Dental Cavitations: What Are They and How Are They Treated?

Cavitations are not cavities, although both are basically holes. Dental cavitations are a serious problem that may be difficult to detect, even on x-rays. Cavitations may not cause pain, making them harder to diagnose. But untreated cavitations can lead to infection, chronic inflammation, toxin exposure, and other systemic diseases. Because most people (and many conventional dentists) are unaware of what cavitations are, we believe it is of the utmost importance to provide this vital information to the general public. This article is your go-to for any cavitation questions.

What Is a Dental Cavitation?

According to historical research, the term “cavitation” was “coined in 1930 by an orthopedic researcher to describe a disease process in which a lack of blood flow into the area produced a hole in the jawbone.”

Cavitations are not cavities, although both terms basically describe holes.
Dental cavitations may be difficult to detect, even on x-rays. Cavitations may not cause pain, making them harder to diagnose. Untreated cavitations can lead to infection, chronic inflammation, immune dysfunction, and other systemic diseases.

Bone cell death in the jawbone was first discussed in an 1848 textbook, A Practical Treatise on Dental Medicine. This textbook recommended removing the necrotic bone completely, but we’ve come a long way since then. In 1915, Dr. G.V. Black, the father of modern dentistry, described jawbone necrosis and cavitation.

He suggested surgically scraping the unhealthy bone tissue, toxins, abscesses, and cysts out of the cavitation. This remains the most popular treatment method.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases explains, “Osteonecrosis happens when the blood supply to part of a bone is disrupted, depriving bone tissue of essential nutrients and oxygen.”

Cavitations can occur in any bone in your body, but the most common cavitation occurs in your jawbone. For the purposes of this article, “cavitation” refers to a jawbone or dental cavitation.

Because most people (and many conventional dentists) are unaware of what cavitations are, we believe it’s vital to provide this information to the general public. This article is your go-to for any cavitation questions.

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Pain and Other Symptoms

  • Facial pain
  • Phantom toothache
  • Headaches and migraines
  • Trigeminal neuralgia
  • Atypical facial neuralgia
  • Lethargy
  • Autoimmunity

Though these are the potential symptoms of dental cavitations, there may not be any noticeable warning signs — making cavitations difficult to diagnose.

If symptoms don’t always occur, you may wonder, “What’s the big deal?”. Jawbone cavitations may not always trigger pain or swelling or visible cavitation lesions, but untreated cavitations usually result in systemic health problems.

The Ultimate Breeding Ground for Toxins

Mounting research suggests that patients with dental cavitations often (or always) test positive for multiple toxic substances at the site. Dental cavitations are the ultimate breeding ground for toxins that can lead to unexpected health issues.

When bone cells die, it leaves a hole (cavitation) in the bone, which can harbor harmful bacteria and other toxins that trigger systemic inflammation and other whole-body health issues.

Recent research by Dr. Boyd Haley, former Chairman of the Department of Chemistry at the University of Kentucky, reveals that every cavitation tissue sample he tested contained toxic substances that significantly inhibit the natural production of energy in the body. These toxins are likely waste products of anaerobic bacteria.

These toxins may combine with toxins already present in the body, such as mercury and other heavy metals, contributing to even worse overall health.

2 Types of Cavitations

1. Neuralgia-inducing cavitational osteonecrosis (NICO)

2. Sickness-inducing cavitational osteonecrosis (SICO)

Cavitations (holes that harbor toxins) can occur in any bone in the body. The main type of cavitation is dental cavitations/jaw cavitations/NICO. NICO specifically occurs in your jawbone. However, all jawbone cavitations don’t necessarily cause neuralgia.

Dr. Mark Breiner also identifies sickness-inducing cavitational osteonecrosis (SINO) as any cavitation in your body that is the root cause of systemic illness. This can be in your jawbone but is all-encompassing compared to the term “NICO”.

What is jaw cavitation? Jaw cavitations (also called NICO, or dental cavitations) are when healthy bone cells in the jaw lose blood flow and die, leaving a hole in your jawbone where harmful toxins congregate and cause whole-body health issues.

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Diagnosis

You test for dental cavitations by using advanced imaging to look at the jawbone for signs of necrosis. Many conventional dentists are taught to overlook certain abnormalities, so it may be necessary for dentists to relearn how to look at diagnostic imaging.
It is difficult to diagnose dental cavitations because they may cause no symptoms while spreading infection and inflammation. Cavitations might not trigger any pain or swelling, and most Americans are unaware of their dangers.

X-rays seldom identify cavitations, and MRI (magnetic resonance imaging) and CT (computerized tomography) scans can be unreliable, according to some biological dentistry experts.

Effective tools for diagnosing dental cavitations include:

  • Cone beam CT scan (CBCT) (recently becoming the standard)
  • Cavitat (an alveolar ultrasound (TAU) instrument)
  • Bone scintigraphy
  • Panoramic radiograph
  • Applied kinesiology
  • Radioisotope bone scan using technetium-99m 

The best diagnostics depend on the root cause. The best dentist should employ multiple non-invasive diagnostic methods to determine the full scope of your condition.

Causes and Risk Factors

Dental cavitations are caused by a blood flow blockage to bone cells in the jaw. These blockages may be caused by:

  • Improper tooth or wisdom tooth extraction procedure, including failure to remove the periodontal ligament after extraction (This is the most common cause, according to the American College of Rheumatology. Up to 94% of dental cavitations are found at wisdom teeth extraction sites.)
  • Tooth abscess penetrating a bone
  • Blood clotting disorders or poor circulation
  • Dry socket
  • Bone cyst
  • Untreated toxins or infection at the root canal or bone socket
  • Overheating bone during a dental procedure
  • Certain medicines, such as excessive use of NSAIDs
  • Overuse of toxic, non-biocompatible dental materials
  • Systemic health issues that decrease blood flow
  • Traumatic injury to the jawbone

Factors that increase your risk of developing NICO and cavitations include:

  • Gum disease (periodontal disease)

  • Long-term alcohol use

  • Heavy smoking

  • Family history of clotting disorders

  • Osteoporosis

  • Low oral doses of bisphosphonates, a preventive osteoporosis treatment

  • HIV infection

  • Radiation treatment for cancer

  • Genetic mutations

Research into the various causes of dental cavitations is still ongoing. Some proposed causes may be considered controversial. However, the underlying problem remains clear. The loss of blood supply to a patient’s jawbone causes cavitations and requires treatment.

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Long-Term Consequences to Whole-Body Health

When cavitations form, dead bone cells can act as a breeding ground for harmful bacteria and toxins. Though they may not cause pain, the pathogen-filled cavitation can cause infection, inflammation, and autoimmunity, impacting your whole-body health.

Cavitation tissue samples often contain toxic substances that significantly inhibit the body's natural production of energy. These toxins may combine with toxins already present in the body, such as mercury and other heavy metals, contributing to even worse overall health.

Untreated jawbone osteonecrosis (cavitations) is linked to the following serious diseases:

Because the dental cavitation might result in systemic inflammation and poor overall health that seems unrelated to the jawbone, it can be doubly hard to diagnose a cavitation based on symptoms and comorbidities.

Treatments

The primary cavitation treatment is cleaning out the cavitation of all toxic substances, harmful bacteria, infected bone tissue, abscesses, and cysts. Below are the most common ways to clean out the cavitation:

  • Laser therapy is noninvasive, precise, and much less painful than other conventional dental treatments. For biologic dentists, laser dentistry is the preferred method of safely and effectively treating cavitations.
  • Ozone therapy is another potential treatment for dental cavitations. Ozone treatment is a non-invasive way to clean out the toxins inside a cavitation and is highly effective against even antibiotic-resistant bacteria strains.
  • Dental cavitation surgery is a procedure in which a dental or oral surgeon removes infected tissue through an incision in the gums and then disinfects the cavitations. Some conventional dentists recommend surgery as the first-line response to jawbone/dental cavitations, but it is needlessly invasive.

In addition to cleaning out the cavitation, it’s critical to ensure blood flow has returned to the bone. To encourage rapid bone growth after the procedure, your provider may also provide you with platelet-rich fibrin (PRF).

One of our patients, Sara, had perfect teeth. But when she came into Rejuvenation Dentistry for a dental checkup, we discovered she had 4 dental cavitations. She says that once they treated the cavitations, she never had a sugar craving again.

At Rejuvenation Dentistry, we offer non-invasive procedures to treat and prevent dental cavitations. Using revolutionary BIOLASE technology, this laser-based healing kills pathogens in jaw cavitations without the pain and anxiety many associate with those outdated dentist drills.

Prevention

Prevention of dental cavitations can be as simple as reading this article, improving your oral hygiene routine, and avoiding unnecessary risk factors.

  • Spread awareness: Awareness is an important part of cavitation prevention. Too many people are unaware of dental cavitations or how they can negatively affect whole-body health.
  • Start at home: Preventing cavitations begins at home. Floss every day, and brush twice a day. Use a high-quality, non-toxic toothpaste. Eat a mouth-healthy diet. Visit your dental office twice a year, preferably with a holistic DDS who understands the importance of biological dentistry.
  • Promote blood flow: Since cavitations arise from lack of blood flow, it should help prevent cavitations to promote healthy blood flow. Regularly exercise, manage stress levels, and consider supplements like nitric oxide-rich beetroot.
  • Ask about extraction alternatives: Conventional dentists are quick to order an invasive procedure, like a tooth extraction. However, other, less invasive treatments may be available for your oral health issue.
  • Avoid epinephrine: We recommend avoiding epinephrine (a local anesthetic) during tooth extractions. Epinephrine can reduce blood flow to bone cells and increase the risk of necrosis. Talk to your dentist about skipping the epinephrine during extraction.

Rejuvenation Dentistry is a unique dental practice that promotes prevention and whole-body health. We offer typical dental services like crowns and bridges, but also specialized dental services like mercury filling removal and cleaning out dental cavitations.

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Frequently Asked Questions

Are dental cavitations real?

How common are dental or jawbone cavitations?

What are dental cavitations also called?

Are dental cavitations real?

Yes, dental cavitations are real. Some conventional doctors and dentists debate their significance, so cavitations may be thrown into the vague basket of “atypical facial pain”. The reality is, plenty of evidence exists for the realness of cavitations and their negative effect on whole-body health.

How common are dental or jawbone cavitations?

Studies have not been able to capture the prevalence of jaw cavitations or NICO, although it’s said to be 3 times more common in females. It’s not incredibly common, but it certainly is underdiagnosed and hard to detect.

What are dental cavitations also called?

As with so many conditions that aren’t widely understood, these cavitations go by many names, further confusing the issue. Dental cavitations are also known as:

Long-Term Outlook

Most people don’t know what dental cavitations are. Nevertheless, they can cause a host of whole-body health issues that don’t obviously stem from oral health problems. Seek out a holistic or biological dentist if you absolutely need a tooth extraction or if you suspect cavitation.

Did you know? A landmark 2006 study on 145,000 patients found up to a 21% reduction in healthcare costs associated with major diseases when oral health is improved.  If you are worried about having a dental cavitation, or just want to check, contact us right away!

At Rejuvenation Dentistry, we work with our patients to evaluate if they have cavitations or other oral health issues that are affecting their overall wellness. Just ask our patients — their success stories speak for themselves.

Dr. Gerry Curatola is a renowned biologic restorative dentist with more than 40 years of clinical practice experience. He studied neuroscience at Colgate University and attended dental school at the New York University (NYU) College of Dentistry where he now serves as Adjunct Clinical Associate Professor in the Department of Cariology and Comprehensive Care.

Concerned about cavitations? Schedule an appointment today to discuss your case with one of our world-class dentists.

Sources

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  4. Dominiak, M., Niemczyk, W., Pitułaj, A., Świenc, W., & Matys, J. (2025). Fatty Degenerative Osteonecrosis of the Jaw: Bridging Molecular Insights and Clinical Practice—A Scoping Review. International Journal of Molecular Sciences, 26(5), 1853. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC11899097/
  5. Breebaart, A. C., Bijlsma, J. W. J., & Van Eden, W. (2002). 16-year remission of rheumatoid arthritis after unusually vigorous treatment of closed dental foci. Clinical and experimental rheumatology, 20(4), 555-558. Abstract: https://pubmed.ncbi.nlm.nih.gov/12175115/
  6. Lechner, J., Schulz, T., Lejeune, B., & von Baehr, V. (2021). Jawbone cavitation expressed RANTES/CCL5: case studies linking silent inflammation in the jawbone with epistemology of breast cancer. Breast Cancer: Targets and Therapy, 225-240. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC8044077/
  7. Huber, R., Choukroun, E., Fahrenholz, H., & Notter, F. (2025). Dental Ultrasonography for Visualizing Osteoimmune Conditions and Assessing Jaw Bone Density: A Narrative Review. Medical Devices: Evidence and Research, 1-13. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC11724658/
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  9. Gandhi, Y. R., Pal, U. S., & Singh, N. (2012). Neuralgia-inducing cavitational osteonecrosis in a patient seeking dental implants. National journal of maxillofacial surgery, 3(1), 84-86. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC3513818/
  10. Wang, H., Chen, M., Li, Y., Cui, W., An, Q., Yin, X., & Wang, B. (2025). Exploring the therapeutic potential of beetroot juice in patients with peripheral artery disease: A Narrative review. Nitric Oxide. Full text: https://www.sciencedirect.com/science/article/pii/S1089860325000266
  11. Gandhi, Y. R. (2019). Neuralgia-inducing cavitational osteonecrosis–Fact or myth, the debate persists. National Journal of Maxillofacial Surgery, 10(2), 228-231. Full text: https://pmc.ncbi.nlm.nih.gov/articles/PMC6883897/
  12. Ratner, E. J., Langer, B., & Evins, M. L. (1986). Alveolar cavitational osteopathosis: manifestations of an infectious process and its implication in the causation of chronic pain. Journal of Periodontology, 57(10), 593-603. Abstract: https://pubmed.ncbi.nlm.nih.gov/2945921/
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