>But also going to the dentist already isn't exactly pleasant, the pokes, scrapes, drill noises, etc. Maybe we improve that first before sticking it in a robot?
Dentists are definitely trying. The drills have gotten smaller and gentler, my dentist (and many others) offers a headset so you can listen to music/podcasts while getting your cleaning, and overall they make an effort to be less scoldy and more encouragey.
The process itself is still kind of naturally unpleasant, and the billing sucks, but the people seem to have taken traditional criticisms to heart and made some moves to make it suck less.
There are a lot of fields like this, where they have mostly been reduced to refinements but ultimately are still very barbaric procedures. All we've done is upgrade the stick (in this case, a nice shiny pick), but the procedure hasn't changed much at all.
Too much of dentistry is still stuck on instant fix solutions. Take hard metal, scrape teeth. Something wrong on inside, just drill into it scrape it out and fill it. Dental implants were the last major invention and that was what, in the 60s? There really needs to be far more money and research in the field, because there is ample opportunity for major improvements here as it's lagging so far behind other health fields.
There's huge inertia to change in Dentistry, we know that drilling and filling is basically the worst way to fix teeth. It's firmly established that ART/HVGIC is a much simpler and superior method for 95% of issues. Could be nearly 100% with proper patient education. The ART proponents have been saying this for 30 years, but it's now too hard to deny the superiority. You don't hear Dentist advocating for it though, instead they push fillings, crowns and root canals. Because the majority of a dentist work is actually repairing the inevitable problems that drilling and filling will cause. Drilled teeth will almost certainly need to be refilled and at a larger portion each time.
Loads of studies that show the effectiveness of ART just as well as composites.
And the difference is Novocaine shots and drilling out a tooth vs no numbing need, minimal cleaning with a pick and toothbrush and then essentially placing a ball of putty in the cavity. A ball of putty which actually chemically bonds with the tooth and releases fluoride to rebuild enamel.
But it's hard to charge $350 for something anyone with two fingers can do in about 15 minutes. And then of course if it breaks or comes out the fix isn't drilling an even larger area, it's just filling a smaller hole with putty.
So what you're saying is, the dental industry is ripe for disruption by someone who can set up a fancy office and hire a half competent nurse? Come on, YCombinator, do your thing.
Nope the regulation is too strict. You either must be a dentist or a hygienist to do any sort of dental work and there are strict limits on what a hygienist can do. To avoid regulation you must have an actual dentist doing everything. Now, the robot angle may open something up. There is already innovation in the manner you are thinking, but it's private equity basically buying the cheapest / worst dentist they can and scheduling them to do like 60 fillings a day in a different location each day of the week. Obviously the goal is extracting the most profit though. They will push all the most expensive procedures that non-dentist can do like periodontal debridement and measuring the gums etc.
At some point, you bottom out on the reality that we are all just big bags of meat and bones. No amount of technology or AI will change the fact that we are material objects who sometimes have problems with that composition and structure of that material.
That hasn't stopped other fields. You can get skin patches that utilize micro-needles to inject serum into your pimple, reducing the need to wait for pimples to "naturally" disappear. This was previously thought to be wildly unaffordable. Didn't we just get a new breakthrough for hair regeneration earlier this year using similar techniques?
Fact of the matter is, dentristry has lagged so far behind other fields because there's a lack of care for it. Dental is often not even considered "healthcare", despite how important oral health is to general health. It's also the easiest to hide, who cares about actual rotting teeth just sharpen them down and replace them with plastic. Whereas things like skincare and hair get far more priority due to being visible. Of course there's also the severity, people don't care if their teeth disintigrate, but a broken leg is a broken leg and gets handled appropriately.
Maybe it's because dermatology is much less risky since you're talking about a surface level treatment for a very small part of a very large organ. With dentistry, you're going into an orifice that humans must use to survive and directly interacting with the only place in the human body where bone is exposed to the outside environment. The risks are huge. You can die of heart failure if bacteria gets into your gums.
> a broken leg is a broken leg and gets handled appropriately.
Funny that you say that because I'm currently stuck on my couch with a broken ankle, unable to walk for the past two months. I'm very grateful for the quality of care I've gotten, but seeing the X-rays with three metal plates and 18 screws going into my bones sure as heck does look barbaric. But when chunks of bone snapped off and need to be put back in the right place and forcibly held there, maybe that's the best you can do.
Add decent calcium processing/distribution. I get too much calcium deposit and vit D+K basically fixed my dental issues. Unfortunately it took 30 years for a dentist to tell me about that.
This has not been the case in my experience. Dentists have always told me exactly how much I owe them, and the one time I forgot a payment, they called me and texted me to let me know and I resolved it in a matter of minutes.
Meanwhile a hospital visit sent me a bunch of bills in the mail ranging from $50 to $100, they refused to tell me the total sum even when I visited in person, and when I missed one $50 payment I was sent to collections a year later.
Perhaps they were referring to the idea that dental "insurance" doesn't cover more than a set amount which is far under the price of most dental surgeries. It is only intended to cover preventative maintenance. As far as I am aware, there is no way to get actual insurance for teeth in the US, even via medical insurance.
I don't know about US and it's healthcare system, but in many countries changing dentists is really easy because it's not tied to your healthcare, just pay out of pocket kind of situation. People discuss dentists, they give recommendations to friends, so it's a pretty efficient market. And people pay a lot of attention to how scary or not scary their procedure was.
In the US, dentists and optometrists are separate from our health insurance system, and have their own insurance. Dental insurance usually covers cleaning every six months, and some percentage of the minimum possible correction for things that need work. For example, they may cover 50% of having the tooth pulled but 0% of putting in an implant, because the implant is considered cosmetic and not necessary work.
Anyway, it ends up being like you say, it's a largely out of pocket service that people shop around for.
> and overall they make an effort to be less scoldy and more encouragey.
Oh, 100%. Yeah there has for sure been progress. I do also recognize that my anxiety is not just "oh I don't like the dentist", I was lied too. That breaks that trust.
I remember before I found my current dentist, I was having a ton of pain and I tried to find someone. I called them, explained the situation, explained the anxiety and where it was coming from. They reassured me, we have someone who knows how to help with that.
I went there, the dentist came in, I again explained the anxiety and where it came from. This was meant to be a, get comfortable thing. It wasn't a cleaning, just talking. He decides the entire time that he was feeling around my mouth with his fingers, he would hold the scraping tool inches from my face. And then, right at the end to purposefully do a quick little scrape as if, its not big deal see its not that bad.
I just got through telling you I was lied too, that is not the time to do something without telling me that you said you were not going to do to try to convince me that "its not that bad". And then he was like, yeah so we have time if you want to get a cleaning. I have not wanted to get up and leave as quick as I had in that situation in my life, never went back...
That is a rant, sorry about that. But that moment is burned into my brain.
I was so thankful to find my current dentist. When I told them, the dentist called me while I was at home to talk to me in my space that I am comfortable in. Then when I got there I just sat in the chair for a while talking, not laying back, my feet were at the side.
Only slightly related, I have a really bad thing with dental dams, clamps, and anything blocking my mouth - I get really paranoid im going to choke and die - and start overthinking swallowing my saliva and freaking out. Especially taking the moulds for my teeth, it really feels like the back of my throat is getting blocked up by the putty, and they just leave me sitting there with it in.
My dentist would always lie to me saying "just a little longer left" (even when there was about an hour remaining) which really didnt help, and after we finished about 5 teeth worth of treatments she said she "realised" I have 3 more places she wants to do as well..
It sounds hysterical I'm sure, but I dont think she realised that several times per each treatment I'm genuinely convinced I'm about to die - like making peace with god level. I got over myself and was in a really good cycle of going because I wanted to finally fix everything, and then that extra "reveal" of another 2 rounds of treatment just broke me, I couldn't do it.
It’s still along those same lines. It’s lying or stretching the truth.
And I do believe that for the most it comes from a good place. They are legitimately trying to reduce anxiety.
When the above happened an I was trying to find a dentist I talked with my therapist about this extensively. And then the dentist I found now, talking through it was a big way that helped me.
And both of them kinda said the same thing. That this was an old trick that dentists used. Particularly on kids, but clearly not limited. And it does come from a good place.
But they don’t think about the long term damage of that. Even on a subconscious level. It wasn’t until into my adult hood that I understood why I had a fight or flight moment when I got in that chair, but I still did.
And I feel you 100% on those tools and stuff. I have gotten better, but I remember early on after finding my current dentist I needed a root canal. I told her, if I am laying 100% back and that plastic film is covering my mouth fully I am going to have an anxiety attack. She listened and worked with me on how to make it work. It still made me anxious, but yeah.
I've had three dentists in my life. One lied to me, one stuck a toe over the line of informed consent and handed me an unexpected bill, the third half-assed his job leaving me with unnecessary work which ended up causing problems later in life.
I'm sure there are great dentists out there who are honest and empathetic but I haven't met one and don't plan on rolling the dice again anytime soon.
I originally had a good dentist, never had a cavity, ever. He retired, next dentist I had a cavity nearly every time. I stopped going, then one of the fillings came out. I went to a new dentist and they said ok, we can fix it. Then drilled my tooth off and literally while I was numbed up and after ~30 minutes of drilling, they freak out and are like.. OOOOOHHHH, you need a root canal, it's $2000, or the other option is extraction.
Dentists are definitely trying. The drills have gotten smaller and gentler, my dentist (and many others) offers a headset so you can listen to music/podcasts while getting your cleaning, and overall they make an effort to be less scoldy and more encouragey.
The process itself is still kind of naturally unpleasant, and the billing sucks, but the people seem to have taken traditional criticisms to heart and made some moves to make it suck less.