It's so simple to do, might as well do it even even it only might provide a benefit.
I certainly can't imagine any downsides to it...
I see what you mean.
But I'm a computer programmer, and if someone asked me to find a top quality academic study proving, beyond a shadow of a doubt, that it's a good idea to indent your code - I couldn't point you to one.
Not only is bias introduced from accidental collection flaws, it’s also often tampered with intentionally cherry picking data, choosing interesting data or in some cases flat out falsifying data. In addition, evidence based reasoning often suffers from there being a lack of evidence to make a decision from. Or in some cases some critical aspect surrounding the decision is very niche to the case so the data may not take that into account unless it’s highly tailored data (evidence based reasoning tends to focus on breadth of applicability because gathering evidence is a long and often expensive process).
There’s still a lot of place for using theory and reasoning in conjunction with or in absence of data. Things like experience, professional opinion, etc. Medicine should be no different in that regard to any profession. The key is of course to always strive for sound empirical evidence/data where possible, but to use sound documented reasoning and theory in its absence if you want the best objective results.
I've personally been on the receiving end of "the data we collected shows...x" (in a non-medical setting), but when I asked to have a look at it, it turned out that while this was true for a large part of the population sampled, there was a material difference between that population and a smaller population that can be clearly identified and for the latter, the data showed the exact opposite conclusion.
(think 100 men and 30 women, kind of scenario, except the difference wasn't gender, but job role).
It's even more amazing to see this at play in domains that are directly tied with your well-being, where there's abundant anecdata, but people are holding out until very long and very expensive research have made a pronouncement. Like, thousands of people claim that this particular herb is {$positive_claim}. I could try it for a week and see for myself, but I think I'll hold on to my 10$ and wait until research confirms this by the time I turn 90.
Another aspect of this fallacy is nicely highlighted by the aphorism Not everything that counts can be measured. Not everything measured counts.
> For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spectacles in their shop. Doctors were University educated in Latin and Greek to read ancient medical texts and despised the uncouth yokels.
> Surgeons muscled their way into the medical profession, originally with the help of the Royal Navy, who only had space for one or two people in charge of both cutting off legs and looking after crew health on their ships.
> Dentists and optometrists never did, so they started their own universities, certification boards, etc. By the time they became respectable enough for people to try to merge them with the medical establishment, in the 1920s, they had no desire to give up their independence.
> The first insurance policies were private contracts with groups of doctors and the system developed from there.
Details vary from country to country of course, but the gist of it generally holds true.
And the final form of dentists, oral-maxillofacial surgeons are an all in one and have to study general medicine, surgery and dentistry.
Good luck if the decision tables are not applicable to you - I pay a huge amount of healthcare tax (many times more than the best US health insurance offer) and yet the medication I need every day to survive and function costs me 100 EUR monthly because the system doesn't recognize the existence of my disease. At least I'm top 1% earner, but again - this is unreachable to the average European.
The system is different but this aspect is pretty much the same everywhere around here.
I mean think about it from the insurer’s point of view. The only reason you’d ever get “the platinum” dental plan is if you were planning to use it. And it isn’t like you have that many “dental emergencies” if you have healthy teeth. If you don’t have healthy teeth you’d already know it when you pick out the insurance plan, so of course you’d get the upper tier.
The only scenario where it makes sense is if your employer picks up a healthy portion of the premium, in which case you are basically getting dental care subsidized by your employer. In that case you’ll likely come out ahead because you knew in advance pretty much how much dental care you’d need.
The same goes for vision care, really. You know in advance how many contacts, glasses and eye exams you’ll need. It isn’t really an insurable thing. If your employer pays for most of the premium, it’s employer subsidized eyewear & contacts for you!
…of course the math does change a bit when you have to pick the same type of plan for a family. In that case it’s time to bust out a spreadsheet and do the math to see the optimal course.
Apparently teeth are luxury bones
(That said, I believe dental issues that are the result of e.g. accidents do get covered by the default care package.)
To the patient maybe. On the other hand (so to speak), if I were gonna spend my day sticking my fingers in people’s mouths, I’d want to wear gloves.
You don't understand the power of the ADA/flouride lobby.
Even just 20 years ago it was routine to have mercury (toxic heavy metal) placed in your mouth for fillings, evidence said the compounds were stable and no one would fund anything that rocks the boat in the US. They did that for children, but they didn't call it mercury, they called it silver fillings (50% by weight mercury).
Normally flouride has very limited uses prior to government mandates, and was so common that it was largely considered a waste by-product not worth selling.
I've yet to find an evidence based study or information on why government require flouride ingestion in any population center above 30,000 when studies have shown its just as effective topically. A study out of african really put the nail in the coffin on this one.
Side effects include lethargy, neurological damage, cognitive decline, hypertension, acne, seizures, and gastrointestinal issues.
It also damages your kids brains more than an adult brain (seemingly lowering IQ permanently), can't be filtered out except by specialized filters that cost a lot (and rapidly become less effective over time).
If they get too much which is very simple indeed, this can happen since its in everything (even bottled water and sodas, GRAS and no label needed under a certain concentration that's well above the toxic limits of new studies).
Nursery Purified bottled Water for infants is a primary source of business.
https://www.readyrefresh.com/medias/sys_master/images/images...
Makes you wonder what's really going on, and why they have to drug broad swaths of the population under the guise that it helps fight dental decay (through ingestion), when most of those studies have been debunked outside the US.
When cities don't have the funding, they magically get the funding for it. When local municipalities don't keep the levels up, they go after them heavy handed, and they disappear from public view.
https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...
Here's a site that gives you those references. Do the critical thinking and reasoning. If you actually do the reading, you'll find what I have said is quite correct (and your downvotes are you exercising your opinion to silence others irrationally, which is coercive and evil when its arbitrary and unbacked by rational evidence).
https://fluoridealert.org/content/50-reasons/ (the list is at the bottom)
Then there is also a good paper here for the history of Flouride.
For those that don't pick out the critical parts, conclusion isn't appropriate because it neglects common factors like funding (rather the lackthereof for anti-flouride research), the lack of ability to publish (subverted journals refusing publication), and a great many papers after the 1950s; and only briefly touches on methodological issues such as the fact that early studies used young men (not infants, kids, older populations, or women), and extrapolated out for the general population.
Women's health, birth, and allergies/thyroid changes were largely ignored, and rather than correct the bad science in a rational way; the expert voices involved were minimized and discredited, while simultaneously being barred from publishing in research pools (for a perceived stance rather than for actual science, ideologically against science). Its not hard to see why the thought that Communism was playing a role in this line of inquiry.
When seeing these tactics, they were commonly known by the public at the time, and were used primarily by Communists and Marxists who weren't follow western thought based in rationalism (science) to try to subvert the population, and if this were the case, its hard to argue that they didn't succeed in subverting the bureaucracy to force the changes despite the health consequences.
Read for yourself, also that objective 15% benefit (not 2/3) extrapolated didn't properly account for increasing tooth hygiene during that same time.
Even the CDC today recognizes the benefits are mainly from topical uses. Most western countries don't allow flouridated water supplies.
Much of the research over the years had to be independently funded, or were government funded by those countries, and the science has been overwhelming, but this isn't how public trust science is supposed to work (in the US). More specifically biasing funding on safety issues to push unsafe options for profit/benefit would fall under political corruption, and a violation of the public trust.
I'm always baffled by all the discussions about flossing, as it's something that can be very easily verified empirically: one can just floss for a month, then stop doing it for another month, then resume and get a feeling for how the gums react. If they bleed or burn (lightly), then the efficacy is evident; if not... lucky person! No need for research either way.
In my case, I don't need to floss daily, but I still need to do it regularly. Two weeks without flossing, and I'll definitely feel the burn once I resume flossing.
It's the same phenomenon as something like the calluses guitar players get. If they take a few weeks off, it'll hurt a bit when they play. That doesn't mean the activity improves their health. It means if you poke a part of the body enough it handles being poked better.
One notable effect when regular flossing is sustained is that your whole mouth just feels generally less sensitive and healthy. Less pain when you chew, your breath feels fresher for longer. The reverse can also be noticed when you stop flossing.
As I said, this is not universal since not everyone has the same teeth arrangement. Which is one more argument in favor of not waiting for evidence. It's considerably cheaper to just get some 3$ dental floss, try it for a month, and see for yourself.
The tobacco industry was a contributing factor but common sense and independent thought was already gone or it wouldn’t have worked for as long as it did.
Just because there's no actual studies for flossing, that doesn't mean that flossing is bad or not-needed per se, but there does need to be more basic-level studies for it. I had bad gum-disease in my 20s, but once I actually started flossing daily, it stopped progressing. So it clearly helped me, but a better study on whether everyone needs to floss and how often should be done.
How we've ended up regulating medicine to the nth degree, but when it's teeth we're like "oh well, lol", continues to mystify me.