Only in California?

Posted by: Barbara

Only in California? - 03/24/03 05:08 PM

There's an outfit here whose sole reason for being is the disposal of animal waste for pet owners. Their slogan: "We Do Doo-Doo."

Posted by: David Dvorkin

Re: Only in California? - 03/24/03 05:37 PM

There used to a company in Denver that would pick up all the dog droppings in your back yard. Their name was The Tootsie Roll Patrol, but the candy company that owns the Tootsie Roll name made them change, and they became something less memorable.
Posted by: Barbara

Re: Only in California? - 03/24/03 08:01 PM

Well, can you blame them? Heavens.

The Tootsie Roll people are quite protective of their name. I wanted to have Kirk in The Three-Minute Universe name the alien ship Tootsie Roll and wrote the company requesting permission. The permission finally came...six months after the book was published.
Posted by: Kay

Re: Only in California? - 03/26/03 10:45 AM

Well, I wish we had a similar company in Roanoke. MOST of my dog walking neighbors are considerate, but occasionally I find a pile in an inconvenient place.

A couple of years ago I was doing some unprogrammed driving around the Blue Ridge Parkway and stopped off at Blowing Rock, NC, where I discovered a townhouse development that had a sign proclaiming it a "pet-free community."

I wonder if that applied even to non-nuisance pets like goldfish.
Posted by: Barbara

Re: Only in California? - 05/14/03 07:10 PM

Dentists here advertise like crazy, and the ads all promise the same thing: a better smile. (As if that were the only reason for seeing a dentist!) The ads all say things like "We are dedicated to giving you a brighter smile" or "We have only one goal -- a better smile for you" etc.

And we're so far north of Hollywood, too!
Posted by: Julia

Re: Only in California? - 05/14/03 10:24 PM

Ah, so this obsession with cosmetic dentistry is not a nationwide thing?

Fortunately it only took a couple of visits before the dental practice I picked accepted that my priority is keeping my teeth functional for as long as possible. But the surgery is covered with posters about how to have an unnaturally perfect smile with veneers, implants, etc.
Posted by: Rita

Re: Only in California? - 05/14/03 10:40 PM

Not nationwide, no. In fact, I have never seen an ad promising me a better smile. And I think I'd be mighty suspicious of the dentist if I did.
Posted by: Kay

Re: Only in California? - 05/15/03 06:10 PM

The dentist I use in Roanoke is a "cosmetic" dentist. I followed my hygienist when she moved and told her (and HIM) in no uncertain terms that I wanted to keep my teeth healthy but they look fine the way they are. The hygienist has since moved again, but so far I am cool with her replacement and the office is very convenient.

The first time Becky mentions "improvements", though, I am outta there.
Posted by: Julia

Re: Only in California? - 05/16/03 01:52 AM

I went to my old practice when I was visiting my parents in Australia last month - I wanted a second opinion on extra work the oral surgeon had been pushing me to have. (It's a bit tricky asking my current dentist, since she sent me to see him for the wisdom tooth extraction, and it puts her in an awkward position if I ask *her* if he's talking through his wallet.)

I'm very glad I went...
Posted by: Christopher

Re: Only in California? - 05/16/03 04:51 PM

Aw, Julia, drop the other shoe. What happened?
Posted by: Barbara

Re: Only in California? - 05/16/03 08:45 PM

Yeah, Julia, what happened?
Posted by: Julia

Re: Only in California? - 05/16/03 10:11 PM

I was having serious trouble with a painful tooth that was painful even after a root canal (twice). I was sent to the oral surgeon to check if the impacted wisdom tooth behind the problem molar was leaning on it hard enough to be causing the ongoing pain. Oral surgeon decided that not only that one but the wisdom tooth on the other side needed to come out, and by the way I also have an impacted bicuspid in the upper jaw that we really ought to have out as well while we're about it...

Um. Yes. I've known about that impacted bicuspid for over twenty years. Nobody else has ever seen fit to suggest that it ought to come out "just in case". Since I've moved around a bit, that's several dentists. This did not endear him to me, as it raised just the tiniest suspicion in my mind that he might be more concerned with his bank balance than clinical necessity. Both in that, and in suggesting that the other wisdom tooth should be removed.

An implant got added to the the list of potential surgery after it turned out that a molar near the impacted bicuspid was so badly decayed under a filling that it wasn't salvageable. When I went for the assessment on taking that molar out (it was a general anaesthetic and drill it out job, so back to the oral surgeon), he had another go at me about let's take out the bicuspid while he was rummaging around in that quadrant anyway. I objected, because there was a distinct possibility that yet another tooth was going to have to come out, and the bicuspid might be useful as a replacement. At which point there was chatting back and forth between practices, and it was decided to leave it alone until they were quite sure they'd cleared up the rest of the mess.

So I trotted along to the Australian dentist, told him what had been happening since he'd seen me as an emergency patient a year before, and asked him what he thought about the proposed extractions and implant.

The impacted bicuspid - if ain't broke, don't fix it. Taking it out is serious invasive surgery, with a lot of pain and discomfort for several weeks, and small but serious risk of things going wrong. On balance, if it's not causing a problem (which it's not), leave it alone and check it regularly by X-ray, rather than taking it out simply as a precautionary measure.

The impacted wisdom tooth - yes, removal is justified, but it has to be balanced against the risk of nerve damage. If the roots are wrapped around the nerve (which needs to be decided by an oral surgeon with full X-ray), it's less risky to leave it alone unless there's serious bone damage.

Having an end-of-row implant will be expensive, invasive, painful surgery with all the attendant risks and ongoing discomfort, for a small amount of cosmetic benefit, and almost no real practical benefit at the moment given that I still have adequate chewing function on that side, and full chewing function on the other side.

Which is pretty much what I thought, but it was nice to have it confirmed. The proposed work can all be clinically justified, but not all of it is necessary and even the item that is needs to have the risks weighed.

[This message has been edited by Julia (edited 05-16-2003).]
Posted by: Lorna

Re: Only in California? - 05/17/03 10:31 AM

Yow. That is scary. Well, we've all heard horror stories about surgeons who perform unnecessary operations, so I guess I shouldn't be surprised that dentists do the same thing. (I hope the moral of that story isn't that you have to go to Australia to get an honest opinion.) But Julia, I am surprised you still have a wisdom tooth. I thought those were routinely yanked during the late teens.
Posted by: Julia

Re: Only in California? - 05/17/03 12:07 PM

It's not that the work's completely unnecessary. It's all justifiable (unlike one dentist I know of who was in the habit of doing expensive work on perfectly healthy teeth). It's just that he was a lot more gung-ho about grey area stuff than I'm happy with - I can't trust this guy to give me an honest risk-benefit appraisal.

As for wisdom teeth being yanked early on - that reflects a difference in attitude that was one of the reasons I went to an Australian dentist when I had the chance. US medical people, including dentists, are far more inclined to practice defensive medicine. I honestly don't know whether the surgeon was simply trying to drum up business on any excuse, or whether he was motivated by the belief that if he doesn't tackle any potential problems, I'll turn round and sue him if they turn into real problems later.

As far as I know, it's not normal practice in the UK (and I think Australia) to remove wisdom teeth unless they're actually causing a problem. My upper wisdom teeth came through normally, but were removed a few years later because they were decaying badly (I have a serious problem with not having much resistance to caries). The lower ones didn't erupt at all, so there were no problems associated with partly erupted teeth. It's only in the last couple of years that they've been causing trouble, and taking one out didn't actually solve the problem it was thought to be contributing to.

The Australian did also give me a second opinion on something else - white fillings. My British dentist was dead set against them a few years ago, with good reason - at the time they had a very poor lifespan compared with amalgam. They've improved in the last few years, but I still wasn't entirely happy about the current dentist's enthusiasm for them. Risk-benefit again - they're a lot better than amalgam for preventing seepage around the filling and subsequent decay under the filling (a major problem for me), but is the physical lifespan good enough that you won't be replacing the filling just as often anyway? Apparently they've improved drastically in the last couple of years, and they're almost as good as amalgam for expected life now.
Posted by: Christopher

Re: Only in California? - 05/20/03 12:29 AM

My dentist calls the white filling a "composite" -- which is no more helpful a word than "amalgam". ("A composite of what?" I asked. "Resins," I was told.) The composite material by itself is less strong than amalgam; but since it bonds to the tooth and amalgam doesn't, the tooth itself is stronger with composite fillings. And less sensitive to heat and cold. I haven't had a bit of trouble with the two I have.

Before the dentist put in the first one, he surprised me by saying "You're not an alcoholic, are you?" He said the daily, heavy ingestion of alcohol can cause the composite to erode.
Posted by: Barbara

Re: Only in California? - 05/20/03 12:30 PM

Hmm, I hope that doesn't apply to wine with dinner. (Fortunately, I don't even like the hard stuff.) But I love being able to buy wine in supermarkets here, from all these little local vineyards I never heard of. It's far from top-of-the-line stuff, but some of it is surprisingly good.

My granddaughter (age 15) just had her wisdom teeth removed. It was the first time she'd ever had novocaine, and she wasn't able to drink the consolation milkshake her dad got her afterwards. Dribble, dribble.
Posted by: Julia

Re: Only in California? - 05/20/03 04:21 PM

Originally posted by Christopher:
My dentist calls the white filling a "composite" -- which is no more helpful a word than "amalgam". ("A composite of what?" I asked. "Resins," I was told.) The composite material by itself is less strong than amalgam; but since it bonds to the tooth and amalgam doesn't, the tooth itself is stronger with composite fillings. And less sensitive to heat and cold. I haven't had a bit of trouble with the two I have.

A lot of my fillings (and I have a lot, sigh) are on the grinding surfaces. The resin composites of a few years ago simply weren't up to the job - 5 years maximum, as opposed to typically at least 10 and anything up to 20 years for metal. They were much too soft to resist the amount of wear.

I had a long, if slightly one-sided, conversation with my dentist about it several years ago, because I'd gone in for filling work a couple of days after the BBC's shock horror expose programme had claimed that dentists were killing their patients with mercury poisoning. He'd already seen the start of the rush to get those nasty mercury fillings replaced with lovely safe plastic, and was happy to be able to rant on the subject to someone who was very determined to have metal, thank you very much. Being a materials scientist, I had a somewhat more informed layman's view than Joe Public, because the ongoing improvement in dental materials is one of those things that gets occasional coverage in the general materials science press.
Posted by: Kay

Re: Only in California? - 05/28/03 07:08 PM

What crowns I have a are YEARS old....and GOLD. I try not to laugh to hard in bright light because I really sparkle. But the dentists (there were two over the years) who did them both opposed the more "cosmetic" porcelain caps...which, I believe, were more expensive than gold.

But at least if times get really bad, I have something of value in my mouth.