Q. Why do so few dentist know how to diagnose or spot such painfull conditions?
A. The Maxillofacial Center for Diagnostics & Research Homepage of Dr. Bouquot, main researcher and proponent of NICO as a legitimate medical/dental disorder,
The research on NICO is very limited. No randomized controlled studies related to "NICO" diagnosis and treatment have been published. Bouquot is the main person diagnosing NICO in the tissue specimens obtained by dentists who claim that the condition exists. Several other pathologists who reviewed some of the same specimens have judged the tissue to be entirely normal.
The concepts of cavitational osteopathosis and NICO have been promoted by the American Academy of Biological Dentistry. Postgraduate seminars held by this organization have persuaded a number of dentists and some physicians to claim they can cure such conditions as arthritis, heart disease, and pain throughout the body by removing infected cavities within the patient's jawbones.
Believers in "biological dentistry" have taken the treatment one step further. They claim that root-canal-treated teeth cause NICO as well as a host of other chronic systemic diseases. They recommend removing all root-canal-treated teeth and most of the other teeth close to the area where they say an infection exists. According to a 1994 article in Milwaukee Magazine, a group of local patients filed suit against several practitioners of this bizarre and dangerous therapy. These patients had many perfectly healthy teeth removed without any improvement in their diseases.
Description
Neuralgia-inducing Cavitational Osteonecrosis described in medical literature since 1976, is known under a number of names including, Ratner bone cavities, alveolar cavitational osteopathosis, Roberts bone cavity, trigger point bone cavity, interference field, and most commonly, NICO. In NICO, it is claimed that small areas of bone in the upper or lower jaw become infected or inflamed and die, producing neuralgia-like pain. Most often, no sign of inflammation appears on x-ray. NICO is said to appear after tooth extraction, jaw surgery, endodontic therapy or crown preparation and is speculated to be the result of a long-standing low-grade infection.
Symptoms
The pain felt is constant and is often burning and cramping, much like atypical facial pain symptoms. Usually there are trigger points immediately over the areas of infected jawbone that will produce pain when pressed. NICO can cause "referred pain" in that the neuralgia-like symptoms are "referred" to other parts of the face, intraoral cavity and head.
Possible Causes
Some cases of NICO appear to be caused or aggravated by infection. Others speculate that minor trauma from extractions, root canal and other dental procedures are common initiators of NICO but believe this only happens in people already susceptible because of a pre-existing blood clotting disorder. Some believe that NICO can develop when blood vessels are injured in the area, resulting in poor circulation which in turn can lead to bone death.
Diagnosis
It is difficult to diagnose this problem as the pain symptoms often are similar to other conditions such as Myofascial Pain Disorder (MPD), Temporal Mandibular Joint (TMJ) problems, atypical facial pain, trigeminal neuralgia, phantom toothache, or headache. X-rays of the jawbone most often appear normal. However, a bone biopsy of the affected area can show positive signs of jawbone inflammation.
Treatment
The only treatment for NICO is jawbone curettage, in which the jawbone is opened, the infected area drilled out, and the bone biopsied to confirm the presence of inflammation or infection. Often the bone cavity is packed with antibiotics such as teramyacin. A course of antibiotic treatment may be prescribed. Jawbone curettage is not currently done routinely, and it is too early to say whether or not it will ever become generally accepted.
Discussion
NICO is not generally accepted as a cause of Trigeminal Neuralgia by most medical and dental professionals. It is possible that NICO is involved in some cases of facial neuralgia [1], especially atypical facial pain. One long-term study (of nearly 5 years) has reported considerably or totally reduced pain in 74% of facial neuralgia patients who had jawbone curettage. However, the pain returned for about 30% of these patients of whom most had been diagnosed with either TN or atypical facial pain -2.
In dental circles, there appears to be two distinct "schools of thought" on NICO. Some medical and dental professionals consider NICO a controversial diagnosis. Not only do they not consider it a possible cause of trigeminal neuralgia or other facial neuralgias, they doubt the condition exists as a disorder. They point to data suggesting bone cavitations are found routinely in cadaver jawbones, casting doubt on the theory that bone cavities cause facial neuralgias.
Another group of dentists believe NICO is the culprit in many facial pain syndromes and that these painful conditions can be cured by jawbone curettage (scraping and removing infected tissue). They point to studies that show a high success rate for jawbone curettage. Some dentists in this group believe that root canals and mercury fillings are partly responsible for NICO.
The research on NICO is very limited. No randomized controlled studies related to "NICO" diagnosis and treatment have been published. Bouquot is the main person diagnosing NICO in the tissue specimens obtained by dentists who claim that the condition exists. Several other pathologists who reviewed some of the same specimens have judged the tissue to be entirely normal.
The concepts of cavitational osteopathosis and NICO have been promoted by the American Academy of Biological Dentistry. Postgraduate seminars held by this organization have persuaded a number of dentists and some physicians to claim they can cure such conditions as arthritis, heart disease, and pain throughout the body by removing infected cavities within the patient's jawbones.
Believers in "biological dentistry" have taken the treatment one step further. They claim that root-canal-treated teeth cause NICO as well as a host of other chronic systemic diseases. They recommend removing all root-canal-treated teeth and most of the other teeth close to the area where they say an infection exists. According to a 1994 article in Milwaukee Magazine, a group of local patients filed suit against several practitioners of this bizarre and dangerous therapy. These patients had many perfectly healthy teeth removed without any improvement in their diseases.
Description
Neuralgia-inducing Cavitational Osteonecrosis described in medical literature since 1976, is known under a number of names including, Ratner bone cavities, alveolar cavitational osteopathosis, Roberts bone cavity, trigger point bone cavity, interference field, and most commonly, NICO. In NICO, it is claimed that small areas of bone in the upper or lower jaw become infected or inflamed and die, producing neuralgia-like pain. Most often, no sign of inflammation appears on x-ray. NICO is said to appear after tooth extraction, jaw surgery, endodontic therapy or crown preparation and is speculated to be the result of a long-standing low-grade infection.
Symptoms
The pain felt is constant and is often burning and cramping, much like atypical facial pain symptoms. Usually there are trigger points immediately over the areas of infected jawbone that will produce pain when pressed. NICO can cause "referred pain" in that the neuralgia-like symptoms are "referred" to other parts of the face, intraoral cavity and head.
Possible Causes
Some cases of NICO appear to be caused or aggravated by infection. Others speculate that minor trauma from extractions, root canal and other dental procedures are common initiators of NICO but believe this only happens in people already susceptible because of a pre-existing blood clotting disorder. Some believe that NICO can develop when blood vessels are injured in the area, resulting in poor circulation which in turn can lead to bone death.
Diagnosis
It is difficult to diagnose this problem as the pain symptoms often are similar to other conditions such as Myofascial Pain Disorder (MPD), Temporal Mandibular Joint (TMJ) problems, atypical facial pain, trigeminal neuralgia, phantom toothache, or headache. X-rays of the jawbone most often appear normal. However, a bone biopsy of the affected area can show positive signs of jawbone inflammation.
Treatment
The only treatment for NICO is jawbone curettage, in which the jawbone is opened, the infected area drilled out, and the bone biopsied to confirm the presence of inflammation or infection. Often the bone cavity is packed with antibiotics such as teramyacin. A course of antibiotic treatment may be prescribed. Jawbone curettage is not currently done routinely, and it is too early to say whether or not it will ever become generally accepted.
Discussion
NICO is not generally accepted as a cause of Trigeminal Neuralgia by most medical and dental professionals. It is possible that NICO is involved in some cases of facial neuralgia [1], especially atypical facial pain. One long-term study (of nearly 5 years) has reported considerably or totally reduced pain in 74% of facial neuralgia patients who had jawbone curettage. However, the pain returned for about 30% of these patients of whom most had been diagnosed with either TN or atypical facial pain -2.
In dental circles, there appears to be two distinct "schools of thought" on NICO. Some medical and dental professionals consider NICO a controversial diagnosis. Not only do they not consider it a possible cause of trigeminal neuralgia or other facial neuralgias, they doubt the condition exists as a disorder. They point to data suggesting bone cavitations are found routinely in cadaver jawbones, casting doubt on the theory that bone cavities cause facial neuralgias.
Another group of dentists believe NICO is the culprit in many facial pain syndromes and that these painful conditions can be cured by jawbone curettage (scraping and removing infected tissue). They point to studies that show a high success rate for jawbone curettage. Some dentists in this group believe that root canals and mercury fillings are partly responsible for NICO.
What do Jews think of Jesus' harsh words about the Pharisees?
Q.
A. It's really surprising that the Jews do not seem impressed by this record in the historical scriptures, yet they go to all ends of the earth to find shards, scrolls, and pieces of more of those historical documents.
Go figure.
Surely, it was not only Our Lord who noted the pharisees treatment of their own people. The Romans, who let the pharisees rule in a country which Romans had conquered, were far more savvy about overcontrolling their conquests. They certainly noted in Roman History that the Jews dealt unjustly. There are also other writings which the Babylonians noted regarding letting them into their country after the Dispersion.
In every country to which the Jews went, they were eventually evicted, because the pharisees had so much power they tried to take over their host countries. History again. It can't be denied.
Yet, I have known so many friends who are Jews, they were dentists, doctors, and the fine man who saved us from starvation by getting my father a job during the Depression at the shoe department at Goldman's Department Store in Milkwaukee! Can't ever forget Jack Fink and his two young sons, now doctors at Milwaukee Froedtert!
But it still puzzles me. I've liked them so much.
Go figure.
Surely, it was not only Our Lord who noted the pharisees treatment of their own people. The Romans, who let the pharisees rule in a country which Romans had conquered, were far more savvy about overcontrolling their conquests. They certainly noted in Roman History that the Jews dealt unjustly. There are also other writings which the Babylonians noted regarding letting them into their country after the Dispersion.
In every country to which the Jews went, they were eventually evicted, because the pharisees had so much power they tried to take over their host countries. History again. It can't be denied.
Yet, I have known so many friends who are Jews, they were dentists, doctors, and the fine man who saved us from starvation by getting my father a job during the Depression at the shoe department at Goldman's Department Store in Milkwaukee! Can't ever forget Jack Fink and his two young sons, now doctors at Milwaukee Froedtert!
But it still puzzles me. I've liked them so much.
I'm looking for a dentist in the Milwaukee, WI area who makes house calls, is there such a thing?
Q.
A. Try this site it might help you
http://nfdh.org/joomla_nfdh/content/view/18/34/
http://nfdh.org/joomla_nfdh/content/view/18/34/
Low cost/low income dental clinics in Wisconsin?
Q. I'm looking for some low income dental clinics in Racine, Wisconsin (or surrounding areas). Does anyone know of any? I can't seem to find them.
A. The Web page below should help. It lists dentists in Wisconsin who accept Medicaid payments. It looks like there are 3 in Racine itself, and maybe some others that are within reach. I hope this helps.
http://www.medicaiddentistry.com/wisconsin.html
Also, check out the news story below about Health Care Network, which offers free and reduced rate dental care in Racine:
http://www.examiner.com/dental-health-in-milwaukee/lost-your-job-live-racine-free-low-cost-dental-care-is-available
I hope this helps. Good luck!!
http://www.medicaiddentistry.com/wisconsin.html
Also, check out the news story below about Health Care Network, which offers free and reduced rate dental care in Racine:
http://www.examiner.com/dental-health-in-milwaukee/lost-your-job-live-racine-free-low-cost-dental-care-is-available
I hope this helps. Good luck!!
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