Cavitation / Chronic Jaw-Bone Infections / Osteomyelitis / Osteonecrosis (of the jaw) / Nico

Cavitation is associated with a range of unpleasant symptoms, including chronic pain and pressure, sinus congestion, bad breath, and a bitter or sour taste. Our experienced holistic dentist provides treatments for cavitations to help you regain your health and wellbeing.

The safety, precision, and comfort of each procedure at our practice are of utmost importance, and we use only those techniques, products, materials, and procedures that complement this fundamental principle. For more information about treating cavitations in Berkeley Heights, New Jersey, schedule a consultation with Dr. Philip Memoli today.


  1. Why do Cavitation treatments have the highest failure rate of all dental procedures?
  2. What exactly is a Cavitation?
  3. What exactly is a Cavitation?


  1. Definition
  2. Symptoms
  3. Radiographic
  4. Causation
  5. Clinical Significance
  6. Treatment
  7. Costs/reimbursements
  8. Other names for jaw bone infections/Cavitations


  1. I’ve never had a problem with my extraction sites. How could I have had an infection for the past 10 to 20 years (or more) and not know it?
  2. What conditions would lead me to suspect I may have a jawbone cavitation/chronic hidden bone infection?
  3. Can certain medications increase my risk of developing jawbone infections?
  4. Are there any objective methods to diagnose jawbone infections?
  5. What reliable subjective methods are available and how are these positively confirmed?
  6. Is Oral Acupuncture the best method to assess a Cavitation?
  7. What other method can be utilized to assess for a potential cavitation?
  8. Can you describe the non-surgical approach and its limited success rate?
  9. Can you describe the surgical method and its variable success rate?
  10. What are ‘biologicals’ and their role in Cavitation treatment?
  11. What is the best approach to cavitation’s with the goal of obtaining complete bone formation/healing?


Level 1: Therapy (Pre-disposing Factor Assessment)

Level 2: Surgical Therapy, Surgical Precautions, Surgical Process

Level 3: Bone Healing Follow-up, Long-Term Bone Healing


Algorithm for Chronic Bone Infections


1. Why do Cavitation treatments have the highest failure rate of all dental procedures?

The majority of patients that I see are having treatment performed again. Some have already had 3-4 surgeries int the same area. Many dental surgeons, in fact, if prompted will tell you the surgery may need to be performed numerous times to be successful or repeated every 3-5 years. Clearly, a firm understanding of Cavitations is lacking at all levels. If a cavitation is simply a hole in the bone filled with bacteria (many clinicians will biopsy the site to ‘prove’ the necessity of the surgery), simply filling the hole with bone or PRF should result in immediate long-term health. This simply does not occur and calls upon us to formulate a new paradigm.

2. What exactly is a Cavitation?

From a theoretical point of view, the definition may be the most important question a patient can ask and a dentist must answer. This answer determines a doctor’s philosophy, diagnostic parameters and treatment approach. From a clinical point of view, there is less agreement among dental surgeons as evidenced by the numerous names and descriptions found in the dental literature.

3. Why does a proper definition of Cavitations matter?

If a doctor does not have a clear view of “exactly” what a Cavitation is, then how can there be a treatment goal to be achieved? If I maintain as the name implies, a Cavitation is simply a ‘hole’ in the bone then my surgical goal is to simply fill it. The whole discussion would focus upon the technological advantages of what material I place in the hole. Healing of the patient and bone regeneration are not even part of the discussion.



  1. The term cavitation literally means “a hole in the bone.” It is much greater than simply a whole in the bone. It’s usually painless and is difficult to detect clinically and by x-rays. The bone cavity may be infected, inflamed, both or neither. If resistance is weak, it may send bacteria, toxins and inflammatory proteins into the body and cause a systemic reaction. This reaction may manifest as one of many chronic degenerative diseases.

2. Symptoms

  1. The Acute Stage is symptomatic. It may result in referred pain which appears elsewhere on the face and is sometimes called phantom pain or causalgia. This pain may be diagnosed as Trigeminal Neuralgia or Atypical Facial Pain/Neuralgia. Perhaps less than 5% of Cavitations are acute.
  2. The Chronic Stage is asymptomatic. The typical signs of infection, such as pain, redness, fever or inflammation, are not present. 95% of Cavitations are chronic with no outward signs of infection, inflammation or bone changes accounting for their difficulty in detection.

3. Radiographs

Typically, x-rays of the bone do not show evidence of bone Cavitations. One reason for this is that the dense outer cortical bone does not allow a viewing of the inner portion of the bone. Also, dental studies on known infections within the jawbone have demonstrated that infections less than 8 mm generally are not visible on x-rays.

However, x-rays may imply bone irregularities which are suggestive of cavitations. These include images of previous root outlines and areas of irregularity.

4. Causation

There are two major causes of Cavitations. One cause is existing systemic conditions which predispose the patient to poor healing. The second cause is improper surgical technique as a result of not understanding the true nature of Cavitations. In either instance, the body may or may not grow new bone in the surgical site, resulting in cavitation formation.

5. Clinical Significance

  1. Chronic bone infections, whether of the jawbone or other bones, can exert both a local and a systemic effect. The local effect involves infections (such as Lyme, co-infections, bacteria, viruses, and fungus), biotoxins and local inflammatory proteins. If any one of these factors spreads through the bone and reaches a vital nerve, it may produce symptoms such as pain. To complicate matters, since the nerve is distant from the source of the infection, the true site may never be suspected.
  2. A systemic effect occurs when a bone, infection spreads throughout the body. We call this a focal infection. Dr. Voll, a German physician and inventor of the electroacupuncture technique (called EAV for Electro-Acupuncture according to Voll), found that over 70% of focal infections originate in the mouth.

6. Treatment

Surgery is the only means of directly reaching the cavitation site. Indirect techniques, such as
cold lasers, ozone injections, and others, offer only short-term benefits, sometimes lasting for
only a few weeks or months!

7. Costs/Reimbursements

Infections are treated on a per site basis. Surgical risks and damaged structures can increase the
cost. Unfortunately, neither dental nor medical insurance companies cover the cost of treating
jawbone Cavitations.

8. Other Names for Jaw Bone lnfections/Cavitations

Acute (symptomatic) Conditions:
• NICO (Neuralgia-inducing Cavitational osteonecrosis)
• Atypical Facial Pain (non-localized pain in the face)
• Trigerminal Neuralgia (inflammation or infection of the trigeminal nerve)

Chronic (Asymptomatic) Conditions:
• OMJ or Osteomyelitis (infected bone) of the Jaw
• ONJ or Osteonecrosis (dead bone) of the Jaw
• BRO NJ or Bisphophonate-related Osteonecrosis of the Jaw
• ARO NJ or Anti-resorptive-related Osteonecrosis of the Jaw
• lschemic Bone Disease/Osteonecrosis
• Medullary Bone Disease
• Avascular Necrosis
• Chronic Osteitis (G.V. Black, 1915)
• Jaw Osteonecrosis (Glueck et all, 1996)
• Alveolar (cavitational) Osteopathosis (Ratner et al, 1979/1986)
• Robert’s Bone Cavities (1979)
• Idiopathic Bone Cavities (Choukas & Romano, 1978), (Boerger, 1972), (Bergenholt &
Persson, 1963)


1. I’ve never had a problem with my extraction sites. How could I have had an infection for the past 10 to 20 years (or more) and not know it?

There are two factors to consider. One is the nature of infections. The other is the process of bone healing.

Infections have a dual nature: an acute or symptomatic state (including pain, redness, bleeding, and swelling) and a chronic or asymptomatic state. Most jaw infections are chronic, so they don’t produce any of the typical symptoms of infections. Because of this, a chronic jaw infection can last 20 years or longer without your being aware of it.

Bone healing is a long-term process which must occur under ideal nutritional and systemic conditions. Once the blood clot following tooth extraction matures and is dissolved, the body must completely fill in the area with new bone. Even under ideal circumstances, it’s a difficult process for the body to orchestrate and complete.

2. What conditions would lead me to suspect I may have a jawbone cavitation/chronic hidden bone infection?

There are several conditions which might cause suspicion:

Lowered Resistance resulting in chronic systemic infections such as Lyme (Borrelia) or any of its coinfections (Babesia, Bartonella, Mycoplasma Ehrylichia, Tularemia, etc). Viral infections, such as Herpes, Epstein-Barr, Cytomegalovirus, and Varicella-Zoster (chicken pox and shingles), may also be an indication.

Infections which don’t respond to treatment. Systemic antibiotic therapy for infections may go on for weeks or months. When therapy is discontinued, however, infections may reappear. Since jawbone Cavitation sites don’t have blood flow, the immune system cannot get into these sites. Therefore, any infections living within the Cavitation may hide safely from the immune system and antibiotic therapy.(Both of which require blood for its transportation in the body). The immune system can’t get inside the bone.

Once resistance is low, the micro-organisms from the Cavitations may reenter the blood stream to cause a chronic infection somewhere in the patients body. (Oral Systemic Infection)

Inflammation of unknown origin. Inflammation is needed to activate most chronic degenerative diseases. Micro-organisms and biotoxins, as well as most focal sites, can trigger inflammation to increase the disease-causing processes in tissues distant from the mouth.

Fevers of unknown origin. Chronic dental infections are common factors to consider when determining the cause of fevers for which no reason is apparent.

3. Can certain medications increase my risk of developing jawbone infections?

Although the risk is reportedly low, certain drugs can cause osteonecrosis of the jaw (ONJ). These drugs do not necessarily cause chronic dental infections. They can, however, predispose
someone to ONJ, whether they are currently taking the medications or have stopped. A patient’s predisposition may continue for up to seven years after taking these medications. A sign of dental induced ONJ is a dead bone protruding through the gums, especially if it persists for months despite treatment. If you have this condition and believe you may require surgery, contact us for strategies to reduce any risks.


Bisphosphonate Medications:
Generic Name
Zoledronic acid

Brand Name
Fosamax (Merck)
Boniva (Roche)
Actonel, Atelvia (Proctor & Gamble)
Zometa, Reclast (Novartis)
Aredia (Novartis)

Anti-angiogenic Medications (Indications: Prevent metastasis to bone tissue):
Generic Name

Brand Name
Avastin (Genentech)

Receptor Activator of Nuclear Factor Kappa-Beta Ligand (RAN KL) Inhibitor Monclonal Medication:
Generic Name

Brand Name
Xgeva, Prolia (Amgen)

4. Are there any objective methods to diagnose jawbone infections?

Ultrasound: The “Cavitat Machine” produced an image that showed the quantity and quality of bone. Although it gave no information as to the aggressiveness or nature of the cavitation, it
was the least invasive method to detect cavitation. As a result of legal problems, the company was forced to close and existing machines (including mine) cannot be serviced.

Technetium-MOP Scintigraphic Scan and SPECT: Diagnostic imaging techniques, such as the TcMDP and single proton emission computed tomography (SPECT) scans, must be used instead of the indium and gallium scans typically used for bone infections: Which do not show cavities. There’s a drawback to imaging, besides the use of radioactive isotopes. Imaging has difficulty with detecting chronic infections. It is easier to detect acute infections because they have a greater number of inflammatory areas (leucocytes or white blood cells) in the bone matrix for the radioisotopes to attach to. Although imaging can work as a diagnostic tool, chronic lesions are less sensitive to imaging and may yield a false negative.

5. What reliable subjective methods are available and how are these positively confirmed?

There are several subjective methods available.

Traditional Dental Radiography: Periapical x-rays (smaller images of 1-2 teeth) are more accurate than a panoramic image of the entire jaw. Analog film, although smaller, is more sensitive than digital film. Although there is no universally accepted radiographic image which provides a definitive diagnosis, images in one study characterized ischemic osteonecrosis as a differential (possible) diagnosis (Bouquot and Lamarche, 1999). The same study also points out that some patients with confirmed histological diagnoses have presented with no radiographic changes at all.

Dental 3-D CT and CONE Beam Scans: The manufacturers of these devices emphatically state these machines cannot diagnose Cavitations and cracks in teeth. One company is currently trying to write an algorithm to detect Cavitations but without success. Further, the rule dental X-rays states, “No diagnosis can be determined by an X-ray alone”. Clinical symptoms must concur with X-rays and most Cavitations have no symptoms. Do not accept a diagnosis on the sole basis of a 3-D Scan.

Diagnostic Anaesthetic Testing: This technique works primarily when referred pain from the trigeminal nerve is involved. If a certain site on the jaw is suspected, anaesthesia in that
segment may relieve pain to confirm the diagnosis. Such a diagnosis is not usually black and white, though, because of interference from nerve “loops” and “overlap” from neighboring
nerves. Also, inflammatory proteins may cause the nerve endings to be hypersensitive. These conditions may produce “anaesthetic resistance” or the inability to obtain full anaesthesia. They
also indicate an underlying pathology (McMahon, Adams, Spolnik, 1992)

Alveolar Palpation: Pressing on the external gums over the sites of the missing teeth may indicate pain or sensitivity. This test, however, may also provide a false negative. In order to test positive, an adequate amount of external bone must be destroyed. Which, would yield a positive radiograph. As a result, this test may be positive in less than 5% of cases.

6. “What about Oral Acupuncture? Is it a reliable method to confirm Cavitation?”

Oral Acupuncture: it is the stimulation of various points of the skin inside the mouth. Beneath the skin are meridians, (energetic pathways) which connect one part of the body to another and provide “electricity” to the whole body. These pathways have been confirmed by research and, as a result, physicians are allowed to practice it.

If you understand the acupuncture system, you can use the biofeedback information it provides. Half of the meridians are tooth meridians, that is, they encompass various teeth. The other half are non-tooth meridians. You can locate “blocks” in the body by appraising tooth vs non-tooth meridians.

Each tooth meridian embraces a particular tooth and then courses through the body to include specific organs, endocrine glands, joints, and other parts. These meridians are essentially the
electrical lines of the body. If one of the electrical lines is “down,” the organs and teeth involved will suffer a virtual “brown-out.” To determine why a meridian is down, you must look at the various acupuncture points which correspond to the tooth and the organs associated with it.

Frequently, one finds the problem originated in a tooth or an extraction site.

An assessment of the meridian can determine the following information:

1. The exact meridian(s) which is blocked. Infections and inflammations in a tooth or organ, as well as any holes in a bone, will exhibit meridian blockage.
2. The quantitative drop in energy.
3. The qualitative status of the meridian. Inflammation (eg, osteomyelitis) will increase energy, whereas degeneration (osteonecrosis) will decrease energy.
4. When there is a disturbance in the meridian’s energy, the organs and glands on that meridian will compensate. This makes assessment more difficult, but it confirms a disturbance exists.
5. The organs and glands on the meridian may show decreased energy, which may in turn manifest as a physical symptom for the affected structure.
6. The acupuncture effect is two-way: it may start in the tooth and affect the organ or vice versa. In some cases a weak organ can cause an otherwise healthy tooth to become devitalized and die.
7. Acupuncture and Acupressure can temporarily balance a stressed meridian.

Methods by Which to assess Acupuncture Meridians
Traditional Chinese Acupuncture
Tai Chi
Electroacupuncture according to Voll (EAV)
Vegetative Reflex Analysis (Vega)
Applied Kinesiology (Muscle Testing)

Note: These techniques are generally performed by acupuncture masters who have studied the discipline for many years. Several of these techniques have been computerized (EAV, Vega) and they can provide a good assessment. Machines, however, can only “see” what the programmer has put into the machine. Machine assessment should be followed up with assessment by an experienced practitioner.

To complicate matters, experienced acupuncture practitioners may not be knowledgeable in western medicine and in bone infections in particular. They may have little or no experience with teeth and their energetic ramifications.

7. What other methods can be utilized to assess for potential Cavitations?

If objective evidence cannot be obtained, you should look to the subjective assessments. See if there is a correlation and confirmed findings in at least two or three of the tests. If more than one practitioner is assessing your condition, make certain they are all knowledgeable on the matter and have the means to properly assess it. Those who treat these conditions should be
able to use various techniques in order to make the proper diagnosis. Also, they should be able to use the same techniques during surgery to confirm that all pathology has been removed.

8. Can you describe the non-surgical approach and its limited success rate?

The goal of any therapy is to reach the cavitation site and heal it. Surgery is the traditional option. However, some have claimed to treat these conditions with non-surgical methods. If you suffer from this condition, you need to be reasonably certain that the technique will reach and heal your cavitation site, especially if your condition is causing a systemic effect. Although none of the following non-surgical techniques have proven effective, here is a list detailing them.

Ozone Therapy uses free radical oxygen to kill bacteria. It is very effective in treating acute infections. It is less effective with chronic infections, and some bacteria are resistant to it. Some physicians and dentists would take issue with my statements. They feel that ozone therapy can cure every illness in the body. However, ozone therapy has no therapeutic effect on coagulation factors and osteonecrosis, even if an “access” hole is made in the bone to the lesion. Ozone claims success mainly with conditions of bacterial origin, such as abscesses. Cavitations, being multi factorial, possess microorganisms as a secondary factor. Ozone Therapy, if over administered, may produce Ozone resistant infections. Ozone, however, is a useful adjunct in surgical and post-surgical care.

Mud Packs: Mud is excellent for the removal of toxins and can reverse an interference field
(a block in the acupuncture system). Most Cavitations, though, present with an intact outer bone and a hollow marrow. It’s impossible for the mud to penetrate into the actual cavitation itself. Mud, however, is beneficial post-surgically, if deep tissue detoxification is needed at the surgical site.

Lasers: Lasers, whether hot or cold, can reduce inflammation. They do not, however, heal the
defect. It may be useful as an adjunct to surgery but cannot work as a stand-alone treatment.

Magnets: Magnets play a key role in the healing process. Innovative things have been done with them and they may play a key role in the future.

9. Can you describe the surgical method and its variable success rate?

Surgery is the only means of reaching the cavitation site. In many instances, the hard outer cortical bone has healed, but we must pass through it in order to reach the defect. This is only possible through a surgical procedure. Once we reach the cavitation, we must assess it and use proper treatments to remove any Osteonecrotic or Osteomyelitic bone. After we complete treatment, a blood clot must form in the bone for healing to begin. Finally, we need to suture the gum back in place.

Key point: Properly performed cavitation surgery does not guarantee bone healing.

What Can Go Wrong? Susan Stockton, the author of a book on Cavitations, found that the procedure had to be repeated on her several times, as it did for many other patients. In another case report of a patient with osteonecrosis, Dr. Bouquet surgically entered several Cavitations and found “soft, gritty and brownish” medullary bone. When the patient’s symptoms returned fourteen months later, he re-entered the sites and found a new cavitation had formed. There was excess fibrous connective tissue instead of new bone.

This raises a key question. If the surgical site did not heal at the original time of surgery, when the patient was perhaps younger and healthier, why should it to heal now that the patient is older?

Reasons the Surgical Technique might fail:
1. Use of general anaesthesia or conscious(partial) sedation.
2. Excessive use of Epinephrine in the local anaesthetic
3. Failure to assess pre-disposing factors related to poor healing.
4. A one-size-fits-all surgical approach (same approach for all situations)
5. Failure to offer a protocol for extended bone healing.
6. The use of protocols which actually impair bone healing.
7.Chronic clenching on the part of the patient after the surgery.

10. What are ‘biologicals’ and their role in Cavitation treatment?

A Cavitation site is essentially a “bullet hole in the jaw.” That hole, as we previously stated, is multi factorial. That is, there are nutritional, root cause, proximate cause, immune, detoxification, coagulations and a host of other factors. If this is properly understood, how can a “one size fits all” approach to cavitation be treatment planned? Can this approach contribute to Cavitation failure?

Biologicals include bone grafts, Protein-rich Fibrin (PRF), various membranes and Growth Factors. All of these have indications and contra-indication. Also, all of them produce non-vital (that is, dead) bone (For a more in depth discussion, see Section VII in Ceramic Implants).

11. What is the best approach to Cavitations with the goal of obtaining complete bone formation/healing?

The best approach is a comprehensive one which involves a systemic and local plan to obtain successful, long-term healing of the bone.

Factors which may predispose patients to poor healing, particularly in the bone, need to be assessed and addressed. These factors also need to be monitored, both during and after the surgery, in order for healing to take place.

Surgery always needs to be tailored to the demands of the surgical sites. Clotting enhancement, PRF and bone grafts should not be an “always” or a “never,” but they need to be diagnosed, planned, and executed.


  1. Identification of Pre-disposing Conditions
  2. Nutritional Program:
    1. DHA (Fish Oil)
    2. Fat Soluble Vitamins: A, D, E and K
    3. B-Complex Vitamins
    4. Multi-Mineral Complex
  3. Homeopathic Protocols
    1. Cell Salts
    2. Complex Fomulae


  1. Surgical Precautions:
    1. No general anaesthesia (or “light” sedation)
    2. Stabilized coagulation
    3. Normal blood pressure and vitals
    4. Ideal blood glucose levels (below 110 mg/di)
    5. High anti-oxidant levels
    6. Adequate protein and mineral levels
    7. Balanced autonomic nervous system
  2. Surgical Process:
    1. Access to bone defect/cavitation
    2. Site curettage (infected and dead bone removal)
    3. Confirmation of removal of all compromised bone
    4. Sinus repair (if indication)
    5. Bone grafting (if indication)
    6. Guided Tissue Regeneration (membranes which stabilize a bone graft):
    7. The use of resorbable collagen or non-resorbable membranes to stabilize the graft
    8. Suturing and post-operative care instructions
    9. Neural therapy (reverse shock, trauma and surgical interference fields)
    10. Meridian stabilization
    11. Homeopathic remedies to stimulate healing response.
    12. Ozone therapy to control micro-organisms


  1. Nutritional
    1. Metabolic diet
    2. Anti-inflammatory protocol
  2. Post-operative follow-up
    1. Infection assessment
    2. Inflammation assessment
    3. Coagulation assessment
  3. Long-term bone assessment
    1. Acupuncture meridian evaluation
    2. Bone healing assessment
    3. Homeopathic protocol




  1. These are bone forming cells which pull calcium, magnesium, phosphorus and other minerals from the blood to build bone.
  1. Osteoblasts require the hormone progesterone to form dense bone. Menopause, amenorrhea and ovulation disturbances may cause low progesterone levels to predispose women to poor bone formation.


  1. These are bone forming cells which pull calcium, magnesium, phosphorus and other minerals from the blood to build bone.
  1. Osteoblasts require the hormone progesterone to form dense bone. Menopause, amenorrhea and ovulation disturbances may cause low progesterone levels to predispose women to poor bone formation.


  1. These cells maintain the integrity of the bone.
  2. Bone which has no osteocytes is considered osteonecrotic bone (dead bone).
  3. As one’s age increases, there are fewer bone osteocytes.

Surgery (including tooth extractions) and bone trauma at normal bone health heal normally. That is, if a tooth, periodontal ligament, and any abnormal bone (osteomyelitis and ostenecrosis) are completely removed, the bone cavity should totally fill in (not forming a cavitation) regardless of the surgical technique utilized.




Increased tendency to develop thrombi
(micro-infarctions) in the blood vessels.

A decreased ability to dissolve clots/thrombi.
Once a blood clot forms, it must be slowly dissolved for healing to occur.

• Vitamin B, C, D, or K deficiency
• Mineral deficiency: calcium, magnesium, zinc, trace minerals, electrolytes

• MTHFR (Methylene Tetrahydrofolate Reductase) Defect
• CBS (Cystathionine BetaSynthetase Genetic Defect
• Anti-phospholipid Antibody Syndrome
• Hyperhomocystinemia
• Factor V Clotting Factor Gene Mutation (Leiden)
• Protein S (Low levels)
• Protein C (Activated Protein C resistance)

• Elevated estrogen levels
• Low progesterone levels
• Corticosteroid therapy
• Hypercortisolism

• Neuralgia
• Neurological symptoms

• Osteoporosis
• Osteopenia
• Osteomyelitis

• Vasculitis
• Atherosclerosis
• Vasoconstriction (epinephrine, stress or nicotine related)
• Raynaud’s phenomenon
• Hypertension
• Hyperlipidemia
• Vascular Insufficiency

• Elevated C-Reactive Protein levels
• Increased level of inflammation producing cytokines {Interleukin 1-B, 6 and tumor necrosis factor-alpha)

Surgery and trauma performed on abnormal bone metabolism may cause a failure of bone to heal thereby resulting in a cavitation.


LEVEL III: FORMATION OF 0STEONECROTIC BONE (ASYMPTOMATIC FAILURE TO HEAL) This section is a graphic the titles in bold letters are framed in a box with the description

(caused by pre-disposing factors)
Pressure may increase 2 to 4 times greater than normal to produce bone tissue damage

l. Clot formation in the marrow EDEMA blood vessels which can cause bone cell death
2. Thrombophilia is a condition in which the formation of clots is greater than normal (microinfarction formation)

The blood supply is disrupted, resulting in vascular stasis, a condition in which blood flow (in the marrow) stops.

(vascular insufficiency)
lschemia is the result of a lack of blood flow which causes oxygen levels to drop. Without oxygen, the cells cannot survive.

Marrow Cell Death
Osteonecrosis (of the jaw)
Osteomyelitis (of the jaw)




(Micro-organism Ecosystems)

Lyme and Co-infections

Actinomyces Species (OMJ)

Staphylococcus aureus

Staphylococcus epidermidis

Candida albicans (ONJ only)

Listeria monocytogenes

Streptococcus Group B

(including L-forms)


(Directed against the host)




Mycotoxins (from molds)


Thioethers (hydrogen sulfide, Methyl-Mercaptan, dimethyl disulfide, etc.)

Bio-Active Amines (putrescine cadavarine, etc.)

Carboxylic Acids (acetic acid, butyric acid, propionic acid, etc.)




detoxification, and

elimination of microbes and toxins




The immune system shuts

down or is overwhelmed.




1.Chronic inflammation may result without normal shutdown mechanisms.

2.Th-2 Dominance (lack of T-killer cell activity may result).




Cathy M. age 59

I went to Dr. Memoli find out if symptoms I had been experiencing could be related to my teeth. He found extensive dental infections mostly in root canal teeth and cavitations from extracted wisdom teeth. He also found that my biting surfaces were imbalanced and corrected this on the first visit. In balancing my bite, it occurred to me that two teeth that had root canals within the last year may have been compromised by the pounding they were taking from the imbalanced bite.

The treatment plan was for 4 tooth extractions and 5 cavitation cleanings and fillings. would also have the crowns with metal bases exchanged for ceramic crowns. Dr. Memoli carefully went over the plan with me noting options and making sure I understood the work he would do and the greater effects it might have on my body. The surgery went smoothly and I felt the work was done very competently. The restorations-the crowns and bridges are nice and fit well.

Right after the surgery I started to notice-and am still noticing the lessening or disappearance altogether of my symptoms. I have clearer thinking and more energy and stamina. My joints are more flexible. My sense of smell found that I am generally feeling much better and sleeping well too. My stress level has greatly decreased. My G.I. tract is working better-it seems all my organs are working better. I haven’t said “I feel great” and meant it for years, and now I can.

I am grateful for the level of care Dr. Memoli gave me which included calls to see how I was doing throughout the treatment and helping me understand the processes my body would go through in relation to the treatment. He advised me how important the elimination of toxins would be for my body to recover well. He also worked closely with my other health care professional. 

Mary Lu Hale

In 2013, in spite of decades of healthy living, Mary Lu Hale had problematic symptoms with no obvious cause, all on the left side of her body. She had back pain in her lower back which caused problems with daily activities that required lifting her left leg such as getting into and out of the car or dressing. She also had drainage in the back of her throat which seemed to increase when she rubbed the spot where her root canaled teeth had been removed. She had pain in the bone above her left eye. She felt like she couldn’t take a deep breath due to pressure in her chest.

She already had her mercury fillings removed, her crowns removed, and her root canaled teeth removed, which she felt had improved her health and quality of life considerably. From her research, though, she was convinced that the various tooth extractions had left Cavitations or holes in her jaw and that her symptoms were caused by Neuralgia-Inducing Cavitational Osteonecrosis (NICO). Dentists and surgeons who did her previous work were not interested or comfortable in performing the cavitation surgery she felt was needed to heal those sites.

So marked the start of her research, on the internet and through personal relationships, for a dentist who was willing to help. Cavitation surgery is only done by a few dentists in the entire US, and they can be difficult to find. She narrowed her options. One had a waiting list. Another was outrageously expensive. Many did not perform Cavitations. She continued her search until finally, a holistic dentist who she had worked with earlier said “You have to go to Dr. Memoli”

On Mary Lu’s first visit, Dr. Memoli and his staff did x-rays and discussed her symptoms. He was particularly interested in the fact that she could rub her gums and increase the drainage in her throat. He manually examined her jaw and discussed differences between live and dead bone and the reasons he suspected part of her jaw bone might be dead. He explained the surgery: under local anesthesia, wherever there was a tooth missing from extraction or root canal, he would slice open her gum, expose the jaw bone, and remove the dead bone until he uncovered live bone. He would then inject bone graft material and ozone to encourage healing before closing up the site.

During the first surgery on the upper left jaw, in the site where the wisdom tooth used to be, Dr. Memoli discovered that a ban of orange mush where the cavitation had created a channel of dead bone that tracked along her jawbone and into the joint.

Mary Lu’s daughter drove her the three hours to Dr. Memoli’s office the day of the surgery. In less than three hours, they were headed home. On the way home, Mary Lu noticed that about half of her back pain had been relieved and the pressure in her chest was gone.

During the hours after the surgery, she experienced the surgery site draining with a steady flow of clear, thick liquid with strings of white matter thick enough to get caught in her teeth. This interrupted her first night’s sleep, but it suddenly it stopped the next morning. The surgery itself was not very painful, Mary Lu said. However, because of her jaw being open for so long, she had trouble swallowing and opening her mouth to eat and speak, she said. She did not experience the wound drainage problem for any of the other three surgeries.

In the days after the surgery, Mary Lu realized the drainage in her throat was reduced notably. The pain above her eye was gone.

A few months later, Mary Lu had the procedure performed on the lower left side. She expected the remaining drainage and eye socket pain to be relieved entirely after the lower left work was done, but she experienced no further improvement.

Mary Lu never had symptoms on the right side of her body, but still she knew there was bad dental work that needed correction. Years earlier, for a failed root canal tooth, a dentist had performed an apicoectomy on tooth #4 and the dentist sealed the roots of the tooth with mercury.

The work on the top and bottom right sides was scheduled for one session. The only surprise with those two surgeries was that Mary Lu’s blood was thinner than the average patient. She believes this was because she had started using a grounding mat (which is also called an earthing mat). The seemingly excessive bleeding alarmed Dr. Memoli, but he quickly realized that the thinning had not impacted the blood’s ability to clot.

That day, after the surgery, all throat drainage was gone. Within a week, her remaining left side lower back pain was relieved. As a licensed massaged therapist and holistic nutritionist, Mary Lu believes both of these problems were related to the lymph system. She believes that the drainage from the right side cavitations had found a path to drain on the left side, perhaps due to a blockage. She believes the lower left back pain was caused by her overwhelmed lymph system.

“Still to this day I am in disbelief when I get into my car and can lift my leg,” Mary Lu said. “At least once a day, it will occur to me that I just feel so good.”

Her recent successes correct a lifetime of sorrows with the dental industry. “I had my mercury filling by age 5. By the time I was 25 I had at least 10 mercury fillings, several root canals and crowns and had lost a number of teeth, including my wisdom teeth. I didn’t realize that the toxicity in my mouth was so great that my attempts to change to healthier eating habits and a cleaner environment produced little improvement. It was an uphill battle.”

In 1998, “I bought a book that forever changed my life. The name of the book is, Alternative Medicine, The Definitive Guide. It’s an encyclopedia of hundreds of different alternative approaches to restoring health. In reading the chapter on Biological Dentistry in a section named, “How Dental Problems Contribute to Illness”, a light bulb went off in my head. I thought, I have a mouth full of mercury fillings. Could they be the cause?”

She began having her mercury fillings removed, and was surprised that she didn’t experience an improvement in health. What she did not know – nor did her dentist at the time tell her – that “there was much more mercury under my eight crowns and even in one root canal tooth. I was under the impression that all the toxic dental work had been removed, when, in fact, yet another toxic root canal was recommended, and, as a good patient, I complied. I became even sicker, and went from one dentist to another looking for answers. I asked: why, after this latest root canal, was my sinus constantly infected? It couldn’t possibly be the root canal, he said. I asked if he would remove the root canaled tooth. Absolutely not, he replied; there’s nothing wrong with it.”

It wasn’t until 2006, 7 years after the fillings were removed, that Mary Lu discovered information that would change her life: “I found on the internet root canal teeth are dead and chronically infected body parts and should be removed for optimal health.” After her prior experience being declined for the service she requested, Mary Lu took the bold move of lying to an oral surgeon in order to get rid of a tooth she suspected was especially problematic. She said she wanted the tooth extracted so she could get an expensive implant.

This was a breakthrough experience. “I went from having recurring sinus infections and on antibiotics constantly to no sinus infection!” I’ve since had 3 more root canal teeth extracted, including the one containing mercury, with miraculous results! In the 7 years since, she has not had there has not been even one sinus infection. And her mood had improved remarkably.

Still, a Cavitat Scan in 2008 showed 11 potential cavitation sites, some from extractions from her childhood that had never healed and she worried about the impact on her health. “After hours and hours of additional research on Toxic Dentistry, I was becoming known as somewhat of an ‘expert’ on the subject and people began to call and email me with their dental questions. I have become the dental patient advocate I wished I’d had all those years ago. Here I am giving advice to others about the wisdom of crowning that tooth or, the most often asked question … What are my options if they don’t do a root canal? But I felt like a bit of a hypocrite because I hadn’t had my cavitations addressed.”

These days, Mary Lu is enjoying her pain-free life with good immunity and has a sense of relief that she has fully taken the advice that she gives to her patients. The patients she has sent to Dr. Memoli also are experiencing improving health. Even a patient with potentially life-threatening health conditions has improved under Dr. Memoli’s care. And for that, Mary Lu is grateful.


Herb Shapiro

In August of 2010, I went to my regular medical doctor. I was in a lot of pain in my neck and shoulders and upper back. He checked me out and found my heart rate to be over 150 per minute, with some problem in my left lung. He decided to put me in the hospital. Even though I was in a lot of pain, I didn’t like the idea, but agreed to go because I didn’t know what else to do. In the emergency room, as well as the rest of the hospital, all the doctors were great and the hospital treated me very well. The cardiologist, who was excellent, was looking for the underlying cause. They gave me several drugs, one of which brought my heart rate down to normal. Normal was considered to be 60-90 beats per minute. X-rays were also ordered and CT scans of my heart and lungs, and other organs. What they found was pericardial and peri pleural effusion. Fluid had built up in the pleura and pericardium of my heart causing a collapsed lung which caused the pain and atrial flutter. The medical dictionary definition of atrial flutter is a rapid vibration or pulsation. It is a condition of cardiac arrhythmia in which the atrial contractions are rapid, but regular. Sometimes there can be 200 to 300 beats per minute, but mine was about 150. Atrial flutter is similar to. Atrial fibrillation, but not as severe.

In the hospital, I was examined by two cardiologists, a thoracic surgeon, a pulmonologist, an infectious disease specialist, and many assistants. They could find no infections, cancer, heart disease or heart attack. As good as the hospital was, they had trouble figuring out the cause of my problem and attributed it to an unknown virus and to inflammation. The infectious disease doctor said there were no bacteria and I was a mystery. He and the cardiologist also ruled out lupus, scleroderma, and other arthritic conditions, even though my rheumatoid arthritis factor was 115 and normal is below 14. Two days later I had the surgical procedure to remove the fluid from my heart and pleura and everything returned to normal. Three days later I was dismissed.

This hospital is one of the finest in the country- with a world-renowned cardiac wing and all the up to date technology. Before I left the hospital, the doctor prescribed an anti- inflammatory which caused so much swelling in my legs that I decided to stop it.

It took almost a week for the swelling to subside. At that point, I had very little energy and could not go to work. I connected with alternative and complementary medical people, but unfortunately about 6 weeks later my heart rate went back up to 125 and my regular doctor sent me to the cardiologist again who ran many tests and scans and could not find any heart disease or fluid build-up. In short, the electrical conducting system of my heart was irregular, but no one knew why. The cardiologist then prescribed a beta blocker and aspirin, which was intended to lower my heart rate and prevent a stroke. I felt fish oil was a better option with no side effects and I refused to start the beta blocker. The cardiologist then informed me that if I did not take the medication my heart muscle could burn out. That made me even more nervous.

As a result, in October 2010, I reached a low point not knowing where to turn or what to do.

I had had a bad experience in childhood with allergy shots (which caused me to assiduously avoid drugs) and I believed these to have been the cause of many health problems throughout my life. The cardiologist did state that these shots were a possible cause of my racing heart. I returned to my regular doctor who did tell me that if my heart rate was 115 beats per minute, my heart muscle would not burn out, but that 15 if I were walking around at 165 beats per minute, that would not be good. He said I could still be at risk for a stroke if I didn’t take aspirin but he knew I would choose the fish oil as an alternative. After that conversation, I knew I had time to try to fix the problem if only I could find the cause.

Looking back at the last 30 years, I always had eaten well nutritionally, slept well, and drank pure water – as good as was available. After this health crisis, I also started to walk 30 minutes a day in a park away from car fumes, and I began to practice meditation which I believe has helped to lower my heart rate. Most importantly, I had studied a healing technique which makes use of frequencies and is effective in determining the cause of a problem and its solution. I had been using this technique for 20 years, and it was having a positive effect on my overall condition except for my racing heart. In addition, as the owner of four health food stores for 42 years, I had access to numerous local doctors and nutritionists, as well as books and health newsletters. Many of my customers had discussed their health concerns with me in detail and the various alternative and traditional treatments they had tried, most of which were of marginal value, and any real benefit soon reached a plateau. But interestingly enough, they all had one thing in common: dental problems!

Then it suddenly hit me in the middle of the night! I woke up excited that the doctors had told me I had no infections. What would the dentist say?

I’d had all the mercury removed from my mouth 23 years ago and I’d had a root canal tooth extracted at that time. I began to research dental infections, beginning with Susan Stockton’s Book, Beyond Cavitations. After reading her book, I discovered that there were many different techniques, some better than others, but the bottom line was there was no technique which produced consistent results. It struck me that the dentists we’re treating the problem without fully understanding the cause to which led to the problem. Many people had had extractions of teeth with poor surgical technique, but why did some heal without consequence and others become chronically ill? Obviously, some underlying issues determined who would heal and who would not. Also, if the body could not heal the cavitation when the person was young and healthy, how could a new surgery alone heal the infection now that the person was older and less healthy?

As I continued my research, I found that there were many experts, many diagnostic, highly technological tools and many techniques. But, again, they all seemed to be aimed at treating the perceived problem, i.e., the cavitation, and not the real problem, i.e., the underlying cause, and the healing. Many had conservative treatments, such as injectable homeopathies and ozone therapy, or computer guided surgery with a new laser, tool, or plasma.

Again, no technique, no matter how technologically advanced, healed their problems because the underlying cause was not being addressed. My customers who’d had cavitation surgery usually ended up relapsing.

Finally, I found a biological dentist, made an appointment had an examination, and much to my delight, he found six infections: four jawbone cavitations, one abscessed tooth, and one gum abscess. He gave me no guarantee that my health would improve if I had the dental work done. However, I learned that each tooth is connected to a different meridian and that the wisdom teeth are on the in my heart meridian. This information was indeed encouraging!

I learned that cavitations are holes in the jawbone that are caused by improperly extracted teeth. The hole causes the bacteria to enter and then when we eat, drink, chew, and swallow, the bacteria can be dispersed all over our bodies. When I understood this, I was overjoyed because I thought I finally had found the cause of my problem and, with the frequencies, the bacteria that did enter my organs could then be removed. One of my wisdom teeth had been extracted 50 years ago and the other 22 years ago. More importantly, my dentist had a protocol in which he was able to determine the cause of poor healing in patients who’d had cavitational surgery and then correct it. I discussed with him my work with frequencies and he felt this work was indispensable for my body to heal under the stress of the surgery and recovery. The result was the combining of techniques together to obtain a higher level of healing. The decision was made to surgically clean out each cavitation and to perfect our technique with each procedure.

The first cavitational surgery was done on the jawbone site of a wisdom tooth that had been extracted 50 years ago. Before the cavitation was eliminated, I measured a 30% blockage in my heart meridian, based upon work frequencies. This meant that the electrical system of my heart could only reach 70% out of 100% energy because of a cavitational infection. So, the infection was draining my energy and I felt weak. After the surgery was performed, my energy returned to normal, although my heart rate still occasionally went up to 100. Nevertheless, the heart meridian for that tooth was no longer blocked.

The second surgery was done three weeks later on another wisdom tooth extraction site. Again, I measured a 30% blockage in the heart meridian. After that surgery my heart rate went down to 90 and has not gone over 90 since.

The third surgery was on a site that was in my lung meridian. After this surgery, my breathing improved. I also had a reaction after the surgery whereby fluid poured out of my mouth for six
hours before it stopped. I thought this could have been retained mercury that was trapped by the infection. It was interesting to find out that the fourth cavitation, which was in the kidney-bladder meridian, also affected my heart rate. This left me with no doubt that the heart rate is, to some extent, also controlled by the adrenal glands and the kidneys. With each cavitational surgery, my health had improved because each cavitation was connected to an organ which was seriously impaired and getting worse as I got older. After all four cavitational surgeries were completed, my heart has not raced again since that time two years ago.

I learned a good lesson from all of this dental work and research. Each tooth runs through a different meridian. The teeth on the right side of the body go through the meridians on the right side and the teeth on the left side of the body run through the meridians on the left side. All root canals and cavitations are infected and, in my case, cavitations blocked my energy by 30%. The only way to unblock the energy was to do the dental surgery and use the frequencies (our bodies resonate with compatible frequencies to regulate homeostasis) to eliminate the bacteria and toxins that had clogged and disabled the organs.

The size of the cavitations was at least 10mm x 10 mm x5mm. These were considered to be big holes. My recovery would not have been complete without both the dental work and the distant energy healing that uses the frequencies as mentioned. All four of my cavitations were in the heart, lung and kidney bladder meridians, but overlapped with the small intestine meridians and other meridians which hadn’t seemed to be compromised. I know that in other people the small intestine will be blocked, and not the heart.

All four of my cavitation were causing chronic health problems but there was no pain and no symptoms in the oral region. Most of all the symptoms were in the distant organs, and I know my cavitations were difficult for the dentist to diagnose.

I am grateful that I found the missing link and a biological dentist to help me. In addition, I exercise regularly now, and continue to apply the practice of frequencies to accomplish this positive result. I take my pulse every day and it averages 64 to 68 beats per minute. When I have my blood pressure and pulse taken by my regular doctor and it goes up slightly he tells me it is situational (white coat syndrome) and, if I survived two years ago, I will be all right now.

Now; that’s the truth, the whole truth, the dental truth; and nothing but the truth.

Recent update:
Four months after this story was written, I was diagnosed with elevated heart rate, not only with a heart rate 60 and 100. Three years ago in August of 2010, in contra t, during the health crisis referred to in the above story, my heart rate had been a more elevated 150 beats per minute involving the electrical conducting system. This time the cardiac muscle was involved. Once again, the doctors ran excellent tests and were very  competent but they were not able to determine the underlying cause for the tachycardia and my dentist could find no additional infections in my mouth. The only real option I knew about was to use the frequencies again to clean out the cardiac muscle.

I’m happy to report that as of now my heart rate is more acceptable, ranging between 60 and beats per minute. My goal is to have a steady rate somewhere in the sixties.

Truthfully yours, Herb Shapiro