Dental Cavitations: Symptoms, Treatment, Surgery Cost, Definition, Diagnosis

Key Facts

• Dental cavitations are hollow areas or pockets in the jawbone, often at the site of a previously extracted tooth
• Alternate Names: NICO (Neuralgia-Inducing Cavitational Osteonecrosis), jawbone osteonecrosis
• In many cases, cavitations are asymptomatic but may cause facial pain or contribute to chronic systemic issues
• Causes are often a result of incomplete healing after tooth extraction, especially wisdom teeth, or due to infections
• Specialized imaging techniques are often required for diagnosis, as regular X-rays may not always detect cavitations

What are Dental Cavitations?

Dental cavitations are areas within the jawbone where the bone is decayed or hollow. Contrary to what the term might suggest, dental cavitations are not cavities in teeth. Instead, they are areas within the jawbone, often at the site of previous tooth extractions, where the bone has not healed properly. These areas can become necrotic and serve as a breeding ground for bacteria, potentially contributing to chronic infection and pain. In some cases, cavitations may be connected to systemic health problems as they can harbor bacteria and toxins that affect overall health.

Medical Terminology

Dental cavitations are often referred to in the medical community as Neuralgia-Inducing Cavitational Osteonecrosis or NICO. The term osteonecrosis refers to the death of bone tissue, which is a defining characteristic of cavitations.

• Neuralgia: Refers to nerve pain
• Inducing: Means causing or bringing about
• Cavitational: Refers to the formation of a cavity or hollow space
• Osteonecrosis: Refers to the death of bone tissue due to lack of blood supply

Together, the term NICO describes a condition where the necrosis of jawbone tissue is associated with nerve pain.

Diagnosis of Cavitations

• Clinical Evaluation: The initial step in the diagnosis of dental cavitations involves a clinical evaluation. The dentist will take a detailed medical history and perform a clinical examination. Patients may describe symptoms such as unexplained facial pain, pressure in the jawbone, or a history of unresolved infections.
• Imaging Techniques: Standard dental X-rays often fail to detect cavitations as they may not provide sufficient detail of the internal structure of the bone. More sophisticated imaging techniques are generally needed for the diagnosis:
  • Cone Beam Computed Tomography (CBCT): This advanced imaging technique provides a three-dimensional view of the jawbone and is more effective in detecting cavitations.
  • Cavitat Ultrasonography: This is a specialized device designed specifically to detect cavitations. It uses ultrasonic waves to create an image of the jawbone and can effectively detect hollow areas within the bone.
• Bone Biopsy: In some cases, a bone biopsy may be performed. In this procedure, a small piece of bone is removed from the suspected area of cavitation and sent to a lab for microscopic examination. This can confirm the presence of necrotic bone tissue and any associated infection.

Causes of Dental Cavitations

Dental cavitations can be triggered by various factors, often involving an interplay of local and systemic conditions.
Some of the common causes include:

• Improper Tooth Extraction: Often when a tooth is extracted, some of the periodontal ligament is left behind, and the surrounding bone does not heal properly. This is particularly common in wisdom tooth extractions.
• Infections: Bacteria can infiltrate the jawbone, leading to necrosis of the bone tissue. These bacteria may originate from periodontal disease, root canal infections, or other oral sources.
• Restricted Blood Flow: Anything that restricts blood flow to the jaw can contribute to the development of cavitations. This includes trauma, clenching, and grinding of the teeth, which can damage blood vessels.
• Systemic Conditions: Certain systemic conditions such as autoimmune disorders or hormonal imbalances may also contribute to the development of cavitations.

Linking Between Dental Cavitations and Chronic Diseases

There is a growing body of evidence suggesting that dental cavitations can be linked to chronic systemic diseases. The hollow areas in the jawbone may harbor bacteria, fungi, and toxins. These pathogens can release toxins that enter the bloodstream and may contribute to a variety of health problems, including:

• Cardiovascular diseases
• Rheumatoid arthritis
• Chronic fatigue syndrome
• Autoimmune disorders

Published Research on the Topic of Dental Cavitations

Several studies have shed light on the implications of dental cavitations. For instance, a study published in the Journal of Oral Science examined the presence of bacteria in jawbone cavitations and concluded that these could be reservoirs for bacteria contributing to chronic infections. Another study in the Journal of Oral and Maxillofacial Surgery focused on the relationship between dental cavitations and facial neuralgia, suggesting that addressing cavitations could alleviate neuralgia in some patients.

As dental cavitations gain more attention in the research community, it is likely that more studies will be conducted to further understand their role in both oral and systemic health.

Treatment of Dental Cavitations

The treatment of dental cavitations focuses on removing the necrotic bone tissue and eliminating any infection.
Treatment options include:

• Curettage: This involves surgically opening the area over the cavitation and scraping out the necrotic tissue. The area is thoroughly cleaned to remove any bacteria or debris.
• Laser Therapy: Some practitioners use lasers to remove necrotic tissue. This can be less invasive than traditional surgery and may promote healing.
• Medication: Antibiotics may be prescribed to help control any infection present in the cavitation.
• Supplemental Therapies: Some holistic practitioners may recommend supplemental therapies such as ozone therapy, vitamin C infusions, or other treatments aimed at supporting the body’s healing processes.
• Regular Follow-ups and Maintenance: Post-treatment, regular follow-ups are crucial to ensure that the area is healing properly and that no new infection is setting in.

Bottom Line

Dental cavitations are a relatively lesser-known dental pathology – hidden pathological hollows in the jawbone that can have far-reaching consequences on an individual’s health. Due to the often asymptomatic nature of cavitations and the difficulty in detecting them through standard X-rays, specialized diagnostic methods are essential. It’s important for individuals who have undergone tooth extractions, especially of wisdom teeth, or who experience unexplained facial pain, to consult a dentist who is familiar with the diagnosis and treatment of cavitations.

This article is complete and was published on June 28, 2023, and last updated on August 25, 2023.