Question about dentists and dental X-rays

[Linnet]

Not really an Aibu but I’m posting for traffic.

Can a dentist tell at your examination that you are brushing your teeth every day? And can you refuse X-rays?

I was at the dentist 2 weeks ago for my six monthly check up. My dentist had a look and did X-rays and told me that I was to come back for deep cleaning as my gums are not looking good at all and to make appointments on the way out. She also advised me to brush my teeth twice a day for two minutes. I told her that I do brush my teeth twice a day for two minutes as I use a timer on my phone and she just laughed and said yes that’s what everyone says!

I’m now going back for two separate appointments for deep cleaning and today I received the estimate for the costs. In the estimate, which is itemised, it mentions X-rays and the cleaning.

Is it usual to have X-rays again after having just having them done 2 weeks ago? Can I refuse to have them? I’m not sure how comfortable I am having more X-rays so soon after the first lot.

This is a new dentist who has taken over the practise and I think I’m a little bit worried that she’s just adding things in to get as much money out of me as possible.

I would get a second opinion about the deep cleaning, if you brush plenty and are not aware of issues. I was told I needed this years ago, I didn't like the sound of it so didn't return to the dentist for 2 years. Since then I've seen 3 other dentists (since moving house) and none has ever mentioned any deep cleaning being needed. They always say about flossing but that's it.
The laughing at you doesn't sound very respectful either. I would go elsewhere.

Reading between the lines, if the dentist has taken X-rays (probably bite wings ) at your recent exam and also told you that need deep cleaning, then you must have scored code 3s or 4s in the periodontal probing part of your check up. This means you have periodontitis. To fully ascertain the level of periodontitis, your dentist needs to take full mouth periapical radiographs to assess how much bone loss you have.

You can refuse to have radiographs , the dentist will advise you of why this is not wise and document the conversation.

Answer to your other question is yes, not only can we tell if you brush twice daily or not; we also are experts in spotting if you are brushing /flossing / TePe-ing effectively. But we can double check with plaque / bleeding indices / disclosing.

Moreover, I'd be wanting to know why this wasn't picked up by your last dentist 6 months earlier. Periodontal disease is insidious. You need more information OP.

To be honest, I think it is possible to know when a patient is lying. For example, I keep my teeth really clean and genuinely floss, brush, scrape and rinse twice a day for 2.5 minutes.

I have attended 6 month check ups in the past and not needed a scale and polish as I had no build up! I think if you’re truly diligent with brushing your teeth, you won’t really get any build up as tartar simply can’t form if you brush regularly.

Whenever they check my gums, my gums never bleed and I always score very high when they read the numbers out.

My dentists (I visit 2) compliment my teeth a lot and praises how I clean them. If they think you’re doing a good job, they’ll let you know

My dentist is lovely and I fancy the pants off him

Had to get a LOT of work done last year and to be honest it made a lot less grueling. He's very sexy

and I always score very high when they read the numbers out.

Sorry, I didn’t mean high as in a high number. I meant highly as in on the good side. I haven’t seen my dentist since September so can’t remember the exact numbers.

Everything @l2b2 had said.

I’ve worked with specialists in perio.

You might brush twice a day for two minutes but if you've not got the placement and technique then your brushing can be just as useless as if you weren’t doing it at all.

It’s sad that so many people think the majority of dental professionals are just out to get your money - some people get into healthcare.. because they care, you know..

@LifesLittleDeciders and @l2b2 have it spot on.

Sometimes, dentists can even tell if you're right or left handed...

Phew, I just had my dental check up and don't remember the dentist giving a score except listing my tooth position and fillings, crowns, implant. From your post, I thought the dentist would hold up a card on a scale of 1-10.

OP, the dentist does not seem to be explaining things to you very well. You are within your rights to ask her to explain why a certain treatment is necessary. You can also ask her to give more specific facts, not just 'gums not looking good'.

Then go back home a google if you need to reassure yourself. It also makes it easier if you decide to switch dentists to fact check the previous one.

www.google.com/amp/s/amp.theguardian.com/society/2000/apr/16/futureofthenhs.health

This is very older but I dont think they've changed one bit. The people I know with the best teeth in old age are the ones who simply focussed on good dental hygiene at home then avoided dentists like the plague.

@l2b2

Reading between the lines, if the dentist has taken X-rays (probably bite wings ) at your recent exam and also told you that need deep cleaning, then you must have scored code 3s or 4s in the periodontal probing part of your check up. This means you have periodontitis. To fully ascertain the level of periodontitis, your dentist needs to take full mouth periapical radiographs to assess how much bone loss you have.

You can refuse to have radiographs , the dentist will advise you of why this is not wise and document the conversation.

Answer to your other question is yes, not only can we tell if you brush twice daily or not; we also are experts in spotting if you are brushing /flossing / TePe-ing effectively. But we can double check with plaque / bleeding indices / disclosing.

Thanks for your reply. When I had my check up last August she mentioned 3s and I was surprised as i’ve not changed anything and I’ve never had those numbers before. This time she mentioned the 3s again and a 4. So she said I should have deep cleaning. To be honest I’m ok to have the cleaning as I’m sure it’s been almost two years since I had a scale, so I feel I do need one.

When you say bite wings what does that mean? The X-ray she gave me was a plastic thing she put in one side of my mouth and then the other are those bite wings? Is it likely to be a different type of X-ray next time?

It’s sad that so many people think the majority of dental professionals are just out to get your money

Sadly as long as they earn more for doing more procedures and treatments, it will be ever thus. Dentists would go out of business if we all had perfect teeth.

@SnackSizeRaisin

I would get a second opinion about the deep cleaning, if you brush plenty and are not aware of issues. I was told I needed this years ago, I didn't like the sound of it so didn't return to the dentist for 2 years. Since then I've seen 3 other dentists (since moving house) and none has ever mentioned any deep cleaning being needed. They always say about flossing but that's it. The laughing at you doesn't sound very respectful either. I would go elsewhere.

Yes I wasn’t happy about the laughing I did think she was quite rude.

@NoIDontWatchLoveIsland

And doctors would go out of business if we’re were all perfectly healthy. But the body doesn’t work like that, neither do your teeth.

Cosmetics is where the money lies. Not a £30 check up or £60 clean.

@LifesLittleDeciders

Everything *@l2b2* had said.

I’ve worked with specialists in perio.

You might brush twice a day for two minutes but if you've not got the placement and technique then your brushing can be just as useless as if you weren’t doing it at all.

It’s sad that so many people think the majority of dental professionals are just out to get your money - some people get into healthcare.. because they care, you know..

I appreciate that people go into healthcare because they care and of course it’s possible that she isn’t out to get me to spend all my money.

But seeing as I had the same dentist for years before they left and I haven’t changed anything in the way I brush my teeth etc and I’ve never had numbers so high it does make me wonder... was my old dentist just a rubbish dentist or is this one over enthusiastic?

The difference is that hospital doctors are not paid by the procedure.

They earn a fixed salary and public health success is measured by metrics on disease prevention etc

The one part of the publicly funded system where doctors have been incentivised based on certain procedures/tests etc is general practice, and its been riddled with problems/poor practice - a good example is with GPs pushing certain forms of contraception (mirena anyone) because they are getting paid for it, when many women request non hormonal options (eg copper coils).

NHS or private dental practice?

Op tooth decay takes years to progress. Its unlikely would suddenly have massive worsening. I would seek another opinion.

Also try and find somewhere that does NHS rather than dental insurance funding. NHS payment rates for treatments are lowers so dentists have less to gain from unnecessary procedures.

It’s an NHS dentist. My dd had to get a filling and she was given a quote for both NHS and private prices so she could choose. Our old dentist never did that.

How would I go about getting a second opinion? Can I just phone up another dentist and ask for a check up?

But if it is an NHS dentist, then won't the x ray and a scale and polish be capped at band 1 of the NHS dental charges, which is set at £23.80? So it's unlikely the dentist is motivated by money.

What was the estimate for the costs?

I always listen to my gum scores which are 0/1 - last time I had a 2 between two upper back teeth and have been super, super vigilant round there since.

A few years ago my dentist said she thought I was clenching my teeth and should get a night guard. I was like, no, I definitely don’t do that. Until I cracked a lower molar. Dentists definitely know stuff! I now wear a night guard every single night.

@NoIDontWatchLoveIsland
This thread is about gum disease not tooth decay. Not comparable except both are in the mouth.
OP Code 4 is concerning . Don't delay if you do decide to move practice.
Periapical full mouth radiographs are standard when periodontitis has been diagnosed.
The X-rays you will have had at your checkup would have been bitewing radiographs, which all patients have (unless edentulous) at least every 2 years.
Your new dentist sounds conscientious tbh and it's quite usual to give a private and a nhs option for restorations in general practice. That sounds open and transparent.

@AlrightTreacle

But if it is an NHS dentist, then won't the x ray and a scale and polish be capped at band 1 of the NHS dental charges, which is set at £23.80? So it's unlikely the dentist is motivated by money.

What was the estimate for the costs?

2 small X-ray £5.28 1 scaling requiring 2 visits £29.16

It’s not the cost that worries me, I was worried it was going to be more and I’m happy to pay. I’m just confused that my teeth or gums rather seem to have gone downhill so rapidly since the new dentist started.