NICO SURGERY
JAWBONE CURETTAGE

Surgical Treatments for Facial Neuralgias

Disclaimer.

A rather controversial dental operation exists in which diseased tissue is removed from the jaw. It is assumed that this inflamed tissue can cause degeneration of the nerves and hence neuralgia-like pain.

The authors cited below use the term neuralgia-inducing cavitational osteonecrosis (NICO) for the lesions that supposedly cause the neuralgia.

The process is not generally accepted as a cause of Trigeminal Neuralgia, at least not of most cases. However, it is very possible that it is at least a partial cause in some cases of facial neuralgia [1], especially in Atypical Facial Pain. One long-term (nearly 5 years) study has reported considerably or totally reduced pain in 74% of patients to whom the operation was done. However, about 30% had the pain return. These patients had either TN or atypical facial pain [2].

The operation is not currently done routinely, and it is too early to say whether or not it will ever become generally accepted.

Links

   NICO
See a more thorough discussion on NICO

What is NICO?
A patient's perspective on NICO

Quackwatch:   NICO and "Biological Dentistry"
Skeptical view of NICO as a "fad diagnosis" from QuackWatch a popular web guide to health fraud, quackery and intelligent health decisions.

  NICO And Cavitations
Article about NICO including pictures of jawbone "cavitations."

Nico and Chronic Jaw Pain Forum - A robust and fairly active web forum on NICO established by a NICO patient and survivor

Sources:

[1] Bouquot JE; Roberts AM; Person P; Christian J. Neuralgia-inducing cavitational osteonecrosis (NICO). Osteomyelitis in 224 jawbone samples from patients with facial neuralgia. Oral Surgery, Oral Medicine, Oral Pathology, 1992 Mar, 73(3):307-19; discussion 319-20.

[2] Bouquot-JE; Christian-J. Long-term effects of jawbone curettage on the pain of facial neuralgia. J-Oral-Maxillofac-Surg. 1995 Apr; 53(4): 387-97; discussion 397-9.