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"Cavitations" is an old idea that has been brought back and is getting a lot of attention. In "alternative" practices many patients are being told to have surgery, or to extract teeth because of diagnosed cavitations - or because of fear that a cavitation might develop. Is this based on science or is it just hype? Here's some basic info about it to help you decide what's right for you.
What IS a Cavitation?
It's a "hole" in the bone. Since the early 1900's cavitations have been talked about in the dental literature. They have been suspected of being caused by different things, such as failing root canal treatment or faulty extractions, and they have been suspected of causing many problems from severe local pain to energetic "interference" with energy pathways in the body effecting remote body parts and functions.
There are many names that have been used for these cavitations and the names come from what the theoretical cause or symptom was thought to be. Some of the most common names include:
-Neuralgia-Inducing Cavitational Osteonecrosis ("NICO")
-Ischemic Osteonecrosis ...... and more..
The wide range of names is not just of academic interest. Each of the names has a very specific and different scientific MEANING. That suggests that there is a significant diversity of opinion as to what they actually ARE. What should be done about them depends a lot on what they ARE....
If you have a lump somewhere you easily understand that it makes a big difference in what the lump IS.... that is to say "what it is called". If it is called a kind of cancer, that's one thing, but if it's just called a kind of swelling, or irritation, then it's totally another kettle of fish ! Well, "holes" are the same. The diagnosis IS important. It may be that no hole is good, just like no swelling or lump is good. But how bad it is, IS important when it comes to deciding what to do about it. If you have a cancer growing in your brain, surgery might be a reasonable option, but if it's just a benign lump that's not changing or causing a known problem, perhaps surgery would not make sense, right? I think if you are still reading this, you get the point.
A lot of good research has been done to try to narrow down what these cavitations are and to try to find out what causes them. As far as I have seen so far we are not at a point where there is general agreement on these issues. In the alternative dental community, the feelings about them are that they are bad and should be removed for many reasons even if you are not aware of any problem with them. The thinking is that root canals are bad because cavitations can be caused by them. And because extractions are thought to cause them also, special protocols have been devised for doing extractions to try to prevent their formation.
What Should I do?
If you are told you have cavitations and are urged to do some pretty scary things because of them, like having surgery, or removing teeth , perhaps a second or even third opinion might make sense.
Recently a new device has been developed to find and diagnose these cavitations because they are notoriously hard to find using conventional dental type x-rays. It is called the "Cavitat"....clever. Suddenly I am hearing from patients that are being told they have cavitations ALL OVER THEIR JAWS !!!!! 3, 6, 10 of them! These cavitations are getting very popular, indeed! At about $30,000- per machine, I would suspect there's a big incentive to find lots of cavitations ......
I have not seen independent, objective evaluations of the Cavitat machine. I would like to see one. Does it really work? What percentage of the results are correct? Does it sometimes give false positive results? .... that is, wrong results, or results that can be misinterpreted?
You should understand that in spite of the fact that diagnoses of Cavitations are being presented almost as simply as tooth decay needing fillings, that cavitations are no small thing! The surgery to remove them may be small and simple or it may be quite extensive and the surgery often has to be re-done, sometimes several times over, because they are difficult to totally remove and have a high recurrence rate. The recurrence is thought to be because a little bit was not removed, but we don't know for sure.
Also, removing teeth that have had root canals, or need root canals, will likely end up requiring you to need multi-thousands of dollars of dental treatment to put you back together again after removing those teeth. Sometimes it can result in dentally "crippling" you so that you can never be made dentally right again, either because the cost is so great or just because it can't be done.
Why am I trying to SCARE you? I want you to ask all the necessary questions BEFORE you get anything done....it's called INFORMED CONSENT. You can do whatever you want ...it's YOUR body. But don't do anything until you understand the risks and implications. If it all sounds reasonable and worth it after that, fine, do what makes sense to you. And if you have any doubt ... maybe even if you don't .... it might make sense to get another opinion. Know what I mean?
So I'm not trying to scare you out of getting treatment; I AM trying to scare you out of agreeing to getting treatment without fully researching your situation and getting supporting diagnoses and treatment plans from as many other professionals as you can! And MAKE SURE YOU UNDERSTAND THE IMPLICATIONS OF WHAT YOU MIGHT NEED AFTER THE CAVITATION TREATMENT IS FINISHED ! ok?
YOU can Help !
Please read this and e-mail me !
If you have had a diagnosis of "Cavitations"...by any of the many names they goes by .... I would like to know your experience before treatment, what the treatment was like, and what if anything you experienced afterward. Was it worth it to you, looking back? Would you do it again and would you recommend it to someone else you cared about?
If you did NOT have any treatment for it, how long has it been and what, if anything, has happened?
If enough of you respond I will pass this information along to others [on this webpage] that are dealing with this confusing, difficult, and emotional problem.
It would be a BIG, BIG help if many of you respond. This is not a scientifically sound "proof", but it would be a BIG help to others trying to decide what to do, and it would help you to get a better handle how valid your decisions were.
Please e-mail me your story and I will post it here "anonymously" ["........from HG in Minnesota"] for others to read.
I suspect it will take a while for search engines to pick this up and for people to begin to respond but I hope you will support this effort so it works .
Here's one email that might be helpful:Hello,My name is Stephen xxxxxxx and I live in Bournemouth England. I saw your website and felt I ought to respond.Let me briefly tell you my story. When I was about eight a dentist told me I would lose all my teeth. I didn't but it might have been better if I had. Several years of phantom toothache around my mouth mostly at night culminated in tingling around my groin just after university. This lasted for two years but went away mysteriously when I developed food poisoning in Egypt. Some years late it returned to my right calf but disappeared after Ayervydic baths in Sri Lanka.Then 5 years ago came the big trauma when I inhaled drain cleaner fluid. This threw my entire body out. I burned froze and sweated producing a chemical smell. Conventional medicine couldn't find anything but alternative therapists found plenty including multiple allergies to just about most things. Instinctvely I felt the problem came from my mouth. After treatment from a bad dentist who made me worse, I found one of the 12 alternative dentists in Britain. He is the first in Europe to get a Cavitat scan and Bob Jones came over. He described my scan as one of the worst he had ever seen affecting all four quadrants and going down well below the nerve on the lower jaw. My dentist went to America on a course and showed my scan to Wes Shankland who described it as the worst he had seen. 2 biopsies from Prof Bouquet have not fully explained the cause. He described it in the first as ischemic sclerosis while on the second there was a small area of necrosis. I suspect osteo myalitis but my dentist feels that I should be bedbound if this was the explanation. I suspect that I have a certain resistance since I have had it since childhood if not birth.I have had four operations so far and they have helped but not completely solved the problem. I am still multi allergic and nerve endings are affected though not so much as before. I suspect I may need full extraction to recover completely though I am having the worst area treated next month and a whole range of alternative practitioners say this should make a considerable difference.One thing I use to combat the problem when things get bad is Bentonite Clay both in bath form with salts and also as a drink. It is not a cure but it relieves the symptoms.The last 5 years have been bad. I have come back from near suicide it got so bad.
Here's another email that might help...
Letter from Bill:
After routine dental treatment for tooth in lower jaw, irritation developed in that area. Treatments from dentist, endodontist, and oral surgeon exacerbated pain. Referred to neurologist who diagnosed atypical trigeminal neuralgia. Over next year suffered intractable serious pain. Had relationship with local dentist who was trained in cavitation surgery and family physician who was acquainted with the procedure. Motivated by their
support and my own desperation had the surgery. Procedure was long but tolerable. Recovery took place over few months with gradual steady improvement. Overall results very successful. Became pain free without medication. Had normal life back. Three years later neuralgia like pain returned to lower jaw. Cavitation surgery repeated. Procedure again resulted in remission of pain. For the next several years was free of jaw pain without medication. But, then pain returned to lower jaw subsequent to dental crown treatment.
IN my opinion: 1. cavitation surgery can result in long term remission of facial pain for some people. However, at some point, facial pain likely to return. 2.A simple placebo effect is not a reasonable explanation for the pain reduction achieved by the procedure.3. Exactly why the procedure helps some people needs greater clarification. Clarifiation should include affect of treatment on neural tissue. 4. Quality research needed to resolve many issues related to the procedure. Preliminary investigation has been done but flaws in study design limit conclusions. More collaborative efforts between dental and medical specialists might achieve a more complete understanding and greater acceptance of the procedure. Given the same set of circumstances, I would have the procedure again. In my situation had an extended relationship with local dentist who did cavitation surgery. Able to review in detail results of his previous surgeries. Family physician was supportive of the procedure. Felt if there was post operative complications, these profesionals would try to help me. Both of these professionals are now retired. Cavitation surgery no longer available in state. Probably, most patients interested in the procedure will find no cavitation surgeon in their state. When treatment not available in your area, local doctors often are uninformed about the procedure. You are
likely to encounter difficulty finding balanced data about cavitation surgeons and their success and complication rates. If you travel out of state for treatment and should post surgical complications occur, where will you turn for help when you return to your local area?
My response to Bill:Hi Bill,Thank you for your letter. I think I probably will post it as it shows a balanced viewpoint, rather than a simple "it's great" or it's a crock...". My guess is that your experience is not atypical.There are other categories of bone lesions that may in fact be "cavitations" but are well-known to conventional, contemporary oral surgeons but perhaps by other names. "Cavitation" only really means a hole in the bone, so any lesion in bone that causes demineralization of the bone to the degree that a "hole" is created...such as what happens routinely with root canal abscessed teeth ... could all be loosely called "cavitations".Lately - among the "alternative" crowd - cavitation has taken on a whole different and unique meaning and it is really unclear as to whether they are uniquely different things. NICO is different only in that it is a bone "hole" lesion that specifically results in nerve pain. But the cavitations that are from root canal problems, for example, almost routinely heal up and disappear after successful root canal treatment.Other bone lesions that oral surgeons try to remove sometimes have a nasty habit of returning, probably because a tiny little bit was not removed and that little bit "seeded" a regrowth... but that is not totally understood as far as I know. The surgery is not easy [for the oral surgeon] to do and extreme care is needed to try to get it all out. So your experience is not just "cavitation"-unique. Therefore, my advice is not to worry so much about if your dentist is into or believes in "cavitations", but rather just to go to the best oral and maxillofacial surgeon you can find! Excellent surgical skills are needed for these things...whatever name you give them. I hope this is helpful.
Here's another email ...
I came across your website some months ago and wanted to email you my story about cavitations in the hope that you might post it and that it might help others.
I have had treatment for cavitations on both sides of my upper jaw, three tooth spaces on one side and two tooth spaces on the other. I have been sick on and off several years with fatigue, low immune system and other aches, pains, headaches and general unwellness. I had tried so many things, been to many doctors, natural practitioners etc and while all helped me a little in some way - I never got to the root cause of the issue. I did not have any jaw throbbing or pain.
I do a lot of reading on the net and read about cavitations and how they can be caused by tooth extractions etc. I have had quite a few of those, mostly for orthodontic work, and had also had several root canals.
I had a Cavitat scan at a clinic in the UK where I live and that showed up these cavitations. I had the surgery without hesitation. I found it pretty scary but was sick at the time and generally not that mentally strong. It turned out the bit that hurt the most was the injections & the rest of the surgery was painless.
Healing was very slow from this surgery but I was already quite sick before it so not surprising really.
I'm writing this three months later and I feel like a different person. I have my health and my life back after all this time. I'm incredibly thankful I caught this when I did, I met others at the dental surgery who did not know until they were in their 50s and 60s & had chronic disease by then. I'm 35.
I hope my story inspires others to investigate this if they have tried everything else. Its been the turning point for me. Am happy to receive questions about this: firstname.lastname@example.org
Business Week magazine / January 16, 2006
The following article appeared and I find it interesting. Thought you might, too. I think it's important to keep in mind that the insurance industry is not geared to look out for the patient's best interests necessarily. It is a business that looks out for its own "bottom line". So the motivation behind this article is suspect. On the other hand the reporters probably did try to write as honest an article as they could, since they would just as much like to nail the insurance industry as a sweet "scoop" of a story .... so, the truth, as it often is, is probably somewhere in the middle of what is said in this article.
HOME TOPICS / INFO ABOUT DR.GOLDMAN TO EMAIL ME CONTACT OFFICE
Michael C. Goldman, DDS
General and Cosmetic Dentistry
3815 East-West Highway
Chevy Chase, Maryland 20815 Phone (301) 656-6171
More info about the following is available if you select "topics".
Holism in dentistry is an approach to dental treatment, primarily caring for patients' health and safety from both a conventional as well as "alternative healthcare" point of view. It is sometimes called "biological" dentistry or "biocompatible" dentistry. In it's fullest sense, I believe it acknowledges and deals with the mind, body and spirit of the patient, not just his or her "teeth". See Topics / Info.....
Cosmetic dentistry is about doing quality , esthetic dentistry in a way that looks natural to begin with, and furthermore, can even improve one's attractiveness through techniques such as bonding, bleaching, veneers, caps, implants and more. It can be like "instant orthodontics" in correcting crooked, twisted or misplaced teeth in many instances. Dark or mis-shapen teeth can be restored. Smiles that lack youthful vigor or beauty can be revitalized! See Topics / Info..
Bleaching, veneers, bonding, caps, bridges, and implants are cosmetic dentistry treatments that are also discussed in Cosmetic Dentistry, and more...