Dentists are able to diagnose abscesses, cysts, and bone infections with x-rays and treat many of them with antibiotic therapy. Because the theory of CO contradicted so much of what was known about bone infections, it was not widely accepted. In addition, the treatment advocated for CO was highly invasive and consisted of drilling into the supposed “cavitations,” scraping the bone and rinsing the wound with antibiotics. Some dentists even rinsed the cavity with colloidal silver and administered intravenous vitamin C. The scientific evidence for both the diagnosis and treatment of CO was extremely weak.

Attorney David Wilzig of Los Angeles, who has a special interest in dental malpractice cases, has filed suits on behalf of at least eleven victims of NICO-related misconduct. The suits indicate that the dentist(s) diagnosed nonexistent “cavitations,” removed healthy jaw tissues alleged to contain them, and sent specimens to Bouquot who confirmed the alleged NICO diagnosis. Some of the plaintiffs also had teeth and/or amalgam fillings removed unnecessarily, and some required extensive medical and surgical treatment to repair jaw damage and disfigurement caused by the NICO surgery. Many of the cases involved activities by the dentists that constituted the unlicensed practice of medicine (rather than dentistry). These included diagnosis via autonomic response testing (ART, a quacky muscle-test procedure); phony diagnosis of mercury poisoning; and neural therapy injections into breasts, stomach, shoulders, and/or other body parts. Some of the suits included Bouquot as a defendant. Nine of the victims settled with payment of undisclosed amounts.

At least ten dentists in Arizona, California, Connecticut, Florida, Iowa, Minnesota, Ohio, New York, Pennsylvania, and Washington who treated "cavitations" have been disciplined by their state licensing boards for insurance fraud or other dental act violations, most of which were related to this alleged diagnosis.

Osteomyelitis near tooth sockets is not common. Deceptive dentists typically list routine (and often unnecessary) extractions as "surgical extractions" (thus charging more) and then scrape out bone from the socket and tooth roots, claiming that an "infection" or osteomyelitis exists. NICO advocates may also remove every tooth with a root canal treatment, regardless of success or failure of the treatment. They claim that root canal treated teeth are "toxic" and cause "cavitations," without any valid biological basis or clinical data to support these assertions.

Multiple extractions on the same day in the same quadrant, coupled with diagnoses of cavitations, osteomyelitis, or other bony pathology

states that, "Cavitations are hard to find. They require lots of skill, years of experience, and most of all, a vivid imagination to spot them on an X-ray film." Vivid imagination may well be the basic requirement of holistic and biological dentistry.