Fixed Retainer Lower Teeth - Obsolete ?

Raiser

*** Only asking this in advance of consulting an Orthodontist - reason is to get a broader opinion & if I'm very lucky an account of first hand experience ***

Was trying to find some info. on this topic but not having too much luck - there are those who say that they are no longer acceptable [obsolete], a dental health liability and an easy "out" for Orthodonists......[?]

- Mine is in place circa 15 years and is not remotely as neat as the one linked to below which has been designed to be flossable [is more like train-tracks but on inside face of teeth]. Would love an alternative if available as a permanent retainer is playground for plaque, makes flossing on lower teeth next to impossible and also is in the way of my tounges normal resting place :mad:

I worry that retained lower teeth ache sometimes and wonder if I'll eventually lose them because I didn't re-assess this treatment/take some action

Any opinions welcome..........

Big_G

Who says this?

I think retention is particularly prudent in cases where there is a risk of late lower incisor crowding, or where crowding or rotations existed before the orthodontic correction.

I don't think it is an easy out for the orthodontist. It is an easy out for the patient. The alternative is wearing a removable retainer for the rest of your life. Studies show that compliance with this modality can be extremely low. From a personal point of view, I lost four hawley retainers before I gave up on them.

If you are unhappy with your retainer, have it replaced with a more modern design. They should be replaced every so often as they can debond, etc.

G

Big_G

On another note, Raiser, I think you will find it easier getting questions answered around here if you change your ridiculously poorly informed and cynical signature.

Raiser

Big_G wrote: »

On another note, Raiser, I think you will find it easier getting questions answered around here if you change your ridiculously poorly informed and cynical signature.

Hi Big_G - many thanks for taking the time to respond to my query - if newer versions are less bulky and/or easier to maintain in terms of oral hygiene I think I'll investigate the associated costs/practicalities involved in getting my retainer upgraded.


I'm not sure which of the comments [or was it both ?] in my signature you disagree with - but I do recognise and respect the fact that you are entitled to your personal opinion; I feel that if I were to fail tolerate your expressed views and/or opinions and instead criticise them on the strenght of a mere variance of personal opinion then I would run the risk of being seen by some as a reactionary Bigot. Nobody likes a reactionary Bigot; Not friends or family, or usually even casual aquaintances - in fact sometimes even their own dog can find them a bit hard to take.

- Now that we've both given each other some sound advice I believe I owe you no further debt.

Big_G

Raiser wrote: »

Hi Big_G - many thanks for taking the time to respond to my query - if newer versions are less bulky and/or easier to maintain in terms of oral hygiene I think I'll investigate the associated costs/practicalities involved in getting my retainer upgraded.


I'm not sure which of the comments [or was it both ?] in my signature you disagree with - but I do recognise and respect the fact that you are entitled to your personal opinion; I feel that if I were to fail tolerate your expressed views and/or opinions and instead criticise them on the strenght of a mere variance of personal opinion then I would run the risk of being seen by some as a reactionary Bigot. Nobody likes a reactionary Bigot; Not friends or family, or usually even casual aquaintances - in fact sometimes even their own dog can find them a bit hard to take.

- Now that we've both given each other some sound advice I believe I owe you no further debt.

I do not criticise them based on a mere variance of personal opinion. I criticise them with a thorough knowledge of the issues involved. I do not accuse people of being drug dealers or leeches when they contribute to society.

With respect to your first comment, pharmacists would make a loss if they continued to dispense methadone under the market control tactics of the HSE at the time. Your signature displays an opinion that is ill informed.

The second part is merely a matter of opinion, but I would suggest that most consultants have put in 10 years minimum postgraduate training at 60-100 hours per week. I think €200,000 is reasonable remuneration for such output. Would you take a pay cut to do the same work that you are doing now? I know I wouldn't.

This is a healthcare forum, I consider pharmacists and consultants both colleagues and (some of them) friends. So you would be right if you suggested that I might have a biased opinion, but at least my opinion is well informed, unlike yours which appears to come from sensationalist tabloid newspapers, judging by the language that you use in your sig.

To say that I am a bigot in the literal sense is true, in that I am intolerant of others opinions. I'll think you'll find that I am only intolerant of others opinions when they are derived from ignorance.

You too are bigoted in that you appear to have no tolerance for the views of pharmacists or consultants. Takes one to know one I guess.

Raiser

Big_G wrote:

On another note, Raiser, I think you will find it easier getting questions answered around here if you change your ridiculously poorly informed and cynical signature.

Big_G wrote: »

I do not criticise them based on a mere variance of personal opinion. I criticise them with a thorough knowledge of the issues involved. I do not accuse people of being drug dealers or leeches when they contribute to society.

With respect to your first comment, pharmacists would make a loss if they continued to dispense methadone under the market control tactics of the HSE at the time. Your signature displays an opinion that ill informed[/U].

The second part is merely a matter of opinion, but I would suggest that most consultants have put in 10 years minimum postgraduate training at 60-100 hours per week. I think €200,000 is reasonable remuneration for such output. Would you take a pay cut to do the same work that you are doing now? I know I wouldn't.

This is a healthcare forum, I consider pharmacists and consultants both colleagues and (some of them) friends. So you would be right if you suggested that I might have a biased opinion, but at least my opinion is well informed, unlike yours which appears to come from sensationalist tabloid newspapers, judging by the language that you use in your sig.

To say that I am a bigot in the literal sense is true, in that I am intolerant of others opinions. I'll think you'll find that I am only intolerant of others opinions when they are derived from ignorance.

You too are bigoted in that you appear to have no tolerance for the views of pharmacists or consultants. Takes one to know one I guess.

I've empahsised the portions in your text that you need to work on to avoid coming across as a prejudiced, small-minded, condescending little troll :rolleyes:

I left most of my tabloids in the lowly tenement that I call home, but a report published by Indecon while back found that Irish pharmacists enjoy profit margins of 33 per cent, the highest in the European Union and more than four times the British level of 7.5 per cent.

I'm sure the Pharmacists will quote how they have to pay high insurance, and the outrageous costs of a new pollen filter for their BMW etc. etc. the fact is that out of all of the outrageously over-priced products on their shelves Methadone was chosen for a reason - and I'm glad the the net effect was to highlight those involved as mean-spirited, inhumane, profiteering morons who should be a million miles from having any role in Irish Healthcare.

Of the many careers that are purely motivated by base greed Pharmacy is only surpassed by aggravated car-jacking; If I'm wrong I'll just take my medicine and swallow that bitter pill - that is if I can afford it

ceidefields

Please. Greed? How about Investment Banking or Trading? I have truly never met a rich Pharmacist, apart from management over at Pfizer or Johnson & Johnson.

Anyway, back to the original question. I second what Big G said. I have invisalign right now that I wear as a retainer. I periodically lose the trays. I do know that many people wear removable retainers at night and most stop wearing the retainer after a while.

Big_G

All the highlighted words are mirrored in what you initially said to me. Your signature is designed to inflame and incite, and to that end you have succeeded, which makes you the troll.

Pharmacists profit margins have decreased considerably since the Indecon report AFAIK, which is reflected in the average cost of purchasing a pharmacy which has decreased by almost 25% since deregulation. In no other sector in Ireland has this been matched. The Indecon report also included both large and small pharmacies and took no account of economies of scale which work frequently in pharmaceutics.

I don't wish to get into a lengthy diatribe regarding the HSE's use of free market economics or centrally controlled monopolies in healthcare when it suits them. But I will because I don't like you.

Essentially, the price paid to pharmacists to dispense methadone did not cover the cost of methadone at market prices (never mind a dispensing fee), so pharmacies negotiated a discount linked to the amount of other product purchased from wholesalers (the less purchased, the lower the discount from 1-8% AFAIK). This made dispensing methadone a profitable rather than a loss making exercise. In no other sector would a qualified professional be expected to provide a service at a financial loss, except for healthcare. The HSE summarily lowered the fees paid for dispensing methodone thus negating the discount and exercising control over a supposedly free market (IMO this contravenes the Competition Act but that is another story).

This is not to mention the somewhat related issue of long term methadone usage. It is a drug intended to be used to relieve the symptoms of heroin withdrawal (of which the major ones last around 7-10 days).

It is my opinion that healthcare systems do not work if they are publicly funded and privately provided, as seems to be the cause with all the auxiliary providers (dental, gp, optometry, pharmaceutical, chiropody and others). This is exactly the type of problem that occurs. A tension exists in a market where there is a gulf between private and public fees. This results in providers eventually dropping public services and going fully private. Either a fully public or fully private system is in order. Enough of this unequal provision of fees and services (both sides of the system).

That is where your lack of understanding lies, the economics of healthcare. It will always cost money, not least of which is due to human resources. It is expensive to train experts in the human body, and is really a vocation. If you are going to draw and keep talent into healthcare, remuneration must be comparable or better than other areas (because it is more demanding than most other ares).

Your signature smacks of begrudgery if you ask me - the Irish condition.

Raiser

Big_G wrote:

Your signature is designed to inflame and incite, and to that end you have succeeded, which makes you the troll.

You have indeed proven yourself to be a shrewd, eloquent and cunning adversary Big_G. - Let me take the bait......No you're the troll :rolleyes:

Big_G wrote:

Pharmacists profit margins have decreased considerably since the Indecon report AFAIK, which is reflected in the average cost of purchasing a pharmacy which has decreased by almost 25% since deregulation. In no other sector in Ireland has this been matched. The Indecon report also included both large and small pharmacies and took no account of economies of scale which work frequently in pharmaceutics.

AFAIK - As far as you know ? [?] Why not inform yourself of the facts ??? You really should try this if you're going to adopt an arrogant, domineering and self-righteous attitude and inflict it on the public at large :rolleyes:

If you understand economies of scale then the economic axiom of supply and demand should be a breeze for you - deregulation in the Pharmacy game and profit margins are not linked in the manner in which you have implied. In much the same way as a 1998 Toyota Corolla went in value from €120,000 to €5,000 overnight when the taxi industry was deregulated.

Big_G wrote:

I don't wish to get into a lengthy diatribe regarding the HSE's use of free market economics or centrally controlled monopolies in healthcare when it suits them. But I will because I don't like you.

Awww you don't like me now ? This saddens me to the pit of my soul - just when your obnoxious ranting, arrogance, pious pontificating and pitiful adolescent jeering were making me really start to warm to you

Big_G wrote:

Essentially, the price paid to pharmacists to dispense methadone did not cover the cost of methadone at market prices (never mind a dispensing fee), so pharmacies negotiated a discount linked to the amount of other product purchased from wholesalers (the less purchased, the lower the discount from 1-8% AFAIK). This made dispensing methadone a profitable rather than a loss making exercise. In no other sector would a qualified professional be expected to provide a service at a financial loss, except for healthcare. The HSE summarily lowered the fees paid for dispensing methodone thus negating the discount and exercising control over a supposedly free market (IMO this contravenes the Competition Act but that is another story).

This is not to mention the somewhat related issue of long term methadone usage. It is a drug intended to be used to relieve the symptoms of heroin withdrawal (of which the major ones last around 7-10 days).

It is my opinion that healthcare systems do not work if they are publicly funded and privately provided, as seems to be the cause with all the auxiliary providers (dental, gp, optometry, pharmaceutical, chiropody and others). This is exactly the type of problem that occurs. A tension exists in a market where there is a gulf between private and public fees. This results in providers eventually dropping public services and going fully private. Either a fully public or fully private system is in order. Enough of this unequal provision of fees and services (both sides of the system).

That is where your lack of understanding lies, the economics of healthcare. It will always cost money, not least of which is due to human resources. It is expensive to train experts in the human body, and is really a vocation. If you are going to draw and keep talent into healthcare, remuneration must be comparable or better than other areas (because it is more demanding than most other ares).

You've lost your credibility Big_G - there isn't enough time in the day for me to try and separate the [undoubtably slim] substance in this meandering diatribe from your self-serving misrepresentations, deluded ideals and stunted opinions borne of the loins of narrow-mindedness.

Big_G wrote:

Your signature smacks of begrudgery if you ask me - the Irish condition.

I've no interest in becoming a Pharmacist in 2007 - the pestle and mortar has been replaced by the stanley knife - slicing open large carboard boxes of Uniflu and flogging the smaller boxes within for as much as you can possibly get away with; thats not a vocation; I don't see Hippocrates here - I see a mean man in a polyester tie exploiting sick people.

I've no interest in being a Hospital Consultant - I couldn't cope with the possibility of emigrating someday and having people fall down laughing uncontrollably at my outlandish wage expectations.

Big_G

Raiser wrote: »

AFAIK - As far as you know ? [?] Why not inform yourself of the facts ??? You really should try this if you're going to adopt an arrogant, domineering and self-righteous attitude and inflict it on the public at large :rolleyes:

As should you instead of resorting to personal attacks, the last vestige of the uninformed. For an argumentative and combative individual, you are woefully informed. You may criticise me telling the world what I know, but you have to produce a useful rebuttal if you want to be involved in a debate.

Raiser wrote: »

If you understand economies of scale then the economic axiom of supply and demand should be a breeze for you - deregulation in the Pharmacy game and profit margins are not linked in the manner in which you have implied. In much the same way as a 1998 Toyota Corolla went in value from €120,000 to €5,000 overnight when the taxi industry was deregulated.

Hyperbole notwithstanding, a Toyota Corolla was never worth €120,000. Taxi plates were worth €50,000 at the time of deregulation. The rules of supply and demand as applied to this poor example are thus - medication and healthcare will always be in high demand. Two limiting factors on supply are manpower/expertise and production rates of medication. I am not for a second suggesting such, but if the rules of free market economics were strictly applied to healthcare in this country, we would doubtless see an entirely different amount of money being made by various parties involved. I agree with you when you say that pharmacy might be an uninteresting profession (there, I expressed an opinion for what it's worth). So how do you attract manpower? You increase the amount of money available to the trained professional.

Raiser wrote: »

Awww you don't like me now ? This saddens me to the pit of my soul - just when your obnoxious ranting, arrogance, pious pontificating and pitiful adolescent jeering were making me really start to warm to you

Again, I'm not the one making personal attacks instead of constructing an argument.

Raiser wrote: »

You've lost your credibility Big_G - there isn't enough time in the day for me to try and separate the [undoubtably slim] substance in this meandering diatribe from your self-serving misrepresentations, deluded ideals and stunted opinions borne of the loins of narrow-mindedness.

You already have made a feeble attempt at separating the substance of my meandering diatribe. I suggest a lack of ability and not a lack of time is putting the kybosh on your success. I might point out that I am neither a pharmacist, nor a consultant and I highly doubt that anyone pays any attention to what is said in this forum anyway, so how am I self-serving?

And you have yet to rebut any of my arguments successfully, but type on...

Raiser wrote: »

I've no interest in becoming a Pharmacist in 2007 - the pestle and mortar has been replaced by the stanley knife - slicing open large carboard boxes of Uniflu and flogging the smaller boxes within for as much as you can possibly get away with; thats not a vocation; I don't see Hippocrates here - I see a mean man in a polyester tie exploiting sick people.

That's exactly it, though isn't it. How much can you get away with? It's how much people will pay. As you correctly point out, a large profit margin is enjoyed on over-the-counter medications, most of which are fairly useless anyway and are self-prescribed. Is it not the fault of the bad consumer as it is the pharmacist? Most over-the-counter items can be bought in a supermarket with much less mark-up anyway. Seventy-five percent of scripts are paid for partially or entirely by government schemes, so who is to blame really for the pharmacists making too much money (you haven't even established that they do make too much money)? And why would they be expected to make a loss on anything they do in a free market, which applies the laws of supply and demand, which you appear to espouse?

Raiser wrote: »

I've no interest in being a Hospital Consultant - I couldn't cope with the possibility of emigrating someday and having people fall down laughing uncontrollably at my outlandish wage expectations.

Why would you emigrate if you were getting such a good wage here? They wouldn't laugh at you in the US. Well they might if you were as ill informed about your job as you are about these issues.

I await your considered response with baited breath. Try and tone down the boorishness, there may be sensitive person(s) about.

eth0_

Big_G - I wouldn't waste your time on this guy, you are 100% correct - he is spouting bile about professions he clearly knows nothing about. And judging his previous posts on here, he's a bit of a bigot alright.

I wonder if he'd be so quick to criticsize consultants if he needed life saving surgery? 200k is definitely not too much for a job that requires huge amounts of training and such enormous responsibility for the doctors in their firm, and their patients.

I'm surprised the OP isn't making any cracks at the earnings of dentists!

Raiser

eth0_ wrote: »

Big_G - I wouldn't waste your time on this guy, you are 100% correct - he is spouting bile about professions he clearly knows nothing about. And judging his previous posts on here, he's a bit of a bigot alright.

I wonder if he'd be so quick to criticsize consultants if he needed life saving surgery? 200k is definitely not too much for a job that requires huge amounts of training and such enormous responsibility for the doctors in their firm, and their patients.

I'm surprised the OP isn't making any cracks at the earnings of dentists!

7,031 posts [?] -The image that comes to mind is of a slackjawed, gawping Troll eating a spam sandwich TBH - I might be able to stomach the other 7,030 pearls of wisdom subsequent to my next appointment with my local consultant Gastroenterologist

Big_G - To be honest I regret the descent of this thread to is current nadir and admit my own culpabilty in this regard. I think this forum is an excellent resource for the Boards.ie community at large & I apologise for my part in lowering the high standard that is prevalent here.

\ Pleads for the mercy shotgun blast of a lock

eth0_

Raiser wrote: »

7,031 posts [?] -The image that comes to mind is of a slackjawed, gawping Troll eating a spam sandwich TBH - I might be able to stomach the other 7,030 pearls of wisdom subsequent to my next appointment with my local consultant Gastroenterologist

I don't think its a gastroenterologist you need to see.

Of course i'm a troll with over 7000 posts, I mean i've only been a member of boards for over six years :rolleyes: