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PaperclipPerfector  10mo ago (text post)   2794 thread views

Small-Scale Question Sunday for January 21, 2024

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

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Any dentists on here?

Is there any truth to some of the things I read about much of dentistry’s research literature being bullshit? Or just that the generally accepted recommendations aren’t really proven empirically?

I’m curious as I’ve been trying to take better care of my teeth as I get older but can’t really floss as my bottom teeth are very close together and even the “shred-resistant” floss gets destroyed. I tried using the Glide floss which worked extremely well but appears to be made of 25% forever chemicals and I don’t want something like that anywhere near my digestive system.

So I’ve just been using a Waterpik but I’m unclear on how effective it is, but I keep seeing that flossing in general does not have much evidence to support it, and maybe even fluoride/brushing in general?

In particular I’ve seen that nano-hydroxyapatite may be more effective than fluoride and there are a few studies that seem to support this.

Any dentists or otherwise knowledgeable parties willing to set the record straight?

I'm not a dentist but I am in healthcare.

Most medical research is crap because people are complicated, research is hard, and the number of questionable incentives is immense. Dentistry might be worse because of the peculiarities of how healthcare is arranged in the U.S., but maybe not. I don't know.

I lean on two things when I'm trying to investigate stuff like this.

  1. Is anyone making money off of this?
  2. What do knowledgable clinicians actually do for their personal care?

As an example - ophthalmologists almost always wear glasses and almost never get laser eye surgery.

Flossing is cheap and I got to imagine almost every dentist does it (maybe not some of the ones with great genetics).

In my personal experience flossing reduced the amount of nagging I got from my dentist, and a water pick had not. Notably, flossing only did so after I got proficient at it. I don't know how true this is but I remember seeing on reddit "flossing doesn't work" type posts and the response being "digging into the research it seems like most people suck and that what leads to that data, just do a good job."

I don't know if the literature supports this however.

As an example - ophthalmologists almost always wear glasses and almost never get laser eye surgery.

I thought that was a myth. This study seems to indicate that they do usually get LASIK when they're a candidate for it.

Oh that's very interesting. I can't argue with the data (well I guess I could use my journal log-in and read the paper but zero chance haha).

I guess I should then clarify that this is based off of anecdote, and association with Ophthalmologists at very high end departments. Perhaps the difference is that some level of conservatism is associated with appointment to high prestige programs and that has an impact on personal healthcare habits that may not be present in the population of eye doctors at large.

Thank you for passing this along.

I am curious though, do you happen to know what the reason is why some of the ophthalmologists you're familiar with choose not to get LASIK? I thought it was a pretty safe procedure if you're a good candidate for it.

I asked one about it once and he gave me this "why the fuck would I laser healthy cornea."

That's perhaps unnecessarily punchy but it is important to keep in mind that the procedure comes with risks, and can succeed in principle but cause dry eye or night vision issues. When compared with nearly riskless management like glasses that may seem like not worth it, especially when you actually are the one who sees people who come in who had it go wrong and therefore said risk is more than hypothetical.

Additionally it's worth noting that the timing for it is important, your eyes change as you age and after a certain point it no longer makes sense. It's possible the issue here is in part medical training - you don't have the time or resources to get it done until after it stops being clearly a good idea.

As an example - ophthalmologists almost always wear glasses and almost never get laser eye surgery.

Why glasses over contacts?

Contacts have a risk of severe infection and other problems, especially when improperly used and cared for. An eye doctor is probably not going to commit any of those sins, but when you see the bad results it can be....motivating.

I think this is too conservative, but I can't blame them for being turned off after seeing some mangled eyeballs.

Many do wear contacts, most women ophthalmologists I know do.

But I agree with the earlier posted that none or almost none have laser eye surgery. By contrast, most female derms I’ve met have had cosmetic surgery, the temptation is too great.

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