It's so sad that most dentists optimise for billable revenue, even at the detriment of long term patient health.
Fillings for example always degrade and need repairs after X years. Drilling and filling even the smallest cavity puts that teeth on a lifetime progression to bigger and bigger fillings, eventually a root canal, eventually an implant.
Cavities, on the other hand can be arrested (stopped), and if small can even be remineralised. Yes, most dentists don't tell you that!
Careful monitoring and patient education on the other hand can lead to permanently keeping that natural teeth, as our teeth are living and can heal.
My personal lived experience: a dentist told me I must fill 2 cavities six years ago. I got a second opinion. That dentist told me I should wait, focus on oral care, chew xylitol gum, and use a toothpaste with novamin.
Both cavities have "arrested" and need no restorative work.
Disclaimer: Not a dentist. Listen to your dentist you trust, and get second opinions if you have doubt.
Novamin toothpaste has been life changing for me. Cannot recommend highly enough. A tooth that was deteriorating and the dentist wanted to cap is now fine enough for them to simply keep an eye on.
I just started using toothpaste with nano-Hydroxypatite after a recommendation from a friend. Obviously I can't say much about its effectiveness long-term. But it feels amazing. Feels like there's a protective layer over the enamel - hopefully there actually is!
If you're in Australia and struggling to find toothpaste with Hydroxypatite, Chemist Warehouse stock "Healthy Care Sensitive Propolis Toothpaste". So far, highly recommended.
I’ve had similar success with toothpastes containing “nano-hydroxyapatite” Amazon has several good ones.
I also have 2 kids, the youngest (4 yr old) had cavity issues which required intervention and then we started using the hydroxyapatite toothpaste and had no issues since.
I also headed down this path via looking for Novamin. I wish there was a reliable way to get it without the “is it fake” on Amazon. I’d gladly accept any reliable sources.
Sensodyne does not have Novamin in the USA(insert conspiracy theory here). You'd either have to import it from a reputable supplier, or try an alternative like Apagard or Biomin F(both of those have to be imported too, but are more readily available).
She said it works sometimes. I definitely like this conservative approach better than my last dentist's, who filled 4 teeth unnecessarily because his DIAGNOdent beeped once.
I'd be suspicious of those claims – anecdotal but, unless US doctors differ greatly, neither of those are secrets that have been withheld from me by dentists in 3 European countries.
In fact the second statement is surely the basis for most modern dentistry...?
(I said US there because it's an assumption that the US approach to dentistry may be different to rest of the world. From afar, seems more cosmetic focused with a lot more emphasis put on whitening/straightening/veneer/fixing procedures than over here)
Mineralisation of tooth is a constant process with a tug-of-war between pathogenic and protective factors [3:09].
If it's in the balance, of the remineralisation factors prevail, you can stop the progress of the cavity. But deeper the cavity, this is harder to achieve.
My dentist friend claims he makes far more money per hour from cleanings than from fillings. This is because most of a cleaning is done by a relatively lowly paid hygienist but still requires him popping in for 5 minutes and a filling requires him to be there the whole time.
That's really strange. Here in Norway I visit a dentist roughly once a year and usually only see my dentist if the dental hygienist has found a problem.
5 minutes may be a bit long for the US. I don't know if it's a legal requirement that the dentist pop in (to supervise) or because people will balk at paying as much without a Doctor appearing. I'm not aware of the dentist usually finding things that the hygienist missed.
My dentist simply put me on toothpaste with high fluoride (IIRC 8%?). Two caries remineralized over the span of about a year and I didn't need fillings.
Unfortunately high fluoride toothpastes require an RX.
Interesting, I knew of someone who also claimed they reversed a cavity by focusing on oral care, and drinking a ton of milk.
Personally, I had a chipped tooth in my early teens and it went away after a decade. I was also drinking about a gallon of milk a day, but I don't know if that's what really fixed my tooth. I wasn't actively doing anything special with my teeth to try to fix them. I just really like milk. The problem just seemed to go away on its own.
> Cavities, on the other hand can be arrested (stopped), and if small can even be remineralised. Yes, most dentists don't tell you that!
What is with this sentiment about evil dentists wrecking peoples' teeth prevalent in this thread? Any dentist will tell you that if you brush and floss daily and consume sugar responsibly, that your teeth will be healthy and happy for the vast majority of your life. A VERY small percentage of the population actually does this.
There is no big dental conspiracy to destroy our teeth. We do that just fine on our own.
> It's so sad that most dentists optimise for billable revenue
I've heard this so often as well as the more general statement that doctors optimize for revenue. I think it's nonsense and even dangerous. People are more likely to die from deadly diseases like cancer because they avoid doctors. The anti-vaccination movement is also very likely linked to this sentiment.
> Cavities, on the other hand can be arrested (stopped),
If they are really small. And even if, teeth with rough surface require multiple times more effort to take care of. (So you really need to chew a lot of gum) Only exception are deep holes, those you sometimes don't want to fill so the tooth can "breathe", at least for some years IIRC.
> and if small can even be remineralised. Yes, most dentists don't tell you that!
2 out of 3 dentists told me to buy remineralization tooth paste and use it once a week. Also I'm getting urged nowadays to go twice a year for tooth cleaning including professional remineralization treatment.
Disclaimer: Not a dentist either. I think medical advice should be taken from people that have actually studied that stuff.
> optimize for revenue. I think it's nonsense and even dangerous.
As with everything, there are caveats to the kind of doctor you are talking. The key distinction is that most dentists keep the residual income: the difference between the fixed costs and income. It can be a quite large sum and high % of dentists' earnings. So a dentist has a very strong incentive to increase it. Overtreating patients is the easiest way to do it since increasing the prices is not an option due to competition.
Who isn't keeping the residual income? It's the doctors who work only for a fixed salary. They can't earn more by overtreating. In fact, if they have less work, they are at profit since their salary is fixed. They don't care about increasing the residual income since they don't get it.
Orthopedic surgeons do the same thing. Inject steroids repeatedly, degrading joints in order to do joint replacements. And those joint replacements aren't great, so they need to be replaced periodically.
Fillings for example always degrade and need repairs after X years. Drilling and filling even the smallest cavity puts that teeth on a lifetime progression to bigger and bigger fillings, eventually a root canal, eventually an implant.
Cavities, on the other hand can be arrested (stopped), and if small can even be remineralised. Yes, most dentists don't tell you that!
Careful monitoring and patient education on the other hand can lead to permanently keeping that natural teeth, as our teeth are living and can heal.
My personal lived experience: a dentist told me I must fill 2 cavities six years ago. I got a second opinion. That dentist told me I should wait, focus on oral care, chew xylitol gum, and use a toothpaste with novamin.
Both cavities have "arrested" and need no restorative work.
Disclaimer: Not a dentist. Listen to your dentist you trust, and get second opinions if you have doubt.