A Critical Look at Cavitational Osteopathosis, NICO, and "Biological Dentistry"

A small minority of dentists, who commonly refer to themselves as "biologic dentists,' claim that most facial pains and even pains and diseases located far from the mouth are caused by cavities (cavitations) within the jaw bones. This concept was first proposed in 1976 and called "cavitational osteopathosis" ("CO"). Proponents of this concept alleged that many patients had infected cavities within their jaws and that these cavities were not treatable with antibiotics or detectable on x-rays.

Dentists are able to diagnose abscesses, cysts, and other bone infections with x-rays and typically treat these conditions antibiotic therapy. Because the theory of CO contradicted so much of what was known about bone infections, it was not widely accepted. In addition, the treatment advocated for CO was highly invasive and consisted of drilling into the supposed “cavitations,” scraping the bone and rinsing the wound with antibiotics. Some dentists even rinsed the cavity with colloidal silver and administered intravenous vitamin C. The scientific evidence for both the diagnosis and treatment of CO was extremely weak.

During the the 1980s, CO was renamed neuralgia inducing cavitational osteonecrosis (NICO), and a new theory of its origin was proposed. NICO’s prime promoter is J.E. Bouquot, D.D.S., M.S.D., an oral pathologist who coined the term. Bouquot was associated with the West Virginia University School of Dentistry, but in 1994 he began operating the Maxillofacial Center for Diagnostics and Research (now called the Maxillofacial Center for Education and Research), a private laboratory and consultation service in Morgantown, West Virginia. The center’s mail-in biopsy service is called Head & Neck Diagnostics of America. In 2004, Bouquot became a professor at the University of Texas Health Science Center in Houston, Texas.