Dental cavitations are a lesser-known yet significant health issue that can lead to chronic conditions. Ischemic osteonecrosis of the jaw, fatty degenerative osteonecrosis in the jawbone (FDOJ), bone marrow defects of the jaw (BMDJ), neuralgia-induced cavitational osteonecrosis (NICO), and even “areas of impaired healing,” as more simply described, can all fall into this category.
Essentially, cavitations are areas of necrotic bone that may occur due to trauma, poor healing, improper dental procedures, and dry sockets. The problem with these areas of cavitations is that the bone has not healed properly; therefore, there is no blood flow to the area, leading to bone decay. Hence, harmful bacteria and microbes have a place to accumulate.
Although difficult to detect by conventional 2D dental X-rays, they are more readily found with a 3D CBCT, or cone beam computed tomography. A trained biological dentist can see cavitations and, with proper software, can measure bone density differences to find the “pockets of necrosis or necrotic tissue areas.”
The Reality of Dental Cavitations
Because most people – and many conventional dentists – are unaware of what cavitations are, they may go undiagnosed for years. If left untreated, they can potentially lead to infection, chronic inflammation, toxin exposure, and, in some cases, neuralgia.
Over ninety percent of cavitations are found after wisdom teeth extractions. They are also found around failed root canal extraction sites, traumatic injuries, and dry sockets—essentially, any area that has had incomplete healing or loss of clotting factors. There are also a few documented reasons for cavitations to occur: clotting disorders, uncontrolled diabetes, and low vitamin D levels.
Hundreds of studies on PubMed, going back ten years, discuss cavitations from accredited researchers globally. Why, then, do many conventional dentists and oral surgeons say it doesn’t exist? Great question! I won’t assume, so I will just say this: many have not stayed current with scientific research and/or clinical studies in dentistry. Unfortunately, this happens more often than I would like in our profession.
Wait – Cholesterol in Bone?!
In almost every cavitational surgery, I have found fat cells, which are not supposed to be in bone. These fat cells, or cholesterol, are the body’s attempt to protect itself. At the first sign of inflammation, our bodies send cholesterol cells to try and surround the source.
In the last ten years, new research on the delicate homeostasis of cholesterol and anti-inflammatory regulation has surfaced. In an otherwise healthy individual, intracellular cholesterol is released to combat inflammation. Obviously, this is a very simplistic explanation of the delicate and balanced dynamic interplay between the uptake, synthesis, storage, and export mechanisms of cholesterol. But the fact remains—fat cells in bone are no bueno. We want to get to the root cause and eliminate these necrotic areas—who wants dead bone in their bodies?
Symptoms of Cavitations
Though these are the potential symptoms of dental cavitations, there may not be any noticeable warning signs, making cavitations difficult to diagnose.
- Facial pain
- Headaches and migraines
- Phantom toothache
- Trigeminal or atypical facial neuralgia
Although cavitations may not always trigger pain or swelling, they typically result in systemic health problems that are not clearly linked to dental cavitations. The harmful bacteria and toxins from cavitations can lead to infection and immune dysfunction, affecting your whole-body health.
The toxins and bacteria may activate an immune response, potentially leading to chronic inflammation and autoimmune dieases, including rheumatoid arthritis, lupus, psoriasis, and inflammatory bowel disease.
Dental cavitations can also lead to or exacerbate other serious diseases, such as heart disease, sickle cell disease, Lyme disease, and pancreatitis.
Treatments, Then and Now
First discussed in the mid-nineteenth century, Dr. GV Black (the father of modern dentistry) described these jawbone cavitations as necrosis. Dr. Black suggested surgical “curettage of the unhealthy bone, tissues, cysts, and/or abscesses out of the cavitation.” This treatment is still the most popular today, almost two hundred years later.
So, how do biological dentists today treat these cavitations differently? Once we see them, we cannot unsee them…and thanks to CBCT 3-D technology, we are able to plot them exactly. Typically, a very small incision is made directly over the plotted and measured area. When we find the hole – and it is a hole, literally – we curettage the area to remove the dead and infected bone and periodontal ligament that was left behind. Generous amounts of ozone and lasers are used to clean, disinfect, and decontaminate the defect. We also use a Piezo with diamond tips and ozone irrigation.
Once this is complete, we graft the PRF (platelet-rich fibrin) that is made from your own blood drawn at the beginning of treatment. PRF contains stem cells and growth factors that encourage the healing of the defect. In my office, we prefer to use PRF rather than cadavers or animal products. Many times, we add some natural supplements and melatonin to aid in healing.
After about four to six months, we can verify healing with a follow-up CBCT of the area. Nearly every patient reports some soreness to mild discomfort for the first few days following the treatment, and the majority report a substantial difference in their general constitution. Only very few of the largest cavitations, because of their degree of defect, will require a second treatment – but these are the exception, not the standard.
No matter how small these “hidden” areas are, a trained biological dentist can read the areas and treat them to encourage proper healing and stimulate and promote new healthy bone growth.
Dr. Josephine Perez, DMD, has been practicing dentistry for 30 years. She is a graduate of Tufts University School of Dentistry in Boston and interned at New Orleans Coast Guard/Navy Base. Her holistic approach to dentistry encompasses each person’s unique and entire (or whole—holistic) state of physical and emotional well-being. The ability to maintain health through preventive measures and treatments of oral disease is her priority. Dr. Perez focuses on the underlying condition, rather than only treating the symptoms. She tests for biocompatibility to find pathways to reduce inflammation and apply biocompatible and biomimetic materials, supplements, essential oils to restore and strengthen the oral cavity and ultimately, the whole body. After decades of restoring and transforming smiles, Dr. Perez has integrated total wellness into her oral health enhancement practice – a revolutionary style of dentistry.
Visit Pure Dental in Naples at 4444 Tamiami Trail N, Ste. 6–7, call 239.692.9623 or go to puredentalnaples.com.