HFH

@SteveGarciaMD @WhiskeyJack321 @ATabarrok Some patients don't ever go to the doctor, we take a full medical history including BP. If it is elevated we can refer them to their MD. We disagree.

@HelgeDDS @WhiskeyJack321 @ATabarrok You are not getting my point. BP matters for the anesthesiologist or whomever is giving sedation. If you can pull a molar without any anesthesia, then the BP won't matter. Surgery is most often associated with general anesthesia. Procedures often don't need general.

Went to the dentist for a cleaning. Refused the blood pressure check, refused redundant x-rays, refused to sign a waiver for refusing the x-rays. Three nos to get one teeth cleaning. I am now known as a troublemaker.

@BelieveOnJesus @Mad_F @ATabarrok We find cavities and abscessed teeth that aren't symptomatic and can provide treatment before problems become more complicated. If you shadowed me for a week it would make perfect sense. What we see on a daily basis would surprise you.

How come an Xray wasn't required every year 40 years ago when I went to the dentist? The dentist just cleaned my teeth and drilled any cavities out. I get the need for them if there is suspicion of something. I just went last week to the dentist after not going for quite some time and got Xrays because there could have been so much wrong. In that case, I think they make sense.

@TonyLiebert Interesting

Minnesota's leading scorer, Tori McKinney (12.9 PPG), didn't play in the regular-season Gophers-UCLA game. Will her availability make up an 18-point difference from that game? It's clear that Minnesota is a different team when she plays. More thoughts: si.com/college/minnes…

@day_natomy @ATabarrok @Seppie123456 I have never billed for it. Its part of the exam.

@HelgeDDS @ATabarrok @Seppie123456 No you do it so you can bill for it

@SteveGarciaMD @WhiskeyJack321 @ATabarrok @Seppie123456 Cleaning teeth is not surgery. Placing implants, extractions, and procedures requiring a significant amount of anesthetic require knowing the patients BP. Your definition of surgery is incorrect.

@HelgeDDS @WhiskeyJack321 @ATabarrok @Seppie123456 Heavens no! Surgery, to me, implies general anesthesia. BP matters much more for the anesthesiologists than the surgeons. Teeth cleaning is not surgery. Tooth extraction is a procedure that does rely on general (my sons had propofol or fentanyl/versed)

@PhillyPaul06 @Cade4ISU Getting from a 3 to a plus is extremely difficult. I have gone from a 10, to a 7 to a 3 to a 1, to a +.1 back to a 1. Getting to a plus handicap is hard/impossible without committing a significant amount of time to practice and playing.

@HelgeDDS @Cade4ISU Agreed Haney couldn’t get Phelps there and Phelps allegedly started around a 14

Rapidly hitting range balls every day is so pointless to me. How’d I go from a 20 handicap to a + last year? It wasn’t lessons It wasn’t practice It wasn’t hitting the range every day (or ever) It was playing. Nothing makes you better at golf than playing. I’ll die on that hill

@Cade4ISU If anybody believes you went for a 20 handicap to a plus handicap in a year, they don't know much about golf, and I question whether you do as well. It would take many years to accomplish it and almost nobody gets there from a 20 handicap.

@PhillyPaul06 @Cade4ISU Even with the best teachers in the world and unlimited time to practice and play, it would still not happen.

@Cade4ISU This reads as though you went from a 20 to + in one year which obviously doesn’t happen without world class instruction.

@NoraNH2 @ATabarrok Yes, I am quite thankful there are other dentists to deal with people like you. I have great relationships with my patients. Mutual respect is all that I ask.

@HelgeDDS @ATabarrok Good thing you’re not the only Dentist in town

@fedupmom12 @pharmdancer @ATabarrok CBCT is used for implant placement, pathology evaluation or wisdom tooth extraction when the tooth is close to a nerve on a 2D image.

@pharmdancer @HelgeDDS @ATabarrok What are they using these for? I think the oral surgeon near me has one….. I hope they’re not being used frequently….

@SteveGarciaMD @WhiskeyJack321 @ATabarrok @Seppie123456 Are you arguing it isn’t necessary to take a BP prior to surgery?

@WhiskeyJack321 @HelgeDDS @ATabarrok @Seppie123456 It’s not a stroke risk at that time. That is a fallacy. There are > million people walking around with a SBP > 180 and they are not having a stroke. The dental school cutoff was not grounded in evidenced based medicine, I promise you that.

@Mad_F @ATabarrok A visual exam is not capable of seeing all potential issues, particularly decay between teeth or an asymptomatic abscess. An exam is required at least one time a year. There are many instances where cleanings are completed without X-rays.

@HelgeDDS @ATabarrok Ok I’m listening, make the case for an x-Ray for a simple tooth cleaning appointment.

@sargeantize @ATabarrok That is a fair point. That is far too many x-rays. My preference is to take as few as possible while not compromising care.

@HelgeDDS @ATabarrok he did say redundant. 1 xray per year should suffice. taking multiple per year on each visit or to just see how clean the hygienist got them is redundant

@Gra76691043Rita @ATabarrok If the patient is new, a comprehensive evaluation is required first. Exams need to be completed on a routine basis to comply with the standard of care and to provide quality proactive care.

@HelgeDDS @ATabarrok He wanted a cleaning. Why does that have to come with a full exam?

@johwhitt @ATabarrok You can refuse a service and I can choose not be the provider. Patients always have a the choice, then it is up to the provider to determine if that is ok with them.

@HelgeDDS @ATabarrok Informed consent. Patient choice. Who's paying who?

@WR4NYGov @ATabarrok Some get anxiety when it is checked. They have white coat hypertension and just want to avoid it. Others are simply disagreeable, those are the ones that cause almost all the issues.

I don’t understand the complaint. Why would anyone refuse a blood pressure check? I have declined X-rays but only once, after discussing with the doctor and agreeing together to wait until the next visit. I’ve always been very happy with dentists and almost always with hygienists.

@TDemmons94408 @ATabarrok It’s a liability issue. I can’t confirm you are healthy without seeing the entire picture. I take many X-rays at no charge and extend frequencies when possible. Refusing X-rays and refusing to sign a informed consent refusal form is a definite bye.

@HelgeDDS @ATabarrok That seems extreme to kick out a patient who doesn’t want x-rays. Me and my family don’t have insurance and can’t afford the recommended schedule. We stretch out our cleanings and x-rays and I’m grateful my dentist is so nice and works with us.

@deezynut @Trialawdan @ATabarrok No. There is a standard of care I am required to follow. This is about quality. All day, every day, I am trying to help people not need me. I don’t advertise at all. All word of mouth and I am busier than I want to be.

@HelgeDDS @Trialawdan @ATabarrok Exactly. Even if they’re designed to take advantage of people. Because that’s their main business model. My dentist office doubles as a marketing firm. There’s a reason dentistry operates as a distinct profession from medicine.

@CarlLefavre @ATabarrok We try to find middle ground.

In my situation, I haven’t had a cavity in at least 30 years. In fact, I suspect I’ve never had a real cavity because at least one of them in my mouth (I think I have 2 fillings) was put there by a reform school dentist who was just a sadistic bastard drilling and filling we’re no real cavity existed. So I don’t like to do a lot of expensive x-rays. But every four years is acceptable.

@Trialawdan @ATabarrok You need more emojis in your profile before I can take you seriously. The Profession has standards we must practice within.

@HelgeDDS @ATabarrok Sorry, thinking the Dentist here is the actual douche. Many others out there. F U.