Cavitations are becoming a popular topic and “buzzword” within the dental and functional medicine community.
Cavitations are also a controversial topic since so few practitioners have a solid understanding of the causes, maladies and appropriate treatment for such a condition. There’s no doubt this entity will become more widely recognized by “modern medicine” in the near future, but at this point the full extent of the causes and treatment for cavitations is still being investigated.
So what is a cavitation exactly?
Simply put, a cavitation is a hole in the jawbone that is chronically inflamed, infected or necrotic(containing dead or nonviable bone). They are often associated with areas where infected teeth have already been removed, existing infected teeth exists, or previously infected teeth treated with endodontic therapy exists. Older Wisdom tooth extraction sites are also a common location. Cavitations are also seen in other bones of the body and are therefore not solely associated with dental conditions. Another reason it is controversial is that many dental practitioners may be overlooking these lesions allowing them to progress and worsen the condition of the jaws all while continuing deleterious affects of the overall health and wellbeing of the patient, and discomfort of the jaws. Typically, 75% of jaw bone cavitations are found at sites of prior tooth extractions. (amalgam.org)(IAOMT.org)
So why are we just now hearing about cavitations?
Despite the seemingly new awareness of cavitations, they have been cited in medical literature since the early 1900’s by G.V. Black(who is considered the father of modern dentistry).
Why is it they are just now gaining prominence in modern medicine?
Cavitations have been hard to recognize and diagnose with standard x-rays. On a normal x-ray, the infected bone can still appear to be normal to the untrained eye. In some cases, a cavitation or other bone lesions and destruction can be impossible to see by x-ray until 30-50% of the jawbone is destroyed.(IAOMT.org) Today, with the newest technology known as a Cone Beam Scan, or CBCT, a 3-D image of the jaw makes it very easy to see what is actually going on within the bone. Additionally, cavitations may often have minimal impacts on one’s dental health while their systemic health issues are further compromised from this threat. This is why they are commonly referred to as the “Silent Infection”. Until recently, few clinicians were looking for them and even fewer were asking about them. A cavitation is not going to kill you outright, it’s not like being septic with a blood infection. It’s a low grade infection in the jawbone that grows over time. The anaerobic bacteria in the necrotic bone slowly release potent toxins that can cause a myriad of complications and effects.(westonaprice.org) Some of the most common effects of cavitations are neuralgia, sinus infections, tooth pain, jaw pain, headaches, and migraines. Oral bacteria is also recognized and documented for causing heart, liver, kidney, and immune system dysfunction. (amalgam.org) Basically, cavitations keep your immune system on alert and ‘running’ all the time. The full extent of their effects are still being debated and understood, but it is plausible to say that a cavitation is taking precious resources from your immune system that could be used to fight battles elsewhere.
How a cavitation is best treated varies with the situation.
Surgical interventions are generally reserved for extensive and symptomatic lesions with apparent health complications resulting from the cavitation. Surgical intervention is not always a necessary first course of action, but possibly so depending on the size and extent. There are non-invasive therapies using ozone, therapeutic lasers, and Platelet Rich Plasma or Fibrin protocols that may be a better solution for milder or less symptomatic situations. If surgical intervention is necessary, the procedure is akin to having your wisdom teeth removed with an often less traumatic recovery. The doctor will go to the site of the infection and remove the overlying jaw bone to access the area that is necrotic and remove the unhealthy tissue, cleanse the area with ozone, fill the area with Platelet-Rich plasma “PRP” and “PRF” (platelet rich products from the patients own blood to help start healing and ward off additional infection), and then suture the gums back over the operated site. It can be a fairly uncomplicated procedure but the area of involvement dictates the extensiveness required to debride and can be done with IV sedation or just local anesthesia depending upon the patients level of apprehension and number of sites to be treated.
As with all healthcare concerns “prevention is the best medicine”. Avoiding cavitations when possible is the best option. This is done by having the residual sockets addressed when unhealthy teeth are necessary to be removed This often involves finding using a dentist that recognizes and utilizes the newest methods of oral surgery and dentistry. Obviously, for many struggling from dental work done decades ago, that is not an option, but a list of skilled and informed biologic dentists you can turn to can be found on www.IAOMT.com (International Academy of Oral Medicine & Toxicity)
Dr. Ted Reese is the current chairman of the IAOMT, Jaw Bone Pathology committee.