any problem so far. But maybe I was just lucky? I'm completely confused now.

tda 4y ago
Yep, sounds familiar. When I was a kid I broke one of my front teeth in half my dentist glued it back on saying it would probably not last too long but worth a try anyway. Many years later it broke off again. I didn't have dentist at the time (just moved) and did some shopping around (most had waiting lists). The first dentist said it was absolutely impossible to glue the bit back on, and offered to replace my tooth with a fake one entirely. Would cost only EUR 1500 or so. I called around a bit more, and then another dentist said she had no time but she was on duty that night in the ER. Said I could just pop by in the hospital somewhere after midnight and she would have a look. In five minutes my tooth was glued together again. I paid 40 euro in cash and that was that.
- 0des 4y ago
  My friend, that was krazy glue.
ladyattis 4y ago
I've been quite lucky with my current dentist since she's not a fan of replacing fillings. I have two old silver amalgam ones and I did ask her about it and she said she'd only do that in like an obvious case where it was freely wiggling or moving but otherwise they should be good for me for the rest of my life. I'm glad she's not one of those dentists that sees everything as a problem. Like when any potential carries were visible on the x-ray she'd usually wait until the next time to do another x-ray then see if it worsened before she went and drilled them out and filled them.
benjaminwootton 4y ago
I had a similar story but tend to view it more generously. I am based in the UK, but ended up seeing dentists in Spain and Dubai who were both alarmed by stuff that the UK dentist was letting slide. Maintenece issues similar to yours. I ended up having most of my fillings replaced at half the cost of the UK work, and have had a problem free 2/3 years. You pays your money and takes your chances, but I prefer the approach of jumping on any issues early in my ear against too many sweets and fizzy drinks!
dwringer 4y ago
I used to get my dental work done at a student clinic, so it was often dental students doing minor procedures supervised by much more experienced faculty. I remember overhearing one explain to a student that different people and mouths have a different standard of what's acceptable. Someone who meticulously brushes and flosses and spends top dollar fixing every problem as soon as it comes up is likely to want a procedure like you described. Someone else who barely has any dental hygiene and a mouth full of fillings and gingivitis would be given all necessary care, but not necessarily given an exhaustive touch-up if the dentist feels they'll just be back for the same thing in a few years and not get any substantive lasting benefit from it. I don't know whether this is a generally-held attitude in the profession.
saiya-jin 4y ago
the problem with this is also that given dentist has huge motivation to replace as much as he can and make big fuss over little. I mean it pays his bills/rooftop, some mortgages and few vacations on top of other costs... did I mention costs? they are not more or less moral than rest of population, spread is the same as in all other professions, so experience vary
- spookthesunset 4y ago
  Don’t forget god knows how much student loan debt. The good kind too… the ones you cannot discharge in bankruptcy.
Mountain_Skies 4y ago
This is where review sites are starting to help. There's a dentist where I used to live who has dozens of reviews, all mentioning that she diagnosed them with microcavities, which couldn't be confirmed by those who got a second opinion. If you have a full blown cavity, you're going to notice but microcavities? You have to take your dentist's word for it or be sure to get a second opinion and hope at least one of them are honest and competent.
- Spooky23 4y ago
  It does help, but these guys know what they are doing. My dad had a benefit fund through his union and because his dentist knew how to milk the program, he ended up with a lot of unpleasant and unnecessary dental work. You see it a lot with telephone company employees, fire fighters, etc.
- samatman 4y ago
  Just in the spirit of sharing, microcavities are in many/most cases treatable with a hydroxyapatite toothpaste. This is true of some larger caries as well.
m000 4y ago
Your friend was quite right. It is quite a bit like replacing aging parts in your car. You may have to eventually replace all your fillings. But you don't know for sure, or when. And it's very unlikely that all of them will fail at the same time. So, unless a filling is already on the verge of failing, replacing them is mostly a matter of personal preference and scheduling.
- taeric 4y ago
  This sort of undermines the necessity of modern dentistry, though. Didn't it? You can even take it further back. How many of those fillings were truly necessary at the time?
  - tartoran 4y ago
    It doesn’t undermine the necessity of modern dentistry because there are times you really do need a dentist. If you travel to poor countries where people don’t have access to dentistry you’ll notice that by 30s or 40s they’re missing a lot of their teeth.
    - taeric 4y ago
      The vast majority of modern dentistry is scheduled deep cleaning. And be careful that you aren't looking at places with malnourished people. Adults should expect some teeth issues, sure. The question is if modern treatment is going a bit beyond what is necessary.
eps 4y ago
For what it's worth - a friend of mine is a dentist and he mentioned once that white fillings (the ones that are set with an UV light) start to shrink after 5 years. On the other hand, silver filling will do the same after 10-15 years and at a slower rate. Whether this shrinkage will lead to problems is a separate question.
- unicornfinder 4y ago
  Entirely anecdotal but in my experience amalgam fillings do seem to hold up much, much better than white ones.
spaetzleesser 4y ago
Unfortunately the economics are firmly in favor of replacing things early even if not yet necessary. This is the same for car mechanics or dentists. There is no money to be made in delaying procedures.
starkd 4y ago
But this is not necessarily a matter of the dentist being greedy (though it no doubt can be). Anyone who has had a toothache on a Friday evening, knows how long it can be until Monday morning when you can get into see the dentist. A dentist could just be eager to avoid such an agonizing experience for the patient.
- misja111 4y ago
  He was offering to replace all my fillings, about 9 in total. So not just the one(s) that might cause my (slight) pain. In fact he wasn't even mentioning my complaint anymore even though I told him initially that this was the reason I wanted him to check.
taylodl 4y ago
Dentists are a lot like software developers - they're not interchangeable. Just like if you ask two software developers what needs to be done to solve a problem you're going to get at least two different answers, the same is true for dentistry. Actually it's true of any professional service. We all have our biases for risk, we all have biases for wanting work - we all have biases. Those biases will manifest themselves in our recommendations for a course of action. That's why they say to get a second opinion. It's not just to assess whether the first opinion is off-base, it's to get a better assessment as a non-expert as to what you're up against and what course of action you should take.
bombcar 4y ago
The "little camera with screen" immediately jumped out as "designed to get the customer to pony up the money right now" - and I've seen similar things with (as others have mentioned) auto maintenance; and if you know something about it the fact that they bring it out unasked for is a huge red flag (the one I've seen is comparing motor oil from the dipstick with new motor oil and saying it clearly needs to be changed, along with the filter and any number of other things they bring up).

tda 4y ago

Yep, sounds familiar. When I was a kid I broke one of my front teeth in half my dentist glued it back on saying it would probably not last too long but worth a try anyway. Many years later it broke off again. I didn't have dentist at the time (just moved) and did some shopping around (most had waiting lists). The first dentist said it was absolutely impossible to glue the bit back on, and offered to replace my tooth with a fake one entirely. Would cost only EUR 1500 or so. I called around a bit more, and then another dentist said she had no time but she was on duty that night in the ER. Said I could just pop by in the hospital somewhere after midnight and she would have a look. In five minutes my tooth was glued together again. I paid 40 euro in cash and that was that.

0des 4y ago
My friend, that was krazy glue.

ladyattis 4y ago

I've been quite lucky with my current dentist since she's not a fan of replacing fillings. I have two old silver amalgam ones and I did ask her about it and she said she'd only do that in like an obvious case where it was freely wiggling or moving but otherwise they should be good for me for the rest of my life. I'm glad she's not one of those dentists that sees everything as a problem. Like when any potential carries were visible on the x-ray she'd usually wait until the next time to do another x-ray then see if it worsened before she went and drilled them out and filled them.

benjaminwootton 4y ago

I had a similar story but tend to view it more generously. I am based in the UK, but ended up seeing dentists in Spain and Dubai who were both alarmed by stuff that the UK dentist was letting slide. Maintenece issues similar to yours. I ended up having most of my fillings replaced at half the cost of the UK work, and have had a problem free 2/3 years. You pays your money and takes your chances, but I prefer the approach of jumping on any issues early in my ear against too many sweets and fizzy drinks!

dwringer 4y ago

I used to get my dental work done at a student clinic, so it was often dental students doing minor procedures supervised by much more experienced faculty. I remember overhearing one explain to a student that different people and mouths have a different standard of what's acceptable. Someone who meticulously brushes and flosses and spends top dollar fixing every problem as soon as it comes up is likely to want a procedure like you described. Someone else who barely has any dental hygiene and a mouth full of fillings and gingivitis would be given all necessary care, but not necessarily given an exhaustive touch-up if the dentist feels they'll just be back for the same thing in a few years and not get any substantive lasting benefit from it. I don't know whether this is a generally-held attitude in the profession.

saiya-jin 4y ago

the problem with this is also that given dentist has huge motivation to replace as much as he can and make big fuss over little. I mean it pays his bills/rooftop, some mortgages and few vacations on top of other costs... did I mention costs? they are not more or less moral than rest of population, spread is the same as in all other professions, so experience vary

spookthesunset 4y ago
Don’t forget god knows how much student loan debt. The good kind too… the ones you cannot discharge in bankruptcy.

Mountain_Skies 4y ago

This is where review sites are starting to help. There's a dentist where I used to live who has dozens of reviews, all mentioning that she diagnosed them with microcavities, which couldn't be confirmed by those who got a second opinion. If you have a full blown cavity, you're going to notice but microcavities? You have to take your dentist's word for it or be sure to get a second opinion and hope at least one of them are honest and competent.

Spooky23 4y ago
It does help, but these guys know what they are doing. My dad had a benefit fund through his union and because his dentist knew how to milk the program, he ended up with a lot of unpleasant and unnecessary dental work. You see it a lot with telephone company employees, fire fighters, etc.
samatman 4y ago
Just in the spirit of sharing, microcavities are in many/most cases treatable with a hydroxyapatite toothpaste. This is true of some larger caries as well.

m000 4y ago

Your friend was quite right. It is quite a bit like replacing aging parts in your car. You may have to eventually replace all your fillings. But you don't know for sure, or when. And it's very unlikely that all of them will fail at the same time. So, unless a filling is already on the verge of failing, replacing them is mostly a matter of personal preference and scheduling.

taeric 4y ago
This sort of undermines the necessity of modern dentistry, though. Didn't it? You can even take it further back. How many of those fillings were truly necessary at the time?
- tartoran 4y ago
  It doesn’t undermine the necessity of modern dentistry because there are times you really do need a dentist. If you travel to poor countries where people don’t have access to dentistry you’ll notice that by 30s or 40s they’re missing a lot of their teeth.
  - taeric 4y ago
    The vast majority of modern dentistry is scheduled deep cleaning. And be careful that you aren't looking at places with malnourished people. Adults should expect some teeth issues, sure. The question is if modern treatment is going a bit beyond what is necessary.

eps 4y ago

For what it's worth - a friend of mine is a dentist and he mentioned once that white fillings (the ones that are set with an UV light) start to shrink after 5 years. On the other hand, silver filling will do the same after 10-15 years and at a slower rate. Whether this shrinkage will lead to problems is a separate question.

unicornfinder 4y ago
Entirely anecdotal but in my experience amalgam fillings do seem to hold up much, much better than white ones.

spaetzleesser 4y ago

Unfortunately the economics are firmly in favor of replacing things early even if not yet necessary. This is the same for car mechanics or dentists. There is no money to be made in delaying procedures.

starkd 4y ago

But this is not necessarily a matter of the dentist being greedy (though it no doubt can be). Anyone who has had a toothache on a Friday evening, knows how long it can be until Monday morning when you can get into see the dentist. A dentist could just be eager to avoid such an agonizing experience for the patient.

misja111 4y ago
He was offering to replace all my fillings, about 9 in total. So not just the one(s) that might cause my (slight) pain. In fact he wasn't even mentioning my complaint anymore even though I told him initially that this was the reason I wanted him to check.

taylodl 4y ago

Dentists are a lot like software developers - they're not interchangeable. Just like if you ask two software developers what needs to be done to solve a problem you're going to get at least two different answers, the same is true for dentistry. Actually it's true of any professional service. We all have our biases for risk, we all have biases for wanting work - we all have biases. Those biases will manifest themselves in our recommendations for a course of action. That's why they say to get a second opinion. It's not just to assess whether the first opinion is off-base, it's to get a better assessment as a non-expert as to what you're up against and what course of action you should take.

bombcar 4y ago

The "little camera with screen" immediately jumped out as "designed to get the customer to pony up the money right now" - and I've seen similar things with (as others have mentioned) auto maintenance; and if you know something about it the fact that they bring it out unasked for is a huge red flag (the one I've seen is comparing motor oil from the dipstick with new motor oil and saying it clearly needs to be changed, along with the filter and any number of other things they bring up).