It's not just the dentists that are perfectionists, but culturally perfect teeth is an expectation in a lot of the world now. I get it; a kid who's hesitant to smile because they're embarrassed with their teeth is heart-breaking, but it's also very expensive.

I feel like as the years go by, more and more of my cognitive cycles are spent trying to avoid scams and predatory businesses.

If the operation is owned/financed by venture capital, stay away. Their priority is obviously not health and wellbeing.

Bonus anecdote: My previous dentist, who I went to once, had an office full of hygienists that were young, blonde, skinny women without exception. Something tells me the interview process was not merit-based...

So sometimes people, typically women and typically larger people, live for years with painful conditions because doctors didn't bother to look deeply at all.

This applies double or even triple for vets. There is a lot of cash to extract from pet owners who would “do anything”, no matter how unnecessary or ineffective, for poochy.

Not only is bias introduced from accidental collection flaws, it’s also often tampered with intentionally cherry picking data, choosing interesting data or in some cases flat out falsifying data. In addition, evidence based reasoning often suffers from there being a lack of evidence to make a decision from. Or in some cases some critical aspect surrounding the decision is very niche to the case so the data may not take that into account unless it’s highly tailored data (evidence based reasoning tends to focus on breadth of applicability because gathering evidence is a long and often expensive process).

There’s still a lot of place for using theory and reasoning in conjunction with or in absence of data. Things like experience, professional opinion, etc. Medicine should be no different in that regard to any profession. The key is of course to always strive for sound empirical evidence/data where possible, but to use sound documented reasoning and theory in its absence if you want the best objective results.

It's the same phenomenon as something like the calluses guitar players get. If they take a few weeks off, it'll hurt a bit when they play. That doesn't mean the activity improves their health. It means if you poke a part of the body enough it handles being poked better.

The tobacco industry was a contributing factor but common sense and independent thought was already gone or it wouldn’t have worked for as long as it did.

> For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spectacles in their shop. Doctors were University educated in Latin and Greek to read ancient medical texts and despised the uncouth yokels.

> Surgeons muscled their way into the medical profession, originally with the help of the Royal Navy, who only had space for one or two people in charge of both cutting off legs and looking after crew health on their ships.

> Dentists and optometrists never did, so they started their own universities, certification boards, etc. By the time they became respectable enough for people to try to merge them with the medical establishment, in the 1920s, they had no desire to give up their independence.

> The first insurance policies were private contracts with groups of doctors and the system developed from there.

Details vary from country to country of course, but the gist of it generally holds true.

(That said, I believe dental issues that are the result of e.g. accidents do get covered by the default care package.)

Apparently teeth are luxury bones

Here's a site that gives you those references. Do the critical thinking and reasoning. If you actually do the reading, you'll find what I have said is quite correct (and your downvotes are you exercising your opinion to silence others irrationally, which is coercive and evil when its arbitrary and unbacked by rational evidence).

https://fluoridealert.org/content/50-reasons/ (the list is at the bottom)

Then there is also a good paper here for the history of Flouride.

For those that don't pick out the critical parts, conclusion isn't appropriate because it neglects common factors like funding (rather the lackthereof for anti-flouride research), the lack of ability to publish (subverted journals refusing publication), and a great many papers after the 1950s; and only briefly touches on methodological issues such as the fact that early studies used young men (not infants, kids, older populations, or women), and extrapolated out for the general population.

Women's health, birth, and allergies/thyroid changes were largely ignored, and rather than correct the bad science in a rational way; the expert voices involved were minimized and discredited, while simultaneously being barred from publishing in research pools (for a perceived stance rather than for actual science, ideologically against science). Its not hard to see why the thought that Communism was playing a role in this line of inquiry.

When seeing these tactics, they were commonly known by the public at the time, and were used primarily by Communists and Marxists who weren't follow western thought based in rationalism (science) to try to subvert the population, and if this were the case, its hard to argue that they didn't succeed in subverting the bureaucracy to force the changes despite the health consequences.

Read for yourself, also that objective 15% benefit (not 2/3) extrapolated didn't properly account for increasing tooth hygiene during that same time.

Even the CDC today recognizes the benefits are mainly from topical uses. Most western countries don't allow flouridated water supplies.

Much of the research over the years had to be independently funded, or were government funded by those countries, and the science has been overwhelming, but this isn't how public trust science is supposed to work (in the US). More specifically biasing funding on safety issues to push unsafe options for profit/benefit would fall under political corruption, and a violation of the public trust.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4504307/

Recently he did some 3-month contract work for a very large dental chain, let’s call it Penass.

I’ve never seen him so depressed in my live. He said that Penass’s business model was all about running up insurance and selling loans for large operations. He was directly encouraged to do extra, not necessary work to run up the bill.

He came out of retirement after that and started another practice out of, what I can only guess, was frustration and guilt.

A lot of these large dental chains absolutely tack on extra work and do a shitty job to keep people coming back.

In the US, I highly recommend looking for independent “boutique” dentists. Even if they are out of your insurance network, a lot of them will give better rates if you pay in cash.

The hospital has been under intense investigation by the local news.

https://www.wral.com/holly-hill-hospital/21507953/

This is the newest scam running, privatize health care so that these companies can rake in billions. I am sure this dental school probably gets millions for doing this.

I told this story to a friend years later and he said the same thing happened to him.

So my friend asks for the explanation. Guy asks him "what's the strongest animal?"

The answer (which I would dispute) was 'the gorilla'

"And what do gorillas eat?"

Thus showing that something is toxic doesn't mean it's something you should never consume. And note that fluoridation started because it was observed that the people in areas with higher natural levels benefited.

However you don’t swallow mouth rinses like Act, so any nonobvious issue is also greatly reduced.

I personally intend to stay vigilante to dihydrogen monoxide poisoning.

I suspect that it's also a question of market forces. A dentist that charged much more for an annual check would simply lose that business as there are plenty of dentists here. And quite likely they would lose any follow up work as well.

The profit margin on treatment is much higher but even that seems cheaper than what some of my US friends say they pay (or their insurance pays). Here's the price list for my dentist. In Norwegian but Google Translate does a good job:

http://www.drammen-tannlegesenter.no/om-oss-priser/priser

They do some cosmetic work as well, I imagine that the profit margins are higher for that.

I have two crowns, both created by an automated process of 3D photography and CNC machine in the clinic (Cerec). The most recent one went like this: I made an appointment to see my dentist at about 8:30 one morning complaining of toothache, she discovered that an old amalgam filling had cracked and taken part of the tooth with it and that the only practical repair was a crown. She then apologised profusely that she didn't have time to do it there and then but could I come back at 13:00 that afternoon? I said yes and by 13:30 the crown had been manufactured, fitted, ground down to an exact fit and I was leaving. The crown was a bit over 5 kNOK altogether, about 500 USD, for half an hour's work. The price has gone up a little since.

None of the work I have done, including the annual check-up, is done by a dental assistant, poorly paid or otherwise. I think that this might be because of the high cost of employing anyone in Norway.

I've had the dentist themselves always do most of the work. The assistant is often shared between multiple dentists in the same office in my experience.

Dentist salaries seem to range between £70-200k depending on experience, specialty, etc.

My friend is getting an implant and the total cost is about USD8000. The government is covering most of it because it was an accident (sporting).

They have much higher rates of these diseases, and recently in a court case the death of a farmers daughter has been shown to be caused by these pesticides.

But yes, the item you want studied might not have been studied. ("However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps.")

https://www.bmj.com/content/363/bmj.k5094

If you manage to do double-blind studies for every single piece of knowledge out there, kudos for you. There's nothing bad in this.

Anyway, it's on topic for several sidelines people are raising. But not on topic for the main article.

I think the real point is that systemic reviews often will have a pretty tilted set of included studies, because they are influenced by what things researchers choose to study.

Indeed, you probably couldn't publish a study saying that parachutes work; it's not an interesting enough finding for publication. So the only stuff you'll find, in many cases, are studies that buck the prevailing wisdom.

It is a normal procedure to be able to safely land this way when power has been lost, and in some ways is safer than a gliding fixed wing aircraft as you don't need a runway to land on.

Of course catastrophic failure is possible in a helicopter where the rotorblades can't turn, and then autorotation won't work. But then if a wing falls off a fixed-wing aircraft, they generally can't be controlled (interesting exceptions do exist like with the Israeli F15[1]).

[0] https://en.wikipedia.org/wiki/Autorotation

[1] https://en.wikipedia.org/wiki/1983_Negev_mid-air_collision

First I don't floss for a month. Then what looks like gingivitis shows up. And when I brush (normally -- not hard) after this, the sites that have the gingivitis bleed and are extremely painful.

If I don't floss my dentist notices immediately and tells me to floss more often because there's food and shit in there, hence why I tend to floss.

did you ever figure out what the root cause of the migraines was?

I would have been totally happy to buck the pressure of "this is what everyone does," but the thing that made me reluctantly agree to it was an explanation that if I didn't, they would bore holes into my then-back teeth as they grew in and I'd have a big problem to deal with.

As I understood it, teeth normally grow straight up, but wisdom teeth grow sideways (with the tops facing the front of your mouth). The wisdom teeth then hit the rest of your teeth and basically bulldoze your mouth.

I have no idea how true/bullshit that is, but it's what I was told to get me to finally acquiesce to the procedure.

Routine wisdom teeth removal is not a thing in most of Europe. Another random example are colonoscopies and routine flu vaccines (except for the elderly).

I went to another dentist in the area, they took some x-rays themselves, and told me that there was nothing that needed immediate work - maybe one pre-cavity that would eventually turn in to something but certainly not worth doing anything with now.

Three years later (and sticking with that new dentist) I still haven't needed to have anything done (and certainly don't have any pain in my mouth anywhere either).

The root canal was eight years ago. I brush and floss twice a day (brushing without flossing feels weird to me now). I haven't been to the dentist since before the pandemic and my teeth feel completely fine.

A prospective study of tea drinking temperature and risk of esophageal squamous cell carcinoma https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.32220

> Previous studies have indicated that hot tea may increase the risk of esophageal cancer. In this large, prospective study, the authors found that drinking hot tea is indeed associated with an increased risk of esophageal squamous cell carcinoma (ESCC). Furthermore, a preference for “very hot” tea more than doubled this risk.

A very-hot food and beverage thermal exposure index and esophageal cancer risk in Malawi and Tanzania: findings from the ESCCAPE case–control studies https://www.nature.com/articles/s41416-022-01890-8

> Thermal exposure metrics were strongly associated with ESCC risk. Avoidance of very-hot food/beverage consumption may contribute to the prevention of ESCC in East Africa.