Some people who have had a tooth extracted experience “phantom pain” – like the extracted tooth is still there and still hurts! Sometimes, they may feel pain in a tooth next to an extraction site for what seems like no reason at all.
X-rays, CAT scans and even MRIs rarely show anything amiss, and the common conclusion is usually “nerve damage”. And even though the phenomenon of cavitations has been in the dental literature for decades, very few dentists are familiar with this condition and how to treat it.
What are dental cavitations?
The term “cavitation” refers to a “hole” in the bone, typically where a tooth has been previously extracted or near the roots of existing root canal teeth. It may be the result of a recent extraction or one performed decades earlier, but it is often the consequence of an extraction site not healing properly.
What are the two types of cavitations?
When discussing cavitations, it's essential to understand the two primary types that impact health. These are:
- Neuralgia-Inducing Cavitational Osteonecrosis (NICO): NICO is a condition that can cause nerve pain. It usually occurs when the bone in the jaw becomes necrotic, or dies, leading to chronic discomfort and neuralgia, which is a type of nerve pain that can be debilitating.
- Sickness-Inducing Cavitational Osteonecrosis (SICO): This type of cavitation involves bone lesions in the jaw that can lead to various health problems beyond nerve pain. SICO may contribute to systemic illnesses and general malaise, affecting overall well-being.
Each type of cavitation brings its own set of challenges, primarily due to the necrosis occurring within the jawbone, which can lead to different symptoms and health implications. Understanding these distinctions is crucial for diagnosing and treating the conditions effectively.
How do cavitations happen?
Improper cleaning of the extraction site can easily create cavitations. Teeth are held in the socket by ligaments. If these ligaments are not removed during the extraction the bone may not fill in properly, leaving a hole in the jawbone. When this happens, the healing process is disrupted and a caviation can appear.
How can dental cavitations be prevented?
The study by Ghanaati et al. (2025) highlights that dental cavitations primarily develop due to programmed socket collapse after tooth extraction, particularly in the upper premolar region (Ghanaati et al., 2025). Preventing cavitations may involve:
- Minimizing Socket Collapse: The study found that after an extraction, the socket walls move inward toward the defect center, leading to a significant reduction in volume. To counter this, interventions such as bone grafting or ridge preservation techniques can help maintain bone volume (Ghanaati et al., 2025).
- Guided Bone Regeneration (GBR): Since the study suggests incomplete socket healing, GBR techniques using biocompatible membranes may help promote new bone growth and reduce void formation.
- Proper Post-Extraction Care: Ensuring the socket remains free of infection and promoting blood flow to the area can aid in healthier bone formation.
- 3D Imaging Follow-Ups: The study highlights the importance of cone beam computed tomography (CBCT) for assessing healing, as traditional X-rays may not detect cavitations (Ghanaati et al., 2025).
How common are dental cavitations?
The study suggests that cavitations are a natural consequence of socket healing in certain regions, such as the upper premolars. Traditional dental teachings assume complete socket regeneration, but the research indicates that instead of filling entirely with bone, the socket undergoes collapse, forming hollow spaces (Ghanaati et al., 2025).
- Vertical socket collapse was found to be approximately 30.1% after three months and 34.3% after six months.
- Buccal socket collapse was 47.7% after three months and 55.7% after six months (Ghanaati et al., 2025).
These findings suggest that dental cavitations may be more common than previously thought, yet they remain underdiagnosed due to limitations in conventional dental imaging.
How to heal dental cavitations naturally?
While surgical intervention may be necessary in many cases, some natural approaches may support overall bone health and healing:
- Bone-Supporting Nutrition: Ensuring adequate intake of vitamin D, vitamin K2, calcium, and magnesium to promote bone density.
- Blood Flow Enhancement: Encouraging natural healing through infrared therapy, acupuncture, and microcurrent therapy to stimulate circulation.
- Osteopathic or Craniosacral Therapy: These holistic approaches can help optimize jawbone structure and alignment, potentially improving bone regeneration.
- Preventing Infection: Maintaining a balanced oral microbiome through probiotics and natural antimicrobial rinses may support healing.
It’s important to note that while these natural methods may support bone health, they do not directly eliminate cavitations, which are physical voids in the jawbone (Ghanaati et al., 2025).
How are dental cavitations treated?
Since cavitations result from incomplete socket healing and bone collapse, treatment often requires a combination of surgical and regenerative approaches:
- Surgical Debridement: Cleaning out necrotic bone tissue to remove dead bone and bacteria from the cavitation site.
- Bone Regeneration Techniques: The study found that bone apposition was observed along the socket walls but not in the center of the defect. To address this, platelet-rich fibrin (PRF), bone graft materials, or biocompatible membranes may be used to stimulate proper healing (Ghanaati et al., 2025).
- Ozone Therapy: Using medical ozone to sterilize the area and enhance bone regeneration.
- Advanced CBCT Imaging: Ensuring complete healing by using 3D imaging to confirm proper bone regeneration.
Why are cavitations so harmful?
Inside cavitation holes, bacteria can flourish and produce debilitating toxins. The latest research has proven these toxins to be highly neurotoxic, which means they can affect the basic functioning of essential bodily systems. These toxins do this by inhibiting protein and enzyme absorption and therefore disturbing cellular function, and contributing to, or inducing disease.
Any infection in your mouth is to be taken very seriously, because the distance between the infection and the brain is very small. Cavitations can lead to osteonecrosis or dead bone material in the jaw. Patients can experience nerve pain most often in the head, neck and face, but also throughout the body.
Since cavitations don’t always appear on x-rays, we recommend Electrodermal Screening (EAV) in addition to a panoramic radiographic survey. EAV can test whether or not your body is dealing with a chronic infection. Cavitations can block the body’s energy meridians – exerting a far-reaching impact. Such blockages (and their locations) can be revealed through Electro-Dermal Screening.
What are the symptoms of dental cavitations?
Identifying dental cavitations can be challenging, mainly because the symptoms aren't always apparent. However, when they do manifest, they can vary significantly in nature.
Common Symptoms
- Facial Discomfort: Many individuals experience unexplained facial pain which can be persistent or intermittent.
- Toothache Without a Cause: Known as phantom toothache, this pain resembles what you might feel from a damaged tooth but without an identifiable source.
- Frequent Headaches: Chronic headaches or even migraines can be linked to dental cavitations, though they might not seem related at first glance.
- Nerve-Related Pain: In more severe cases, people might suffer from trigeminal neuralgia or atypical facial neuralgia, resulting in intense and sudden facial pain.
The Silent Condition
Interestingly, some people with dental cavitations might not notice any symptoms. This lack of visible signs makes it difficult for healthcare providers to diagnose the condition early on.
Hidden Impact on Health
Even in the absence of symptoms, cavitations may lead to broader health issues that go undetected as being related to dental health. These can include systemic concerns that impact your overall well-being.
Understanding these symptoms can be critical to receiving a timely diagnosis and effective treatment.
What is the long-term outlook for individuals with dental cavitations?
Dental cavitations, often overlooked, play a crucial role in overall health. These hidden oral issues, found in the jawbone, can be silent disruptors. But what happens if they're left untreated?
Potential Health Risks
- Chronic Infections: Cavitations may harbor bacteria and toxins. Over time, this can lead to chronic infections, impacting the immune system and possibly contributing to systemic diseases.
- Connection to Systemic Diseases: Research suggests a fascinating link between dental health and body health. A pivotal study identified a significant reduction in healthcare costs related to major diseases when oral health is prioritized. This indicates how untreated oral issues like cavitations could escalate into more severe health problems.
- Persistent Pain: Individuals may experience persistent or sporadic pain localized around the jaw. This discomfort can affect daily activities and quality of life, especially if it radiates to the head or neck.
How are dental cavitations diagnosed?
- Regular Dental Checkups: Early detection is key. Routine visits to a knowledgeable dentist can uncover issues before they become serious.
- Advanced Imaging Techniques: Technologies like 3D cone beam imaging offer a detailed view of jaw health, assisting in diagnosing cavitations effectively.
- Holistic Health Approach: Maintaining a comprehensive wellness routine that includes diet, exercise, and oral hygiene can help manage and mitigate potential impacts of cavitations
Ignoring dental cavitations can have long-term consequences for your health. However, by staying informed and proactive, individuals can significantly improve their health outcomes and enjoy a better quality of life. Embrace a holistic approach to wellness and regular dental consultations to ensure that small oral issues don't transform into significant health challenges.
What do I do if I think I have a cavitation?
The recommended treatment for most cavitations is cavitation surgery, which clears away any dead tissue left behind from an extraction, and cleans and sterilizes the area affected. Complementary at-home therapies will also be prescribed.
If you are concerned about cavitations and would like to be evaluated further by one of our doctors, make an appointment to visit our office.
Source: Ghanaati, S., Śmieszek-Wilczewska, J., Al-Maawi, S., Heselich, A., & Sader, R. (2025). After Extraction, Upper Premolars Undergo Programmed Socket Collapse with Development of Cavitations Rather than Complete Socket Healing: A Radiological Study. Bioengineering, 12(128). https://doi.org/10.3390/bioengineering12020128.
