TeethRemoval.com

Second Opinion Advertisements for Dentists

Posted on 07. Jan, 2012 by wisdom.

An article in The Journal of the American Dental Association titled “Are Advertisements That Offer ‘Free Second Opinions’ Ethical by Rod B. Wentworth (October 1, 2011, vol. 142, no. 10, pages 1199-1200) talks about the ethics involved with dentists advertising “free second opinions.”

In the article it says

“So simply offering free second opinions is not in and of itself unethical. It is perfectly acceptable for a patient to seek a second opinion. In fact, dentists should consider suggesting that their patients obtain second opinions, especially when they have questions or concerns about the appropriateness of the recommended treatment.”

One issue raised in the article is that in a second opinion, if a patient has any x-rays they should be sent along with the patient for the second opinion to avoid unnecessary radiation.

The other issue raised is giving second opinions without making disparaging remarks about the patient’s dentist from the first opinion also known as jousting. Doing so can result in possible disciplinary action against the dentist and may have potential legal implications but as a patient if it was warranted I would like to hear the truth.

The purpose of a free second opinion would of course be to help dentists take patients away from each other.

I think second opinions from different dentists is a good idea in some cases but as addressed in this post http://blog.teethremoval.com/are-dentists-ethical-or-scam-artists/ knowing whether a dentist is being too conservative, too aggressive, or somewhere in the middle is difficult often for patients to know. I tend to think more dentists at least in the U.S. lean towards the aggressive side but certainly some are more conservative in their treatment approaches.

The author ends by saying

“Second opinions are not cut-and-dried in an ethical sense. Advertising them certainly is not unethical, and patients are free to select the dentist of their choice, which they may do on the basis of the information received in a second opinion. However, certain actions, such as criticizing a dentist unjustly, administering unnecessary tests or treatment, or misrepresenting fees, skills or experience may be unethical. Only the dentists involved know their motivation and whether it leads to unethical conduct. One hopes that dentists will take the high road to ensure that the oral health of the public and the welfare of patients are of primary importance”

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Do Teeth Define Your Personality?

Posted on 30. Nov, 2011 by wisdom.

I was alerted to an interesting infographic that was just produced by http://submitinfographics.com/

The infographic discusses some different characteristics of teeth. It also discusses some statistics about how 164 million work hours per year are spent treating dental problems for adults and 51 million school hours per year are spent treating dental problems for children.

(Click to enlarge)


[Via: Carrington College's Dental Assisting Training Program]

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Swimming and the Potential Harmful Effects on Your Teeth

Posted on 22. Oct, 2011 by wisdom.

Recently an article has appeared on DrBicupsid.com titled Swimming in acidic pool nearly destroys man’s teeth written by Rob Goszkowski and posted on September 6, 2011, located at http://www.drbicuspid.com/index.aspx?sec=sup&sub=rst&pag=dis&ItemID=308363
The article describes a case of a 52 year old man who nearly lost the enamel of his teeth in just 5 month by swimming regularly at his home pool.

In fact, while it is widely appreciated that exercising regularly is good for your health you should consider the potential harm of any sort of new exercise program and yes this includes swimming and even walking.

This man was suffering from hemangiomas in his liver and was told by his doctor to stop jogging so he decided on his own that he would take up swimming and in fact would do so for 90 minutes a day at a pool in his house that was not being professionally maintained.

It was found that the reason for his rapid enamle erosion was due to having a highly acidic chlorinated swimming pool (low pH). The normal pH of a pool should be between 7.2 and 7.6 which is considered to be basic.

Image from http://www.flickr.com/photos/gcwest/136945653/ and has a Creative Commons License.

Tom over at OralAnswers.com has also explored swimming and it’s effect on teeth in his article titled Can Chlorine in Swimming Pools Dissolve or Stain Your Teeth? published June 15, 2011, and located at http://www.oralanswers.com/2011/06/chlorine-swimming-pools-dissolve-stain-teeth/

In his article he states:

“This means that in a basic swimming pool, the calcium and minerals present in your mouth will harden onto your teeth rather than dissolve (as they would if the pH were acidic – this is why your teeth dissolve slowly when you eat or drink anything acidic.) “

An article titled Swimmers Risk Stained Smiles, Chipped Teeth http://www.knowyourteeth.com/infobites/abc/article/Default.asp?abc=S&iid=331&aid=1324 updated March 2007, says:

“Athlete swimmers, who often swim laps more than six hours a week, expose their teeth to large amounts of chemically treated water. Pool water contains chemical additives like antimicrobials, which give the water a higher pH than saliva, causing salivary proteins to break down quickly and form organic deposits on swimmer’s teeth. The result is swimmer’s calculus, hard, brown tartar deposits that appear predominantly on the front teeth.”

This is not the first case where dental erosion has occurred due to a low pH in a swimming pool due to inadequate maintenance. This is described in an article called Etiology of dental erosion–extrinsic factors by DT Zero appearing in Eur J Oral Sci, vol 104, no. 2 part 2, pages 162-177,  April 1996.

Hence it is important to know what the pH is of the pool you are swimming in and especially so if you begin to notice some dental erosion.

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Why People Hate the Dentist

Posted on 14. Oct, 2011 by wisdom.

Numerous posts on the internet have attempted to shed light on the why people hate the dentist.

Tom over at OralAnswers.com has a two part series on why people hate the dentists located at http://www.oralanswers.com/2011/09/why-people-hate-the-dentist/ and http://www.oralanswers.com/2011/09/why-people-hate-the-dentist-my-theory-part-ii/

Dr. Joe Bulger DDS in Canada changed the name of his blog to hatedentists.com and his written several posts on the topic of people who hate dentists located at http://www.hatedentists.com/1319/hate-dentist/ , http://www.hatedentists.com/1326/dentist-haters/ , and http://www.hatedentists.com/1363/top-10-reasons-people-hate-dentists/

SaneDentist.com has a post by Dr. Mujtaba Ali regarding 5 reasons why people hate the dentist located at http://www.sanedentist.com/here-are-5-reasons-why-we-hate-the-dentist-and-what-a-dentist-thinks-about-them.html

Reading, over these posts and potential explanations for hate towards the dentist just doesn’t seem to do the hate justice and doesn’t touch on all the issues.

So here are some reasons why I think people really hate dentists (subjective opinion):

1) Being motivated by money to the point of detrimental care to their patients

Let’s face it, people go to work to make money so they can survive and look after their loved ones. However, dentistry is not a business and should be about making people motivated to practice healthy habits and not pushing unnecessary surgeries and care. This is touched on on the controversy page of this site and in this post on if dentists are ethical or scam artists. People want to know the facts regarding their care and if it will be helpful or harmful.

Now yes doctors and dentists do have increasing outrageous tuition costs at the undergraduate and professional levels http://blog.teethremoval.com/lets-give-our-kids-a-chance-to-succeed/. What should be happening is strong leadership and organization in dental professional societies to help insure tuition costs do not continue to spiral out of control. Of course dentists should be fairly compensated for their efforts and skills but the current fee schedules often times do not promote health to the fullest.

2) Not factoring liability into the patient side of the equation and ensuring patients who are injured receive fair compensation.

As discussed on this website and well known, doctors and dentists have concerns with liability when they see a patient. Numerous physician groups in the U.S. such as the American Medical Association and American Association of Oral and Maxillofacial Surgeons are actively pursuing legislation to limit non-economic ‘pain and suffering’ damage caps to $250,000. http://blog.teethremoval.com/the-war-on-healthcare-patients-who-hate-doctors/ and http://www.teethremoval.com/legal_standpoint.html

The American Association of Oral and Maxillofacial Surgeons continues to recommend and say that most healthy wisdom teeth should be removed when a patient is young and healthy such as a teenager but yet also push for damage caps of $250,000 at the national level. Several cases are illustrated on this site at http://www.teethremoval.com/complications.html and http://www.teethremoval.com/dental_malpractice.html in which a damage award of $250,000 for certain cases is just downright unfair, unjust and ridiculous.

In fact I argue that you should avoid having wisdom teeth extracted in any state such as California and Texas which have $250,000 non-economic damage caps. There are other potential approaches instead of the current medical malpractice system such as discussed here http://www.teethremoval.com/legal_system_medical_malpractice that dentists should be advocating for for their patients. This includes such things as a no fault insurance for negative outcomes, a no-fault approach, or health courts.

3) Lack of focus on research

Let’s face it many people simply do not like the dental drill and needles and other instruments used by a dentist. New approaches should be further explored. For example, extract wisdom teeth without the need for all these tools with perhaps some other method to prevent wisdom teeth from even growing.

Further echoing back towards #1 many dentists and doctors are motivated to go into specialties that pay higher instead of going into more academic and research oriented careers. This works to hinder much needed progress and discovery.  In addition many patients who want to know the latest up to date research are left in the dark.

Further it is my belief that patients and their reactions both positive and negative to treatments should be investigated. Often times there will be no record of how a patient responded to a treatment.

4) Engaging in conspiracy, collusion, and trying protect themselves from potential liability to the detriment of their patients

There are numerous complications that can occur from having wisdom teeth extracted as indicated here http://www.teethremoval.com/complications.html.

However, when I had my wisdom teeth extracted I consented to only around 8 such complications and was never made aware that there are numerous other potential serious risks involved. Furthermore the fact that healthy wisdom teeth are not extracted in the U.K. due to the risk of harm was not disclosed.

Still to today I have yet to see any informed consent forms that list permanent headache as a known complication from having wisdom teeth extracted.  As discussed on wisdom teeth removal stories by others other patients have had headaches occurring from having wisdom teeth extracted and were told as was I that it was not related to the surgery. It is my belief that patients have a right to know about serious potential risks before consenting to a potentially life altering surgical procedure.

In addition, other dental websites on the internet fail to disclose many of the potential risks and complications from having wisdom teeth extracted.  Some of this may have to do with dentistry being focused on the oral cavity and so some do not like to readily admit that teeth have implications on other aspects of the body and health. Another reason of course is going back to #1 where their is a push towards selling procedures and care instead of providing information to patients to better help them make health decisions.

Patients get angry when they are lied to and feel like they have been taken advantage of. In some cases patients are told they had to have impacted wisdom teeth extracted even though no scientific evidence currently supports having healthy impacted wisdom teeth extracted. Further patients get angry when they are lied to by their dentist and office staff about complications that have occurred from surgery.

5) Pain

Ultimately going to the dentist can cause a lot of pain. Some of this pain may just be due to their teeth hurting or it could be due to a lasting horribly painful complication from treatment.

6) Anxiety

Since patients know that dentists can cause them a lot of pain they get anxious about seeing a dentist. This may even cause them to have nightmares and be unable to sleep for days prior to seeing their dentist.

7) Giving patients a hard talk

Some patients may need to be told that certain things they are doing to take care of their teeth are not good. Some dentists may discuss this in a way with the patient that they take offense to, although it really shouldn’t be taken that way.

8 ) Taking sexual advantage of patients

As discussed here http://www.teethremoval.com/sexual_assault_under_anesthesia_for_wisdom_teeth_removal.html some dentists have sexually assaulted their particularly young female patients during treatments and procedures. This has absolutely no place in dentistry. Certainly dentists are people and can have urges but this has no place in the workplace with paying customers.

9) Dental boards and organizations not protecting the public

I had no desire whatsoever to create this website. It is very unfortunate that high quality care and protecting and providing information to the public so they can make an informed choice about dental treatments is not the top priority.

Many oral surgeons continue to recommend that healthy impacted wisdom teeth be extracted in young patients http://blog.teethremoval.com/the-truthiness-of-extracting-wisdom-teeth-james-r-carey/ without adequately providing information on the facts, evidence, risks, and harms of surgery.  Again this goes back to #1 .

10) Poor service

Ultimately all of these issues set up for poor service and unsatisfied patients. It can be hard to please every patient and know how different patients will react. However, poor service really encompasses all of the issues already touched upon. Other things that could be a problem is lack of knowledgeable dental staff or a dated dental office.

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How does Flouride really Protect Teeth from Cavities?

Posted on 20. Apr, 2011 by wisdom.

A recent study that appeared in the journal Langmuir looked into the role of fluoride and their protection on teeth. The researchers who published the journal article found the protective shield fluoride forms on teeth is up to 100 times thinner than what was previously thought.

It is well known that fluoride is found in toothpaste, mouthwash, and public drinking water in many areas in the world. The use of fluoride of course is to help prevent tooth decay which causes cavities to form.

Researchers found the fluorapatite layer created by fluoride on the hard white substance covering teeth’s surface called enamel is only 6 nanometers thick. This layer is very small and over 10 times thinner than what was indicated in any prior studies. Hence the researchers raise questions about how a layer so thin can protect teeth from decay. Hence it is possible that fluoride may have another unrecognized effect on tooth enamel.

It is worthy for researchers to explore how fluoride protects teeth from cavities as there is some controversy surrounding the fluoridation of drinking water. Previously I have discussed how large amounts of fluoride consumed can lead to fluorosis in young children.

Source: Frank Müller, Christian Zeitz, Hubert Mantz, Karl-Heinz Ehses, Flavio Soldera, Jörg Schmauch, Matthias Hannig, Stefan Hüfner, Karin Jacobs. Elemental Depth Profiling of Fluoridated Hydroxyapatite: Saving Your Dentition by the Skin of Your Teeth? Langmuir, 2010; 26 (24): 18750 

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