Part 9: At-Home Care and Patient Compliance

Abstract: In Part 9, the role of ozonated fluids are examined for At-Home Care and Patient compliance. Ozonated liquids potentially play a very important role in patient after care, at-home general usage, and may solve some of the treatment compliance issues clinicians face in everyday ‘Lamasil TM’, comes in cream and tablet hich the efficacy of most anti-fungal agents are may lead to -microbial effect. Part 2: The Chemistry of Ozon Part 3: Part 4: The Chemistry of Ozone in W The Chemistry of Ozone in Pla Part 5: Dental Unit Water Lines (DUWL’s Part 6: Part 7: Oral Hygiene & Infection Control Periodontal & Implant Care Part 8: Disinfection in Dental Practice Part 9: At-Home Care & Patient Complian & Patient Compliance Co g treatment. For example, a routine anti-fungal agent, formulations. It is the standard product against w compared. However, treatment time may be measured in weeks to months with this product, depending on the location of the fungal infection and difficulty of direct access to it. In comparison, the treatment of fungal infections in nails, one of the most difficult to successfully treat, is very simple with a twice daily application of ozonated plant oils, and the treatment may last just 5 days in some cases. Patient compliance becomes a real issue at extended treatment times. The most common issue is the observed resolution of the problem, so the course of treatment is discontinued, without a full understanding that residual tissue infection recurrence of the problem. Another issue is compliance by clinicians themselves, as they fail to fully understand the treatment protocol, apply it and pass on that knowledge to patients and the public. Clinicians take short cuts as they observe good results with this ‘modified’ protocol. In doing so, practitioners create the potential for failure of treatment. The product is then blamed rather than the issue of compliance. Dental researchers have started to examine the effects of ozonated fluids in periodontal disease. Huth et al in two papers in 2006 and 2007 (Huth et al 2006, Huth et al 2007) examined the effect of ozone on periodontal tissues. The 2007 paper compared traditional periodontal anti-microbial products with the use of ozonated water. Both papers concluded that ozonated water has an excellent anti Huth et al (Huth et al 2007) in their later paper examined the effect of ozone on the influence on the host immune response. These researchers chose the NF-kappaB system, a paradigm for inflammation-associated signaling/transcription. Their results showed that that NF-kappaB activity in oral cells in periodontal ligament tissue from root surfaces of periodontally damaged teeth, was inhibited following incubation with ozonized medium. The Huth 2007 study stablishes a condition under which aqueous ozone exerts inhibitory effects on the NF-kappaB of ozonated water inactivates antibacterial agents (Dodd et l 2006) and in particular amoxicillin (Andreozzi et al 2005), progesterone (Barron et al 2006) oils and extracts. e. Do not freeze. Replace the container lid when not in use. Container Disposal: Dispose of the containers with care and consideration to your environment. Inflammability: This product is not inflammable under normal conditions and use. Do not If in doubt, consult your usual doctor. Ozonated fluids are available in encapsulated form. Please contact Lime Technologies Medical Ltd on Treatment Duration – For areas of infection, the treatment time is from 2-3 weeks. For the ical practitioner who you normally consult with. Further information is available from the Internet and World Wide Web on www.the-o-zone.cc. e system, suggesting that it has an anti-inflammatory capacity (Huth et al 2007). The use of ozonated water in dental ultrasonic systems, such as scalers, sonic preparation systems (KaVo Sonic-Sys, KaVo GmbH, Germany) and air abraision systems would seem to be supported by Huth et al 2006 and Huth et al 2007. There are many benefits to control oral hygiene and as a source of sterile water. However, patients should also be informed that there is an interaction of aqueous ozone with antimicrobials. This research has been published, illustrating the importance of potential interactions of dissolved ozone and prescribed anti-microbials. Patients who are taking a course of antibiotics may need to be informed that the use a and tetracycline (Dalmázio et al 2007). For concern to dentists is that ozone may inactivate the anti-microbial effects of triclosan (Suarez et al 2007). A current topic of debate in dental material science and long term potential effects, are endocrine disruptors found in resin-based dental restorative materials. Deborde et al (Deborde et al 2005) showed endocrine disruptors were destroyed by ozonated water. This paper potentially points towards a pathway to remove these chemicals from the body system after placement of ‘modern’ tooth-coloured or ‘white’ fillings. Ozonated Oils and Oil-Gels – General Information The LT-Oil TM range of ozonated oils is made to strict manufacturing standards with medical grade oxygen. This oxygen is 99% pure, and is passed into a converter to form ozone. Ozone is then combined with pure vegetable Storage - Please refrigerate or keep in a cool, dark plac Spillage: Clean up oil spills and dispose of carefully. The oils are non-toxic. Use a recycling centre if possible. expose to heat sources. Directions for use – These products are not toxic, and if swallowed, there are no special precautions that should be taken. info@limetechnologies.net for further details. treatment of skin surface ulcers, the treatment time for small areas is 3-4 weeks, for large ulcers, from 3 to 4 months. Healing time is dependant on the age of the patient, the medical status of the patient, and the size of the lesion being treated. If in any doubt, contact Dr Julian Holmes at julianholmes@mweb.co.za or your own med Presentation: - Ozonated oils are pure plant extracts, through which pure oxygen and ozone are passed. The plant extracts undergo a chemical reaction to form a thick, viscous oil, or in some cases, a petroleum jelly like product. The final products contain ozonides. These ozonoids have a pharmaceutical activity similar to ozone gas, but at a reduced activity level. They are bactericidal, fungicidal, and veridical. The oils are chosen for their innate healing properties, and the ozonides enhance this effect. Directions for use - Medical: These oils have been used for periodontal and surgical healing work. Several dental and medical practitioners are using it for skin and nail-bed infections, all with positive results. In severe ulceration cases that 'modern pharmacology' has not been able to resolve, ozonated oils have allowed full ulcer granulation and wound closure within 3 months, with resolution of pain and discomfort. Several football clubs use these oils after on-pitch wounds. The ozonated oil prevents bout 30 minutes, and promotes accelerated healing. cted surface. n the ulcer site and surrounding area with cooled boiled or sterile water. Dry to a damp surface if possible and apply a thin layer of the ozonated oil over the ulcer site and There is no need to cover unless protection from further trauma is required, or work place health the nail and surrounding finger/toe skin surface with cooled boiled or sterile water. Dry and apply a thin layer of the ozonated oil over the nail and surrounding skin surface. If The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected area. inger cot, or gloves will help keep the oil/oil-gel in the correct place, and prevent touched areas being left with an oil film. k place health and safety regulations require treatment area coverage. Skin Penetrations: eg Thorns /Splinters If possible clean your hands and the affected skin surface with cooled boiled or sterile water. infection, resolves pain within a Skin Surface Abrasions and Cuts: Clean the affected skin surface with cooled boiled or sterile water. It is important if possible to remove all foreign bodies from the skin surface, such as gravel, small stones, sand, and dirt. Dry and apply a thin layer of the ozonated oil over the affected skin surface. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affe There is no need to cover unless protection from further trauma is required, or work place health and safety regulations require wound coverage. Skin Ulceration: Clea surrounding skin edge. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected area. and safety regulations require wound coverage. Nail Infections: Clean possible, work the oil/oil-gel below the nail and into the creases on either side of the nail. On fingers, a f On toes, there is no need to cover unless protection from further trauma is required, or wor Remove all parts of the thorn or splinters if possible. Dry and apply a thin layer of the ozonated oil over the affected skin surface. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. Cover with a dressing if possible. Seek medical help if parts remain embedded below the skin Skin Wounds: If possible clean your hands and the affected skin surface with cooled boiled or Remove all parts of the thorn or splinters if possible. Dry and apply a thin layer of the ozonated th a dressing if possible. Seek medical help if necessary. 1. Bacterial: eg Acne Clean the affected skin surface with cooled boiled, sterile water or Dry and apply a thin layer of the ozonated oil over the affected skin surface. Seek medical help if The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. cover with a dressing. n dry. 3. Viral: eg Shingles, Lip Herpes Clean the affected skin or lip surface with cooled Dry and apply a thin layer of the ozonated oil over the affected skin surface. Seek medical help if The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. There is no need to cover unless protection from further trauma is required, or work place health Superficial Burns: Clean the affected skin surface with cooled boiled or sterile water. surface. sterile water. oil over the affected skin surface. Seek medical help if necessary. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. Cover wi Skin Infections: skin cleanser. necessary. An alternative product is the LT-HN Acne Gel. There is no need to 2. Fungal: eg Athlete’s Foot Clean the affected skin surface with cooled boiled or sterile water. Dry and apply a thin layer of the ozonated oil over the affected skin surface and between the toes. Seek medical help if necessary. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. Wear open shoes to allow the foot to remai Change socks every day and wash following manufacturer’s instructions. boiled or sterile water. necessary. and safety regulations require wound coverage. Dry and apply a thin layer of the ozonated oil over the affected skin surface. Seek medical help urgently. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. Cover with a dressing if possible. Seek medical help urgently if the burn is extensive. Deep Burns: Clean the affected skin surface with cooled boiled or sterile water if possible. Dry and apply a thin layer of the ozonated oil over the affected skin surface. Cover with a Trauma Injuries: Clean the affected skin surface with cooled boiled or sterile water if possible. Dry and apply a thin layer of the ozonated oil over the affected area. Cover with a field dressing if ater. Dry and apply a thin layer of the ozonated oil over the affected skin surface. 3-4 hours after re-cleaning the affected surface. and safety regulations require wound coverage. ted skin surface with cooled boiled or sterile water. Make sure any residual sting or insect parts are removed from the bite/sting area. eek medical help if necessary. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. further trauma is required, or work place health and safety regulations require wound coverage. The ozonoid oil product is not sufficiently active enough to destroy superficial micro-biological structure. ion is gross caries with pulpal exposure, but this has not been tested or reported. The oil-base will interfere with dentine and enamel bonding systems. Ozone gas delivered from the LT CMU3 Unit is the only ozone gas product that should be used in these cases. For further comment and information, see www.limetechnologies.net. dressing if possible. Seek medical help urgently. possible. Seek medical help urgently. Surgery Sites / Surgical Suture Lines: Clean the suture line with cooled boiled or sterile w The patient should be instructed to re-apply every There is no need to cover unless protection from further trauma is required, or work place health Insect Bites & Stings: Clean the affec Dry and apply a thin layer of the ozonated oil over the bite or sting surface. S There is no need to cover unless protection from Directions for use - Dental: Dental Caries: Ozonated oils play NO part in the treatment of caries. niches and demineralisation in enamel, nor deep micro-biological niches in dentine tooth Ozonated oils may help to reduce pain and infect Gum Tissue Infections: 1. Bacterial: Clean the affected area with cooled boiled or sterile water or hydrogen peroxide mouth rinse. nated oil over the affected skin surface. Seek dental help if necessary. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. Dry Socket: Dry socket is a superficial bone and soft tissue infection, usually following teeth (especially 8’s) but this can occur in any site in the mouth after surgery. It is painful, and can take a long period of time to settle and heal with routine antibiotics. s, clean the affected area with cooled boiled or sterile water or hydrogen peroxide mouth rinse. nge with a blunt end, for example the Ultradent 1.2ml syringe with a fine acid etchant delivery tip, is filled with ozonated oil. The syringe tip is introduced into the dry socket to its full The patient should be sent home with a supply of the oil, syringes, delivery tips, and instructions, boiled or sterile water or hydrogen peroxide mouth rinse. Clean the denture with soap and water, Apply a thin layer of the ozonated oil over the fitting surface (the surface that touches the gum surface. de. pply a ld be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. re-apply every 3-4 hours after re-cleaning the affected area. phthous Ulcers: Either ozone gas from the LT-CMU3 unit can be delivered onto the ulcer . Apply a thin layer of the ozo There is no need to cover with a dressing. the removal of a tooth or To treat with ozone oil A small syri depth if possible, and the oil is expelled into the socket as the syringe tip is withdrawn. and instructed in oral hygiene care, and the case reassessed at regular time intervals. 2. Fungal: eg Denture Sore Mouth: Clean the affected gum tissue surface with cooled rinse, and dry. tissue) of the denture and replace. The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected 3. Viral: eg Lip Herpes Clean the affected skin surface with cooled boiled or sterile water or hydrogen peroxi A thin layer of the ozonated oil over the affected lip surface. The patient shou Mouth & Tongue Ulceration: Clean the affected skin surface with cooled boiled or sterile water or hydrogen peroxide mouth rinse. Apply a thin layer of the ozonated oil over the ulcer site and surrounding skin edge. The patient should be instructed to A surface, or ozonised oils can be placed onto the ulcer surface directly Clean the affected skin surface with cooled boiled or sterile water or hydrogen peroxide mouth rinse. l over the affected skin surface. Seek medical help urgently. ted surface. r hydrogen peroxide mouth rinse. ek medical help urgently. Periodontal Pockets: These oils should be used in conjunction with thorough scale and debris depth should be recorded. mall syringe with a blunt end, for example the Ultradent 1.2ml syringe with a fine acid etchant delivery tip, is filled with ozonated oil. The syringe tip is introduced into the periodontal pocket to its full depth, and the oil is expelled tissue. The aim is to fill the pocket with the ozone oil or gel as an adjunct to debris removal. regular time intervals. pplied at 1 week intervals in all cases, or in severe cases, more frequently. ent, such as a ‘Micro-Brush’. The patient should be instructed to re-apply every 3-4 hours after refrom further trauma is required. Al Shorman, Abu-Naba'a, Coulter W, Lynch E. Ozone, An Effective Treatment For Dental L by P. aeruginosa and its Eradication by Ozone. IADR Abstract 2003. Apply a thin layer of the ozonated oi The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affec Superficial Burns: Clean the affected skin surface with cooled boiled or sterile water o Apply a thin layer of the ozonated oil over the affected skin surface. Se The patient should be instructed to re-apply every 3-4 hours after re-cleaning the affected surface. prophylaxis. They are NOT an alternative to routine professional oral hygiene care. All periodontal pockets should be charted and measurements noted. Points of bleeding and pocket After professional prophylaxis, a s into the pocket as the syringe tip is withdrawn. At no time should the oil be injected into the soft The patient should be instructed in oral hygiene care, and the case reassessed at Ozonated oil can be re-a Surgery Sites / Surgical Suture Lines: Clean the suture line with cooled boiled or sterile water, or hydrogen peroxide solution. Apply a thin layer of the ozonated oil over the affected skin surface with a suitable instrum cleaning the affected surface. There is no need to cover, such as with a perio-pack, unless protection References: Unit Water Lines. IADR Abstract 2002. Al Shorman, Abu-Naba'a, Coulter W, Lynch E. Primary Colonization of DUW Andreozzi R, Canterino M, Marotta R, Paxeus N. Antibiotic removal from wastewaters: the ozonation of amoxicillin. J Hazard Mater. 2005 Jul 15;122(3):243-50. Molerio J, Bada A, González B, Zamora Z, Remigio AC. Clasificación xicológica del OLEOZON®", Revista CENIC Ciencias Biológicas, 32(1):57-59, 2001. ada AM, González B, Remigio AC. Evaluación del leozon® en ensayo de Toxicidad de Clases. OZ-P-130. be B. Kinetic and mechanistic vestigations of progesterone reaction with ozone. Water Res. 2006 Jun;40(11):2181-9. zone therapy today. J Biol egul Homeost Agents 1996: 10: 31-53 nd periodontitis. 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Oxidative modification of salivary biomolecules with therapeutic levels of ozone. J Dent Res 2002: 81:A-502. Cruz C, Menéndez S, Martínez ME, Clavera T. Application of Ozonised Oil in the Treatment of Alveolitis. Dalmázio I, Almeida MO, Augusti ozone in aqueous medium via atmospheric pressure ionization mass spectrometry. J Am Soc Mass Spectrom. Deborde M, Rabouan S, Duguet JP, Legube B. Kinetics of aqueous ozone-in of some endocrine disruptors. Environ Sci Technol. 2005 Aug 15;39(16):608 Díaz M, Gavin J, Hernández F, Ledea O, Moleiro J. "1H NMR Study of methyl linoleate Ozonation", Ozone Sci. & Eng., 2002. D ozonation of methyl oleate", Boletín de la Sociedad Chilena de Química, 42(3):349-353, 1997. Díaz M, Hernández F, Alvarez I, Velez H, Ledea O, Moleiro J. "La espectroscopía de resonancia magnética nuclear protónica en el seguimiento de la reacción del ozono con los ácidos rasos insaturados", Revista CENIC Ciencias Químicas, 29:89 93, 1998. rnández F. 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Published 2005 lant Extracts. WW LTH, February 2006. olmes J. A New Dental Practice. WWW LTH, January 2007. olmes J. Changes in Dental Care. WWW LTH, January 2007. g Díaz M, Lezcano I, Molerio J and He w Dodd MC, Buffle MO, Von Gunten U. Oxidation of antibacterial molecules by aqueous ozon m Sci Technol. 2006 Mar 15;40(6):1969-77. Durnovo F, Kinyapina I, Kontorschikova C. Ozone Influence on Pro-In M Ebensberger U, Pohl Y, Filippi A. PCNA-expression of cemento ro Fernández S, Quinsan C, Menéndez S, Gómez M. "Evaluación mutagénica del aceite ozonizado administrado intragástricamente" 1 Fernández SI, Quinzan C, Menéndez S, Gómez d CENIC Ciencias Biológicas, 20(1-2-3):45-47, 1989. G lamblia", Revista CENIC Ciencias Biológicas, 20(1-2-3):55-58, 1989. González M, Molerio J. y 2-3):118-121, 1989. Hernandez F, Moleiro J, Fernandez I, Regüeiferos o Holmes J. Management of Volatile Sulphur Compounds with Ozone. I Holmes J. The use of Ozonated Water as a Mouth Rinse to Reduce Bad Breath. 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Holmes J, Grootveld M, Smith C, Claxson AWD, Lynch E. Bleaching of Components Responsible for Extrinsic T Holmes J, Lynch E. Modern Dental Care: Published 2005. Holmes J, Lynch E: Modern Management of Caries. Lecture Series,: 2003 - 2008 Huth KC, Jakob FM, Saugel B, Cappello C, Paschos E, Hollweck R, Hickel R, Brand K. Effect of ozone on oral cells compared with established antimicrobials. Eur J Oral Sci. 2006 Oct;11 Huth KC, Saugel B, Jakob FM, Cappello C, Quirling M, Paschos E, Ern K, Hickel R, Brand K. Effect of aqueous ozone on the NF-kappaB system. J Dent Res. 2007 Jardines D, Ledea O, Zamora Z. Dicarboxylic Acids and their Origins in t Administration of Oleozon®. OZ-P-128. Jardines D, Ledea O, Zamora Z. "Triglicéridos insaturados ozonizados como precursores de ácidos dicarboxílicos urinarios de ratas Wistar", Revista CENIC Ciencias Químicas, 32(2):65-69, 2001. Jardines D, Zamora Z, Correa T, Rosado A, Moleiro J. 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L Analysis of Ozone-treated Grapeseed, Olive, and Sunflower Seed Oils. IADR Abstract 2003 L Hygiene. M around dental implants. J Dent Res 2002: 81:A-101. Menéndez S, Falcón L. "Ozonized sunflower oil in the treatment of tinea pedis", Mycoses, 44 2001. Menéndez S, Moleiro J, Díaz W, Lezcano I, León FL, Ledea O, Falcón L, Simón RD, Pérez O, Moya S, Landa N, Hernández C, Fernández LA, Díaz M, Gómez M, Jardines D, Aqu A Oleozon® en la Epidermofitosis®". OZ-P-132. N oral microorganisms. Oral Microbiol Immunol 2004: 19:240–246. N vías digestivas de ratones tratados con aceite ozonizado", Revista CENIC Ciencias Biológicas, 20(1-2- Ozone: The Revolution in Dentistry. Copenhagen: Quintessence Publishing, 2004:155–164, ISBN 18-5097-08-82. Sechi LA, Lezcano I, Nuñez N, Espino M, Dup S 284, 2001 S Disease. Sorokina S, Zaslavskaja S . S and consequent loss of antibacterial activity: relevance to municipal wastewater ozonation. Water Res. 2007 Jun;41(12):2481-90. Yamayoshi T, Tatsumi N. Microbicidal effects of ozone solution on methicillinresistant Staphylococcus aureus. Drugs Exp Clin Res 1993: 19:59–64.