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Ah this article put the finger on why I don't trust my 'new dentist': The operation is just too slick from a business POV. As someone familiar with SaaS or in

• edouard-harris 4y ago
  Yup. In fact, a great hack is to go to an inexperienced dentist instead of an experienced one for routine work. The reason is that dentists who are fresh out of school are competent enough to do basic cleanings and checkups. But they haven't yet had time to accrete the expensive habits, and the little business optimizations that feed them, that highly-paid professionals often develop. I generally switch dentists every five years or so, and find that cadence works nicely. (Source: a couple of my close friends are dentists and suggested this strategy.)
  • Scoundreller 4y ago
    I think this depends on what the debtload of your area’s new dentists might be like.
    • Sebguer 4y ago
      Yeah, this seems like questionably consistent advice, especially in this day and age of endless 'maximize your profit' courses. I'm sure there's plenty of things online on how to extract the most value out of your patients that any inexperienced dentist can use.
    • edouard-harris 4y ago
      Interesting point. For whatever it may be worth, I live in Canada, though I don't believe dental school here is especially less expensive than it is in (say) the US.
  • deleted 4y ago
    [deleted]
  • cardanome 4y ago
    Here in Germany it is actually the really old dentists that can be trusted. They were not raised to think business oriented. Though most of them have have retired by now. My old childhood dentist used to do the absolutely necessary. He just cared about keeping my teeth healthy and not putting me under unnecessary stress. He did not even remove my wisdom teeth. When he retired the new doc would simply maximize the amount of procedures. One routine checkup and he would find ten things that needed to be done. What had changed? In Germany doctors used to be basically paid from a fixed budged. In 2007 there was a health care reform changing that. Now they would be paid for individual procedures. So obviously doctors would try to do as much profitable procedures as possibles. The articles misses the target a bit, probably because health care in the US has been run like a business for much longer so it is harder to see the real issue: It is not cultural, it is not some dentists being shady and it can not be fixed by educating dentists. It it the natural result of the incentives that are in place. If you try to run health care like a business you will necessarily and always produce these issues. And this is not dentist specific. Lot's of unnecessary but profitable surgeries are being performed as well.
    • cardiffspaceman 4y ago
      Perhaps there is a U-shaped curve with the range being the desirable properties and the domain being years in operation. Young ones can often start with the MBA stuff, and I've experienced MD's who seem like they are about to retire by selling their practice to a whole army of MBA's, but in the meantime they don't just do stuff for the revenue.
    • bombcar 4y ago
      The best dentist I ever went to had a picture of his airline pilot wife on the wall - and from how he treated his patients and charged, I got the feeling he worked because he liked to, not because he needed to. However, if you have a "flat fee" dentist/doctor you could be now encouraging the opposite - do the minimum work necessary to get done with the day. It's hard to legislate "be a caring, honest professional" but we can at least remove some of the incentives to not be.
      • 4y ago
• kcplate 4y ago
  Here is my hack… Caveat: I have a couple of “Cadillac” dental insurance plans due to great employee benefit packages for both me and my wife. So they cover quite a bit. I just tell the hygienist before I get in the chair that if my insurance doesn’t cover it, I won’t be doing it, and don’t even suggest it. Generally that stops the upselling.
  • bombcar 4y ago
    Hygienist: "Let me check your plan, we'll do everything covered" is probably what they hear.
    • kcplate 4y ago
      Which is fine by me.
• cableshaft 4y ago
  > ...but every 3 months. When pressed on why, eventually they'll admit it's how nice it feels to have clean teeth and how important your smile is - but NOT strictly necessary for health. Sometimes they can give a proper reason. Like in my example I've got some largish gum pockets around three of my teeth that are getting better but still not great (was a lot worse before they did some deep cleaning 9 months ago, I was seriously worried I had a couple of abscesses, lots of pain, gum swelling, and bleeding), so every 3 months makes sense to check in on them and keep them cleared out enough they can heal better.
  • helij 4y ago
    Did the hygienist measure your gaps and recommend interdental toothbrush sizes so you can do it yourself regularly? Tepe is a good brand but any really will do as long as you know what size to use. My hygienist measured and wrote sizes down for each gap between teeth.
    • cableshaft 4y ago
      They measure my gaps each time, yeah. I had three 6mms that are now two 5mms and a 4mm, and a lot of 4mms and 5mms that are now 3mms. They didn't mention the interdental brushes, but that might be because I have a Waterpik, which they did recommend I use 2-3 times a day, instead of just once, as well as brushing. My gums also generally feel a lot better now, except for some periodic issues with the two 5mm gap teeth. Like it's pretty obvious to me that they're better. It used to be painful just to lightly brush some of those places that aren't now, and bleeding is a lot less common, and swelling is way down. The Tepe brushes look interesting though, I might have to give those a try.
    • azinman2 4y ago
      Fun fact that I’m quite proud of: my father is the reason measuring your pockets is standard of care (he’s a periodontist turned attorney and lecturer). Question any dentist that doesn’t do this as part of cleanings.
  • nsxwolf 4y ago
    My pockets got better after I started using a WaterPik with a special attachment called the "Pik Pocket". I use warm water with a little splash of hydrogen peroxide and irrigate them all.
• clairity 4y ago
  my dental group actually calls/emails me on a regular basis to get me to come give them that sweet, sweet free insurance money. but note for instance that cavities and fillings are prone to being overdiagnosed for the sake of income, not patient outcome. glasses are regularly overprescribed for the same reason. patients really need to understand the incentives and motivations of medical professionals to make the best decisions for themselves. dentistry, optometry, therapy, veterinary, and even primary care all are vulnerable to the "recurring revenue" model. it's reasonable to be skeptical of their motivations even as we go to them for help and care. that's why patients should view medical professionals as an informed but biased opinion, not an authority. the patient needs to become knowledgeable about their own malady to make the best medical decisions they can, and it's part of the professional's job to aid that journey, not to make the decisions for the patient. that's also why patients need to see multiple professionals to triangulate their best option, rather than getting locked in to a single care provider. monopoly forces are antithetical to this process. the shaman strategy is alive and well, and will be for many centuries/millenia to come (in other words, we're not uniquely advanced in the history of humanity).
  • bombcar 4y ago
    Optometry at least you can track it (if you actually do need and use glasses) because the differences should be noticeable on the prescription. What does happen is that if you buy a new pair even with the same exact prescription, the fact that it's new and clean and not bent in anyway will make it look much clearer. So that can trick people into thinking they need yearly new glasses. A good optometrist will tell you when your prescription has stopped changing and when they expect it to start changing again (usually in your 40s).
    • clairity 4y ago
      sure, but wearing glasses also weakens your eye muscles. we're living, dynamic, nonlinear, and stochastic systems, not automata with orthogonal settings that we can tweak simply. glasses can actually make the problem worse (i've personally experienced this in my younger, naiver days[0]). optometrists don't question orthodoxy because doing so could threaten profits. note, that's not to advocate the other extreme of never trusting anyone about anything, but every decision is a trade-off and has drawbacks. the visual acuity afforded by glasses should clearly outweigh the downsides, rather than outsourcing your brain to a hammer-wielding optometrist. [0]: i still have dry-eye from an eye infection that was likely caused by contacts. that was actually the impetus for getting rid of corrective lenses altogether and the subsequent realization that i didn't need them in the first place.
• WalterBright 4y ago
  When I was 21, my dentist recommended removal of my wisdom teeth. I asked why, he said because they are difficult to clean, and so I'd lose them anyway by 30. I switched dentists. I'm old now, still have those teeth, and they are the healthiest teeth in my mouth. If you want to keep your teeth, 1. get an electric toothbrush 2. brush for the full 2 minutes, twice a day 3. floss twice a day, gently (overdoing it will erode the teeth) 4. run one of those rubber pointy tools (gently) around the gum line twice a day Take a look at people 60 and up. Most have false teeth. Do 1..4, your old self will thank you.
  • collyw 4y ago
    I got mine out recently in mid 40s. Wish I had done it sooner. Constant minor infections. And every so often the would move and cause a lot of pain, especially in 2020, when it was all arranged then got cancelled for the covid overreaction.
  • dlp211 4y ago
    0. Be born with the right genetics. There is this idea that the only thing you need for good oral health is to simply do the maintenance. This couldn't be further from the the truth, and an honest dentist will tell you so. There are plenty of folks that take exceptional care of their teeth, yet still have issues and there are plenty of folks that don't take care of their teeth the way their dentist recommends and still have healthy teeth. Genetics plays a massive role in oral health and this has been known at least since I have been a kid (almost 40 now).
    • WalterBright 4y ago
      Very true. I've got the genes that require aggressive and thorough efforts to keep my teeth. It's still a losing battle.
    • nonameiguess 4y ago
      1. Be born (and stay in) the right part of the world, too. I'm fairly lucky to be in my 40s with all my wisdom teeth intact and zero cavities, in spite of not flossing, never seeing a dentist, and only brushing once a day with a plain toothbrush. That is clearly genetic, since out of my entire immediate family, one sister has had one cavity and that is it for all 6 of us. But we've always lived in first-world cities with fluoride in the water. My ex-wife had impeccable dental health for a long time until she did a military deployment to Djibouti for 12 months, and came back with 8 cavities. In the 15 years since then, she's never gotten another.
• matwood 4y ago
  I hate going to the dentist for this reason. It used to be they cleaned your teeth fixed any issues, come back in 6 mos. Now, I feel like they make up issues, they have cleaning or super cleaning - how about just do the damn cleaning, etc… A couple years ago I had one recommend putting on a crown on a back molar. I asked why b/c I had no pain and they couldn’t really explain. Every other dentist I’ve been to since never brought it up again. At the moment, I go to a new dentist every 6 mos. to a year because I can’t find one that doesn’t feel like one step above a used car salesman. Final note, get a SonicCare. Dental friend (sadly in another state) says those things changed dentistry/brushing/teeth cleanliness.
  • david-gpu 4y ago
    Sonicare specifically, or electric toothbrushes in general? I have an old Braun electric toothbrush and it seems to work well, but I could switch brands next time.
    • matwood 4y ago
      Not sure it has to be that exact brand, but those that do the fast vibration style different from ones that just spin a brush.
• dijonman2 4y ago
  I always visit dental offices with low overhead, poorly decorated, etc. I had a dentist one time that had a different car for every day of the week. I left them after only a few visits.