Ozone – The Revolution that is Changing the Face of Dental Care.

It is a sad fact that every Monday morning, thousands of dentists around the world do not stop to think as they turn on their compressors, pick up a dental drill or turbine of some description, and then proceed to amputate parts of their patients teeth. All in the certainty that at some time in the future, the fillings they are about to place will need to be replaced. Rather than follow the Victorian engineering principles of “drill and fill” or the amputation-approach to dental care, would it not be better to have a system that allows infection control, tissue preservation, and natural remineralisation?

THis is not a dream, as this technology has been available in Europe for the last 3 years, and has been successfully launched into other world areas over the last 12 months. The HealOzone (CurOzone USA and KaVo GmbH, Germany) is the only device that is safe to use in a patients mouth. It delivers a timed dose of ozone of 40 to 60 seconds through a special hand piece, to a tooth surface via a vacuum delivery system that effectively sterilises areas of decay (1), removing not only the bacteria, but also the acid-niche environment and their bio-molecules to depths of 4- 5mm into infected dentine (2). A mineral wash is applied afterwards, and a special oral-hygiene kit is dispensed to the patient that continues this remineralisation process. In some cavity types and shapes, dentists that have invested in this technology have seen reversal and complete remineralisation in just 4-6 weeks, and a recent study showed 100% reversal in ozone treated lesions (3) at 18 months.

New systems like this in dental research and practice can only be made with advances in how dentists detect and diagnose decay. For the last 100 years, dentists have used the traditional mirror, probe and x-rays to look for areas and signs of decay. Research has shown that when these tools show decay, the area of infection is far greater inside the tooth – up to 3-4 mm inside the living dentine part of your tooth. The Diagnodent from KaVo is one of the simplest new technologies that can diagnose decay in a tooth long before it can be seen with a probe or imaged on an x-ray.

For the first time the dental profession has the ability to arrest areas of decay, take patients out of pain in some instances, and allow caries reversal without the need for injections, pain, the use of the “drilling & filling”. All these were factors that research by H Domingo et al (4) and others have shown to be the number-one reason why a vast number of people seek dental help at the late stages of decay and in pain, by which time the removal of the infected tooth is the only appropriate treatment option available.

For the treatment of children, this treatment modality is idea, as they become entered into a treatment pathway that can avoid the need for injections and tissue amputation. So too the treatment of lesions that are still within enamel, as these often require no additional restorative care, thus avoiding entering the patient into the cycle of destruction & amputation, and restorative care that requires periodic renewal, with increasing-cost consequences.

For example, research has show that sealing molar teeth without thorough cleaning and sterilisation of the surface can actually allow areas of decay to continue below the sealant. In this example, the surface of the tooth was cleaned, then sterilised using the HealOzone system, then resealed – all without drilling, anaesthetics, distress to the child, for a long-lasting effect. By avoiding drilling and filling, this tooth does not enter into the cycle of tissue destruction, filling, filling failure, and re-filling on a cyclical basis.

It is routinely used for cervical sensitivity, where for the majority of patients, a single-40 second dose of ozone onto the sensitive area, followed by a mineral wash is sufficient to remove the sensitivity for not just a few days or weeks as is the case for some surface applications, but for a number of years. In the UK and Europe, the HealOzone is so integrated into general dental care, that these practitioners would not want to have to return to the pre-ozone care time, as they are using the HealOzone for all cavity preparations prior to filling, around crown margins where the first stages of marginal decay has started, crown and veneer preps prior to cementation, root canal therapy to sterilise the root systems, ulcers and herpes. For surgical and periodontal care, ozonated oils are used with great effect, and at UK-Implants, all patients scheduled for implant placement are given ozonated oil after surgery to hasten healing and ensure pain & infection free surgical fields. The oils can also be used for any tissue lesions or infections on the external skin surface with great effect. At last, the dental profession has a clear choice to offer their patients; amputation or natural healing. Research (4) has shown that people will choose the alternative to the amputation treatment if offered this choice even if the alternative option takes less time and is more expensive. There are published abstracts, papers and journal articles about the use of ozone in dentistry that can be viewed at www.the-o-zone.cc. The use of ozone in dental care is science-based; there are evidence-based publications, clinical trials, and support from the medical profession (5) for the use of ozone. If the dental profession fails to meet this new challenge and fails to inform patients that this may be an alternative treatment modality, there are ethical questions to answer, and the concept of informed-consent will not have been achieved with potentially legal consequences. The HealOzone has changed the face of dentistry for an estimated 2 million people in Europe. There is no pain, no fear or anxiety associated with this treatment modality, and is completely safe. For the dental team, instead of amputating lesions, they can now allow the natural healing ability of the body to deal with these areas of infection. Lastly, it is less stressful for the whole dental team, the patient, and those accompanying the patient (4).

References 1. Baysan A. Management of Primary Root Caries using Ozone Therapies. PhD Thesis, University of London, 2002. 2. Baysan A, Whiley R, Lynch E. Anti-microbial effects of a novel ozone generating device on microorganisms associated with primary root carious lesions in vitro. Caries Res 2000; 34: 498-501. 3. Holmes J. Clinical Reversal of Root Caries using Ozone, Double Blind, Randomised, Controlled 18-Month Trial. Gerodontology. 2003. 20.2, 106-114. 4. IADR Abstract 7 March 2002 San Diego 1337 Patients Attitudes to Managing Caries with Ozone H. DOMINGO, C. SMITH, R. FREEMAN, and E. LYNCH, Queens University, United Kingdom 5. Bocci V. Biological and clinical effects of ozone. Has ozone therapy a future in medicine? Br J Biomed Sci 1999; 56: 270-279. Resources; www.the-o-zone.cc www.rainbow-smiles.co.za julianholmes@mweb.co.za Dr Julian Holmes, O3 Dental Care.