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Comment by tempacct | Hacker News Reader

Am I the only one here who's never been to a dentist? From my perspective, it seems like they do more harm than good with the drilling, scraping, filling, etc. People I know who go seem to end up "repeat customers", with all kinds of "problems".

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I tried not going to the dentist during grad school, yes. (More out of absent-mindedness than with any definite plan.) I spent perhaps four or five years dentist-free.

My reward was a series of extremely painful toothaches followed almost immediately by a bunch of very expensive root canals and crowns.

Let me assure you: Once your toothache starts, your time as a dentist-denier is going to come to a fast end, one way or another. They hurt a lot. Not to mention the fact that if you get an abscessed tooth it can literally threaten your life.

Of course, you don't necessarily have to have the dental insurance and the well-paying job that I had when my dental emergency arrived. Instead you can elect the more traditional option: Have all the offending teeth pulled out. Then you may eventually need dentures. [1] I'm told that dentures are no fun whatsoever. I have had no reason to regret spending money on dentistry instead.

Of course, if you literally never touch soda or sugar, brush your teeth carefully, and are blessed with better genetics than mine you might get lucky...

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[1] Pulling one tooth can have a negative effect on neighboring teeth, as the bone loss under the empty space causes the neighbors to loosen and slip. That's why people who lose permanent teeth tend to get crowns or bridges.

I think genetics is the main factor. I've known a few people who never floss, brush once a day in the morning, eat pretty much whatever they want, go to dentists once every five years, and never have cavities. On the other hand, I'm very careful to floss before sleep and brush twice a day, but I still end up with a cavity or two every year.

In my continuing review of the dental primary literature and frequent consultation with dentists (my professors), I have found that genetics actually play a minor role in the frequency that an individual develops dental caries lesions.

More important factors include: (1) frequency and dose of fluoride (2) bacterial ecology of the mouth (possibly related to genetics, but also inextricably linked to the environment to which the individual has been exposed since birth) (3) FREQUENCY of meals -- look up "Stephan Curve" or the unethical "Vipeholm Study" if you are interested in this...

In my continuing review of the dental primary literature

I would love a post about your most interesting findings. Looking into the Vipeholm Study now.

I tend to get cavities every now and then, but always have very little plaque build-up. In fact, when I went on one 4-year hiatus from the dentist, the assistant cleaning my teeth said it looked like I had just recently had them cleaned. She said it probably had to do with the chemical makeup of my saliva being more plaque-resistant that average. Funny thing is my mom always gets similar comments when she goes to the dentist. We live very far away from each other and have very different diets. Based on that, I would conclude that the bacterial ecology of the mouth and related chemical composition of saliva, are probably quite genetic.

Also, based on the fact that my dad has horrible luck with his teeth (cavities, root canals, etc), and dminor's comment (http://news.ycombinator.com/item?id=1108895) in this thread saying that they have very different luck with their teeth from their brother, I would venture to guess that it may have a lot to do with the mother's side of the genetics (being linked to the X chromosome that gets passed down). In dminor's case, they could have received one X from their mother and their brother have received genetic makeup from the other X, which could explain their differences in dental hygiene at least partially. If it were Y-linked, then I'd obviously have much closer luck to my dad's, and those two brothers would be much closer in results to each other, since there is only one Y to be given from one parent.

Of course, this is all nothing more than educated conjecture. I'm probably totally off base and it's likely much more complicated than that. For all I know, these results could be all coincidence, and the genetic characteristics could be totally unrelated to the sex-giving genes. (In other words, I have no dental training and nothing more than a curious, inquisitive disposition.)

http://wholehealthsource.blogspot.com/2009/03/preventing-too... fingers diet as the main factor instead. Perhaps when these people eat what they want, what they want generally jibes with this advice.

My brother and I grew up eating the same foods, but he had 17 fillings by college, whereas I had none. Our dad is a dentist (and now my brother as well), so we had pretty good oral hygiene growing up.

You've never been to a dentist? Whoa. Where are you from?

I imagine, to some extent, that there it is the best interest of dentists to have you come in regularly, but I have to imagine that the research says that going to the dentist prevents all kinds of tooth and gum problems.

Do you have high salivary flow, by any chance?

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