Cavitations: €4,000 for two holes and promises to cure multiple sclerosis

Cavitations: €4,000 for two holes that promise to cure multiple sclerosis

A woman whose health is already fragile leaves the dentist with a €4,000 quote for two surgeries. She has been told she has two "cavitations": holes in the jawbone with necrotic tissue, a legacy of extracted wisdom teeth. And that this focus of infection could, over time, lead to multiple sclerosis, arthritis or "various cancers." According to those close to her, the patient was stunned. And no wonder: she is being sold a problem and, on top of that, the solution.

The concept exists, but not the way it was explained to her. In the medical literature it appears as NICO (neuralgia-inducing cavitational osteonecrosis): areas of poorly vascularized bone in the socket of an extracted tooth that fail to heal properly. That much is real. What is far less real is the whole package. The list of associated diseases — multiple sclerosis, arthritis, cancers — is the one popularized by Hal Huggins and his recycled focal infection theory. Huggins lost his license, and the American Dental Association has spent decades debunking that link. If a clinic promises that removing a piece of bone will make multiple sclerosis go away, the problem is not in the jaw.

What evidence there is, and what is done with it

The patient underwent an X-ray, a CT scan and a manual examination. In theory, that can reveal osteonecrosis. The leap lies in the diagnosis and the treatment: from there to scheduling two surgeries for €4,000 is a stretch the evidence does not cover. Her antiestéticar is not trivial: it is not only expensive, she worries about ending up worse than she is. It is the logical reaction when you are offered aggressive surgery based on a theory conventional dentistry does not support.

Osteonecrosis after extractions: when it is real and when it is a business

Osteonecrosis enclosed in the bone does exist and, according to one participant, usually appears after poorly performed extractions, especially in weak patients or those with previous root canal treatments. Up to that point, the ground is defensible. The line is crossed when the diagnosis is stretched to justify surgery in any mouth. In the United States there are specialists who treat these conditions; in Spain, information in Spanish is scarce and most of what circulates are English-language forums, with cases that improve and cases that spiral into infections. The sample is biased by definition: those who share their experience usually have something to tell.

The second opinion, the advice that keeps coming up

The most repeated recommendation is to seek a second opinion, and not at the same practice. Fernando Cebrián, a specialist in mandibular bone regeneration, is mentioned as a reference for cases others have given up on. The accompanying warning: not all extractions or all surgeries are done the same way, and it is wise to steer clear of anyone who turns every molar into an invoice. Hygiene, xylitol for gingivitis — without swallowing it, as it alters gut flora — and common sense complete the kit.

The unsettling detail: the patient has not yet decided anything. And she already knows how much antiestéticar costs.