"My dentist offered me the opportunity to do a fancy oral cancer scan with some sort of blue light for the low, low price of $99. I declined. I’m in my 40s and have never used tobacco. "
Same here, but after I refused she tried to frighten me into having the test by making me sign a waiver stating that I had been offered the test but was refusing it. It made the whole thing sound like I was proceeding at my own (great) risk if I didn’t have this test. But I already knew that the type of oral cancer detected by the test is extremely rare in nonsmokers like me.
I never do generalized questionnaires. Who wants that marginally inaccurate information in their records now that everything is electronic and saved forever.
Sleep Apnea is serious. My 50-60 female cousin died during the night. She wasn’t wearing her CPAP. She was overweight but not obese.
Asking about having a gun was ruled out, then in, by my state. It is not on my questionnaire, but for sure I ask that question if I’m worried someone could do harm to self, or harm to others. In 40years, this hasn’t been an issue between my patients and me, but I have colleagues who have asked new patients to remove guns from their home. For the record, since I am a solo practitioner, none of my files are stored electronically, nor do they include sensitive material.
My H stopped breathing multiple multiple times (I believe in the hundreds) when he had the sleep study. He didn’t think he could sleep, but he did.
I didn’t need this to know. It’s not just obstructive for him. He has central apnea–his brain literally forgets to breathe. His arrhythmia has settled down, his chronic psoriasis has is much better, he’s significantly less tired during the day, and he has real dreams–he literally did not understand that dreams were more than fleeting colors or images.
So yeah, what it picked up was real. My beef is not with him needing the CPAP, but in the money the sleep doc pockets on other unnecessary procedures and lack of useful monitoring.
PSA - While I’m not condoning the dentist for pushing a $99 oral cancer screening, I do need to share that my SIL - a non-smoker - was diagnosed with cancer of the tongue 10 years ago, and it was her dentist who caught it. She is alive thanks to him, but they had to remove 3/4 of her tongue which means she can’t eat (gets all nourishment through feeding tube) and has impaired speech. The cancer she has is not curable - it always resurfaces in another part of the body. In her case, it’s spots in her lungs, which are stable for now but will eventually grow. Having seen first hand the devastation of this disease, I urge all of you to make sure your dentist is at least doing the routine oral cancer screening which should be done (at no charge) as part of your check-up. Also FYI, HPV is a leading cause of cancer of the tongue - so it’s not just smokers at risk. And, most oral cancers are discovered late stage, meaning low survival rates - which is why the dental check is so important.
I had the sleep study and slept better there than I ever did in my own bed. I wanted to go back every night. Perhaps it was because H wasn’t there, lol! I used the CPAP until I had surgery and got a hernia repair and a lapband.
Years ago, H went for a consult to a local dentist, whose son was one of my D’s best friends. The work suggested totaled $20K and he didn’t take insurance! The kicker was that the estimate had written on it - “Family and friends rate.” I still wonder what he charged strangers. My MIL was taken by a friend to a dentist, who had her sign a contract for $15K worth of work - she was about 85 at the time! When H called to get her out of the contract, the office said it was a contract and they were going to hold her to it. MIL is competent but no 85 year old needs that kind of work. We threatened to go to the dental board and we got the contract back in the mail, marked void.
My current dentist did sell teeth whitening kits to my two oldest kids. D uses it and S has never touched it, I might start using it. The practice does check the tongue, etc. for oral cancers and hasn’t offered me the healing blue light. I have a dental HMO so I pay set prices. For instance, I get a root canal for less than $200. I got a crown for about $300. If I have enough money left in my FSA at the end of the year, I will get a 3 tooth bridge for about $700. Extractions are $35 and I had the kids’ wisdom teeth out for about $150 total, per kid. I have not been asked to fill out these questionnaires.
I find that the dermatologists around here are the ones who push the most extraneous stuff on you.
“Dietz…About $500 OOP for the sleep study. Then he was routed to the one individual in the area which makes a special mouth guard type thingy - marketed as ‘you don’t have to use those uncool CPAP thingies’. That little special item was going to be charged to the insurance at … wait for it…wait for it…6K!”
SIX THOUSAND DOLLARS for a mouthguard? And they suggested antidepressants for answers to vague questions? Who HASN’T “felt sad in the last two weeks”? You are right. Anyone could be diagnosed with something, depending on the day and our circumstances.
What kind of nuttery is going on out there?
“Scipio: Same here, but after I refused she tried to frighten me into having the test by making me sign a waiver stating that I had been offered the test but was refusing it. It made the whole thing sound like I was proceeding at my own (great) risk if I didn’t have this test.”
This is one of the oldest manipulations in the book. Patients have been subjected to this nonsense for every kind of medical decision from declining tests to medications to procedures.
“bookworm: For the record, since I am a solo practitioner, none of my files are stored electronically, nor do they include sensitive material.”
This would be beneficial to everyone. It should be opt-in, where you let your records be accessible if you choose to do so for specific reasons (such as an elderly parent who decides to do this).
I wish there were more like you. We all know how well our ahem, privacy, is protected.
Medicare has what IIRC called PQRS requirements and there are certain things we were required to screen for (selected from a list of screening options) when seeing a new client. And Medicare penalized the providers if they didn’t do it. I carefully did it (and the required review at each session) and it was submitted with the billing ,but somehow they didn’t have it correctly and I got penalized anyway. Trying to get it straightened out was an exercise in futility.
http://annals.org/aim/fullarticle/2522436/yes-you-can-physicians-patients-firearms seems to be the rationale behind physicians asking about guns in the home (though it suggests selectively asking based on other risk factors, under “When to Ask”). Of course, since guns are a hot-button political topic, that can be controversial.
I had a dentist working in a small group. For my last 3 visits, I was told that I had no cavities and I’m doing great. Just a month ago, I was called by the dentist office because I suddenly have 9 cavities with no apparent explanation. They offered to let another dentist fill them. I told them no. I believe that 90% of cavity fillings are completely unnecessary. Unfortunately for me, I followed the advice of these dentists and went there like a good little schoolboy. 1 filling here, 2 fillings there. Enamel doesn’t grow back. Now, whenever I get a filling, I can’t chew on one side of my mouth for at least 2 months. I’m barely in my 40s.
What do you mean they called you to tell you that you had 9 cavities? Don’t they discuss that stuff with you when you are in the office getting your checkup, @coolguy40? That seems very odd to me.
@doschicos That’s exactly what they did, and it was very suspicious. Either my dentist forgot everything she learned in dental school and she’s too incompetent to fill cavities, or there’s a money trail somewhere. Either way, I won’t be going back there.
After we moved three years ago, our new dentist found a number of cavities and issues. I’ve ended up with two root canals and three (or is it four ) crowns. But…but…but…in the few years before we moved, I lost two back molars to what I called spontaneous combustion - decay inside the teeth had gone undiscovered until it was too late to save the teeth. And the root canals were identified because I had pain. So it’s been a lot of expensive dental work but I think my new dentist has newer and better equipment to find the decay before it gets out of control. She’s been working with me to improve my dental care routine which is also helping.
It was a shock on the first visit to hear about all the problems but she showed me everything on the screen and I am saving my teeth. So I trust her.
Seems like if a dentist finds cavities, the patient can ask to see and feel where they are by looking in the mirror while the dentist pokes a probe where it sticks in the cavity. They should also be visible in X-ray images.
That is what I remember when a dentist found a cavity – the dentist pointed out the cavity with the probe sticking in the cavity.