What Is In Your Mouth?

Most chronic diseases including autoimmune diseases are rooted in inflammation, so I’m always looking for the sources of that inflammation when I treat my patients. I’ve found that inflammation is often caused by five major environmental factors: our diets, a leaky gut, stress, toxins, and infections.


All teeth have a periodontal ligament.  The periodontal ligament (abbreviated PDL)  helps hold your teeth in place and functions like a shock absorber.  When you bite down with force, the PDL protects your teeth from shattering by letting teeth compress a fraction of a millimeter (like a spring).

In an extraction, the PDL should be removed with the tooth as a preventive measure.

It is standard of care for an oral surgeon to leave the periodontal ligament behind.  The PDL is composed of collagenous bundles, loose connective tissue, blood, lymph vessels, and nerves.  If left behind, its continued presence in an extraction site prevents biologic recognition of the absence of the tooth; bone cells will not proliferate and migrate through a membrane intended by nature to define growth limits.  Another potential problem of leaving the PDL behind is that, if the remaining PDL retains infection, your body will wall off the remaining bacteria and toxins with calcium-dense bone (condensing osteitis or lamina dura); an anaerobic pocket called a cavitation can form.


Most of us have had our wisdom teeth removed, and cavitations are a common complication. They can occur in the jaw after a tooth extraction, when gum tissue grows over the hollow area and bacteria begin to propagate. Bacteria within a cavitation again create inflammation and agitate the immune system. 

The primary cause of these jawbone cavitations in extraction sites is the failure of the conventional dentist or oral surgeon to remove all of the periodontal ligaments when pulling a tooth. These remaining periodontal ligament pieces later act as a barrier to the creation of new blood vessels and, therefore, to the regrowth of new bone. Dr. Hal Huggins likens the severity of this dental omission to the failure of removing the placenta (afterbirth) after delivering a baby: “Bone cells will naturally grow to connect with other bone cells after tooth removal—providing they can communicate with each other. If the periodontal ligament is left in the socket, however, bone cells look out and see the ligament, so they do not attempt to ‘heal’ by growing to find other bone cells.

Understanding the Problem

Significantly, cavitations of the jaw may or may not cause pain. Unfortunately, this raises the possibility of a patient suffering from a very regrettable oral condition for years without even knowing it.

And this, in turn, brings us back to the uncomfortable reality that many forms of visual observation, including X-rays, will not necessarily reveal a patient’s cavitations. All of which is made especially troubling by the potential ramifications of suffering from them.

The problem is not just dead bone; it is what forms around it. The absence of healthy tissue facilitates the accumulation of bacteria, fungi, and parasites. The area of bone subject to cavitation gives rise to a kind of dental cesspool of unwanted microbial invaders. And as anyone who has ever spoken with a dentist knows all too well, our mouths already harbor enough of those as it is.

Equally troubling is the ease with which jawbone cavitations can occur. Common but nonetheless extensive dental procedures—think root canals and tooth extractions—can cause trauma that gives rise to cavitations. In fact, according to the American College of Rheumatology, most instances follow dental extractions.

Making matters worse, there are links between osteonecrosis—including dental cavitations—and other serious forms of disease. These include: heart disease, autoimmune diseases, HIV infection, sickle cell, pancreatitis, Gaucher’s disease, and others.

Root Canals 

A root canal is a common procedure in which a tooth’s nerve is killed, but the tooth itself is not removed. The dead tissue becomes a breeding ground for bacteria, and the immune system is powerless to halt the growing infection. In particular, bacteria cling to the periodontal ligament, a hard to reach area of the tooth that is very difficult to flush out manually, and because the tooth no longer has a blood supply, neither immune cells nor antibiotics can reach the decaying tissue. The ongoing infection leads to inflammation which stresses the immune system.

Bridges and Retainers

Any kind of dental work that remains in your mouth permanently could pose a potential risk to your health and be irritating to your immune system. Just as so many people with autoimmunity and other chronic health conditions have sensitivities to certain foods, they may also have sensitivities to specific materials used in dentistry. Bridges and retainers for example, are usually made with stainless steel that contains nickel, a known allergen which can also activate the immune system.

Amalgam Fillings

Amalgam fillings are made with a mixture of copper, silver, and mercury. Mercury is incredibly toxic, and exposure to mercury has vast health consequences, including neurological symptoms, muscle weakness, and impaired vision. Dental amalgams emit mercury vapor, that can leach into your bloodstream. In fact, mercury fillings aren’t only harmful to dental patients, but handling them is even dangerous for dentists themselves.

Porcelain Crowns

A crown can actually exacerbate the effects of mercury when placed over a tooth with an amalgam filling. It can create an electric current that interferes with your own body’s natural electric current, which can create bizarre and uncomfortable auditory and sensory symptoms for those who are sensitive.

What to do?

It is essential to choose a well-trained and skillful dentist or oral surgeon to treat these ischemic cavitation sites. Also important to replace any mercury fillings with composite white fillings. It is important to remember that x-rays are not always definitive in determining dental foci. In fact, radiological evidence of a bone cavitation area is not even visible until as much as thirty to fifty percent of the jawbone is destroyed. Further imaging studies may be appropriate such as a 3-D Cone Beam Scanner, which uses digital technology to record images, revealing much more than simple “flat” x-rays.


1. Dr Serge Agafontsevhttp://www.doctorserge.com – #66 – Keefer Place, 

Yaletown, Vancouver, BC, V6B 0C9, Canada – (604) 708-6042

2. Dr. Ara Elmajianhttps://www.enlightendental.ca – 805 W Broadway 

Ste 701 Vancouver, BC V5Z1K1 – (604) 876-9228


  1. J. Bouquot, In Review of NICO (Neuralgia-Inducing Cavitational Osteonecrosis), G. V. Black’s Forgotten Disease, 3rd ed. (Morgantown, WV: The Maxillofacial Center, 1995, p.3.
  2. A. Nichols, The Virulence and Classification of Streptococci Isolated from Apical Infections,” The Journal of the American Dental Association, 13 (1926), p. 1227.
  3. A. Black, G. V. Black’s Work on Operative Dentistry, vol. 1 (Chicago: Medico-Dental Publishing Company, 1936), p. 4. Ibid.
  4. H. Huggins, It’s All in Your Head (Garden City Park, NY: Avery Publishing Group, Inc., 1993), p. 46.
  5. R. Borneman and L. Williams. “Histological Signs of Dental Ischemic Necrosis and Oteomyelitis Correlated with Clinical and Kinesiological Testing Indicators” (unpublished research findings from the Head and Neck Diagnostics of America Laboratory, Seattle, 1995-96).
  6. H. Cotton, The Defective, Delinquent, and Insane (New York: Arno Press, 1980 [orig. pub. 1921]), p. 46.
  7. https://www.westonaprice.org/health-topics/dentistry/dental-cavitation-surgery/
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