I had a conversation recently that caused me to think back to an incident that occurred in my life quite a while ago. If you’re feeling particularly Scooby-Doo- or Hardy Boys-ish, this blog post may also be referred to as “Matthew Canning and the Case of the Disappearing Cavities.”
A few years ago, I moved into an area outside Philadelphia, and, after a few months, decided it was time to visit a dentist. I wanted to find someone local, as my previous dentist was now about forty-five minutes away. I searched online, and arbitrarily chose a practice that was both close to my home and received good reviews.
Upon entering the lobby, I was faced with the following painting:
Had I been there due to the mumps or some sort of threatening, throbbing abscess, this may have been a bit off-putting. I just hope that this was painted entirely from the artist’s imagination, and not from the actual likeness of a wriggling, pained child model.
The office was very nice, and awash in activity; even at seven in the afternoon, it was bustling with nurses, doctors, and patients. Due to the location, decor, and equipment, I deduced that the practice was doing quite well. I was promptly seen by a nurse, who took a series of about fifteen X-rays. Soon, the doctor arrived.
I had “a few cavities.”
For many, this may not seem odd. However, at the time, I was approaching thirty years old, and had never had a cavity in my life. Despite admittedly performing bare minimum dental care (brushing twice per day and a visit to the dentist every other year or so; no flossing, no mouthwash), I’ve always had perfectly healthy, strong teeth. Genetically, I had done well in the dental dice game (not so much in the eyesight one).
Legitimately, naively curious, I asked to see the X-rays. The doctor pointed to an X-ray, and, with the lid of a marker, traced wide, casual circles around my back teeth, and said something that she couldn’t possibly have expected me to understand without a degree in dentistry.
As a society, we have a tendency to trust dentists and other medical professionals in a somewhat unquestioning manner. Though “unconditionally” isn’t quite the word to use, I think it’s safe to say that we put more merit in doctors’ assessments than we do other professionals/specialists who work within domains of knowledge with which the average person is unfamiliar. If something seems “off” with our mechanic’s assessment of our car (especially when a hearty price tag is concerned), we are likely to distrust or seek a second opinion. This is not so much the case with doctors. We trust that, with our health (and, at times, lives) in their hands, they are always going to “do the right thing,” and put our interests well ahead of the almighty dollar.
That said, if a dentist tells you that you have a cavity, would you question it?
I was experiencing no pain or discomfort, and could see nothing on the X-ray films that indicated anything out of the ordinary. In this case, given my lack of rapport with this practice, it occurred to me that there was a chance — paranoid as it may seem — that I was being swindled. Hustled. Gamed. Taken for a ride. Bamboozled. Having the ol’ wool pulled over the eyes.
With so many terms for the same thing, you’d think we’d be more conscious of the risk across all domains.
Conjuring up my most innocent, non-accusatory tone, I said to the doctor, “if I were to let this go and not have them treated, how long would it be before I start to notice pain or other symptoms?” Her response was, “three months, tops.”
So, I waited three months. In fact, I waited well over a year, a time during which I received about a dozen mailers, a birthday card, and several phone calls from the office, hoping to schedule an appointment to remedy my alleged condition. Each time, I simply put it off.
Almost two pain-free years later, I went to see another dental professional; another local doctor who my wife had begun to see. Without mentioning a word about my previous, questionable visit, I got a full checkup, cleaning, and suite of X-rays.
As you have probably guessed by now (unless you were expecting an M. Night Shyamalan-style twist), I had no cavities. After confirming a clean bill of dental health, I told her the story of my previous encounter. My new dentist confirmed several suspicions:
- There was absolutely nothing on my X-ray films or found during my checkup that indicated the presence of cavities.
- To the best of her medical knowledge, had I indeed had cavities, there is no way they would have “disappeared.”
- Some people have “sticky spots” in their teeth — deeper-than-normal valleys — which can be mistaken for cavities. However, I had no noteworthy instances of such spots.
- In the past, she had heard several people complain about their experiences with this particular dentist.
After this episode, I spoke with a few friends, and asked them how many had addressed cavities with no symptoms, and found that almost every single one had. Although I’d like to believe that the likelihood of corruption in the dental industry isn’t some rampant, unchecked plague, I can’t help but wonder what percentage of these procedures were, in fact, unnecessary. Though I’ve so far never had to undergo such a procedure, it is my understanding that they are generally far from pleasant.
It turns out I’m not alone in my experience. After scouring the internet, I was able to find quite a few individuals who claim to have gone through a similar ordeal.
How Much Trust Is Too Much?
This episode got me thinking — How much unchecked trust do we put in medical professionals? Insulated through our widespread use of medical insurance, it’s easy to forget that many doctors are paid quite well for the performance of outpatient procedures. I began to think back. As a young boy, I had had a series of questionable freckles removed. As an adult, I had had my wisdom teeth removed, as well as a tonsilectomy and septoplasty (correction of a deviated septum). Told that I had very limited airflow in my right nostril, I underwent the septoplasty, under the impression that it would improve my ability to breathe, lessen my seasonal allergies, and help with snoring. The recovery was tremendously difficult and painful; and the results? Arguably negligible. The snoring subsided for a few weeks, only to return again to the same extent. My allergies remain the same to this day. My breathing didn’t seem to improve (though it was never a problem to begin with).
My mind began to race; were these procedures flesh extractions or wallet extractions?
According to the Journal of the American Medical Association (JAMA), 12,000 people die every year as a result of “unnecessary surgery.” One could easily assume that in order to make such a bold claim, for each of these 12,000 individuals, a suit was filed or an investigation led, resulting in the court’s assessment that the procedure was indeed unnecessary. Most likely, quite a few more died from such unnecessary surgeries, but the individuals’ loved ones never thought them unnecessary (or simply failed to pursue the cases for one reason or another).
It seems likely that substantially more still lived through such surgeries, and to this day have no suspicion that they were anything but necessary. Have I been one of them?
Of these 12,000 reported/judged deaths, likely even more unreported/unjudged deaths, and likely even more undetected unnecessary procedures, how many were due to a misjudgement on the behalf of the doctor, and how many were due to his or her personal interests?
Just something to think about. Sometimes a second opinion is well worth the effort and cost.With all teeth intact, Matthew