Something about the like soft almost dream like lighting of this era of games just feels so much more comforting and inviting than todays hyper realistic graphics.
I've often felt this most with the Grand Theft Auto games, there was a level of visual abstraction in the III series that IV and V lost and trying to take in the world moving around you is too much.
Art is born out of limitations, if you only have a PS2 to work with you have to get creative to make it look good. Now you can just dump whatever you want into the game.
Everyone I know doing things like this has actual abysmal work output. They spend all their time playing with their toys and no time actually producing useful output.
I swear projects exactly like this were EVERYWHERE like 25 years ago. Couldn't throw a rock on the internet and not hit a MacOS Platinum theme/simulation layer for any given OS.
I used one for Windows back in the day that somehow successfully lifted the file menus (well for most apps) from your apps to the top of the screen.
> The people at my job who are most positive about AI are those who didn't particularly enjoy programming.
At least two people I've worked with have become "AI Influencers" on social media. They were two of the least capable programmers I had ever worked with. Both super nice people, and I enjoyed their company, but both generated absolutely terrible code.
I think there's generally something to people who were sidelined by their lack of skill feeling empowered by AI.
Why would anyone want a crime free society. I think anyone but a small child understands that a ton of things now and historically have been illegal that really just shouldn't be. Society functions as a whole through lack of enforcement of a large percentage of current laws.
Like 15 years ago now I had broken a filling. Went in to a new dentist because my insurance had changed. They told me I had 14 cavities, and 3 of my teeth needed crowns - and they were surprisingly rude about the whole ordeal.
Reading the reviews on Yelp, someone had said they had a similar experience with their first visit and went to a different dentist and were told they had none.
I decided to get a second opinion and heavens am I thankful I did. They replaced my filling right then and there and I think I've had maybe 3 cavities in the 15 years since.
I put very little faith in dentists to not be scam artists.
The part I find particularly … funny is the disagreements. I had one dentist who insisted I needed to be using a pre-rinse. That dentist ended up leaving, and a different dentist at THE SAME OFFICE told me it was a waste of money and I should stop because it does nothing. I swear they all just make it up as they go.
I've had multiple dentists tell me this rough tooth in the back of my mouth needed to be capped because it was "falling apart". I started using imported NovaMin on it out of curiosity and it became super smooth instead of rough and no one has mentioned it since.
One dentist I saw for a number of years would try to insist I needed a dental implant for a missing molar and if I didn't all my teeth were going to come out alignment. I didn't have money for it at the time. Not a single dentist before or since has mentioned this.
A journalist with Reader's Digest famously visited 50 dentists in 50 states and received WILDLY different diagnoses for... the same mouth, ranging from essentially "you have a single cavity you should get filled" to "you need 21 crowns for $30,000", and this was back in 1997:
I remember in the 90's a Swedish TV consumer rights show did the same thing with the same conclusion. And there was no correlation with if the dentist was a public health or private dentist, it was just a variation in their judgement rather than a "we want to make money" type of scam.
How can you have this widely different amount of cavities based on judgement? How are they not snake oil salesmen, if judgement makes the diagnosis different by magnitudes?
A cavity is just a hole or groove of various depth. It's probably less that one dentist sees a cavity and the other sees nothing and more that one dentist sees a cavity worth addressing the the other sees the beginning of a cavity that they figure will need to be addressed eventually, but there's not a major reason to do it now rather than next year or the year after that.
Also, I imagine some dentists might decide for their patients benefit (as long as there's no pain reported) to let a couple develop to a level is there's a few in various stages of development, so they can do them all at once with a single procedure.
I don't know how likely or accurate those are, but those are some of the obvious ways that came to mind that dentists might be seeing the same thing and suggesting different actions that don't boil down to them wanting to fleece a customer.
My dentist shows me the xray they take once every 5 years. Then they walk me through what a cavity would look like. Then they show me that i have none.
I can understand that the external "poke at it" method requires some judgment, but an xray shouldn't have that much variance.
That's why I also go get a "poke around and look" checkup every year. The X-ray is to spot deeper things, but you can't do that every year without the x-rays becoming a risk factor themselves.
In the United States, it is routine to get your mouth X-Ray’ed every 6 months when you go in for a cleaning. Dental plans include these checkups at no extra charge.
That's what I was led to believe by my dentist when I asked. I just checked danish national guidance, and they say the dose of x-rays is so low the increased risk is incalculable. Instead they say the dentist should only ever use an x-ray if they find it medically necessary out of a principle of minimization.
So it sounds like it's the individual dentists judgment, and their organizing body says that they base it on the occurrence of dental problems in the population the clinics they oversee, with some adjustments based on patient age and risk factors.
So according to Danish authorities, you should be safe getting x-ray'ed every 6 months. They just don't recommend it, since it's a waste.
Yet you are probably in the 90% of developers who cannot estimate properly.
I would like to have a professional judgement closer to how it's done in statics, instead of developers, since you fuck up lives directly with one, and usually not with the other one.
If you ask software development companies, plumbers, builders or lawyers to give an estimate of what some work might cost you'll probably get similar variations?
But that's more a matter of pricing. Not the basic parameters of the job.
Building a wall of known size takes X bricks, Y windows, etc. Contractor 1 might have more markup or estimate different hours to complete the job vs contractor 2 but the parameters of the job are relatively fixed.
The dentist is seeing the same mouth (wall) and telling you there is vastly different numbers of cavities (bricks/windows). And not off by a small margin, but orders of magnitude.
At least software development and laywering has 100s of parameters that can influence some work, even when the requirements are well specified ahead (and those almost always change later, or meet some changed reality).
Tell me you haven't worked in the trades without saying you haven't worked in the trades.
The older the building, the higher the chances stuff will go seriously, sometimes catastrophically with no chance of recovery, wrong. Say for the plumber, according to the plans or the knowledge of the building owner, there should be no more lead pipes left in the building. Lo and behold, you open the wall, and find a lead pipe still under pressure, and next to it a tap to somewhere else that doesn't show up on any plan.
Endboss is if you find asbestos. That turns a jobsite worth a week of work instantly into a hazmat site plus immediate concerns for OSHA aspects.
Or for electricians, the plan was to rip out the entire electrical work in an apartment, and you suddenly find out that half the rooms of the neighbor next to you suddenly don't have lights any more because for some unknown reason half of his apartment actually runs via your client's apartment and no one ever noticed. (In this case it turns out that decades ago, this was one giant apartment that was split as part of a divorce proceeding and then sold off separately)
You're describing the same plumber/electrician changing their estimate after getting more information. That's nearly the opposite of the dentist situation, where it's different dentists giving different estimates with the same information.
> Tell me you haven't worked in the trades without saying you haven't worked in the trades.
Tell me you missed the point without telling me you've missed the point.
Plumbers can give widely different estimates for the SAME job, with the same knowledge (initial or after finding out about all the asbestors, strange piping, and other issues).
Some plan for random bullshit beforehand, some milk you for each and every problem or change request, and some just mark up a "make it worth my time", e.g. if your installation is many decades old and they actually don't want the job or at least get comped very well for their trouble.
> it was just a variation in their judgement rather than a "we want to make money" type of scam.
Sure. I mean, dentists, unlike every other human, are not interested in making money, and would not abuse their position to give incorrect information that is in their benefit. /s
I had a dentist who preferred to see patients each 12 months for a relatively cheap routine check while avoiding doing anything if something was discovered during the check if that could wait. She fixed a minor cavity for me like after 4 years of checks. At some point she stopped accepting new patients because she had too many of them.
That's why I mentioned there was no difference seen with public health dentists. They are on a salary paid by the government and have a huge backlog, they have zero incentive to do more treatment than absolutely necessary.
Parent already covered dentists who are not making money by the widely differing diagoses, because they work for a set salary for non-for-profit government health coverage, and yet still do that.
That sounds like a similar story of taking a car to various places (including the official dealer) and getting wildly different and massively overpriced estimates for totally unnecessary work.
I had my car at a dealer. It was there so I asked for an estimate on a muffler fix. $7000. To be fair they also recommended trying the repair place down the street for that one.
i've told this story on here before but a dear friend of mine is a dental hygenist and worked for a very prominent dentist in ketchum (maybe hailey?), idaho. the hygienists were on a rev-share agreement to push every 'product' imaginable.
Call me crazy, but it’s almost like incentives to make money rather than good patient outcomes may just lead to a whole bunch of unnecessary treatments.
As a European, I can assure you we have the same problem. Healthcare providers still get payed by the insurance for the work they do, so there’s both an incentive to bill them for as much as possible and also to upsell special premium services the insurance won’t cover for, like better filling materials, invisible aligners, these kinds of things. As a layman, of course you never know if what they are offering you is really the right way, and asking different doctors for their opinion can also lead to wildly different diagnoses.
Perversely though, there is another incentive for doctors to spend as little time as possible with each patient, because they need to justify all time spent and procedures done to the insurance, which is naturally suspicious of the provider to overbill. Thus, they require tons of documentation the provider has to fill out, and neither that nor just talking to a patient for longer than usual are line items they get paid for, leading to appointments being as short as they can manage - usually rushing in, working through the list a medical assistant prepared, annoyedly answering a question if you can manage to slot it in, and rushing out to the next person.
Having a general sense of ease that a malade won’t ruin me or be a death sentence is a good thing, really, and I cannot imagine living another way. But we haven’t really figured it out yet fully either.
While some of that might be true for some countries with publicly funded dental care, it’s certainly not true for regular healthcare. Doctors are paid fixed salaries, there’s no incentive for them to perform unnecessary procedures. Quite the opposite in fact, departments have strict budgets and so they have a strong pressure to ensure all procedures are medically justifiable, and cheaper / simpler / preventative options have been tried first.
Individual doctors working for a clinic are paid a flat salary, true - but the clinics themselves, or the small doctors running their own office are absolutely dependent on accurate billing to the insurances. They have an incentive to optimise their margins, even if patients are not paying directly, and that means both trying to spend as little on care as possible while getting back as much as possible from the insurance providers.
It sounds like you’re describing a country with a public-private hybrid system. Certainly in the UK and the Nordics, the systems I’m most familiar with, there is no “getting back as much as possible from the insurance providers”, as there are no insurance providers. The hospitals are run by the government, funded by regional governments, and have fixed yearly budgets, not treatment dependent billing. The only exception is some privately run GP clinics that may bill per service rendered.
People say 'Europe', speak as if their experience is the same across the continent, and anyone with a different experience is somehow not in the Europe they mean. It's very annoying.
European healthcare is run very differently across the continent. 'Insurance' can mean a [state] social insurance institute that the doctor must bill. Some countries would employ the doctor directly as part of a nationalised health system. Some places it might be the municipality or city that would then get some subsidy from central government. Some it is a mix of all of this. 'Free' healthcare might actually mean a few hundred Euros, or literally nothing.
This! We went to a pediatric dentist with my kid on Monday, with a referral from another dentist, both private. After small talk, their first proper question was: "Do you have insurance?". Before I could respond, my wife responded affirmatively. Insurance here in Ireland means private insurance. After an x-ray, we were presented with a menu of treatment options ranging from around €2k to €5k.
Later I requested the clinic to share the x-ray with me and consulted with another pediatric dentist from another EU country. His assessment was completely different, and recommended very minimal intervention.
My point was that for the specific critique raised here, the European (or the be exact, the German) healthcare system doesn’t really offer much of an improvement, but suffers from similar problems. The fact that you don’t pay yourself doesn’t change the incentives medical professionals have in terms of getting paid for their work.
The UK has the opposite problem. You don't get overtreated, but you may get undertreated - sometimes it is impossible to find a NHS dentist at all. Indeed, I went private because I literally couldn't find one after my old one sacked me. The private dentists probably have the same problems as described here. But I luckily found a small, nice, ethical one who was recommended by people in town I trust. Literal word-of-mouth still beats any algorithm I know for this kind of question.
Honestly, I think it can happen anywhere - I've had several fillings for very marginal cavities from an NHS dentist that probably weren't necessary.
Part of the reason is that fashions change... that dentist was trained at a time when minor cavities were always treated as soon as they were noticed, but the more recent recommendation is to monitor and treat only if it gets worse.
For what it's worth, the same thing happens with physicians.
For some reason when I was living in Jersey City about 7 years ago, there was a lack of dermatologists in the area that took my insurance and were also taking new patients. I finally found one, made an appointment, and went in for a full skin exam. I waited for about 20 minutes after my appointment time, finally was called in, the dermatologist commented that someone my age (late 20s) shouldn't have any acne on their chest and tried to prescribe and sell me a bunch of ointments directly from his office. He spent maybe 2 minutes looking at me and definitely didn't do a full skin exam.
A couple of years ago I moved and had to find a new PCP. Went to the first one I could find that was close-ish and took my insurance. While I'm in the waiting room, I see 50% of the people leaving with these packs of meal replacement shakes for weight loss. When I was finally called back, I see a bunch of signs about subscriptions for the shakes and all of the different flavors they had. I ended up getting a physical from the PA in the office instead of the physician that I had made my appointment with. I have nothing against PAs or NPs, but I expect to see the physician I make my appointment with. The whole thing was so shady that I ended up just finding a new PCP.
Dermatologists are hit or miss. I had one years ago who had her own practice. Her office was fancy and filled with skincare products; I guess her main clienteles were women wanting better looking skin. But she was good. She looked at the symptom for a minute, prescribed a cream, and gave detail instruction on how to apply it. The whole visit was less than 5 minutes. My skin condition plaguing me for several years were gone within two weeks.
Years later I had dermatologists in hospitals who were bad to useless. The only good one was a new graduate doing substitution shift for my dermatologist who was on leave. The sub prescribed medication that actually work.
That's even relative to the condition you have. The right match of doctor to condition gives you the right treatment. But the same doctor facing a different condition might be clueless. From that angle, the whole situation looks less weird.
The quality of a doctor then could be measured in how many conditions they are good at, maybe weighted by likelihood of occurrence, as well as how self aware they are about whether they have a clue or not.
A corrollary is that a single data point does not tell you much. "Go to this dermatologist, they are great" is only good advice if you have the same condition as the recommender as their sample size is likely very small.
And it's not just scams for $, it's missing standard care.
My father (80) and I have the same (genetic) heart condition. My current and previous cardiologist (due to a move) ordered a week long heart rhythm recorder, noting that doing this every 2-3 years was the standard of care for the condition, to catch irregularities before they become serious.
My father's current and 2 previous cardiologists did not. They ended up having to do an urgent pacemaker implant since he was frequently on the verge of passing out in his apartment due to an irregular rhythm.
> noting that doing this every 2-3 years was the standard of care for the condition
You can't predict when a medical emergency will happen. It's not surprising that someone in their 80s got worse over time. It's unfortunate that he had a condition that caused fainting, but we can't monitor everything around the clock lest something happens.
You cannot give every patient a defib or pacemaker the moment any tiny deviation from normal is detected. If you did, it would lead to more deaths due to complications and excess pain. There has to be a line drawn, and unfortunately that requires exhibiting a serious symptom first.
Should every child carry an asthma inhaler because they might have asthma? No, they have to show signs first. It's unfortunate we cannot prevent all suffering but it's impossible and or impractical.
I'm saying they should have done the (week long) recording every 2-3 years, which is standard. This would almost certainly have given them some advance understanding of the issue.
One of the reasons I am an anesthesiologist is that while you might have issues with the surgeon or the surgery, I find that very few people decline my services. If anything, they generally want more.
My father-in-law once asked me how long it would take to teach him how to put people to sleep. I said, five minutes, but if you want them to wake up at the end, a lot longer.
I interpret that as they lose people all the time, but if you come into the ER with 10 bullet holes in you or after coming to a grinding halt on the freeway after a head on collision, they don't expect you to make it and it's not the sleepy drugs at fault.
Here's a thing humans do: They knew what they meant, but saw an amusing way it could be parsed, and said that, because it's amusing. We all knew what the comment really meant.
There's actually a few ways it could have been meant, or it could have been meant to convey all of them. We all have a pretty good idea in the general sense what they meant, but that amusing reply is also an invitation for the person to elaborate and add nuance.
They probably do. Not all medical procedures have a greater than 50% expected chance of survival, but it still might be better than the alternative. That doesn't necessarily mean the anesthesiologist is the once responsible for the death, nor that anyone is, for that matter.
I have a friend that is a retired anesthesiologist.
He made very good money, in his day, but, apparently, the malpractice insurance for anesthesiologists, is sky-high.
I am fortunate to have a very good dentist, these days. This was not always the case. I have two crowns, and I believe they are both from dentists that caused tooth damage, on purpose.
Was always a childhood plan to do anaesthetics. Always fascinated me. But I did get to spend time as a paramedic and did many a rapid sequence induction. I never met an anaesthetist who wasn't happy to share time and knowledge when we had to do periodic tubes for recert or CE. So I appreciate you.
Dermatologists (at least, the mundane sort you come across in a suburban office park) are another matter entirely. I assume it comes from doing a lot of elective work for wealthy people who are concerned with their appearance rather than their health. The PCP is more surprising to me.
Otoh the Derm I go to is the most pleasant experience I have in medical care. Super nice office, very pleasant chatter, quick full body check in and out. Something to be said about wealthy elective care subsidizing my healthcare experience.
> They told me I had 14 cavities, and 3 of my teeth needed crowns
A few years ago there was a story floating around about a young dentist who purchased a practice from a retiring dentist, and the practice wasn't making as much money as it should have.
He reviewed patient records and realized that the prior dentist was performing a lot of unnecessary procedures; and contacted the patients. Some patients had persistant pain from the unnecessary procedures, too.
There was at least one lawsuit, from what I remember. I think it had to do with the prior dentist misrepresenting the business's value.
The seller was performing the unnecessary procedures and the practice value was based on that revenue. The buyer was ethical and therefore revenue was lower than expected.
My wife had a similar experience. Went to a new dentist (A) that had good reviews, high tech facility, etc, said she had 7 cavities. Thought that was a bit odd (and high), so asked friends for recommendations on a second opinion.
Second opinion dentist (B) says she doesn't have any cavities. Wife mentions how dentist A said she had 7 cavities and mentions his name. Turns out dentist B was a professor at Uni and taught dentist A. Dentist B remarked "Dentist A was always an ambitious student".
Wife has had 1 cavity since we switched to Dentist B 15 years ago now. He's been the best dentist we've ever had. The funny part is if dentist A had told her 2 cavities instead of 7 initially, she probably would have stayed with him. But 7? He got too greedy.
I dated a dentist for a while. She found (and filled) more cavities than any dentist prior or post. No profit motive. She was also a high achiever. I posit that they are seeing cavities, but there's a large and subjective gap between "we should do something about it now" and "it can wait a long time before we need to consider work." Some cavities are tiny and never grow with proper oral hygiene. The "correct" approach is probably to fill them because it arrests any future risk.
> The "correct" approach is probably to fill them because it arrests any future risk.
But it doesn't. A filling has an expected lifetime. A good proportion of them will eventually crack, dry up, or fall out, or bacteria will find a way in. It may well be that a sufficiently well executed filling will reduce the overall risk, I don't know, but filling overall are by no means risk free.
Yea, there are good ones out there. I had a horrible experience with unnecessary work done because I didn't know any better, drilled too deep, root canal, then installed a crown that cracked. Told me everything had to be filled.
Next dentist basically just said I need regular cleanings, or to learn to floss better. I've been going to him for 10 years now. Recommended lots of people to him.
Another signal is, how nice is their office? Is it a little converted bungalow with drop ceilings? Or a big modern monstrosity with floor ceiling windows.
I've also had experience bringing a friend to Mexico to get work done, which worked out well. Ended up saving a bunch of money, got the work done that day.
Im at a well known megaprofessional dentist,priced "a little above the average" if you want something unusual.
One day, we started to initiate "small project" for some teeth, involving some additonal costs for "beauty-stuff". The accounting appartment(!!!!) of them adviced me to get whatever-XY-insurance before the first step is done to save some costs.
On the first day in the morning when step 1 started, I talked to the doc about this advice - she said: "I do not know what they thought but this is a dentist, not an insurance reseller. I do not suggest to do this, you wont need it in your case."
When I was in my early 20s I hadn't been to the dentist in a few years, couldn't see my old reliable one, but visiting family I was encouraged to make an appointment with a new one during the trip. He wanted to fix I think 13 cavities. And I regret that I let him... Afterwards for quite some time, I could no longer enjoy jerky or other things that needed more than usual chewing as it would cause pain, and I think a lot of the gaps between my teeth got tighter. Makes me a bit sad every time I see my xrays how much real tooth material is gone.
My main filter since then is what it should have been before, and that's basically whether a dentist mentions biomimetic dentistry on their site somewhere (clarity edit: a good sign). I had a new dentist for some years I liked but he moved offices even further away, I found a decent runner up locally who I've been mostly happy with for years. He's also happy to take a wait and see approach on some things.
I went to a dentist in one of the new dental clinic "chains" that recently opened at my place, regarding some pain in the jaw, and they suggested to pull out a molar, and if the pain does not disappear, then suggested to take an X-ray.
I excused myself nicely, and went to someone I know for a long time, and they figured that the pain was due to the fact that I was using one side more than the other when chewing. And fixing that fixed it...
I had serious calf pain. The experts were advising orthotics and special shoes. Long story short, turns out the experts were wrong and ChatGPT diagnosed it correctly in a few minutes. It was caused by me pointing my toes while I was in bed. After loosening my sheets and consciously keeping my feet at a right angle, the pain has permanently disappeared.
> I went to a dentist in one of the new dental clinic "chains" that recently opened at my place, regarding some pain in the jaw, and they suggested to pull out a molar, and if the pain does not disappear, then suggested to take an X-ray.
The dentist suggested pulling out the tooth first and then doing an x-ray?
Regulations help if they are enforced. But it usually works that customers need to raise a complain, but customers do not have the knowledge to validate the dentists claims.
Regular inspections reward good doctors and punish bad ones. A lawless society rewards bad practice. So, bad practice grows and it is just limited by individuals that prefer to earn less but treat their patients with dignity. And they pay a price for helping you.
Profit incentives work great for the person paying. The problem is you are no longer the person paying, your insurance is. And insurance pays for filling cavities, they pay nearly nothing for preventative services.
It's easy to say add inspections. What specific regulations/laws would you put in place and how do you prevent regulatory capture?
I had multiple similar experiences and I’ve had deep mistrust of dentists since.
I had an amazing dentist while I lived in Japan, never upsold. There was a complication after a root canal (which I heard is just inherent possibility) and then they took full accountability and fixed the issue without charging me a dime.
Now I’m back from Japan and the first dentist tries to sell me some toothpaste and toothbrush wtf
I've found that the mentally around medicine in JP is pretty different to the west, dentistry included.
It's a bit different to the quality of care.
Personally I'd say the quality and availability of the latest technologies is limited, but the honesty around up selling and responsibility for ongoing outcomes resulting from their intervention is better.
There are some other aspects, like the general bias against intervention in JP.
Oh really? My wife and I went to different dentists. I went to one in CBD and she went to one in our town and we both thought they were amazing compared to what we got in NZ.
I went to a dentist 10 years ago because I had some pain eating candy, they told me I needed to get my wisdom teeth removed because there was a cavity forming from where the teeth were impacting..
I went to a surgeon and got them removed, due to which I developed a sinus infection that needed to be scraped out surgically under general anesthesia, after all that I went back to the original dentist and when they looked, they didn't see anything there...
I definitely wish I'd gotten a second opinion and saved myself a lot of pain and money.
If it makes you feel better, it's usually a matter of when, not if, cavities form between the impacted wisdom teeth and the back molars. They're usually very difficult to clean properly each day. If cavities do form, they can be difficult to fill, and they're often bad enough they require root canals or extraction. Which means you now have no wisdom tooth and no rear molars.
I like to avoid dentists with flashy “STATE OF THE ART WHITENING/IMPLANTS” advertising and gleaming new expensive equipment. They need to make payments on all that stuff, so they’ll go looking for problems that aren’t there.
My erstwhile dentist had a quite unassuming office that seemed to be a quite low-rent neighborhood, and all his equipment was rather ordinary and well-aged. Although he had invested in a modern 3D full-head scanning system, that's not unusual. And the front office tended to do everything on paper, had no patient portal, etc. But they were very good at what they did.
However, he was always pressuring me for more work and more profitable work. And here's the thing: all of the art in every room of the office was his own photography. These were large painting-size photo prints, and they were all taken on holiday, every single one in an exotic location. Ancient ruins, sheep in pasture in Ireland. He and his entire family were inveterate tourists and loved the outdoors. He also had at least 3 children, so not just a DINK household!
Also, and I learned this on the first visit: his mother was also a dentist, and her name/patroness was that of the Hindu goddess of wealth and money. The signs were there all along, just really subtle!
>One dentist I saw for a number of years would try to insist I needed a dental implant for a missing molar and if I didn't all my teeth were going to come out alignment.
I'm in the same situation! I had an impacted molar when I got my wisdom teeth removed, and this dentist who is otherwise okay mentions it every time. I'm skeptical of its necessity and nice to see someone in the same boat
Thats a US thing;
in Europe dentists do not try to "upsell" you any stuff, usually; for sure there are some shady practitioners, but their number is small. This behaviour is induced to how the local health schemes over here work: The doctor usually does not have an incentive to sell more stuff.
My experience from Denmark and Belgium is that dentists here will definitely disagree a lot.
I had one dentist tell me I needed 6 cavities filled. Let him do two and then went to another dentist who told me all my teeth were good. I've only ever had problems with the two teeth the first guy drilled.
Later a dentist wanted to drill another few teeth that were hurting. I instead got a better toothbrush and all the issues went away.
I Denmark we're talking about including dentistry in the national healthcare. I wonder if that will clean up the business or make it worse.
It’s interesting how many people report issues with drills + fillings. I’m 44 and had my share, but never had a single issue. Had three dentists in my life (due to moving). I don’t have anything negative to say, except for the German dentist I had for a few years, because he never did anything, not even a good cleaning, only checks.
Thats not true in Spain as well... i have had complete different diagnosis between different dentists, even in the same office, some trying to up sell a bunch of stuff that i would have to pay out of pocket.
Wrong, why do people think they can speak for a whole continent? There's good and bad ones and the bad ones are as bad as US. I have many similar stories.
I've been getting told my wisdom teeth need to be pulled out for the last 20 years for example, never touched them, no issues.
I don't want to defend dentists too much as I also have mostly negative experiences with them, but I heard recently that when you either haven't been in for a long time or it's your first time at that dentist, they're more likely to want to fix stuff they'd otherwise just mark "watch" or give you a warning about, in case you don't come back. I went in for the first time in over 5 years a few months ago, I had no tooth pain or anything (which is notable because I've had sensitivity the dentists couldn't fix for years, thanks n-Ha toothpaste), they told me I had 6 cavities, I think. They also wanted to push their extra fluoride toothpaste on me, but I'd used it before with no luck so I said no to that. I got the fillings because honestly I might not be back for another 5 years, my health insurance is spotty. Short term I felt a bit worse, but the newly filled teeth normalized after a week or two. The most noticeable were my canines, they're more smooth and blunted at the tips now. In hindsight I think I did have small holes on both that I could feel with my tongue, but it'd been that way for years and didn't hurt.
It just so happened it didn't cost me a dime, or else I was ready to walk. In fact the reason I didn't get their toothpaste just to be polite is because it was gonna be $12 or something and I was worried I might have to pay out of pocket, for something I knew I wouldn't use.
Oh yeah, but the worst part of going in after all that time was actually the x-rays. The thing they stick in your mouth caused me significant eye-watering pain. I think they had to take over 25 pictures and some were messed up and had to be redone on top of that. Some tool they used, I forget if it was a brush or a drill or what, also made a horrible high pitched whine that was really rough on my ears.
I had skin abnormalities 3 times in my life, with years between them, minor things, but they served as interesting experiments:
In all the 3 times I had no idea of what was the phenomenon, but I went to 2 different doctors for diagnosis, 3 doctors in one of the cases. Every doctor said a completely different thing. In one of the cases the doctor applied a bunch of weird allergy tests and concluded that he didn't know, but didn't confess this, instead he looked up a quick article on the internet in front of me, not realizing I was noticing, and recommended me some bogus solution.
I've implemented every of their suggested solutions and remedies, none of them ever resulted in any visible improvement and I abandoned them after a couple of weeks.
All the 3 skin abnormalities faded after a while (2 months in one case, around 6 months in another and around 1 year on the other) with no treatment.
I had a dentist once tell me they needed to graft my entire gumline with bovine tissue. Never been mentioned since, so I explicitly ask now and there's been no more concerns.
I had a root canal done on a molar when I was ~16 that a dentist in basic training said needed re-done, because it wasn't done correctly. At a different duty station a couple of years later it was required that it me redone again because it wasn't done correctly the second time. Years later a civilian dentist wanted to re-do it again, because it apparently wasn't done correctly the third time. I had never had any problems whatsoever with the tooth since the first root canal.
> I needed a dental implant for a missing molar and if I didn't all my teeth were going to come out alignment. I didn't have money for it at the time. Not a single dentist before or since has mentioned this.
I have a missing the permanent teeth molar in both sides of my lower-jaw, I wore dentures for those missing teeth from 12 (when the baby molars were removed) until around 22 years old when I got implants (at a separate dentist, since the one I went to didn't do this kind of procedure).
I am pretty sure that was the correct decision from my dentist, but boy was it painful to get those molar implants because my jaw-bone was so weak in that area after so many years of having a gap in there.
If you have had a missing molar for a long time your teeth probably already moved what they were going to move and if that didn't cause a problem in alignment it probably won't happen.
There's serious arbitrage available for a startup to come in and help with this mess. Like: scan your mouth with your iphone and get a recommendation. I'll be called crazy, but ...
The last dentist I went to had serious bro energy and insulted me to my face a few times. They lied about a treatment and tried to get me to pay for it on the last day of the month shortly before I actually got it done (presumably so that they could book the revenue and do something sheisty with their numbers). They have a 4.9 rating on all major review platforms so I can only imagine what shenanigans they pulled to achieve that.
I just switched providers and pray that I have a better experience with this new one.
Yeah, took a look at your legacy codebase. Lots of deadwood, spaghetti, misalignments. I'd even say there was skeletal deformities in the architecture. If I was your uncle, I'd say it needed at least two full rewrites. Yeah, two, because the first rewrite will suffer from second system syndrome. You don't want that. Better to plan for both rewrites ahead of time.
> The part I find particularly … funny is the disagreements.
Does anybody else find it hillarious that this statement could just as well apply to programming, or even software engineering in its entirety? We the HN crowd should be in a perfect position to be able to understand, emphasize and even explain how this is possible and maybe that it is not that surprising.
Let anyone who has never said “this old big ball of mud isn’t even worth fixing, the only move forward is to completely throw it away and rewrite it from scratch!” cast the first stone.
I found a dentist that wasn't, they even cut my bill from time to time from what the expected cost was going to be. They never up-sell me on the most expensive treatment. She's very kind and puts my comfort first.
I've been going to her for 20 years, even since I moved away - I will drive 1.5 hours in awful traffic to go see her, because other dentists just can't compare.
I tried a local dentist one time when I moved away, they sucked, badly. I went right back to my old dentist even though the drive is long. I'll never use another dentist as long as I live. I've referred friends to her, and they've had great service too.
This scam is as old as the hills. In the 70's my family's dentist gave us root canals all the time. He was later arrested for a bunch of fraud and drugs. Old co-workers later testified against him saying he made up cavities and root canals.
I had three root canals by him I probably did not need.
Not been to a dentist in 20 years (I am late 50's), no issues.
Oh you should see the current thing that dentists are using to capture revenue. They're force spamming their clients to "confirm" appointments, cancelling if you don't do this. ON top of that, don't visit them for 7 years, they'll spam you with more messages that you're over due. Then they'll gaslight you on a poor review that they get for this practice.
> That dentist ended up leaving, and a different dentist at THE SAME OFFICE told me it was a waste of money and I should stop because it does nothing. I swear they all just make it up as they go.
No some make things up, some do and excellent job an tell you that this is nonsense. Same like any other profession.
Any non-US Sensodyne Repair and Protect. You can get them off Amazon at a premium price. They will all claim to be Canadian but you will almost certainly get Turkish or Indian. However for you this doesn’t matter because they have the same active ingredient.
I use this stuff and it is really surprisingly effective. I have no idea if it will turn my tonsils into concrete or something down the road, but it does work.
Having similar experiences to yours in the past, I would suggest oh they know for sure what they do. All of it is a deliberate scam game.
I was lucky to find a decent dentist (and human being). And while I am not living in the country anymore, I still fly in for dental work.
Before you ask, I did try to find a replacement and it was just like you said - oh you have 25 cavities, 5 of them life threatening if we don't deal with it right now. Went back to my dentist and we laughed it out.
Its very unfortunate our healthcare is full of scam artists, with concentration of scammers likely comparable to scam call centers.
I’ve certainly encountered healthcare providers whose motives seem more about profit than best outcomes. In my teens an orthodontist tried to pressure me into having jaw surgery to correct a 5mm overbite.
They did that to my mum in the swiss when she was young. Swiss (had/has?) a deal for dentists, that is similar to that for airplane pilots - so you come out of studying with a ton of debt. She was a privat paying patient - and she got no 2nd opinion- so the guy drilled up perfectly healthy teeth and added fillings where he could. That rudeness is the bad conciousness - for using clueless patients to repair yourself financially.
There are prescription-only high-fluoride toothpastes. Excessive fluoride (more than you can get from Act + normal fluoride toothpaste) can cause fluorosis, which ends up being bad for the teeth. Normal amounts of fluoride are good for the teeth. The prescription-only toothpastes have enough that you don't want to use them regularly for a long period. As with most things, the dose makes the poison. Some dentists prescribe them even when they're not needed, since it won't be harmful to use a tube of the stuff every year, or even every 6 months, and it's profitable to them.
I thought it was floss -> mouthwash -> brush, but either way brush was always last because the toothpaste fluoride is what you wanted left on your teeth at the end of the process with the mouthwash serving as a base layer.
I think the most important thing is to make sure your process leaves a fluoridated product in your mouth at the end. You want the fluoride to stay on your teeth for 30 minutes.
I’m 40, have virtually never flossed, and I’ve never had any cavities or other tooth problems. I honestly wonder about the whole flossing and cleaning ideas.
If you are lucky enough to have very straight and packed teeth, there is very little room between your teeth for any food to be lodged in.
I used to never floss then one day I tried it and it took me 3 weeks of flossing before the wire came out clean and odorless.
That sounds like decent sized gaps between the teeth, wide jaw, not eating a ton of (sweet) stuff that gets stuck, etc. Or just lucky genes in general. YMMV.
E.g. there are many examples of people chain-smoking until the ripe age of 90+ and never having lung problems, but that does not invalidate the other 95% of the bell curve.
I have heard of Step 3 too, but shouldn't we bit at least a little bit concerned about the fluoride calcifying our pineal gland? I know some people might take my last sentence and think it's woo-ey but if you search it up, basically it seems like there's nothing conclusive one way or another.
> Some dentists prescribe them even when they're not needed, since it won't be harmful to use a tube of the stuff every year, or even every 6 months, and it's profitable to them.
How is it profitable for them? If I get a prescription from my dentist and fill it at a pharmacy, how does my dentist make extra money from that transaction?
3. Even if the dentist’s drug rep was interested in committing a felony. Fluoride toothpaste doesn’t have enough profit margin to send dentists on expenses paid international vacations. We’re definitely not talking about enough money to risk jail time.
4. Most physician groups and hospitals prohibit taking money from pharmaceutical companies or at least low limits.
5. My wife is a physician and most of our friends are physicians. No one that either of us knows has ever gone on drug company sponsored conference trip.
6. I always check my physicians and dentists on the open payments site. I’ve never seen any of them taking more than a few bucks for meals.
Insisting on more fluoride is basically the hallmark of stupidity.
There are special fluoride gels in Germany that you must only use once per week so in the end it doesn't really change anything if you don't have access to them.
What really makes a difference is getting bio glass or hydroxyapatite or recaldent and switching between fluoride and the previous stuff once per day.
Also, cavities bacteria cannot digest xylitol so a mouth wash with xylitol will significantly reduce the presence of them. Another thing that helps against cavities is taking an oral probiotic once a year to reset your mouth microbiome.
Also another thing, the most common source of "invisible mouth pain" near the root of your teeth is either swollen gums aka gingivitis or just straight up bruxism. Of course you might also have sensitive teeth but that is a solved problem if you use hydroxyapatite.
Prescription grade tooth paste with high fluoride or prescription grade mouth wash with chlorhexidine meanwhile are not that good long term and only used for their acute treatment potential.
Benefits of Xylitol for teeth were discovered in Finland in 1970s see link below. In Finland I think by now most candy can be bought either in the xylitol- or non-xylitol version. If this was the case also in the US I suspect it could have a major impact on national (dental) health.
And here's a question: Do dentists promote the use of Xylitol? If not, why not?
I have done a bit of a changeup, in the mornings I use a novamin+fluoride based toothpaste, at night before bed I use an nhap+xylitol based (non-fluoride) toothpaste and it's been flying colors and no cavities for years. Takes care of cold/sweets sensitivity too. I floss every couple of days. I also use a cheap braun electric toothbrush with 2 minute timer. I don't see why anyone needs a $100 bluetooth tracking toothbrush tbh. Anyway, may your teeth always be a natural teeth color and you be cavity free :)
> Using HTTP/1 (GODEBUG=http2client=0), calling this function 100 times against index.golang.org takes ~710 milliseconds on Go 1.26 on my machine. On Go 1.27, the same program takes ~150 milliseconds.
Does this mean I need to disable http2 for this to work or is that just a further proof that http2 isn't actually being used?
As explained in the post, you don’t need any of this in HTTP/2, since you get the benefits of connection sharing without having to read the drain connection body by protocol design
Right. Although the article demonstrates the changes by making requests of a public web server, I would imagine this change has been primarily motivated by a desire to reduce overhead and latency on internal communication between microservices, which very often uses unencrypted HTTP/1 traffic.
HTTP/2 works differently, you can multiplex and prioritize different data over one TCP connection with HTTP/2. But 60-70% of the web is still HTTP/1 IIRC.
> You can have up to six members of the household enrolled on Apple HomeView through the Home app. They each must have an Apple Account and an iPhone or iPad running the latest software.
I assume my kids will be able to use it without an iPhone?
Only your iKids, which are based on frontier models and can fully replace your actual kids for conversation and emotional connection without ever leaving a mess behind them you have to ask them 17 times to clean up.
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