Case Study: Lori Presents Severe Pain, Fatigue
Lori was a 49-year-old self-employed businesswoman who presented with a four-year history of severe left mandibular (lower jaw bone) pain. Her symptom complex began when she suddenly developed pain in the first molar left mandible. Fourteen years before the pain developed, she had a gold crown placed in that location. She also had her wisdom teeth extracted.
Loris’s pain gradually became worse and her dentist treated her by placing a root canal in the painful tooth. She was then referred to an endodontist, and as a result had two gold crowns with root canals placed in the left upper molars. Unfortunately, the pain in the left lateral mandibular region became worse, and Lori was referred to a prosthodontist who fashioned a splint which made no difference whatsoever to her pain. She was then referred to an Ear Nose Throat specialist who suggested that she had isolated dental pain with possible nerve inflammation.
An oral surgeon found that the crown associated with the pain appeared to be satisfactory, and an X-ray of the left mandible revealed a normal-appearing jawbone with possible scar tissue at the root tip of the tooth in question. The oral surgeon then performed a series of nerve blocks, but these still did not have any effect on Loris’s chronic pain. She finally consulted a neurologist, and was placed on a series of medications including an anticonvulsant and an antidepressant. The antidepressant gave some relief from the pain but Lori gained 35 pounds and was able to work only part-time. Seven months before she came to my clinic, she discontinued the antidepressant and the pain escalated to a point where she became suicidal.
When I examined her, Lori appeared tired, worn out, and she wept easily. Her fingernails showed signs that she had zinc deficiency, and her balance testing was abnormal. She had thirteen mercury amalgams as well as three gold crowns. The lateral portion of her left lower jaw was very tender to touch. I told her that she probably was suffering from NICO (Neuralgia Inducing Cavitational Osteonecrosis) and if that were the case we should be able to help her. She promptly burst into tears.
We performed a Cavitat scan which revealed presumptive evidence of osteonecrosis under Lori’s molars of the lateral side of her left lower jawbone.
The normal images [you will see in the book] on the left side of the scan show solid three dimensional blocks representing normal bone. In the two dimensional images underneath, normal bone is represented by solid green rectangles. Yellow represents inflamed bone, orange represents necrotic (dead) bone, and red represents an empty space where there is no bone at all. Lori’s first Cavitat scan shows presumptive evidence of absent and necrotic bone just underneath the place where the wisdom tooth used to be. The bone under the root-canal treated tooth is two squares to the left, and the scan shows presumptive evidence of inflamed, necrotic bone at that site.
With this evidence in hand, I referred Lori to a dentist skilled in dealing with NICO lesions. The dentist initially performed a series of local anesthetic injections into Lori’s jawbone near the affected site and within 10 minutes her pain had completely resolved, which confirmed the working diagnosis of NICO. The dentist then performed limited surgery to her jawbone, opening up the region of decayed bone and removing as much as he could. A specimen was sent for analysis, and Lori was given a device containing high intensity red and infrared light emitting diodes (LEDs) that she applied to her cheek for 15 minutes each day. She used this device for three months.
Two weeks after Lori’s first dental procedure she had complete resolution of the severe pain that had plagued her for four years, and was able to discontinue her pain and antidepressant medications. The pathology report showed that she indeed had necrosis at the tip of the root canal. During the following months a series of Cavitat scans showed complete restoration of new bone in the lateral left lower jawbone.