Empty Evidence of Dentistry Helps Millions of Butchers Benefit from Profit Butchers / Boing Boing

Dentistry has always been the poor cousin of medicine, with lower prestige and funding, with much less definitive research; it means that it's harder for someone to point to a procedure and say definitely: "It was useless."

At the same time, better oral hygiene and fluoridation have improved our overall dental health; and like this was happening, tuition fees increased in parallel with all other forms of student indebtedness.

You can see where this is going: dentists graduate from the university buried by punishing their debt; Dental patients need fewer procedures to generate money and it is easy to get them through unnecessary procedures. What could go wrong?

Although this is a perfect storm of advanced and late capitalism, the lack of evidence-based standards huge piece of the problem. Although we are certain that dental mastics are really useful for children (although few dentists use them because they take a lot of time and do not generate a lot of billing), and that fluoridation is also good for children, there is nothing to it. There is not enough evidence to tell if fluoridation is good for adults, if flossing fights dental plaque (although it is good for your gums), if you need to have wisdom teeth removed, and so on. And the proof for other common procedures is: really mediocre or nonexistent: everything from the visit to the dentist twice a year (most people can go there once every 12 or 18 months, assuming good oral hygiene); replace metal fillings with resins, etc.

Incredibly, some of the most invasive, painful and costly procedures have not been studied in depth, including the question of whether root teeth should be repaired with fillings or crowns.

What is More and more to study is whether dentists engage in "over-treatment" (a euphemism for unnecessary procedures). In a secret trial, 50 Zurich dentists recommended, for example, completely useless fillings for minor caries.

L & # 39; AtlanticFerris Jabr has published a 7,500-word essay on dentistry: a dreadful new: In 2012, dentist Brendon Zeidler purchased a cabinet in San Jose, Calif., From retiring John Roger Lund. When Zeidler started seeing Lund's patients, he realized that Lund had done a shocking amount of dental surgeries on his patients, at great expense. Lund was arrested in 2016 and is facing criminal prosecution even though he maintains his innocence.

Jabr would like to point out that most dentists are honorable and compassionate, which is undoubtedly true. I had very little bad spending with dentists (although I was shocked by the aggressive attempts of American dentists to sell me teeth whitening services, often during a medical examination , mixing a sales pitch with the medical advice they gave me). On the other hand, my mother and her family were dentured in the '50s and' 60s by a dentist, who would have been a butcher, who has lined his pockets mutilating the mouths of his patients.

Among other problems, the difficulties dentistry faces in investing in scientific research have left dentists considerable leeway to advise unnecessary procedures, intentionally or otherwise. The standard euphemism of this inclination is the excessive treatment. Preferred interventions, many of which are elaborate and expensive, include root canals, crowns and veneers, teeth whitening and filing, deep cleansing, gum grafts, "microcavity" fillings – primitive lesions that do not require immediate treatment – and unnecessary restorations and replacements, such as the exchange of old metal fillings for modern resins. While medicine has progressed in taking into account at least some of its own tendencies to excessive and erroneous treatment, dentistry is lagging behind. Mary Otto writes that "surgical interventions to treat the symptoms of the disease remain largely oriented." "The American dental system continues to reward these surgical procedures for more than just prevention."

"Excessive diagnoses and treatments are endemic," says Jeffrey H. Camm, a 35-year-old dentist who ironically describes his peers' "creative diagnosis" bias in a 2013 review by the American Dental Association. . "I do not want to be fatal. I think the majority of dentists are very good. "But many have" this attitude of "Oh, here's a place, I have to do something." I have been contacted by all kinds of practitioners who are upset by the patients who come in and they already have three crowns or 12 fillings, or another dentist told them that their 2 year old child had several cavities and had to be sedated for the procedure. "

Trish Walraven, who worked as a dental hygienist for 25 years and now runs a dental software company with her husband in Texas, remembers many troubling cases: "We would have seen patients ask for a second opinion and treatment plans to tell them that they eight fillings in virgin teeth. We looked at X-rays and said, "You make fun of me." It's a grossly flagrant treatment – piercing teeth that do not need it at all. "

The truth about dentistry [Ferris Jabr/The Atlantic]

(via naked capitalism)

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