The Good News / Bad News Thread

[ian]

I now have two new fillings (he found another missing filling at the back), though I assume composite resin as he set it with UV. Guaranteed for 'a year' – sheesh, I have amalgam fillings that are probably twenty-plus years older than the dentist. My childhood dentist was off her head on drugs and basically performed unnecessary procedures to fund her recreational bad habits till she was struck off. I mean, I'm fine with them taking a pop of nitrous at the end of the day. Now £450 poorer because I forgot to tick the 'dental insurance' option in the work benefits computer. Never see a dentist in the US though, it's terrifying.

[Kim]

I have amalgam fillings that are probably twenty-plus years older than the dentist.

I have a several of those, on account of:

My childhood dentist [...] performed unnecessary procedures

In this case, there was a brief early-90s fad for capping children's perfectly good molars with some sort of UV-curing resin, presumably on the basis that middle class parents would pay handsomely in order to give their offspring a purported degree of immunity to sugar.

In practice, this mostly served to prevent the teeth from meshing together properly, until the resin (and underlying enamel) cracked under the stress, with the inevitable result of lots of mid-90s amalgam fillings.  Credit where it's due, my particular dentist was a lot better with amalgam than she was with resin, to the point where they've never given me any trouble. 

My latest toothiologist (who has probably removed me from the list since I turned down a checkup at the start of the pandemic), was keen to drill them out and replace them, on the basis that they were evidently very old.  I muttered something about bathtub curves and ran away.


While we're on the subject, apparently the niblings (8 and 5 respectively) have both had a milk tooth pulled, which seems odd.  I had to have a couple removed when I was a small, on account of them interfering with the growth of the adult teeth below.  But that was done after x-rays and careful consideration, and with the aid of a whole brain-needle^[1] of anaesthetic.  It appears that the niblings just got a swift yank, followed by lots of bleeding.  Seems odd that they'd both need the same procedure like that...


_{[1] The ones normally brought out to persuade drunks that they don't want to be in A&E any more.}

[andrewc]

Going to the dentist reduces me to a gibbering wreck,  mainly because I think my childhood dentist did a lot of needless work rather badly.  He'd jam probes into teeth until you jumped, and every session seemed to result in a filling being required.  I had a lot of extractions under gas as well. Do local dentists still do those ? 


My current dentist is a very gentle Spanish lady,  I'm still on the books as an NHS patient and the last 2 times I've had fillings repaired I don't think she's charged me the full amount.   She's part of one of the big conglomerates though, so I expect I'll eventually be pressured into signing up for a monthly payment plan.

[Pingu]

...I had a lot of extractions under gas as well. Do local dentists still do those ?....

They were stopped from doing that ages ago. Something to do with killing too many patients I think.

[alfapete]

In this case, there was a brief early-90s fad for capping children's perfectly good molars with some sort of UV-curing resin, presumably on the basis that middle class parents would pay handsomely in order to give their offspring a purported degree of immunity to sugar.

In practice, this mostly served to prevent the teeth from meshing together properly, until the resin (and underlying enamel) cracked under the stress, with the inevitable result of lots of mid-90s amalgam fillings.  Credit where it's due, my particular dentist was a lot better with amalgam than she was with resin, to the point where they've never given me any trouble. 

As a working dentist during that period I struggled to understand what on earth you were going on about in this passage. Then figured it must be fissure sealing - a visible light-cured material which flowed into the very narrow fissures in the tooth surfaces to prevent decay in areas inaccessible to the brush and the cleansing action of mastication. It had absolutely no effect on the underlying tooth (?meshing together...?). It was evidence-based and highly effective but was never funded by the NHS and so didn't catch on sufficiently to prove effective on a population wide basis. The difficulty was getting six year olds (it was most effective in first permanent molar teeth) to sit still with their mouths open and tongues relaxed for the 60-90 seconds it took for each tooth, which had to be perfectly dry, to be sealed.

Oh, just going through that description makes me grateful yet again for retirement.

[Polar Bear]

I remember having something which sounds like this done when I was young on an upper and a lower molar on the left side of my mouth.

I am 60 now and the only teeth that have ever given me issues are those two.  Both have broken.

[alfapete]

I remember having something which sounds like this done when I was young on an upper and a lower molar on the left side of my mouth.

I am 60 now and the only teeth that have ever given me issues are those two.  Both have broken.

But association is not causation....
And if you remember the 'work' being light-cured then you would have been far too old for the sealants to have been preventive which is what I was talking about. Light curing became widespread in the late 80's.
Light curing of restorations (fillings) comes with a whole host of other (polymerisation shrinkage) problems but this probably isn't the place for that.

[Cudzoziemiec]

My dentist experience is the other way round. Childhood visits were fun and always included the comment "Perrrfect" in the dentist's Jamaican accent (he was about 20% of the town's unwhite population). Adult experience, less fun.

[Kim]

In this case, there was a brief early-90s fad for capping children's perfectly good molars with some sort of UV-curing resin, presumably on the basis that middle class parents would pay handsomely in order to give their offspring a purported degree of immunity to sugar.

In practice, this mostly served to prevent the teeth from meshing together properly, until the resin (and underlying enamel) cracked under the stress, with the inevitable result of lots of mid-90s amalgam fillings.  Credit where it's due, my particular dentist was a lot better with amalgam than she was with resin, to the point where they've never given me any trouble. 

As a working dentist during that period I struggled to understand what on earth you were going on about in this passage. Then figured it must be fissure sealing - a visible light-cured material which flowed into the very narrow fissures in the tooth surfaces to prevent decay in areas inaccessible to the brush and the cleansing action of mastication. It had absolutely no effect on the underlying tooth (?meshing together...?). It was evidence-based and highly effective but was never funded by the NHS and so didn't catch on sufficiently to prove effective on a population wide basis. The difficulty was getting six year olds (it was most effective in first permanent molar teeth) to sit still with their mouths open and tongues relaxed for the 60-90 seconds it took for each tooth, which had to be perfectly dry, to be sealed.

Oh, just going through that description makes me grateful yet again for retirement.

That'll be the one.  I was a child at the time, so I didn't get a proper explanation of what was going on - I think I assumed it was some sort of novel cleaning procedure, because what else would they be doing to healthy teeth?  And for obvious reasons I was guessing about the wavelength, as I don't have eyes inside my mouth.

What I do remember was it being applied (which wasn't exactly fun, but as a veteran of ENT procedures I was good at staying still, especially as this one was neither loud nor painful), and the resulting change in the shape of the upper surface of the teeth - which nobody has warned me about (which as a kid who'd never had a filling or anything, I found quite distressing).  And then needing a load of fillings a few years later on teeth that were ostensibly supposed to be decay-proof.  Maybe it didn't cause the damage, but it certainly failed at its one job.

I think they gave up on my younger brother, who was a wriggler.

[rafletcher]

Meatball dentistry on the NHS to get the piecework payments was commonplace. In the late 80’s, when I still trusted dentists to do what was best for me as a patient (more fool me) I had one such in Coventry plough through 4 adjacent molars - on both sides of my mouth, so 8 in total - in 2 sessions. Guess which teeth, some 35 years later, are missing or capped.

Fortunately dentistry has improved markedly for us lucky enough to still have an NHS dentist. Admittedly ours are only there for a 6 month, occasionally 12 month placement, but at least, as recently qualified ones, they are up to date. The practice owner (who, naturally, only does private work) is a lecturer at Kings dental school. My first NHS dentist at that practice is now a maxillo-facial surgeon, but still pops in on a Saturday morning to see a few (private) patients.

[Kim]

When comparing this sort of anecdata, it's important to bear in mind that:

a) Even if the dentist is doing less-than-necessary work to get the money, they're going to pick the teeth that are in most need of it, because they're a dentist.

b) Of course the tooth that needed previous work is the one that's going to cause problems later on.

[ian]

Given I’d not graced a dentist’s chair for about twenty years, I figure two fillings is getting off lightly. UV cured resin seems to be the thing these days. Does anyone use amalgam or is it now on a banned list? I presume there is a small risk. Amalgam fillings astonish American dentists.

[SteveC]

My dentist prefers to use UV cured resin. However there are some circumstances when it is not appropriate and he will use amalgam then.

[Canardly]

Crematoria have had to have specialist filter equipment fitted in recent years to deal with the level of lead bearing amalgam contained in the age group now coming to end of life.

[alfapete]

Crematoria have had to have specialist filter equipment fitted in recent years to deal with the level of lead mercury bearing amalgam contained in the age group now coming to end of life.

FTFY

Amalgam fillings (principally silver, mercury, tin and copper) were wonderful, invented in the days before concerns about metal toxicity. It's main advantage was the tolerance of it's chemistry in the hostile, always wet environment that it was used making it quick, simple and cheap to use. This characteristic is not shared by the newer resin materials which have now largely taken over - these are very technique sensitive, time consuming and expensive.
No decent studies show any ill effects from the mercury which releases so slowly from the material over many years, and amalgam remains fairly widely used. In recent years the main driver towards resin materials has been amalgam's poor aesthetics, and an understandable determination to reduce mercury in the overall environment - it's banned in one or two Scandinavian countries, I believe.

[ian]

Non-organic room temperature mercury isn't particularly biologically labile, so any slow wear in amalgam fillings is unlikely to have any health effects, I'd have thought. Mercury vapour would be more toxic, so I'd imagine the most risk is to the dentist who regularly manipulates and drills into amalgam (and, of course, burning dead bodies). Other than the tooth I broke (and it was the enamel and not the filling) and the other filling that must have fallen out entirely, those childhood amalgam fillings show practically no wear despite a good number of decades chomping. Anyway, the dentist didn't give me a choice, just the cost of big filling and little filling. Modern life, innit.

[hellymedic]

...I had a lot of extractions under gas as well. Do local dentists still do those ?....

They were stopped from doing that ages ago. Something to do with killing too many patients I think.

Correct.

Kids needing a general anaesthetic for dental treatment are admitted to hospital formally, usually as day patients.

This is the commonest reason for a child to be admitted to hospital.

I think dentists resist filling milk teeth nowadays; they either wait for the decayed tooth to fall out or admit for GA extraction.

[barakta]

Crematoria have had to have specialist filter equipment fitted in recent years to deal with the level of lead mercury bearing amalgam contained in the age group now coming to end of life.

FTFY

Amalgam fillings (principally silver, mercury, tin and copper) were wonderful, invented in the days before concerns about metal toxicity. It's main advantage was the tolerance of it's chemistry in the hostile, always wet environment that it was used making it quick, simple and cheap to use. This characteristic is not shared by the newer resin materials which have now largely taken over - these are very technique sensitive, time consuming and expensive.
No decent studies show any ill effects from the mercury which releases so slowly from the material over many years, and amalgam remains fairly widely used. In recent years the main driver towards resin materials has been amalgam's poor aesthetics, and an understandable determination to reduce mercury in the overall environment - it's banned in one or two Scandinavian countries, I believe.

Our last dentist had a real thing against mercury amalgam and tried to convince us we REALLY NEEDED to pay extra as NHS patients for resin AND that we needed our mercury fillings replaced. He was REALLY pushy about it. He didn't know what to say when I came back having looked it up on Cochrane and said "no thanks". I disliked his pushy approach as it really felt very pressury and bullying, by someone who could not understand that I was unemployed at the time and did not have the money for what he was suggesting nevermind whether it was justified. Felt like putting the fear into people unreasonably.

Same practice that allegedly supports 'anxious' patients but repeatedly refused to listen to me about deaf awareness and what would make dentistry accessible for me as a deaf patient. Instead insisting They Knew Best and babbling at me throughout so I couldn't work out what was an instruction and what was meaningless whitter that I was getting massively stressed trying to process and hear.

I have not been back. I can't find a dentist who will do deaf/disability access, so no dentistry for me. The old fangs seem to have been fine for the several years since, so...

[barakta]

I think dentists resist filling milk teeth nowadays; they either wait for the decayed tooth to fall out or admit for GA extraction.

Except for my sister's family new dentist who apparently yoinked a milk tooth (not wobbly or decayed) without anaesthetic from each of my nieces 8.5 and 5.5 years old respectively last week. I need to find out where I can direct my sister to independent advice on whether that is appropriate cos my nieces were quite upset and it was apparently very painful and one of them bled a lot too. I'm of the Get Another Dentist, except sister had just moved to this practice from another horrid rude dentist...

[Canardly]

Crematoria have had to have specialist filter equipment fitted in recent years to deal with the level of lead mercury bearing amalgam contained in the age group now coming to end of life.

FTFY

Amalgam fillings (principally silver, mercury, tin and copper) were wonderful, invented in the days before concerns about metal toxicity. It's main advantage was the tolerance of it's chemistry in the hostile, always wet environment that it was used making it quick, simple and cheap to use. This characteristic is not shared by the newer resin materials which have now largely taken over - these are very technique sensitive, time consuming and expensive.
No decent studies show any ill effects from the mercury which releases so slowly from the material over many years, and amalgam remains fairly widely used. In recent years the main driver towards resin materials has been amalgam's poor aesthetics, and an understandable determination to reduce mercury in the overall environment - it's banned in one or two Scandinavian countries, I believe.

Ooops senior moment thinks.....

[PaulF]

Bad news: my train was cancelled

Good news: because of the disconnect between buses and trains which means I always have a long wait at the station for either a train or bus I was actually able to catch the earlier one.

Bad news: we’re stationary so I probably won’t arrive any earlier

[TheLurker]

Good news.  Ha'penny Bridge has re-opened after 5 months.
Bad news. The direct road to Swindon is now open.
Worse news.  Traffic through the town has returned to pre-closure levels.

[Mr Larrington]

Hurrah: New remote for the PVR arrived today
Bah: It's half the size of the old one and consequently less operable by stubby peasant fingers
Bah²: It doesn’t work
Hurrah: Put flatteries back in old remote, switched box on, swapped flatteries back into new one which now works

Begone, foul shitverts!

[Wowbagger]

I couldn't find a Good News thread, so this is OT - I'm not including any bad news. Maybe it's a Tenuous Claim to Fame?

My sister was part of a change-ringing team that won a competition today. She was in Prittlewell A, who came first, and Prittlewell B came second. There were 7 teams in all and the competition took place at St. Laurence Church, Eastwood - the one that was threatened with demolition when the airpot expanded a few years ago.

Huzzah!

[Pingu]

I couldn't find a Good News thread...

https://yacf.co.uk/forum/index.php?topic=12.0