The Health Effects and the Controversy

Thank you Google!!! If I ever have a question, I simply Google the topic to gain clarity and information. Unfortunately, the Google results that we get are not always accurate. In fact, confusing and conflicting reports are too often the norm. Dental Cavitations fall into this category. Recent Google searches provided the following information:

• “A dental Cavitation can be defined as an unhealed toxic containing hole in the jawbone caused by an extracted tooth or root canal treated tooth. Since wisdom teeth are the most commonly extracted teeth, most cavitations are found in the wisdom tooth sites.”

• “Cavitations have many scientific names such as ischemic osteonecrosis, chronic non-superative osteomyelitis, and neuralgia inducing cavitational osteonecrosis (NICO). According to Cavitat Medical Technologies, Inc., some 80% of all extractions performed on adults eventually turn into Cavitation infections.”

• “The Cavitation claim explains that when a tooth (even a healthy one) is extracted, the socket and jaw bone around it are typically cracked or fractured which reduces the blood supply to the traumatized bone and thus sets up the perfect stage for a Cavitation to form. Additionally, teeth that are pulled often have infected roots and/or membranes, and unless all of the infected material is carefully removed together with the tooth, some of the infectious material will be left behind. The blood produced during the extraction will clot in the socket, which gradually closes – sealing in the bacteria which happily multiply and start a Cavitation infection. In most all cases, the end result (which can take years to accomplish and is usually painless with no signs of acute infection such as swelling, redness etc.) seems to be the formation of a hollow centre or cavity lined with dead bone (this bone death or ischemic osteonecrosis is due to poor perfusion of oxygen from the blood). The body responds by sealing the area off with fat.”

My Clinical Experience

In spite of the Google search results, dental Cavitations are not a recognized problem according to Health Canada and the Royal College of Dentistry. As a dentist in Canada, I am therefore obligated to tell you that there is no such thing as dental Cavitations.

Most patients who come into my office asking about Cavitations have chronic systemic disease and they are looking for answers. I do my best to explore any suspicious dental link to ensure there are no additional pressures placed on their system. If an area in the mouth is tender to the touch or responsive to percussion or temperature, there may be some disease present. Often a cone beam Ct scan can be ordered to verify a diagnosis. Interestingly, upon performing dental surgery in these problem areas, I have often found conditions that do meet the criteria of dental Cavitation (even when the CT is clear, meaning nothing is found). I cannot call these findings Cavitations, so I will call them poorly formed bone. The problem area can literally be scraped with a spoon and dead bone tissue comes off. Alternatively, healthy bone would be shiny and white; it is not soft enough to be scraped off.

Case History

I will give you a specific example. A lady, let’s call her RM,  came to see me two months ago. She had been suffering from Hidradenitis Suppurativa for the past 12 years. Symptoms included very large painful boils in her armpits and genital area. She believed that her symptoms were related to her wisdom tooth extractions which took place five months prior to the onset of her symptoms. I advised her that this was unlikely.

Upon examination, a retained root tip was discovered in the upper right wisdom tooth area. A cone beam CT scan confirmed that the root tip was present, although no diseased tissue was found. The CT report stated that the finding was incidental and not an issue. Worthy of note was that the patient had discomfort when the area was touched.

She decided that she wanted the root tip extracted, so I surgically removed the root tip. During surgery I discovered a large hole surrounding the root tip which turned out to be an infection that was not picked up by the CT scan. To treat the area, I carefully scraped off the infected tissue, ozonated the area, and packed it with platelet-rich fibrin.

After the surgery, the patient suffered a worsening of her boils, that lasted two days. Once it cleared up, she felt better than she has in many years. This finding prompted us to explore the upper left area of her jaw bone even though it had appeared to be completely clear on the CT. (RM had insisted from the beginning that the upper left was more problematic than the upper right.) It was significantly more tender to palpation. With exploratory surgery, a very large defect was found in the bone again. This time there was no root tip and again it had not been detected by the CT scan. The problem area was cleaned and disinfected, and RM has been boil-free since the second surgery.

Success Stories

Through no prodding of my own, many patients have reported significant improvements to their systemic conditions after “successful poorly-formed-bone surgery.” I have one patient who reported a 50% increase in her memory after the surgery. Another patient had suffered from chronic flu-like symptoms for a long time, but after she received dental surgery a few months ago she has not had a single episode of the ‘flu’.

I can’t explain these findings from a dental perspective. I can’t explain why these areas of pathology don’t show up on a cone beam CT scan. However, I can share individual success stories and raise awareness of the potential harm caused by after-effects of tooth extraction or root canals.

When I extract teeth, I ensure that the area is cleaned to avoid any potential ‘Cavitation’. I can verify my protocols as I am frequently re-entering extraction sites during patient follow-up visits. If the extraction site did not heal well, I would be able identify this issue when I returned to place an implant.

A note about dental implants: It is common to extract a tooth and then let the bone heal. Four to six months later, an implant can be placed. Implant placement is a routine component to the practice and to this date I have not found poorly formed bone present itself after tooth extractions done according to my protocol.

Currently, I am relying on ozone oil, natural mouth rinse, and platelet-rich fibrin treatment to prevent the re-occurrence of poorly formed bone.

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