Dental Cavitations: What are they and how are they treated?

A dental cavitation is a hole in the jawbone, even though “dental” usually refers to the teeth. The more medical term for this is “neuralgia-induced cavitational osteonecrosis”.

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 are dental cavitations?

Dental cavitations are lesions within the jawbone, often due to blood flow blockage. These holes in the bone harbor toxins and bacteria, but they may not cause any noticeable symptoms. However, these cavitations have been linked to systemic health problems.

This term 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”.

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.

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”.

But the reality is that there is plenty of evidence for the realness of cavitations and the negative effect on whole-body health.

Up to 94% of dental cavitations are found at wisdom teeth extraction sites.

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

  • Cavitations
  • Jaw cavitations
  • Jawbone cavitations
  • Ischemic bone disease (“ischemic” means lacking oxygen)
  • Chronic ischemic jawbone disease
  • Neuralgia-inducing cavitational osteonecrosis (NICO)

The National Institute of Arthritis and Musculoskeletal and Skin Diseases explains that osteonecrosis “results from the loss of blood supply to the bone. Without blood, the bone tissue dies. This causes the bone to collapse. It may also cause the joints that surround the bone to collapse.”

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 jaw cavitation.

Symptoms of Cavitations

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

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, but they usually result in systemic health problems that are not obviously linked to dental cavitations.

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.


It is sometimes difficult to diagnose dental cavitations because they may cause no symptoms. Cavitations might not trigger any pain or swelling, and most Americans are unaware of the dangers of dental cavitations.

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

Effective tools for diagnosing dental cavitations include:

  • Biopsy
  • Cone beam 3D CT scan
  • Cavitat (an alveolar ultrasound (TAU) instrument)
  • Bone scintigraphy
  • Panoramic radiograph
  • Applied kinesiology
  • Radioisotope bone scan using technetium-99m

How do you test for cavitations? You test for dental cavitations by using advanced imaging to look at the jawbone for signs of necrosis. Many dentists are taught to overlook certain abnormalities, so it may be necessary for dentists to relearn how to look at x-rays and other imaging.

What causes cavitations?

Cavitations are triggered by blocked-up blood flow to bone cells. These blockages may be caused by:

  1. 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)
  2. Tooth abscess penetrating a bone
  3. Dry socket
  4. Untreated infection at the root canal or bone socket
  5. Overheating bone during a dental procedure
  6. Increased bone pressure
  7. Certain medicines, such as excessive use of NSAIDs
  8. Injury or trauma to the jawbone

Risk factors associated with NICO and cavitations include:

  • Gum disease (periodontal disease)
  • Long-term alcohol use
  • Heavy smoking, which discourages bone healing
  • Family history of clotting disorders
  • Osteoporosis
  • Low oral doses of bisphosphonates, which are used in the prevention or treatment of osteoporosis
  • HIV infection
  • Radiation treatment for cancer
  • Genetic mutations

One genetic mutation concerns nitric oxide (NO) production. NO is a vasodilator, meaning it relaxes blood vessels. When you produce less NO — in this case, due to genetics — your blood vessels are less relaxed, increasing your blood pressure and decreasing your blood flow. Decreased blood flow to bone tissue is the underlying cause of cavitations.

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 necrosis (the death of bone cells).

Cavitations and Whole-Body Health

When cavitations form, that dead bone can harbor harmful bacteria and toxins. This can cause infection and immune dysfunction, affecting your whole-body health.

The potent toxins and bacteria in the cavitation may activate an immune response that never goes away, potentially leading to chronic inflammation and autoimmunity. Common autoimmune diseases include rheumatoid arthritis, lupus, psoriasis, and inflammatory bowel disease.

Osteonecrosis is linked to other serious diseases, whether they are risk factors or symptoms:

  • Heart disease
  • Sickle cell syndrome
  • Pancreatitis
  • Gaucher’s disease
  • Lyme disease

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.


The main treatment for dental cavitations is cleaning out the cavitation of all toxic substances, harmful bacteria, infected bone tissue, abscesses, and cysts.

Laser therapy is non-invasive, precise, and much less painful than other conventional dental treatments. It is the preferred method of treating cavitations for many biological dentists.

Ozone therapy is another potential treatment for dental cavitations. Oftentimes, a mix of oxygen and ozone fills the sinus and ear canals to fight harmful bacteria and other toxic substances. Ozone is a non-invasive way to clean out the toxins inside a cavitation and is highly effective against even antibiotic-resistant bacteria strains.

What is dental cavitation surgery? Dental cavitation surgery is a procedure in which a dental surgeon or oral surgeon removes infected tissue through an incision in the gums, then disinfects the cavitations. Some experts recommend surgery as the first-line response to jawbone/dental cavitations.

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 dental cavitations. Using revolutionary BIOLASE technology, laser-based healing can kill harmful pathogens in cavitations without the pain and anxiety many associate with those outdated dentist drills.


An important part of cavitation prevention is awareness. Too many people are unaware of dental cavitations or how they can negatively affect your whole-body health.

Preventing cavitations begins at home. Floss every day, and brush twice a day. Visit your dental office twice a year.

Some experts recommend avoiding epinephrine, a local anesthetic and vasoconstrictor, during tooth extractions to prevent cavitations. Talk to your dentist about the use of epinephrine before an extraction procedure, since epinephrine can constrict blood vessels and reduce blood flow to bone cells.

Rejuvenation Dentistry is a unique 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.

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.

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 suspect you have 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.