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My mom has crowded teeth. My dad has gaps. I must have gotten a little of both because my teeth are straight and even. Good thing, because I\u2019m in high school and braces would dissolve what small nuggets of game I have. \u2018Well!\u2019 declares the dentist as he emerges from my mouth. He pulls off his glove and I close my jaw. There\u2019s a pop that could have come from either. \u2018The thing is that the two halves of your face didn\u2019t grow at the same rate. Here, take a look.\u2019 He holds up a mirror and I see my disfiguration for the first time. The right side of my jaw is a little crooked. My nose on that side is angled, my eyelid is a slightly different shape. \u2018Oh wow\u2026\u2019I am shocked and embarrassed. I touch my face. I had no idea.\u2018So, do I need braces?\u2019 \u2018No, but your bite is a bit off. Fractions of a millimeter here and there.\u2019 His own teeth strobe out from between his lips as he talks. They rival the overhead lamp for xenon brilliance, accentuated by his deeply tanned skin. \u2018You\u2019ll want to get it corrected or you could end up wearing your teeth down. I can do it today if you\u2019re up for it?\u2019\u2018I\u2019m not sure\u2026what about my jaw?\u2019\u2018Oh it will make that better actually. Your jaw will slot right into place after this. No more sliding around to find the right bite.\u2019\u2018Are you sure? Because I really don\u2019t\u2014\u2019\u2018If you were my son, I would say the same thing.\u2019 \u2018OK,\u2019 I say, \u2018Let\u2019s do it.\u2019 Tooth reshaping was a euphemism. Voluntary torture would have been more accurate. My teeth fit together better alright. But they are shorter now, and that makes the impingement of my jaw into the right socket worse. Fucking guy. Never going there again. That hygienist was pretty though\u2026mom-pretty because she was like 28, but still. I wish I had never done it. But hey, at least I didn\u2019t have to get braces. I\u2019m 20, in Florida. My face is still warm from the radiation bath the ancient x-ray machine gave me. It is a tall, forbidding machine that would have at least a dozen skulls painted on its nose cone if it was a fighter plane. The office is a couple rooms in an office building basement. The hygienist is out for another back surgery and the front desk lady is sick. So the sweaty old dentist is doing it all himself today. \u2018Well no cavities,\u2019 he murmurs, looking at the pictures. The good news momentarily lifts the weary folds at the edge of his mouth but the smile does not reach his sad eyes. \u2018Great,\u2019 I say. I expected no less. I am 20 after all, and I will live forever. \u2018But looks like you\u2019ve started to grind your teeth. And you say the jaw hurts?\u2019 \u2018Grind my teeth? I don\u2019t think so.\u2019 I run my tongue along the inside of my teeth. \u2018Well, it happens when you\u2019re asleep so you don\u2019t notice.\u2019Yeah whatever pal. \u2018Anything we can do about the jaw?\u2019\u2018Well, I can make you a splint. That\u2019ll help both issues. It\u2019s like a retainer that your front teeth rest on. It allows them to glide a few millimeters above the others so you don\u2019t grind. And it will probably allow your jaw to relax.\u2019\u2018Is it hard to sleep with?\u2019\u2018Not really once you get used to it. I just made one for my daughter.\u2019Seems easy enough. \u2018OK. Let\u2019s do it.\u2019 I\u2019m 22, and living in Utah. The splint was great but I\u2019ve lost it and I haven\u2019t had a cleaning in two years. I looked up the top-rated dentist on Google and now I\u2019m walking into my appointment. I open the door and squint into the shining plasticky sleekness. \u2018Hello and welcome!\u2019 beams a beautiful girl with flowing blonde hair and red lips. She sits in a Herman Miller chair behind a white marble countertop. The lights are bright and fancy green wallpaper accents one wall. The office air is chilly, fancy chilly, the kind of chilly that says \u2018we don\u2019t care how much electricity costs, as long as you\u2019re comfortable.\u2019\u2018Spa water?\u2019\u2018Oh wow, sure, thanks.\u2019 The hygienist that does my cleaning is also beautiful, about my age. Ring on though\u2026my sister was a hygienist for a while and wore a fake ring to keep the men at bay. 22 and married? This is Utah, so probably legit. When did they start cutting scrubs to make them sexy? Another girl takes my x-rays on a new machine the size of a small ottoman. She is also beautiful and also wearing form-fitting scrubs that somehow leave a lot and a little to the imagination at the same time. Dentist comes in. She\u2019s an attractive blond that paid for about 50% of her looks. Mom-attractive though, because she\u2019s like 38. She looks me full in the face and leans forward.\u2018Good news. I can make you a new night guard. You said your last dentist made you a splint?\u2019\u2018Yes it worked really well. My jaw never felt better.\u2019\u2018Well splints aren\u2019t good because your top teeth need your bottom teeth to strike against. Without that pressure they move around and eventually loosen and fall out.\u2019 \u2018Oh jeez. Well, it felt great\u2026\u2019\u2018I\u2019m sure it did.\u2019 She gives me a pitying smile. Her teeth are so white and her skin is so tan. If you smile while lying in a tanning bed does it bleach your teeth while it\u2019s darkening your skin? \u2018Now I have some bad news: you have twelve cavities.\u2019 \u2018What!? Twelve cavities?\u2019 I am shocked and embarrassed. I put my hand to my mouth. My oral hygiene isn\u2019t that bad, is it? Jesus\u2026I had no idea. \u2018How could that be? Two years ago I had none. Do they grow that fast?\u2019\u2018They can!\u2019 She brings up the x-ray on the sleek Dell x-ray viewer. \u2018See the smudge between these teeth? That\u2019s a cavity.\u2019 I lean forward. \u2018I don\u2019t really see it\u2026\u2019\u2018Well you can\u2019t because you\u2019re not a dentist. But I can. That\u2019s the worst one. And you have eleven more.\u2019\u2018Oh gosh\u2026\u2019 I imagine great painful pits in my teeth, crumbling molars, my grandfather\u2019s champing gums.\u2018The good news is I can fill five of them today.\u2019\u2018Shoot, I would but I have to get back to work. I\u2019ll reschedule.\u2019 \u2018Well do it soon. There\u2019s no cure for a cavity you know, and they\u2019ll just get worse!\u2019Back at work I tell the guys the shocking news and urge them all to brush more often. \u2018Wait,\u2019 says Petey. \u2018You said you went to Dr. Greene?\u2019 Petey\u2019s a quiet young Mormon guy, but now he gets heated. \u2018That freaking dentist\u2026she is the worst, the absolute worst. She said I had fifteen cavities! I was so darn scared. I had her fill the first few but she drilled too deep and I got an abscess and almost freaking died. Whatever you do, don\u2019t go back to her. She\u2019s just out to milk her patients. How do you think she affords that nice office?\u2019\u2018It was a nice office\u2026\u2019\u2018Plus they give people discounts if they leave a 5-star review.\u2019 \u2018Oh yeah\u2026they had like 200 reviews and an exactly 5.0 star rating. That\u2019s sketchy.\u2019 \u2018Yeah man. Here\u2019s the number to Dr. Frank, the dentist that fixed me.\u2019***Dr. Frank\u2019s office has a low drop ceiling with yellowing panels, peeling wallpaper, stacks of files along the back wall, busted-ass waiting room chairs. The fax machine is running loud and hot in the corner. The woman at the desk has normal, baggy scrubs. She calls me \u2018hun\u2019. Dr. Frank is a wide man with a confident grip and a straightforward manner that lives up to his name. \u2018I reviewed those x-rays from Dr. Greene. Let\u2019s just say I\u2019m not a fan of her work. She showed you these shadows right? Well I like to call that \u201ctrolling for dollars\u201d. They may be cavities. They may not be. It will be years before we can say for sure.\u2019 \u2018So I don\u2019t have twelve cavities?\u2019 \u2018Well some of them probably will turn into cavities some day. But not now. And some may just go away.\u2019\u2018Really? Because she said\u2014\u2019 \u2018Oh yeah, I\u2019ve seen it happen. Look, if you were my kid I\u2019d say don\u2019t go drilling anything right now. Don\u2019t let her scare you into doing something you don\u2019t need to do.\u2019 I\u2019m 26, living in Burbank, California. Back in a dental chair with my mouth open. The place isn\u2019t exactly dingy, but it isn\u2019t exactly nice either. I\u2019ve learned my lesson about nice offices. The waiting couch sags, the receptionist reminds me of my second-grade teacher and the hygienist has such veiny, muscular forearms that I wonder if she\u2019s there to restrain patients as well as clean their teeth. Dr. Hong is calling numbers out from inside my mouth to the hygienist who types them into a chunky old Lenovo laptop. Dr. Hong snaps off the yellowing overhead light and gives an exasperated sigh. \u2018You need wear night guard. Your teeth terrible. Grinding and clenching all night.\u2019 Damn it. I never got a new one. \u2018Hahhyeah I han hegetha nother un hut eely herk?\u2019 He takes the dam out of my mouth and hand-cranks the chair upright. \u2018Yes night guard work. But only if you wear it.\u2019\u2018But\u2014\u2019He waves me silent and drops his bombshell. \u2018You have to wear night guard. You have teeth of 50-year-old!\u2019 \u2018What?! The teeth of a 50-year-old!?\u2019I\u2019m shocked and embarrassed. I run my tongue along the inside of my molars. I mean, I knew I should be wearing the night guard but, god\u2026 I had no idea I did such damage. \u2018Oh yes, you have old teeth. Very terrible. But night guard only $250. I can take impressions for it today.\u2019\u2018But they\u2019re hard to keep in all the time. And there\u2019s my jaw...\u2019\u2018Too bad. You need to get used to it. If you my grandson I tell you wear it or you lose your teeth! And hurry up because I retire soon. I will refer you to TMJ guy for jaw.\u2019\u2018OK\u2026let\u2019s do it.\u2019 I\u2019m so cowed he could have charged me $1,000 and I still would have paid. The night guard does not help my jaw. And it pushes a couple teeth out of line so now they strike wrong. Dr. Hong retired and I\u2019m moving soon. I don\u2019t have time to get it adjusted. Plus, is it really doing anything? I don\u2019t think I\u2019m really grinding. It was that stupid tooth reshaping when I was 17\u2026Eventually I get in with the TMJ specialist, and he refers me to an oral surgeon. \u2018Best guy in town for a jaw like yours.\u2019 It seems this surgeon is dental royalty because his dad founded the big university dental school. Junior is a hotshot surgeon but he\u2019s retiring soon so I should get in with him as soon as I can. I arrive at the swanky building off Wilshire Blvd. Elevator to the 30th floor. Doors open right into the office and I\u2019m greeted by a bored, curvy little blonde with light brown eyes that flash up from her Apple laptop. She instantly catalogs me from under her elegant mascara. No ring. But it\u2019s clear from the wince she passes off as a smile that I wouldn\u2019t have a chance anyway. The office is nice in an old money sort of way: stiff leather chairs, thick wool carpet, muted red and white and gold, immaculately clean. \u2018Spa water?\u2019\u2018Sure, thanks.\u2019 Dentist is a large tanned man with a quarterback\u2019s hands. He doesn\u2019t use them to shake mine. He has pictures of dead African big game as his Macbook Pro screensaver. He touches his gold-rimmed glasses and pulls up my x-rays.\u2018You have what we call a large skeletal anomaly. Essentially your face is deformed. The only way \u2014 the only way \u2014 to solve it is to saw your jaw apart, graft bone, cut off your gums and move the whole thing over fractions of a millimeter with posts and pins and glue made from your own powdered bone.\u2019A chill runs up my spine. \u2018Plus you have some gum recession which we can take care of at the same time. It is a coordinated care plan that involves four different specialists. It takes about 9 months in total. It will cost about $100,000. Maybe $150,000. But I am confident we can probably help you.\u2019 \u2018But what about\u2014\u2019 \u2018It is the only way. Nothing else is really worth getting into.\u2019 \u2018But\u2014\u2019\u2018Look, if you want things to keep getting worse, live your life. But if it was me, I\u2019d bite the bullet and get it over with.\u2019 \u2018In terms of a second opinion, I think his recommendation was way too drastic,\u2019 says my neighborhood strip mall orthodontist. She\u2019s in her early thirties, still paying off her student loans but not trying to pay them off tomorrow. Office is modest and her assistant is a niece with bad skin. \u2018I guess there\u2019s a skeletal anomaly but it\u2019s not bad at all. About 6 months with some gentle Invisalign and you\u2019d be all set. Your jaw will not be perfect, but I can promise that you\u2019ll have a better bite.\u2019This should make me feel better. But all I feel is exasperation. \u2018That\u2019s great. But I don\u2019t know what to think. I got him saying $150k and 9 months, and I got you telling me 6 months of light correction. Who do I believe?\u2019 She shrugs. \u2018Well, he\u2019s a surgeon. Maybe every mouth looks like a nail he should hammer.\u2019 I wince at the thought. \u2018How could I have prevented this?\u2019\u2018Oh well you should have gotten braces when you were young. And a palate expander. But after about 21 your bones are hard and set. No changing them unless you do those crazy surgeries he was talking about.\u2019 \u2018Damn. So just a little Invisalign?\u2019\u2018Yep.\u2019\u2018Would you need to do any tooth reshaping or anything like that afterwards?\u2019\u2018Oh sure. But that\u2019s nothing. Just fractions of a millimeter. I can take your impressions today if you want to get started?\u2019\u2018No thanks. I need to think about it.\u2019 I\u2019m 33, just moved back home to Austin. I never got the Invisalign. Jaw still hurts from time to time. I haven\u2019t had a cleaning in two years. And my tooth sensitivity from the gum recession is getting worse. I can\u2019t drink cold water without pain. My teeth aren\u2019t as sharp as they used to be either. I have not been wearing a night guard. Both my parents have recently gotten root canals and explained the process in graphic detail. They wish they had taken better care of their teeth. It is time to get my shit together. But first I need to find a good dentist. \u2018You should see mine,\u2019 says my sister over tacos. \u2018She\u2019s cool and pretty. I call her Hottie Doc. It\u2019s a super nice office.\u2019\u2018Hottie Doc? Nice office? No thank you.\u2019\u2018Oh trust me, I understand, but they really do good work and they don\u2019t try to upsell you on shit all the time.\u2019 She would know. She was a hygienist after all. \u2018OK, well I don\u2019t have any other recommendations and I don\u2019t trust Google so\u2026 I guess I\u2019ll give them a shot.\u2019 Spa water. Beautiful hygienist. Cold office. New handheld x-ray machine. Form-fitting scrubs. \u2018Well you have 6 cavities,\u2019 says Hottie Doc. Her perfectly bronzed skin glows in the afternoon sun coming in through the floor to ceiling window. \u2018See these shadows between the teeth?\u2019At least I see the shadows now, because they\u2019re bigger. And those were some of the same teeth Dr. Greene said I had cavities in ten years ago. It\u2019s time. \u2018OK fine. And what about the gum recession?\u2019\u2018Yeah your recession is pretty bad. For that I\u2019ll get you in with the periodontist. It's worth a consult and he\u2019s great.\u2019 \u2018And the jaw thing?\u2019 \u2018Well you need a night guard for sure. I\u2019ll make you something called a splint.\u2019\u2018Oh no, I\u2019ve tried those before and another dentist said\u2014\u2019\u2018Well, you\u2019re not meant to wear them for a long time. A few weeks to allow your jaw to relax so we can see where it wants to go. Then we get you a proper night guard made in that shape, so all night your jaw is relaxed and happy. Your bite will feel off but in the morning it will just go back to where it normally does when you chew.\u2019\u2018OK, I guess that makes sense.\u2019\u2018And then we\u2019ll refer you to the best ortho in town, Dr. Trudy. She\u2019ll tell you what you need. Are you ready to take care of these cavities? I can do your left side today.\u2019 \u2018Sure, better now than later right? But god I hate getting my teeth drilled! Every few years I read some promising article about how scientists are working on lab-grown organs and stuff. It\u2019s always like 10 years away from actually being ready. When are we going to be able to just regrow teeth in the lab from our own stem cells or something?\u2019 She guffaws. \u2018I don\u2019t know! Ask Elon Musk! OK now lean back and open your mouth.\u2019 Poor form. A good dentist should have more professional curiosity than this. Further thoughts are drowned out by the screaming whine of the dental drill.On the way out the pretty little hygienist hands me two referrals. At 19, she\u2019s too young for me and probably too young for these scrubs that show so much deep cleavage.\u2018This one is for Dr. Trudy the ortho. She is just the best. That\u2019s who my parents took me to.\u2019 Her teeth are wide and white and straight. She has no skeletal anomaly. \u2018And here is the referral to the periodontist Dr. Gupta.\u2019\u2018Thanks,\u2019 I slur through Novocaine lips. \u2018Guess I shouldn\u2019t have been brushing so hard all these years.\u2019 \u2018Oh that\u2019s been totally disproven as a cause of recession,\u2019 says Hottie Doc, appearing behind the counter. \u2018It's caused by grinding and by genetics. Brush as hard as you want. I\u2019ve seen gums grow back after wearing a good night guard.\u2019\u2018Oh really? I thought that once gum tissue was gone it was gone forever.\u2019She shrugs. \u2018I\u2019ve seen it. Bye bye now. See you next week for the other side!\u2019 \u2018Yes, you have some light recession,\u2019 says the periodontist Dr. Gupta. He pops in a mint and sits down onto a fancy swivel chair. Unlike other dentists, Dr. Gupta came by his dark complexion the old-fashioned way. His office is nice but I\u2019m not sure if the same rule about niceness applies to a gum specialist. \u2018It\u2019s really not too bad. See all this tissue here? I\u2019d say you\u2019re fine.\u2019\u2018Well, that\u2019s good to hear.\u2019\u2018The main thing is to manage the sensitivity and not brush too hard.\u2019\u2018Wait, I thought hard brushing was disproven?\u2019\u2018Not really. Who told you that?\u2019 I feel a surge of anger. Good lord. Do any of these dentists actually know what they\u2019re doing? \u2018OK, well I\u2019m getting this night guard which my dentist says will help with the recession.\u2019 He gives a noncommittal head bobble. \u2018I\u2019m pretty excited about it because she\u2019s making one that will help my jaw go back to where it wants to be.\u2019He frowns and squints at my jaw. \u2018Hmm, yes. Look, just make sure it\u2019s a flat one, and doesn\u2019t pull your jaw out of alignment. Those sideways ones might feel good while you\u2019re sleeping but then your teeth don\u2019t fit together right. If it's off by fractions of a millimeter you could end up doing serious damage to your teeth and maybe worsening the recession.\u2019 \u2018Oh. Well I already paid for it. I was really going to do it right this time\u2026\u2019\u2018Well if I was your father, I\u2019d say stay away from those types of night guards.\u2019\u2018Oh\u2026\u2019\u2018As for the recession, if the sensitivity is really bothering you we can do a gum graft. That\u2019s where I scrape tissue off the roof of your mouth, cut into your gums so they lift up in flaps, and then I paint the scraped tissue back on around your teeth and reattach your gums. It costs about $10,000.\u2019 A shiver shoots up my spine. \u2018Oh boy. Isn\u2019t that just a stopgap though? Without really knowing what caused it, how do I know the recession won\u2019t keep getting worse?\u2019 \u2018We don\u2019t. You know, if I were you, I would wait. We\u2019re only a few years away from being able to culture gum tissue from your own stem cells and reapply it painlessly to your teeth.\u2019\u2018Really?! Now that\u2019s what I like to hear! And who knows, maybe with light brushing and wearing the night guard, some of it will grow back on its own.\u2019Dr. Gupta scoffs. \u2018That\u2019s a myth. Once gum tissue is gone, it\u2019s gone forever. Who told you that?\u2019 \u2018My dentist\u2026\u2019 He chuckles. \u2018Well, she\u2019s not a perio.\u2019 I catch the unmistakable odor of stale tobacco under the mint on his breath. I notice the outline of a pack of smokes in his scrubs pocket. For Christ\u2019s sake, isn\u2019t smoking a major cause of gum recession?\u2018One last question. I saw Dr. Trudy for ortho before I came to you. If I do get the gum treatment, she said I should do the ortho first. Is that right?\u2019 \u2018Oh, no no no! You do perio first and then the ortho. Moving your teeth around, even fractions of a millimeter without gum coverage, is a good way to lose even more. Listen, Dr. Trudy is\u2026well, let\u2019s just say I am not a fan of her work.\u2019\u2018You aren\u2019t?\u2019 I ask weakly. A gray swirl of frustration and confusion and hopelessness wells up inside me.\u2018No. In fact, I\u2019m glad she\u2019s retiring. You know, I\u2019ve seen a few cases like yours over the years.\u2019\u2018You have?\u2019\u2018Yes and with coordinated care, we could really correct your entire mouth. But the first thing you need to do is see an oral surgeon.\u2019He spins on the little chair and calls to the tall, raven-haired stunner at the front desk. \u2018Hey Crystal, who was that really good oral surgeon out in California?\u2019Discussion about this postReady for more?" ], "output": "readability", "pwd": "/data/archive/1792015701.191916", "schema": "ArchiveResult", "start_ts": "2026-10-14T22:13:46.742014+00:00", "status": "succeeded" } ], "screenshot": [], "singlefile": [], "title": [ { "cmd": [ "curl", "--silent", "--location", "--compressed", "--max-time", "120", "--user-agent", "Mozilla/5.0 (Macintosh; Intel Mac OS X 10_15_7) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/118.0.0.0 Safari/537.36 ArchiveBox/0.7.4 (+https://github.com/ArchiveBox/ArchiveBox/) curl/curl 8.14.1 (x86_64-pc-linux-gnu)", "https://mapwriting.substack.com/p/dentists" ], "cmd_version": "curl 8.14.1 (x86_64-pc-linux-gnu)", "end_ts": "2026-10-14T22:13:46.734779+00:00", "index_texts": null, "output": "Do dentists actually know what they\u2019re doing?", "pwd": "/data/archive/1792015701.191916", "schema": "ArchiveResult", "start_ts": "2026-10-14T22:13:46.698591+00:00", "status": "succeeded" } ], "wget": [ { "cmd": [ "wget", "--no-verbose", "--adjust-extension", "--convert-links", "--force-directories", "--span-hosts", "--no-parent", "-e", "robots=off", "--reject=js,mjs,woff,woff2,ttf,otf,eot,mp4,m4v,mov,webm,ogv,mkv,avi,flv", "--timeout=120", "--restrict-file-names=windows", "--page-requisites", "--user-agent=Mozilla/5.0 (Macintosh; Intel Mac OS X 10_15_7) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/118.0.0.0 Safari/537.36 ArchiveBox/0.7.4 (+https://github.com/ArchiveBox/ArchiveBox/) wget/GNU Wget 1.21.3", "--compression=auto", "--timestamping", "https://mapwriting.substack.com/p/dentists" ], "cmd_version": "GNU Wget 1.21.3", "end_ts": "2026-10-14T22:13:46.687171+00:00", "index_texts": null, "output": "mapwriting.substack.com/p/dentists.html", "pwd": "/data/archive/1792015701.191916", "schema": "ArchiveResult", "start_ts": "2026-10-14T22:13:42.213665+00:00", "status": "succeeded" } ] }, "icons": null, "is_archived": true, "is_static": false, "latest": { "archive_org": null, "dom": null, "favicon": "favicon.ico", "git": null, "media": null, "pdf": null, "screenshot": null, "singlefile": null, "title": "Do dentists actually know what they\u2019re doing?", "warc": null, "wget": "mapwriting.substack.com/p/dentists.html" }, "link_dir": "/data/archive/1792015701.191916", "newest_archive_date": "2026-10-14T22:13:49.338910+00:00", "num_failures": 0, "num_outputs": 6, "oldest_archive_date": "2026-10-14T22:13:41.167296+00:00", "path": "/p/dentists", "schema": "Link", "scheme": "https", "snapshot_id": "f1820dc9-4a51-4e07-b701-f56d4ad14e04", "sources": [ "/data/sources/1792015701-import.txt" ], "tags": null, "tags_str": "", "timestamp": "1792015701.191916", "title": "Do dentists actually know what they\u2019re doing?", "updated": "2026-10-14T22:13:41.166800+00:00", "updated_date": "2026-10-14 22:13", "url": "https://mapwriting.substack.com/p/dentists" }