Dangers Of Root Canals And Crowns, &  What To Do Instead

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Dr. Michelle Jorgensen, a dentist, tells us that it’s a lot rarer than people think to actually need a crown or a root canal; there are ways of avoiding such:

The tooth, the whole tooth, and nothing but the tooth?

First, some of the problems with the treatments that are most popular, especially in the US:

Problems with root canals:

  • Involves cleaning and filling the tooth’s main canal but leaves microtubules that can harbor dead tissue and attract bacteria.
  • This can lead to infections, often undetected for a long time due to the nerve removal, potentially harming overall health and weakening the tooth.
  • Root canals often result in brittle teeth that can break, necessitating crowns.

And then…

Problems with crowns:

  • A crown requires significant removal of tooth structure (up to 1.5 mm of enamel), making the tooth more vulnerable and sensitive.
  • Crowns can also lead to new cavities underneath due to weak bonding to dentin.
  • The cycle often leads from a healthy tooth to fillings, crowns, root canals, and eventual extraction (and then, perhaps, an implant in its place). That’s great for the dentist, but not so great for you.

Biomimetic dentistry the exciting name currently being used for what has been more prosaically called “conservative restorative dentistry”, which in turn has also been known by other names in recent decades, and its goal is to strengthen and preserve natural teeth as much as possible.

Methods it uses:

  • Treats affected but still living teeth with non-invasive procedures.
  • Uses ozone treatment to kill bacteria in deep cavities, avoiding direct nerve exposure.
  • Applies conservative partial restorations like onlays instead of full crowns.

Benefits of this approach:

  • Preserves enamel, minimizes trauma, and reduces the risk of tooth death.
  • Maintains long-term tooth structure and health.
  • 95% success rate in saving affected teeth without resorting to root canals.

In short, Dr. Jorgensen says that 60–80% of traditional crowns and root canals can be avoided. Which is surely a good thing.

For more on all of this, enjoy:

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Want to learn more?

You might also like:

Tooth Remineralization: How To Heal Your Teeth Naturally

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  • Scheduling Tips for Overrunning Tasks

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    Your Questions, Our Answers!

    Q: Often I schedule time for things, but the task takes longer than I think, or multiplies while I’m doing it, and then my schedule gets thrown out. Any ideas?

    A: A relatable struggle! Happily, there are remedies:

    • Does the task really absolutely need to be finished today? If not, just continue it in scheduled timeslots until it’s completed.
    • Some tasks do indeed need to be finished today (hi, writer of a daily newsletter here!), so it can be useful to have an idea of how long things really take, in advance. While new tasks can catch us unawares, recurring or similar-to-previous tasks can be estimated based on how long they took previously. For this reason, we recommend doing a time audit every now and again, to see how you really use your time.
    • A great resource that you should include in your schedule is a “spare” timeslot, ideally at least one per day. Call it a “buffer” or a “backup” or whatever (in my schedule it’s labelled “discretionary”), but the basic idea is that it’s a scheduled timeslot with nothing scheduled in it, and it works as an “overflow” catch-all.

    Additionally:

    • You can usually cut down the time it takes you to do tasks by setting “Deep Work” rules for yourself. For example: cut out distractions, single-task, work in for example 25-minute bursts with 5-minute breaks, etc
    • You can also usually cut down the time it takes you to do tasks by making sure you’re prepared for them. Not just task-specific preparation, either! A clear head on, plenty of energy, the resources you’ll need (including refreshments!) to hand, etc can make a huge difference to efficiency.

    See Also: Time Optimism and the Planning Fallacy

    Do you have a question you’d like to see answered here? Hit reply or use the feedback widget at the bottom; we’d love to hear from you!

    Share This Post

  • Chew On This… But Don’t Swallow − by Dr. Blanche Grube & Anita Vasquez-Tibau

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Dr. Blanche Grube is a dentist with over 40 years of experience, and Anita Vasquez-Tibau is a well-respected research scientist with many peer-reviewed publications to her name, and both have lectured extensively.

    So, what do they want us to know?

    It’s mostly about the iatrogenic (i.e., caused by treatment) harm done by many common conventional dental practices (including dental mercury amalgams, metal crowns, root canals, implants, and even braces), and how we can avoid such, and enjoy better treatment instead.

    After an introductory overview of the basics (and also where her own work came from in the first place, namely, her own root canals that were established as largely responsible for her leukemia), the largest part of the book is practical advice, laid out practically. What things come with what risks, what things get advertised differently than they really are, and which way to go in the case of unenviable situations where one must choose the “least bad” option out of a bunch of bad options.

    Lastly, she discusses a range of solutions that can help side-step most problems, provided one implements them early. The good news is, they are “do these small things every day” recommendations, not “get this prophylactic surgical treatment” options. And yes, they are beyond the obvious of good dental hygiene, though she does cover that too.

    The style is in part narrative, in part explanatory, and/but very readable throughout.

    Bottom line: if you love having teeth and/but don’t love going to the dentist, this book will help you take good care of yourself, and also mean you can safely and informedly advocate for yourself if you do find yourself in the dentist’s office.

    Click here to check out Chew On This… But Don’t Swallow, and protect your teeth!

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  • Cows’ Milk, Bird Flu, & You

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    When it comes to dairy products, generally speaking, fermented ones (such as most cheeses and yogurts) are considered healthy in moderation, and unfermented ones have their pros and cons that can be argued and quibbled “until the cows come home”. We gave a broad overview, here:

    Is Dairy Scary?

    Furthermore, you may recall that there’s some controversy/dissent about when human babies can have cows’ milk:

    When can my baby drink cow’s milk? It’s sooner than you think

    So, what about bird flu now?

    Earlier this year, the information from the dairy industry was that it was nothing to be worried about for the time being:

    Bird Flu Is Bad for Poultry and Dairy Cows. It’s Not a Dire Threat for Most of Us — Yet.

    More recently, the latest science has found:

    ❝We found a first-order decay rate constant of −2.05 day–1 equivalent to a T99 of 2.3 days. Viral RNA remained detectable for at least 57 days with no degradation. Pasteurization (63 °C for 30 min) reduced infectious virus to undetectable levels and reduced viral RNA concentrations, but reduction was less than 1 log10.

    The prolonged persistence of viral RNA in both raw and pasteurized milk has implications for food safety assessments and environmental surveillance❞

    You can find the study here:

    Infectivity and Persistence of Influenza A Virus in Raw Milk

    In short: raw milk keeps the infectious virus; pasteurization appears to render it uninfectious, though viral RNA remains present.

    This is relevant, because of the bird flu virus being found in milk:

    World Health Organization | H5N1 strain of bird flu found in milk

    To this end, a moratorium has been placed on the sale of raw milk, first by the California Dept of Public Health (following an outbreak in California):

    California halts sales of raw milk due to bird flu virus contamination

    And then, functionally, by the USDA, though rather than an outright ban, it’s requiring testing for the virus:

    USDA orders testing of milk supply for presence of bird flu virus

    So, is pasteurized milk safe?

    The official answer to this, per the FDA, is… Honestly, a lot of hand-wringing and shrugging. What we do know is:

    • the bird flu virus has been found in pasteurized milk too
    • the test for this is very sensitive, and has the extra strength/weakness that viral fragments will flag it as a positive
    • it is assumed that the virus was inactivated by the pasteurization process
    • it could, however, have been the entire virus, the test simply does not tell us which

    In the FDA’s own words:

    ❝The pasteurization process has served public health well for more than 100 years. Even if the virus is detected in raw milk, pasteurization is generally expected to eliminate pathogens to a level that does not pose a risk to consumer health❞

    So, there we have it: the FDA does not have a reassurance exactly, but it does have a general expectation.

    Source: US Officials: Bird flu viral fragments found in pasteurized milk

    Want to know more?

    You might like this mythbusting edition we did a little while back:

    Pasteurization: What It Does And Doesn’t Do ← this is about its effect on risks and nutrients

    Take care!

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  • Millet vs Couscous – Which is Healthier?

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Our Verdict

    When comparing millet to couscous, we picked the millet.

    Why?

    In terms of macros, they’re pretty much equal, and are both moderately high glycemic index foods so to abate that, it’s good to have them with some fibrous foods (e.g. some vegetables) and fats (e.g. perhaps sauté the vegetables with a little olive oil), to slow down the carbs a little. But, as there’s nothing meaningful between them in this regard, we declare this category a tie.

    In the category of vitamins, millet has more of vitamins B1, B2, B3, B6, B7, B9, K, and choline, while millet has more of vitmains B5 and E. An easy win for millet here.

    When it comes to minerals, it’s a similar story: millet has more copper, iron, magnesium, manganese, phosphorus, potassium, and zinc, while couscous has more calcium and selenium. Another clear win for millet.

    For those avoiding gluten, you want to be aware that millet is naturally gluten-free, while couscous is usually made of durum wheat and thus contains gluten.

    For those avoiding oxalates (shouldn’t make any difference for most people, but if you have certain kidney problems, then it can matter), millet is low in oxalates and couscous is high in oxalates.

    All in all, it’s a clear overall win for millet!

    Want to learn more?

    You might like to read:

    Grains: Bread Of Life, Or Cereal Killer?

    Enjoy!

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  • Pain Clinics Made Millions From ‘Unnecessary’ Injections Into ‘Human Pin Cushions’

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    McMINNVILLE, Tenn. — Each month, Michelle Shaw went to a pain clinic to get the shots that made her back feel worse — so she could get the pills that made her back feel better.

    Shaw, 56, who has been dependent on opioid painkillers since she injured her back in a fall a decade ago, said in both an interview with KFF Health News and in sworn courtroom testimony that the Tennessee clinic would write the prescriptions only if she first agreed to receive three or four “very painful” injections of another medicine along her spine.

    The clinic claimed the injections were steroids that would relieve her pain, Shaw said, but with each shot her agony would grow. Shaw said she eventually tried to decline the shots, then the clinic issued an ultimatum: Take the injections or get her painkillers somewhere else.

    “I had nowhere else to go at the time,” Shaw testified, according to a federal court transcript. “I was stuck.”

    Shaw was among thousands of patients of Pain MD, a multistate pain management company that was once among the nation’s most prolific users of what it referred to as “tendon origin injections,” which normally inject a single dose of steroids to relieve stiff or painful joints. As many doctors were scaling back their use of prescription painkillers due to the opioid crisis, Pain MD paired opioids with monthly injections into patients’ backs, claiming the shots could ease pain and potentially lessen reliance on painkillers, according to federal court documents.

    Now, years later, Pain MD’s injections have been proved in court to be part of a decade-long fraud scheme that made millions by capitalizing on patients’ dependence on opioids. The Department of Justice has successfully argued at trial that Pain MD’s “unnecessary and expensive injections” were largely ineffective because they targeted the wrong body part, contained short-lived numbing medications but no steroids, and appeared to be based on test shots given to cadavers — people who felt neither pain nor relief because they were dead.

    Four Pain MD employees have pleaded guilty or been convicted of health care fraud, including company president Michael Kestner, who was found guilty of 13 felonies at an October trial in Nashville, Tennessee. According to a transcript from Kestner’s trial that became public in December, witnesses testified that the company documented giving patients about 700,000 total injections over about eight years and said some patients got as many as 24 shots at once.

    “The defendant, Michael Kestner, found out about an injection that could be billed a lot and paid well,” said federal prosecutor James V. Hayes as the trial began, according to the transcript. “And they turned some patients into human pin cushions.”

    The Department of Justice declined to comment for this article. Kestner’s attorneys either declined to comment or did not respond to requests for an interview. At trial, Kestner’s attorneys argued that he was a well-intentioned businessman who wanted to run pain clinics that offered more than just pills. He is scheduled to be sentenced on April 21 in a federal court in Nashville.

    According to the transcript of Kestner’s trial, Shaw and three other former patients testified that Pain MD’s injections did not ease their pain and sometimes made it worse. The patients said they tolerated the shots only so Pain MD wouldn’t cut off their prescriptions, without which they might have spiraled into withdrawal.

    “They told me that if I didn’t take the shots — because I said they didn’t help — I would not get my medication,” testified Patricia McNeil, a former patient in Tennessee, according to the trial transcript. “I took the shots to get my medication.”

    In her interview with KFF Health News, Shaw said that often she would arrive at the Pain MD clinic walking with a cane but would leave in a wheelchair because the injections left her in too much pain to walk.

    “That was the pain clinic that was supposed to be helping me,” Shaw said in her interview. “I would come home crying. It just felt like they were using me.”

    ‘Not Actually Injections Into Tendons at All’

    Pain MD, which sometimes operated under the name Mid-South Pain Management, ran as many as 20 clinics in Tennessee, Virginia, and North Carolina throughout much of the 2010s. Some clinics averaged more than 12 injections per patient each month, and at least two patients each received more than 500 shots in total, according to federal court documents.

    All those injections added up. According to Medicare data filed in federal court, Pain MD and Mid-South Pain Management billed Medicare for more than 290,000 “tendon origin injections” from January 2010 to May 2018, which is about seven times that of any other Medicare biller in the U.S. over the same period.

    Tens of thousands of additional injections were billed to Medicaid and Tricare during those same years, according to federal court documents. Pain MD billed these government programs for about $111 per injection and collected more than $5 million from the government for the shots, according to the court documents.

    More injections were billed to private insurance too. Christy Wallace, an audit manager for BlueCross BlueShield of Tennessee, testified that Pain MD billed the insurance company about $40 million for more than 380,000 injections from January 2010 to March 2013. BlueCross paid out about $7 million before it cut off Pain MD, Wallace said.

    These kinds of enormous billing allegations are not uncommon in health care fraud cases, in which fraudsters sometimes find a legitimate treatment that insurance will pay for and then overuse it to the point of absurdity, said Don Cochran, a former U.S. attorney for the Middle District of Tennessee.

    Tennessee alone has seen fraud allegations for unnecessary billing of urine testing, skin creams, and other injections in just the past decade. Federal authorities have also investigated an alleged fraud scheme involving a Tennessee company and hundreds of thousands of catheters billed to Medicare, according to The Washington Post, citing anonymous sources.

    Cochran said the Pain MD case felt especially “nefarious” because it used opioids to make patients play along.

    “A scheme where you get Medicare or Medicaid money to provide a medically unnecessary treatment is always going to be out there,” Cochran said. “The opioid piece just gives you a universe of compliant people who are not going to question what you are doing.”

    “It was only opioids that made those folks come back,” he said.

    The allegations against Pain MD became public in 2018 when Cochran and the Department of Justice filed a civil lawsuit against the company, Kestner, and several associated clinics, alleging that Pain MD defrauded taxpayers and government insurance programs by billing for “tendon origin injections” that were “not actually injections into tendons at all.”

    Kestner, Pain MD, and several associated clinics have each denied all allegations in that lawsuit, which is ongoing.Scott Kreiner, an expert on spine care and pain medicine who testified at Kestner’s criminal trial, said that true tendon origin injections (or TOIs) typically are used to treat inflamed joints, like the condition known as “tennis elbow,” by injecting steroids or platelet-rich plasma into a tendon. Kreiner said most patients need only one shot at a time, according to the transcript.

    But Pain MD made repeated injections into patients’ backs that contained only lidocaine or Marcaine, which are anesthetic medications that cause numbness for mere hours, Kreiner testified. Pain MD also used needles that were often too short to reach back tendons, Kreiner said, and there was no imaging technology used to aim the needle anyway. Kreiner said he didn’t find any injections in Pain MD’s records that appeared medically necessary, and even if they had been, no one could need so many.

    “I simply cannot fathom a scenario where the sheer quantity of TOIs that I observed in the patient records would ever be medically necessary,” Kreiner said, according to the trial transcript. “This is not even a close call.”

    Jonathan White, a physician assistant who administered injections at Pain MD and trained other employees to do so, then later testified against Kestner as part of a plea deal, said at trial that he believed Pain MD’s injection technique was based on a “cadaveric investigation.”

    According to the trial transcript, White said that while working at Pain MD he realized he could find no medical research that supported performing tendon origin injections on patients’ backs instead of their joints. When he asked if Pain MD had any such research, White said, an employee responded with a two-paragraph letter from a Tennessee anatomy professor — not a medical doctor — that said it was possible to reach the region of back tendons in a cadaver by injecting “within two fingerbreadths” of the spine. This process was “exactly the procedure” that was taught at Pain MD, White said.

    During his own testimony, Kreiner said it was “potentially dangerous” to inject a patient as described in the letter, which should not have been used to justify medical care.

    “This was done on a dead person,” Kreiner said, according to the trial transcript. “So the letter says nothing about how effective the treatment is.”

    Over-Injecting ‘Killed My Hand’

    Pain MD collapsed into bankruptcy in 2019, leaving some patients unable to get new prescriptions because their medical records were stuck in locked storage units, according to federal court records.

    At the time, Pain MD defended the injections and its practice of discharging patients who declined the shots. When a former patient publicly accused the company of treating his back “like a dartboard,” Pain MD filed a defamation lawsuit, then dropped the suit about a month later.

    “These are interventional clinics, so that’s what they offer,” Jay Bowen, a then-attorney for Pain MD, told The Tennessean newspaper in 2019. “If you don’t want to consider acupuncture, don’t go to an acupuncture clinic. If you don’t want to buy shoes, don’t go to a shoe store.”

    Kestner’s trial told another story. According to the trial transcript, eight former Pain MD medical providers testified that the driving force behind Pain MD’s injections was Kestner himself, who is not a medical professional and yet regularly pressured employees to give more shots.

    One nurse practitioner testified that she received emails “every single workday” pushing for more injections. Others said Kestner openly ranked employees by their injection rates, and implied that those who ranked low might be fired.

    “He told me that if I had to feed my family based on my productivity, that they would starve,” testified Amanda Fryer, a nurse practitioner who was not charged with any crime.

    Brian Richey, a former Pain MD nurse practitioner who at times led the company’s injection rankings, and has since taken a plea deal that required him to testify in court, said at the trial that he “performed so many injections” that his hand became chronically inflamed and required surgery.

    “‘Over injecting killed my hand,’” Richey said on the witness stand, reading a text message he sent to another Pain MD employee in 2017, according to the trial transcript. “‘I was in so much pain Injecting people that didnt want it but took it to stay a patient.’”

    “Why would they want to stay there?” a prosecutor asked.

    “To keep getting their narcotics,” Richey responded, according to the trial transcript.

    Throughout the trial, defense attorney Peter Strianse argued that Pain MD’s focus on injections was a result of Kestner’s “obsession” with ensuring that the company “would never be called a pill mill.”

    Strianse said that Kestner “stayed up at night worrying” about patients coming to clinics only to get opioid prescriptions, so he pushed his employees to administer injections, too.

    “Employers motivating employees is not a crime,” Strianse said at closing arguments, according to the court transcript. “We get pushed every day to perform. It’s not fraud; it’s a fact of life.”

    Prosecutors insisted that this defense rang hollow. During the trial, former employees had testified that most patients’ opioid dosages remained steady or increased while at Pain MD, and that the clinics did not taper off the painkillers no matter how many injections were given.

    “Giving them injections does not fix the pill mill problem,” federal prosecutor Katherine Payerle said during closing arguments, according to the trial transcript. “The way to fix being a pill mill is to stop giving the drugs or taper the drugs.”

     

    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

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    KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.

    Subscribe to KFF Health News’ free Morning Briefing.

    This article first appeared on KFF Health News and is republished here under a Creative Commons license.

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  • The Healthiest Bread Recipe You’ll Probably Find

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    It’s Q&A Day at 10almonds!

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    ❝[About accidental scalding with water] Is cold water actually the best immediate treatment for a burn? Maybe there is something better, or something I should apply after the cold water.❞

    If this is a case of spilled tea or similar—as in your story, which (apologies) we clipped for brevity—indeed, cold running water is best, and nothing else should be needed. It’s up to you whether you want to invest the time based on the extent of the scalding, but 10 minutes is recommended to minimize tissue damage.

    If it’s a more severe scalding or burning, seek medical attention immediately. If it’s a burn to anywhere other than the airway, cold running water is still best for 10 minutes, but if you have to choose between that and professional medical attention, don’t delay the help.

    If it’s a burn you’ve given 10 minutes of cold running water and it still hurts and/or has blistered, cover it in a sterile, non-adhesive dressing that extends well beyond the visible burn (because the actual damage probably extends further, and you don’t want to find this out the hard way later). If the burn is to the face, do still irrigate but not cover it; wait for help.

    Do not apply any kind of cream, lotion, oil, etc. No matter how tempting, no matter where the burn is.

    All of the above also goes for splashed oil, chemical burns, and electrical burns too (but obviously, make sure to get away from the electricity first).

    Source: this ex-military writer was trained for this sort of thing and, suffice it to say, has dealt with more serious things than spilled tea before now.

    Legal note: notwithstanding the above, we are a health science newsletter, not paramedics. Also, circumstances may differ, and best practices may change. In the case of serious injury, call emergency services first, and follow their instructions over ours.

    Take care!

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    Learn to Age Gracefully

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