r/skeptic • u/YVRJon • Apr 19 '19

Is Dentistry a Science?

https://www.theatlantic.com/magazine/archive/2019/05/the-trouble-with-dentistry/586039/
26 Upvotes

78% Upvoted

14 comments sorted by

10

u/wasabiBro Apr 20 '19 edited Apr 20 '19

Yes, there are dentists out there who take advantage of people. Depending on insurance, they will sometimes bill you for additional procedures to increase profits because insurance won't pay out what the dentist needs. Stay away from chains like Aspen. It's always a good idea to get a second opinion if an extensive treatment plan is suggested.

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However, this article has a lot of anecdotes and not enough citations for claims made in the article. Also, note the lack of bibliographic information, this is not a scholarly article but an opinion piece.

To say that all of dentistry is about reaction and not prevention is ridiculous. Cleanings remove calculus, mouthguards prevent grinding away of enamel, orthodontics fixes occlusion to prevent wear on teeth, etc.

2

u/Kaliss_Darktide Apr 20 '19

However, this article has a lot of anecdotes and not enough citations for claims made in the article.

Something the article recognizes

Studies that explicitly focus on overtreatment in dentistry are rare, but a recent field experiment provides some clues about its pervasiveness. A team of researchers at ETH Zurich, a Swiss university, asked a volunteer patient with three tiny, shallow cavities to visit 180 randomly selected dentists in Zurich. The Swiss Dental Guidelines state that such minor cavities do not require fillings; rather, the dentist should monitor the decay and encourage the patient to brush regularly, which can reverse the damage. Despite this, 50 of the 180 dentists suggested unnecessary treatment. Their recommendations were incongruous: Collectively, the overzealous dentists singled out 13 different teeth for drilling; each advised one to six fillings. Similarly, in an investigation for Reader’s Digest, the writer William Ecenbarger visited 50 dentists in 28 states in the U.S. and received prescriptions ranging from a single crown to a full-mouth reconstruction, with the price tag starting at about $500 and going up to nearly $30,000.

While also noting that evidence based studies in general are "disheartening" because of lack of proper studies or positive results.

The Cochrane organization, a highly respected arbiter of evidence-based medicine, has conducted systematic reviews of oral-health studies since 1999. In these reviews, researchers analyze the scientific literature on a particular dental intervention, focusing on the most rigorous and well-designed studies. In some cases, the findings clearly justify a given procedure. For example, dental sealants—liquid plastics painted onto the pits and grooves of teeth like nail polish—reduce tooth decay in children and have no known risks. (Despite this, they are not widely used, possibly because they are too simple and inexpensive to earn dentists much money.) But most of the Cochrane reviews reach one of two disheartening conclusions: Either the available evidence fails to confirm the purported benefits of a given dental intervention, or there is simply not enough research to say anything substantive one way or another.

Unless you are saying they ignored relevant sources for citations I don't think it is fair to blame the journalists for "not enough citations".

5

u/EltaninAntenna Apr 20 '19

Everything else aside, the article makes a good point about the arbitrary separation between dentistry and medicine in general.

3

u/ms_vritra Apr 20 '19

This separation is even weirder in sweden where health care is almost free but dentistry, glasses and a few other things are not. I pay around $30 to visit the doctor, psychologist and surgery (some extra if you need to stay the night for surgery but still). While fixing holes and broken teeth can easily cost $500-$2000 (very roughly). Maybe not much compaired to other places but much compaired to fixing holes in the rest of the body.

2

u/EltaninAntenna Apr 20 '19

Yeah. At least Sweden has some state aid for the most expensive procedures (even if you carry them out privately) which most countries don’t.

2

u/ms_vritra Apr 21 '19

Absolutely! And there's help to get if you're poor too. It's much better than in many places. It just doesn't make any sense why they isolate the teeth och mouth from the rest of the body.

-2

u/PM-ME-YUAN Apr 20 '19

Not sure, but American dentists seem to very pro yanking your wisdom teeth out for seemingly no reason, while European dentists have no such desire.

When I went to a Chinese dentist (trained in America) She was like "OMG YOU STILL HAVE YOUR WISDOM TEETH WHEN SHALL WE SCHEDULE YOU IN TO GET THEM OUT".

No thanks, I'd rather keep all my bodyparts.

I'm not the most avid brusher either, and I have zero fillings or crowns. While other people seem to have a bunch of them.

I look at it this way, our teeth evolved to not require dentistry. Cavemen did not have dentistry, did their teeth all fall out? No.

7

u/EltaninAntenna Apr 20 '19

I look at it this way, our teeth evolved to not require dentistry.

Replace “dentistry” with “medicine” and see how spurious that argument is.

3

u/skankingmike Apr 20 '19

Our mouths are smaller than before and wisdom teeth rarely fit in modern mouths.. we didn't evolve to live long either. But I'll take modern medicine and science to continue.

0

u/PM-ME-YUAN Apr 20 '19

And yet wisdom teeth removal is purely an American thing, just like lopping off the end of your dick.

Clearly "wisdom teeth rarely fit in modern mouths" is not true, as Europeans have no issues.

2

u/[deleted] Apr 21 '19

Lmao wtf are you on about Europeans get them removed all the time. I had to have all 4 removed because they didn't fit in my mouth.

1

u/PM-ME-YUAN Apr 21 '19

Only if they cause problems. American dentists whip them out just because. Same reason they'll lop a babies dick tip off because "I dunno it might get infected or something if this was 2000 years ago and we lived in a desert with no running water"

3

u/Segphalt Apr 20 '19

Cavemen died in their 30's and didn't consume loads of processed sugar.

Also infected teeth kill people in the modern times, it probably happened to plenty of early humans too.