Austin is out this week due to a Dental Procedure, which leaves Patrick, Rob, Cado, and Danielle to come to terms with their own oral hygiene. Does anyone go to the dentist enough? How long is too long between visits? Excuse me did Rob just say the word "decade"?
I’ll preface this by saying not trying to go all ‘anti-orthodontics’ on people, clearly oral hygiene is a necessity and many dentists I’m sure are honest and do good work, but I just want to spread some awareness. Especially because I feel like dentistry is one of those things we (at least in the US) take for granted and kinda don’t really question.
Anyway, I read a good, yet disturbing article by The Atlantic about dentistry that messed me up. It gets into the startling fact that many dental procedures are unfortunately not adequately clinically tested. The author makes a very good point that oftentimes when a dentist points out a problem and recommends a procedure, we don’t feel like we’re in a position to disagree or question it. And this can sometimes lead to costly and unneeded procedures being conducted. Here’s a couple excerpts, link to the article is at the end (CW: general body injury stuff, medical procedures, etc.):
“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…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.”
“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.”
A dental episode the day after I had my own dental episode, strange coincidence.
Love the early ep releases btw, the usual time is somewhere around midnight for me.
This is not the content I need in my life with multiple major dental procedures in my my immediate future.
Yeah it’s rough lol. I read it a couple months after getting a few semi-major dental procedures myself.
I’ll wish you the best though 
I’m gonna say up front that the dentist office should have checked with the insurance company that they were in-network and would cover the services before taking on Rob as a patient. That is what I do all day here at my awful day job. It is absolutely ridiculous that they would expect a patient to be able to sort out networks and CPT codes or whatever other bullshit.
Pro-tip: Check with your insurance first to find an in-network doctor in your area. There’s sometimes a list you can find.
Real Talk: Fuck insurances hard. Burn them all to the ground and salt the Earth below them.
Being poor, I’ve not been able to go to the dentist since I was in high school.
I sincerely believe that the day your dentist and your doctor work in tandem is the day that medicine as a whole takes its biggest leap since the invention of antibiotics.
okay i am listening to this episode and it is unfortunate how naïve Americans are to how terrifically fucked our own insurance system actually is. Like you might think it’s bad, and you might know things that prove it’s bad, but you truly have no fucking idea until you’ve grappled with the gnarliest, most inhumane parts of it.
It is, wildly, not fraud for the insurance company to turn around and say “actually no”, and it is totally normal for the provider to say “well this is not what we expected! anyway here’s the bill.” Typically you sign a waiver saying you understand you will be responsible for the cost of the procedure if your insurance is not approved in advance of the procedure, but even then…not always! Worse, the insurance company can legally retroactively cancel coverage under certain circumstances, back to the beginning of a month that you were previously covered under, and they (the insurance company) can then bill YOU for the things that they previously approved coverage for.
Additionally, the amounts they will bill you for, which are astronomically fucking large - like, say, $10,000 for a CT scan - are wholly invented. They are a product of what the hospital billing department (the true dark bane of the existing US healthcare system) has determined it to be in coordination with the insurance companies based on bureaucratic nonsense unrelated to the actual procedure, much of which is actually the cost of paying for the billing department itself and those who work it!
You can effectively negotiate with the provider and say to them, “I can’t pay $10,000. I can pay the actual cost, which is [for the sake of argumentation] $800.” and they may just say “okay sure”, knowing they will never get $10,000 out of you. It is an imaginary number. The lower, “true” cost is typically what medicare/medicare recipients pay for the procedure when they/those covered by it receive the procedure.
If you ever find yourself stuck with a fucking enormous medical bill, you DO have options. You can default on it after 7 years, at which point I believe it is finally scrubbed from your credit score (this means never making a single payment, as each payment resets this clock); you can negotiate a lower cost with the provider because you know for a fact the procedure does not cost as much as they say it does, that is just what they’ve convinced insurance companies to pay for it; or you can appeal the coverage rejection by your insurance company. If your coverage is through work and that coverage is somehow fucking you, you can also contact the department of labor agency in your area. Companies do not like receiving calls from them, and they may be convinced to resolve an issue they are legally in the right about just because it’s easier to do so than to keep fighting you.
All of it fucking sucks, all of it is deeply, deeply dehumanizing, all of it will cost you many hours a day, every weekday, for months on hold on the phone, but…it is possible.
Look I’m already dreading finding a new dentist because I already can tell my poor teeth have been abused by not seeing one in a year. Can I just hold off until those lab grown teeth become a thing? Just swap them all out for fresh lab teeth in like 5 years?
Ok wait, hold up, Double Dash was controversial??? I’ve literally never met a fan of Mario Kart that doesn’t put double dash in the top 3 of the series, with most of em putting it in the top 2.
Was I just too young and missed this? Because that controversy does NOT exist anymore.
I was pretty young at the time too so also might be missing something but: only “controversy” I remember was people being really skeptical when it was announced. Once it was out, I never heard a negative thing said.
Rob, hope you enjoyed Michigan over the Holiday weekend. Up north is beautiful this time of year.
I was interested to hear Patrick’s comment about how, in horror film discussion, there has been some recent drive by some to create a new name to apply to more thoughtful, or basically just better, horror films. As a comic book fan, this called to mind the phenomenon where some people seem to think the term “graphic novel” means “good comic book that I am not embarrassed to read but assume must be qualitatively different from what I assume the rest of comic books are.” I suppose it shouldn’t be surprising that other forms of culture that are occasionally looked down upon deal with the same issue.
