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(& honestly the number of “cowboys” who do fillings that aren’t needed is tiny despite what almost everyone says about Dentists)
I think that is true now but not when I was a kid. My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling
Most dentists still are but the philosophy behind how treatment is planned has changed. Ie much less aggressively and less invasive/ interventive
The prevention I outlined above is better understood and dentists spend more time educating people now.
Remember The 70s was 50 years ago, attitudes have changed a lot but back then the vast majority of dentists were following the best practice / knowledge base of the time, things have changed a lot like they have in all of medicine. No one even back then was filling teeth that didn’t look like they had a hole in I promise you, or were you one of the few people doing all the right stuff I outlined above?
I'm not saying pay them less. Get value for money is my point
Same way good Charity's have expensive ceos....
At the risk of further thread drift all my adult molars were filled pretty much as soon as they appeared. Not had any time to decay. No holes in any of them - just brown marks ( 50 yr old memory) there is no way every adult molar had to be filled by the time I was 14. In hindsight the dentist was a cowboy and its caused me issues all my life
I think that is true now but not when I was a kid. My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling
Definitely the case for me too. No outward signs of any problems or any pain yet every visit unto the age of around 16 would find something. Strangely since I left that dentist I've had no new fillings or problems apart from a root canal under an existing filling.
Definitely the case for me too. No outward signs of any problems or any pain yet every visit unto the age of around 16 would find something. Strangely since I left that dentist I’ve had no new fillings or problems apart from a root canal under an existing filling.
Sounds familiar. My last few dentists have been keen to avoid any intervention unless absolutely necessary, and that's pleasantly rare.
@ceepers That's absolutely brilliant, thanks for taking the time to write it.
I'd reply further but, ironically, I need to go eat something...
As I said, NHS is the largest employer in the world
It really isn’t.
So the PM today outlined how he was going to save the NHS, except he didn’t say anything
Let’s see if Keir comes up with any better idea’s tomorrow
My teeth were wrecked by an overenthusiastic dentist back in the 70s when IIRC they were paid per filling
Ditto, though it was the 80's and the offender was an orthodontist.
Wisdom teeth out aged 12, lower canines out aged 12. Two upper premolars removed aged 12 to allow my mouth to 'relax' and space everything out.
Bastard was a gorilla, i ended up with him capping some, aged about 14. Ended up going caps, then bridges when it became apparent all the roots had been damaged.
Basically doing far more work than was required at that age because it was private and he was a crook.
Eventually he was caught, struck off and imprisoned, which is fine and right, only we had nobody to sue, couldnt sue the health board to get something like remedial implants because he was private and for my life all teeth eventually went the way of the dinosaurs.
Due to homelessness and not having a dentist during that time i had to extract 3 myself.
If i met him today(though likely long deceased, I'd push him under the first bus that came along.
As I said, NHS is the largest employer in the world
US DoD is the largest, it employs almost 3 million people.
It really isn’t.
What is bigger? Armies don't count. Indian railways maybe?
What is bigger? Armies don’t count.
Says who? They are a public sector employer. But the NHS is still behind McDonalds & Walmart.
70s kid, mid 50s now. Dentist every six months. All my teeth, one filling dating back to when I was a kid. Keen to keep it that way when I went to do a degree in the late 80s, I registered with a local dentist who told me I needed six fillings. Riiight.... sacked him off, and still fine 35 years later...
BTW, like many of you I completely agree with Dr P - but how do you square that with the response to Covid, which was all part of the same hand wringing response to the fact old people are unfortunately rather prone to getting sick and dying?
If you think a global response to a global pandemic is "hand-wringing" then I square that by thinking you're an idiot.
Any further questions? Would you like a list of people I know (of varying ages) who it killed?
****'s sake, really?
I’m not going to get into a big argument but….
Yes there have been cowboys that have been prosecuted like there are in every profession but I promise you they are much rarer than you (& everyone over the age of 50) all seem to think.
Like I said attitudes have changed - the orthodontic tale outlined above was a genuine mode of treatment that has now been discredited and outdated as brace technology progressed. ( you didn’t have any wisdom teeth at age 12 to have taken out though so must have been your 6’a maybe?)
Dentistry believed it needed to be more invasive and everything “suspect” was filled rather than monitored as we would now.
Each filling had a prescribed “shape” rather than following the actual hole so fillings tended to be larger than they would be now ( material advances have allowed much less invasive treatment also.)
You are all talking about medical thinking that is 40 years out of date. Knowledge and treatment improves like everything.
Also two final points, diagnosis in dentistry like all medicine is often a matter of opinion and educated guesswork. Some people are better at it than others, guidelines and opinions have evolved over time.
Lastly, people like to think that there’s nothing wrong with a tooth that’s not hurting. This is NOT true. A hole will only cause pain once it gets close to the nerve of a tooth. Filling at that stage leads to more trauma to the nerve of the tooth ( which is already irritated by the decay being close ) and more chance of the tooth not settling and needing root canal or extraction. MUCH better to do small fillings on small holes picked up early to stop them getting to a stage that might risk nerve death / toothache ( which look like small brown spots or shadows on the surface of the tooth - the hole is always much bigger on the inside as the inside of the tooth is softer and decays more quickly - you will only get a true “hole” the patient will notice once enough tooth has been destroyed inside that the outer layer collapses in on top of it )
Anyway let’s get back to bashing the Tories, some dentists even vote labour……
On DrPs post. It actually goes against much of how nurses are trained to say " this person is old and dying, don't investigate or treat" It takes a fair bit of confidence to say it and to do it and it can be very difficult if you don't know why they are actually dying
The ward I worked on was rehab / long term care of the elderly. Wehad a new charge nurse from the acute sector. One patient was showing signs of stroke and she was thinking F.A.S.T as we are trained to for stroke and wanted to send the patient by 999 to the general hospital for testing. I went to get the patients notes and to check the advanced care plan which clearly stated not for transfer to acute, ward based care only. I still had to argue with her not to call 999
To add to that TJ, I would imagine clinicians in the current age are very aware of their decisions being scrutinised by lawyers for the family later - it’s always safer to go to the ends of the earth from a personal jeopardy pint of view no?
Would you like a list of people I know (of varying ages) who it killed?
I worked like a **** all the way through it, as did my sister in her mid 50s. Don't know a single person who died or suffered long term effects, through personal contact or at several removes, apart from a couple of people who were already totally ****ed. Anecdotes, eh?
Fully vaxed up, isolated for five days and wore a mask last week after testing positive on Xmas Eve. I'm not some wingnut denier. I just hoped we might have a serious discussion about attitudes to life and death, and the quality of life in the wake of this. But we've just gone back to the defaults, nothing ever changes. Never voted Tory, on board with all the comments about needing to reform social care etc - but equally, I don't have much time for people banging on about 'our NHS' while eating, drinking and idling themselves into a state of chronic ill health (y'know, like some of the ebike riding ****s on here).
My 80 year old dad also had Covid recently, too. Fit as, worked in construction all his life, he's fine. Got all his own teeth, too...
ceepers
Not in reality but the myths are powerful
the key thing is to get the advanced care plans / advanced directives in place so there is no ambiguity but even then it does not always work this is a case where it went wrong
it’s always safer to go to the ends of the earth from a personal jeopardy pint of view no?
No, document history, findings, observations, care plan and justification.
I worked like a * all the way through it, as did my sister in her mid 50s.
As did a lot of people.
Don’t know a single person who died or suffered long term effects,
How fortunate for you.
I’m not some wingnut denier.
Perhaps not, but you're trivialising a life-changing (and in some cases, life-ending) event.
(y’know, like some of the ebike riding * on here).
Wow.
What's your narrative here? That the people who died were either ancient and due to go anyway, or were just lazy bastards who didn't try hard enough?
My 80 year old dad also had Covid recently, too. Fit as, worked in construction all his life, he’s fine.
Was he sufficiently hand-wringy to not bother with vaccines?
No, like me he weighed up the evidence and got jabbed. But he also recognises he's an old guy who's had a decent life. He could do with getting knee replacements but has made the decision not to pursue it rather than clog up the system and deny that avenue to younger people who can make better use of those options. Like I say, realistic assessment of life, death and quality of life. We all make our choices.
So your 80-year old dad wasn't hospitalised or worse by covid because he was vaccinated.
Am I missing something here? Where does hand-wringing, working in construction and e-bikes come into this equation?
Nurses are obviously very underpaid. We also haven’t trained enough doctors for decades due to claims that training is too expensive! It seems to be far cheaper to train doctors than lawyers.
I guess that’s partly why medical colleges set ludicrously high grade requirements for students. The NHS pension scheme is a joke . It encourages many senior staff not to work or reduce hours otherwise they would have to start paying penal rates of tax on arbitrary pension contributions.
I worked like a * all the way through it, as did my sister in her mid 50s. Don’t know a single person who died or suffered long term effects, through personal contact or at several removes, apart from a couple of people who were already totally *. Anecdotes, eh?
what does this even mean? I was fit as a fiddle, worked outside, on building sites and in a mill at various points in my life. Not that it matters in the slightest. Had Covid three times and never really recovered from the first bout. Fitness ruined, get lethargic and brain fog and my stamina is shot to shit. My name’s Phill, I’m 45. Well done, you’ve just met someone at several removes who is suffering long term effects. I don’t even own an eBike either!
@radioman ironically the grades are set high partly to cut the numbers applying for medical school down to manageable numbers for the unis to make their selections.
@drac fair enough.
I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!
Don’t know a single person who died or suffered long term effects,
You can have some of mine then. Knew 7 people who died directly due to COVID-19 and know of another 6 who are living with long-term effects. The mental toll on the majority of people I know, including myself, won't become clear for another few years.
Don't trivialize a major event that has affected the whole country in unprecedented ways and has shown us the true value of the NHS at the very point where it's fighting for it's survival.
So your 80-year old dad wasn’t hospitalised or worse by covid because he was vaccinated.
We'll never know, will we? You, like others, seem to be confusing population level effects with individual responses. It's about taking personal responsibility for your health, and (as Dr P pointed out) realistic expectations for an ageing population. I look at things in the bigger picture. Like my dad, I agreed that individual Covid vaccination was better for the population as a whole. However, I actually don't agree with his decision about his knees on an individual level, because I think he'd get more quality of life from new knees than many people 20 years his junior. But, hey, it's his decision, and seen in the wider context (an ageing society unwilling to fund unlimited healthcare), it's maybe the right one.
As someone in my mid 50s, I've already made my choices. I've protected the NHS by keeping myself healthy all my life, and I absolutely will not add to society's burden in my latter years by turning into someone sitting in front of Teletubbies and Homes Under the Hammer, p!ssing myself into an adult nappie in a residential home, with family members absolving themselves of financial responsibility while simultaneously berating the caring professions.
Nope, that's not for me. My strategy is already in place, everyone who needs to know notified accordingly. Quality of life. Complicated, isn't it?
Care Homes are now accepting those from the NHS, but along with that they are bringing in covid, which, given the health of the folk there is causing more deaths. It's a terrible situation, but beds are blocked. I know this as I know somone working in a care home and 'floors' are being isolated dut to cases being brought in and of additionla deaths. Don't forget, flu is just as bad for the elderly and frail. You can't keep a hosptial bed full of people that can't really be 'improved' enough - we need more 'halfway homes' to take those that don't need intensive care.
I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!
A sad sign of the times... sureley they would be more likley to make a mistake with relatives interfering...just let them get on with it is the best thing you can do in that scenario?
I do know of a max fax surgeon who had a patient have an “episode” in his waiting room. He and his team started CPR, the patients relative started filming them with a phone in case they made a mistake!
Cool story.
As someone in my mid 50s, I’ve already made my choices. I’ve protected the NHS by keeping myself healthy all my life
what if you get hit by a car, beaten up, break a limb, get cancer, have a stroke, come down with the bad cat aids. You’ve not protected anything, you’ve been lucky. I know plenty of healthy people that have become ill or had accidents. Hell, I knew a couple who just dropped down dead.
what if you get hit by a car, beaten up, break a limb, get cancer, have a stroke, come down with the bad cat aids. You’ve not protected anything, you’ve been lucky.
No, I've been careful, stayed healthy, and, on the two occasions when I've broken bones, been very proactive in making a full and quick recovery (aided by being fit and healthy in the first place). In my mid 50s, I've already decided that if/when I get cancer, I'll turn down invasive treatment and go down the palliative care route. Like I say, realistic expectations and quality of life. You lot get too emotional about this stuff.
It actually goes against much of how nurses are trained to say ” this person is old and dying, don’t investigate or treat”
Agreed, and I think this is because the frail and elderly are, as far as medical training goes, a fairly new 'patient cohort'....
As such, the med profession aren't used to managing them....
We need global training, public awareness that there medical profession are NOT negligent for managing a bedbound 96 year old in a much less aggressive way when they get very ill, compared to a 56 year old with a potential recovery ahead of them!
DrP
Not emotional in the slightest. You’re just coming across as a bit condescending to be honest. As per above, you’ve been lucky is all. Yes, keeping fit will help but, as I’ve found out, it doesn’t always work out that way.
No, I’ve been careful, stayed healthy, and, on the two occasions when I’ve broken bones, been very proactive in making a full and quick recovery
What a Ledge
I have never had issues with the public on this issue - and the unit I used to work in was in general " no escalation". good medical team managing expectations helped as did a very strong proactive use of advanced care plans
IME is more the staff than the families that can't grasp this. It is not easy tho when asked. "whats wrong with them?" and you have to say " I don't know" I have had that conversation many times and had various techniques for guiding it in the right way
What a Ledge
Not the hero we want, but the hero we need. 🙄
No, I’ve been careful, stayed healthy, and, on the two occasions when I’ve broken bones, been very proactive in making a full and quick recovery
What a Ledge
The physio who helped me with the first break liked working on me because I didn't complain, just told her to get on with it. She also said 50-60% of her patients were suffering extended complications because they were overweight. Get as personal as you want, helps avoiding the real issues, right?
Just watching 'Ambulance' and you can see the time wasters - fuming.
Montgomery. when in a hole stop digging.
You are coming over as patronising and condescending and very irritating and also showing a total lack of grasp of the issues
Just watching ‘Ambulance’ and you can see the time wasters – fuming
24 Hours in A&E last night was an emotional one. Old boy with dementia came in with sudden breathing issues, turns out had an infection in his colon, developed sepsis. Was put on an EoL pathway. Wife was in bits. Clearly see the impact on the team, especially the consultant who had to relay the bad news.