Ozone in Dentistry

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In the same way that ozone therapy is minimally invasive for the body when compared to other methods of treatment, ozone aero-therapy is a minimally invasive form of tooth care, with the added benefit that it prevents damage before it sets in instead of just repairing it. In their introductory article on this approach Stephen Gaines and Kenneth Serota give a historical overview on the development and point out the changes that might lead from the current approach of macro-dentistry to the future of micro-dentistry.

Macro-dentistry is what we know from visiting the dentist’s office.  As the authors state and we remember from experience: from a view that developed in the early 1900s and regarded caries as ‘dental gangrene’ it was a logical step for macro-dentistry to “promote the complete removal of a carious tooth structures, without regard for structural or biological implications.”  Thus there are “realities in the macro-dental model of treatment that cannot be ignored: recurrent caries, restoration failure, and irreversible pulpal damage will invariably persist in spite of our best efforts to eradicate them”, with the result that artifacts will be increasingly replace the original healthy tissue.

Two new tools are needed to change this situation, from replacing healthy tissue to supporting the continued structural strength and therefore survival of the same: new diagnostic devices for early detection and diagnosis of ‘hidden caries’, and, which to some may sound strange the means to deliver ozone to the niches that are in the process of developing ‘hidden caries’.  Both sets of tools are available.  On the diagnostic side there is laser fluorescence spectroscopy, magnification of various types and transillumination.  There are also appropriate instruments to deliver ozone to the teeth affected with niches of ‘hidden caries’.  In micro-dentistry the approach thus is to discover and then alter the niche environment where cariogenic (acidogenic and aciduric) bacteria thrive before they can do their damage of demineralizing dental hard tissue.

But, why ozone?   What can this allegedly toxic gas do for the health of our teeth?  Gaines and Sarota explain: “Professor Edward Lynch and others have shown that ozone, delivered through a specially designed generating device at a concentration of 2100 ppm and at a rate of 615 cc per min for a time of >1o sec, can substantially reduce and neutralize cariogenic, pathogenic micro-organisms and contribute to the reversal of both root caries and pit and fissure caries.

By way of further explanation they add, “Ozone’s effectiveness as a bactericidal agent, viral and fungal deactivator, as well as its ability to kill bacteria 3000 times faster than chlorine-based agents has made it the primary disinfection source for many water utilities globally… It has been clinically demonstrated to eradicate microorganisms associated with caries development, promote natural remineralization of enamel, remove volatile sulphur compounds associated with halitosis, and whiten discolored caries by destroying the chromatic chemical rings.”

A textbook on ozone in medicine therefore sums up the uses in dental treatments as follows, "In dental medicine, ozone takes the form of ozonized water and is applied as a jet spray, with the aim of disinfecting and improving local circulation. Its principle uses are for:
  1. Conservative and prosthetic treatment (disinfection of cavities, root/pulp canals, and stumps)
  2. Periodontics (treatment of gingival sulci, or periodontal pockets and in periodontal surgery; also in the treatment of para-dental pyorrhea and of difficult/retarded dentition, or dentitio difficilis)
  3. Applications in maxillary surgery (extensive and complete disinfection of the buccal cavity prior to surgery, as a coolant during work with burrs, for rinsing wounds and stop seeping hemorrhage)
By the way, ozone has been used in dentistry since 1932 when the Swiss dentist patented "Cytozone", the first dental use of an ozone apparatus.  A famous Austrian surgeaon, Dr. med. Erwin Payr, then received ozone dental treatments by Fisch.  He was so impressed that he adapted it to his own surgical practice, increasin its acceptability in surgery, in Germany and Austria in the 1930s to the end of World War II.

This short piece can only point out the validity and far reaching consequences of the approach.  Readers who are interested to learn more, and especially have a look at the case histories and documentation behind the article are suggested to go to the following link:

http://www.oralhealthjournal.com/issues/story.aspx?aid=1000199312&type=Print%20Archives

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