Firstly, it must be said that NICOs are a very contentious area and although they have been reported in the dental literature by eminent dental colleagues, main stream dentists remain largely unaware of the suggested condition.

Please refer to the following websites for further information:-

(please note we may not agree with all of their content)

Dr Rimmer has attended several courses in relation to NICO and has spent a week being mentored by Dr Volz at his impressive clinic in Switzerland.  At the clinic he witnessed many NICOs being removed as well as titanium implants removed and PRF techniques.

He has also met with likeminded dentists from around the world all supporting the efficacy of NICO removal.

NICO (Neuralgia inducing cavitational osteonecrosis)

Several clinicians believe :-

NICOs, also referred to as cavitations (not to be confused with cavities), are holes in the bone of the jaws.  They can occur following loss or extraction of teeth, root canal treatment and other dental surgery procedures or trauma. The hole or pocket can act as a breeding ground for bacteria and toxins.  Often patients are unaware of this silent infection, and they can remain undiagnosed for years potentially causing or contributing to chronic ill health.  They are thought to be very common. The conditions that NICOs have most commonly been associated with are atypical facial neuralgia, trigeminal neuralgia, chronic sinusitis, phantom toothache and headaches including migraine.


                           (Courtesy Dr. Wesley E. Shankland II, DDS, MS, PhD)(Courtesy Dr. Wesley E. Shankland II, DDS, MS, PhD)

A suggested method for detecting NICOs is through a Cone Beam CT scan (CBCT) . Once diagnosed, NICOs can be treated by surgically removing all the dead tissue and thoroughly cleaning the site.  Laser and/or ozone therapy can be used to ensure a clean and sterile environment is achieved.


Side view of a mandible(jaw bone) showing an area
of necrotic bone otherwise known as a cavitation
Illustration showing the components of the jaw in and around a cavitation