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What’s A Dental Sink Hole?

Q: About six weeks ago, I’d had it with my front teeth. They were so sharp they’d cut my tongue and it would literally bleed and then become sore – the very tip, and you know how the tongue is – can’t leave anything alone and is always testing to see it’s feeling better. It was miserable. I said to my husband, I’ve got four front teeth that don’t look right and the front ones are killing my tongue.

So, I went and got a very thorough work up, but I said I just want my four front teeth crowned. Well, wouldn’t you know he found I had lost a lot of bone on one side of my left front tooth – the real sharp one. He told me that my bite was partially to blame, and I needed a bone graft. He showed me my x-ray and it was plain as day. I asked him where would the bone come from so he told me it would be a mix of my own bone, some human bone made for that purpose, and what he called growth factors.

So, I went for it. He temporarily fixed my front tooth (because that was my main concern while the bone graft was maturing). When I was finished, he told me he’d run into something that was fairly rare. He said as he was getting some of my own bone, he ran into something, I can’t remember the right term but he explained it was like dropping into a sink hole. He explained that sometimes a tooth socket doesn’t grow back and it becomes a space with bad stuff but curiously doesn’t usually hurt, or swell, or have normal infection symptoms. He also said that these sink holes aren’t seen on normal or 3D x-rays. I’ve never heard of that. It was unexpected. He said he cleaned it out and put bone in there, too. Is that normal?

A: The ‘sink hole’ you’re referring to is commonly called a cavitation. It was observed as an entity by several historical dental surgeons over 100 years ago. It was not embraced as a dental pathology by dental schools or surgeons at large through most of the twentieth century.

Cavitations are not seen in traditional x-rays or even new dental three-dimensional x-rays. In my experience they are discovered by chance while doing other surgeries. It is best that they are thoroughly cleaned out and the surrounding bone ‘scrubbed’ to eliminate all unhealthy remnants. In my experience I’ve mostly grafted the boneless caverns but on one occasion, the space permitted an implant after thorough debridement and channeling for implant insertion.

Many causes are listed but I’m not sure all that are listed in an online fact sheet are reliable. My reading, study, and coursework have made me aware that serious health conditions or symptoms that can manifest with cavitations may seriously affect one’s health and the cause not be readily found or understood.

When these cavitations are discovered, they must be treated and thank goodness yours was.If we can help, we’d like to. Call 778-410-2080 for a consultation.

Based on actual patient cases

© Calvin Ross Crapo

Victoria Implant Centre

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