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.”
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.
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.
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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This doctor may have quite literally saved my life!!
Thank you for the kind words. We are always happy to help.
I saw your article while researching cavitations. I don't know if this can be related at all, but 2 years ago I had an awful infection due to a cracked tooth in my left lower last back molar (my wisdom teeth have been out for 30 years). After a round of antibiotics, the dentist removed an old filling in my back molar and did a new filling. She wasn't sure if it would work or not as the tooth was cracked. We tried this in an effort to save the tooth. Of course it didn't work and the infection came back, left lower jaw, worse than before. She had to give me 2 rounds of heavy duty antibiotics this time to kill the infection and then about 10 days later pulled the tooth. It came out clean, didn't break or anything. Since it was in back and not visible, I left it alone. It healed fine. EVER SINCE THAT TIME, I seem to get sick 3-4 times a year and what makes me wonder if it's related is that every time I get sick, I start to feel the left side of my jaw and throat area kind of ache or feel swollen and then I know it's coming.
This is the same area that the infection was in where my neck/jaw area was swollen and in so much pain prior to having the tooth pulled. Sometimes I can head it off with iodine and large doses of Vitamin C, but not always and then I end up sick. Scratchy throat, then a hard dry cough, then a full blown cold (runny nose, etc.). Before the tooth was pulled, this never happened. When I would start to get sick (maybe once a year) the symptoms were different. Never was it ever related to my neck/left side of my throat feeling swollen. When I had my infection that lead to the tooth being pulled though, this is exactly where it was and what hurt. This last time I got sick (the 3rd time since December) although the "cold" part has since passed, this on again, off again feeling in the jaw/neck area has lingered going on a month. Even though I got the cold about a month ago I can't seem to kick this part. Mostly I feel OK but this comes and goes and truly has me concerned. I started doing research and wonder if this could be a cavitation or lingering infection? Any guidance would be greatly appreciated!
I understand your concern. I am happy to see you for a consult. Otherwise, please consider seeing a dentist near you. all the best
Are some Cone Beam scans better than others (in Ontario Canada)? I'd hate to expose myself to radiation with no insight.
Hi Dr. Schecter
This post looks like an amazing piece!
Great to find your blog.
Good work.
Regards
Marina
What exactly is your procedure for cleaning the socket after an extraction?