Dr. Huggins Protocol for Revision of Cavitations (CVs).
Dr. Hal A. Huggins DDS, MS who was both an American Doctor of Dental Medicine, Immunologist and research scientist and considered the grandfather of the holistic dental movement revealed that jawbone necrosis developed in 88% of cases after wisdom teeth extractions.
The following protocol is for primary cavitation revision and is described below.
Primary Revision Protocol…
- Necrotic Bone Penetration. A low speed handpiece is utilized with the # 10 burr after an incision in the gingiva, if required. Usually only a few millimeters of necrotic bone were penetrated to reach the healthy tissue. During the drilling with the burr, the socket must be irrigated with sterile saline, using a Monojet 412, 12 cc syringe. In some cases, several syringes of this type are used. The flushing will remove all of the contaminated bone fragments as the bone was cut, so as not to allow any other bone fragments to become trapped during the healing process. This also requires diligent suction to avoid the patient risking swallowing any of the contaminated material.
- Bony Socket Flushing. After the socket is properly routed, it must then be flushed with a non‑vaso‑constrictive anesthetic which should be allowed to remain for about thirty seconds. Suction must then be gently applied to the area for just an instant in order to remove only a majority of the anesthetic, leaving the socket coated with the remainder. For more extensive areas of old extraction, full thickness flaps of the overlying tissue needs to be reflected away from the bony area to be explored. Three units of protamine zinc insulin should be injected adjacent to the extraction site, this will greatly enhance the healing process. Antibiotics are not to be routinely recommended. Clinically, antibiotic administration appears to make its own contribution to a greater chance of a dry socket with an eventual CV is spite of performing an otherwise proper procedure. It is theorized that the use of antibiotics may convert the osteoblasts back into osteocytes, impeding a full healing of bone in the socket area.
- New Bone Perturbation Procedure Instructions. Taking at least one millimetre of good bone insures for the proper removal of both periodontal ligament and most of the bone directly bathed with the toxins produced by the mutant streptococcus in the dentin tubules. It is very important not to use a high speed handpiece. Using the low speed handpiece prevents excessive heat production, avoiding the undesirable cauterization effect that can denature the proteins present and impede complete healing. The cutting process serves to “perturb” the adjacent bone, allowing amore effective stimulation of osteoblast formation from monocytes, which results in the needed new bone growth necessary to fill the cavity. This bone perturbation also appears to be superior to the stimulus for healing that occurs with manual curettage. The anesthetic also serves to perturb the bone and stimulate greater osteoblastic activity.
- Do Not Use Simple Manual Curettage. Simple manual curettage is discouraged, for the scraping required in the process can “push” much of the toxic products into the adjacent, good, cancellous bone, resulting in a greater chance of persistent or recurrent CVs, or simply a lack of primary healing after a tooth extraction. Flu‑like syndromes, persisting for days, have been observed after the cleaning of CVs. While this protocol is certainly not the only way to remove a periodontal ligament or clean out a CV, it has realized clinical success and minimized the formation of dry sockets or recurrent CVs.
- Notes On Circular Routing Motion. Following this, the contrast agent was promptly flushed out and suctioned, with the remainder of the protocol for CV treatment then being followed. It should also be noted that a circular, routing motion with the dental burr is never performed until the operator feels the burr drop into a pre‑existing CV. The CVs are never created by the dental burr, but they may be slightly expanded initially in the course of debridement in order to ensure that good bone is reached which is capable of healing.
Did You Know?
Cavitations (CVs) are persistent holes found at the extraction sites of permanent teeth after apparent healing has taken place. Current den‑ talliterature considers this common phenomenon to be rare. In the scientific literature, CVs have a plethora of synonyms. They have been variably labeled as Ratner, Roberts, or trigger point bone cavities, interference fields, neuralgia‑inducing cavitational osteonecrosis (NICO), and alveolar cavitational osteopathosis. Evidence suggests that the incidence of CVs is presently grossly underestimated.)
Dr. Grube’s Updated Huggins Protocol for Revision of Cavitations (CVs)..
Prior to Dr. Hal A. Huggins DDS, MS death, Dr. Huggins passed the torch of Applied Healing to Dr. Blanche Grube, founder of the new and re-modernized Huggins-Grube Protocol.
The following steps are based on the Huggins protocol and together with the primary cavitation revision steps outline the procedure to be followed in the Huggins-Grube Protocol
Enhanced Revision Steps…
- Start Early. Plan your treatment jointly with the dentist, physician, IV personnel, acupressurist, nutritionist, detoxification doctor and other health professionals so that the timing of events complement each other, and do not interfere with final results.
- Health Cycle Scheduling. Set your appointment schedule in accordance with the 7-14-21 day immune cycles. If this is violated, it is too easy to create an autoimmune disease you might otherwise have never had. Be sure to allow 48 hours in between appointments, and keep your appointments as close to 2 hours or less, however, it may be necessary for the dentist to go an additional 15 minutes and that is acceptable. Be sure to get all of the “removal” appointments accomplished within a 30-day period or less if at all possible. (read more).
- Health Cycle Exception. If you are using Intravenous Conscious Sedation, then there is generally only one removal appointment, and it can be 6 or 8 hours long without a problem. Since IV sedation gives a time compression and amnesia, you won’t really care how long you have been there. Treatments can be done at any later time without regard to the immune cycles.
- Eat For Blood Chemistry Diet. Start your nutritional program based on your blood chemistry interpretations as soon as is feasible in the program. The amounts of carbohydrate, protein and fat intake are suggested with the first blood test, and a more refined diet can be determined with follow-up blood tests to check for individual overdoses, under doses or being right on target.
- Blood Chemistry Supplementation. Supplements may be started prior to the dental procedures when possible. Needs for calcium are specific, and most patients suffer from an overdose of the improper form of calcium. Care must be exercised when prescribing calcium. Most of the rest of the necessary supplementation is based on your chemistries (not blood type) and is individual. Modifications in dose are based on follow-up chemistries.
- Vit-C Exception. Do not take Vitamin C the day of dental procedures. Vitamin C by mouth may shorten the effect of the dental anesthetic. The IV form of Vitamin C does not do this for reasons unknown, but even 500 milligrams in the tablet form will detoxify the anesthetic adequately to let you feel the pain of drilling or surgery.
- Follow-up Procedures The dentist/surgeon will determine the need to use ice packs immediately after the procedures are finished, the use of magnets if desired, or dispensing of homeopathic remedies or pain medication. Please avoid codeine when possible, for it makes many people nauseated, and is constipating for the majority of people. Minimal travel after surgery is advisable (like 5 miles or less) for the vibration in a car can release the blood clot resulting in the famous painful “dry socket”. Smoking after surgery will almost guarantee the formation of a painful dry socket. Be forewarned.
Did You Know?
Routine dental extractions involve just the withdrawal of a tooth, intact or in pieces. As long as all of the bony tooth is removed, the extraction is considered to be complete. A most critical factor, however, in socket healing is not addressed by this standard approach. (Learn More)
Our Advanced Protocol…
Costa Rican BioDental helps to safely remove existing dental cavitations with biologically compatible techniques so patients can enjoy the benefits of living chronic infection free while getting to keep their natural oral bone health longer over the course of their lifetime.
The following steps combine the primary and enhanced revision protocols along with a specially designed advanced holistic & biological dentistry application technique.
Advanced Revision Steps…
- The Five Healing Days. It is imperative for patients to take at least three days off after surgery, but the most optimal protocol is to take the day of, plus the following four days off, a time period I have labeled as the “Five Cavitation Surgery Healing Days.” Patients should plan to rest and avoid any strenuous physical activity during this time. In fact, any exercise (except slow and short walks) or vibration from extensive car and plane travel can delay, and even block, healing of the surgery site. This rest and healing time is significant because if a “dry socket” forms from the invasion of bacteria in the area between the blood clot and the bone and the blood clot is lost, the surgery almost always must be redone at some later point. Dry socket is signaled by significant pain in the surgical site or the ipsilateral ear, and typically a foul odor. The standard treatment of antibiotics often does little because there is no blood flow in the area, and eugenol from the oil of cloves may actually further impair healing of the site. The best course of action though is for patients to take five full days off and follow this protocol carefully in order to allow complete healing of the site, and therefore only have to undergo this cavitation surgery procedure once.
- Homeopathics. Acute homeopathic remedies are also an important component in this protocol. Arnica montana 30C is most commonly prescribed to reduce pain and heal the bruising post-surgery at a dose of two pellets, three times a day, for five days, and then once a week thereafter. If the surgery was very deep and there is a chance that the maxillary (upper jaw) or mandibular (lower jaw) trigeminal nerve was injured, Hypericum perforatum 30C should also be taken at a different time of the day, but at a similar dosage schedule as the Arnica. If the surgery was particularly extensive and intense, patients may want to take the stronger 200C potency of both of these remedies. However, for those individuals who are already on their constitutional homeopathic remedy, usually redosing this remedy one to two times after surgery is all that is required.
If an individual is very ill, it is often necessary to have this patient on his or her deepest homeopathic constitutional remedy for at least a month or two in advance, in order to facilitate immune, metabolic, and nervous system functioning before surgery. The new Sankaran sensation method of constitutional homeopathy is the single most curative modality known by this author to achieve health, and thus prepare an individual for a successful surgical outcome.
Plaint Based Diet. Vegans, and even many lacto-ovovegetarians typically do not consume enough protein to heal tissue, and thus, the surgical site, adequately. Lacto-ovo-vegetarians often become sensitive to the over-ingestion of eggs and dairy foods over the years, which greatly reduces their absorption of these normally utilizable protein foods. Lab tests and energetic testing can determine if a patient is deficient in protein, and if so, the encouragement of eating more eggs and dairy (if there is no allergy) as well as meat broths if the patient is willing, is often needed for at least one to two months in order to have a successful surgical outcome. (read more).
Did You Know?
Cavitational osteonecrosis is not rare. In fact, it is exceptionally common for anyone with wisdom teeth removed. While cases of neuralgia inducing cavitational osteonecrosis are now well documented, it is not necessary that overt clinical disease of any kind be present for Cavitations to exist.