- Let me paint you a picture. Every Monday morning, dental
practices over the world power up for a week's worth of drilling and filling,
tooth removal, and reconstruction work. Queues of fearful patients, tearful
children being comforted by anxious parents, people in considerable pain,
line up outside the doors to their dental surgeries. Once inside, these
patients are subjected to the traditional smells of oil of cloves, disinfectants,
and the noises of the high pitch whine of the dental drill; the odd scream
or two filters through the hushed, usually silent waiting room into the
street outside. It is a sad fact of life that every dentist is trained
that if there is an area of decay in your tooth, the only way to treat
this is to drill the decay out or amputate it, and then place a filling
that will have to be replaced at some stage.
- For a small minority of patients, where their dental
practices have chosen to invest in a new technology, the opposite happens
almost every day. The queue is one of bright, cheerful adults and children;
there are few smells to associate this practice with the traditional one
down the road. The noise of the drill is seldom heard, and happy smiling
faces emerge from the treatment room.
- Since 1998 researchers, lead by Professor Edward Lynch
from Queen's Dental Hospital and Belfast University, Ireland, have opened
a radically and revolutionary way forward. The dental profession no longer
has to destroy tooth tissue to eliminate bacteria. A simple 60 second (average
treatment time) treatment with a device that delivers a burst of ozone
will destroy all the bacteria that caused the infection and the decay.
It destroys all the organic effluents that are produced by these bacteria;
this is shown in Fig 1 opposite. The top data shows the spread of organic
bio-molecules produced by an active carious lesion. The lower data shows
the effect of 10 seconds of ozone; the profile now consists of a single
main spike of acetate acid, and the other oxidation by-product is carbon
dioxide. This H MNR research proved that ozone worked as a pharmaceutical
approach to caries in-vitro. By effectively sterilising the lesion, minerals
from the patients own saliva will re-enter the areas of mineral loss to
harden them. Once hardened, it is more resistant to future bacterial attack
and mineral loss.
- There is in all our mouths a natural balance. Your tooth
surface losses minerals into your saliva at certain times, usually just
after you start to eat. These acidic conditions favour mineral loss. The
normal acid/alkaline balance exists in the oral cavity. When bacteria attach
themselves to a tooth surface, they set up a complex community of some
450 different bacterial types over a period of time. If patients skimp
on using a tooth brush, or forget to use dental floss on a regular basis,
these communities of bacteria evolve into one which produces large volumes
of acids. These acids attack the tooth surface, dissolving out the minerals,
leaving a hole or cavity. As this cavity now gives the bacterial colonies
a degree of protection, tooth brushing cannot remove the bacteria and so
the process of decay accelerates.
- Yet decay is only an infection process that leads to
the softening of the tooth, and the formation of a cavity, so could this
infection be treated with, say, antibiotics? The bacteria that cause tooth
decay are often found deep within the structure of the tooth, so their
removal has to date only been by amputating the infected part of the tooth.
Antibiotics and other pharmaceutical agents cannot penetrate deep enough
through bacterial pellicle and tooth structure to eliminate acid niche
environment. This teaching and technique is based on sound engineering
principles that originate from the Victorians! Despite modern advances,
there is no simple test that can be applied to a cavity to tell the dentist
if they have removed all the infection! or enough tooth material!
And if areas of infection are left behind, there is a good chance that
the filling placed will fail at some time in the future.
- In an attempt to prevent further infection and to restore
the tooth to its original shape and function, a filling is then placed.
Studies over the years have shown that fillings do not last very long,
any where from 6 months to several years. But once a tooth has had part
of it amputated, there is no going back. For each time the filling needs
to be removed and replaced, there is a little less of the original tooth
left and a larger filling. A point is reached where there is no option
but to opt for expensive reconstruction work with advanced dental care
or have the tooth removed.
- The dental professions goal is to help and educate the
patient, how to avoid them entering into this cycle of tissue amputation
and periodic filling replacement. Oral care education and modern toothpastes
have helped reduce the number of cavities, but in poorer communities, those
with disabilities and in long term institutions, as well as our aging population,
decay is still prevalent. And diet advice is often lacking, so although
patients may think they are doing well at home, the process of decay continues!
The days of 'Wait & Watch' are over the profession is not entirely
sure of what it is watching unless clinicians are using advanced clinical
- Dental Ozone is a completely new way to look at decay.
In the early stages of mineral loss, no use of the drill is required. The
treatment is simple, inexpensive (certainly less than the cost of a filling),
and requires no injection of anaesthetics. This does of course depend on
the use of modern diagnostic equipment, such as the DIAGNOdent (KaVo GmbH).
This laser is more accurate than x-rays, and far superior to the traditional
mirror and probe that dentists often use. The mirror and probe are tools
that can find holes, not diagnose areas of first stage decay. And research
has shown that x-rays are very poor to visualise decay in a tooth surface,
until it is 2-3 mm inside the inner layer of the tooth.
- If the area of decay is deeper, and more extensive, Ozone
still has a role to play. The dental drill may need to be used to remove
the cover of enamel over the decay, but this can also be carried out with
air abrasion. No local anaesthetics are required, and Ozone is used to
sterilise the area of decay, without the need to amputate a large volume
of tooth structure. In this way, damage to the tooth is limited, and the
inherent strength is preserved. Even in really deep areas of decay, Ozone
can be used to preserve tooth tissue.
- When Ozone is combined with traditional care, then there
are a number of advantages that patients and the dental profession can
make use of. Ozone can be used to sterilise a cavity before a filling is
placed, so there will be virtually no sensitivity after the local anaesthetic
wears away. It can be used to eliminate sensitivity after new crowns or
veneers are placed. And where wear facets have produced sensitive areas
at the necks of teeth, in most cases a simple 40 second application with
ozone can eliminate this sensitivity. There are many more applications
for Ozone in a general dental or medical practice, and the studies for
some of these can be found on www.the-o-zone.cc. This www site not only
allows you to find a dental practice which has and uses Ozone, but also
allows you to view the research papers that have been published from centres
around the world.
- There is not a single facet of a medical, dental or veterinary
practice where ozone cannot be used in some form for the benefit of patients
from the general to specialist practice and health care centre all
can take advantage of this new technology.
- So, perhaps a Monday morning at a dental practice that
has invested in modern technology is no longer the stressful, painful and
anxious visit that it used to be. The waiting room in this practice are
full of smiles, people chatting to the dental team members as they wait
with happy anticipation at being called through for their turn in the treatment
room. Mums and dads with children have no fear or anxiety, as they are
reassured that modern technology has opened a door for them, that most
of the older population had never believed possible. For both the patient
and the dental practice, it is a technology that has a winning solution
for both; the treatment is fast, it is predictable, it is painless, and
also reduces the long-term cost of the treated tooth. For the dental practice,
the treatment times are reduced, it is profitable, and the treatment less
stressful. For the patient, modern technology has allowed them to have
a 21st century treatment, rather than one that is old fashioned, and out-dated.
- In a lead article published in 2003 I wrote;
- 'In the vast majority of dental practices - not just
in the United Kingdom and Europe, but throughout the world - the primary
method to reverse the effects of decay remains 'drill and fill'. The entry
of a patient into the cycle of drill and fill is irreversible. Once a hole
is drilled into a tooth, the patient always will have it; and no matter
how good a clinician each dentist perceives themselves to be, any restorative
material will fail at some time.'
- The dental profession has not kept up with their medical
counterparts in finding a holistic treatment method for what is a prevalent
infection caries. The Victorian principles of amputation to establish
a sound foundation for restorative care no longer are valid in the light
of new published research and clinical experience.
- Ozone at last offers the dental profession this new approach
instead of the out-dated and Victorian amputational model.
- Dr Julian Holmes, 2007.
- The Ozi-cure is a self-contained device to generate
ozone gas from air for the use in Dental, Medical or Veterinary Practice
for surface application.
- The Ozi-cure Dental Unit manufactured by O3 and distributed
in Germany by American Dental GmbH. The Ozi-cure achieved CE and Medical
Directive Certificates in November 2006.
- The treatment times used in dental ozone treatment are
short from 10 to 60 seconds (Baysan and Lynch, 2001). The area to be treated
and the application of ozone is carefully controlled by localised 'bagging'
and high-volume suction.
- The use of ozone in dental practice takes dental care
into the 21st Century. It sets the standard of a modern pharmaceutical
method to treat dental and medical patients;
- Studies from Europe (Abu-Salem et al, 2003; Baysan and
Lynch 2001; Holmes, 2003; Holmes and Lynch, 2003) have shown conclusively
that the use of ozone in dental care is effective as a non-destructive
method to manage decay and its destructive effects. The use of ozone has
been shown to be the ideal way to manage anxiety of patients young
and old - and their carers (Dahnhardt et al, 2003; Domingo et al, 2004).
- The effects of ozone reduce tooth destruction in routine
preparation (Clifford, 2004; Holmes, 2004; Holmes and Lynch, 2004) and
ozone reduces the time and the cost of dental care (Domingo and Holmes,
2004; Johnson et al, 2003) and raises the practice income. In Endodontics,
ozone is effective against Enterococcus faecalis (Chang et al, 2003).
- Professor Velio Bocci from Milan University (1994) has
emphasised that the potential toxicity of O3 should not preclude its employment
for medical, dental & veterinary purposes. This statement has been
echoed by thousands of health professionals who use ozone in clinical practices
around the world, and millions of patients that have been treated.
- The correct operation of the Ozi-cure meets all current
Health and Safety Regulations in all countries. The Ozi-cure is completely
safe when used according to the Ozi-cure Operating Instructions.
- Ozone is perceived to be a dangerous gas; let's put this
into a scientific context. In 1978 an FDA Report showed that 1.5 million
people were hospitalised by pharmaceutical reactions, and there were 140,000
deaths from prescription drug usage.
- In stark contrast, a 1980 German Medical Society Report
for Ozone Therapy cited 5.6 million ozone treatments carried out for that
year. Of the 5.6 million ozone treatments, there were just 40 reported
cases of side effects (0.000007%), and 4 deaths from inappropriate administration
of ozone gas. Ozone remains the safest and effective pharmaceutical treatment.
- In World War I, ozone was used to treat wounds, burns
and infections. The modern development of ozone's application to Medicine
began in the 1950s in Europe, Australia, Israel, Cuba, Brazil and Columbia.
Today, over 9000 doctors, dentists & vets worldwide now routinely use
ozone in their clinical management.
- Research in Cuba, Europe, the USA and South Africa concerning
the anti-microbial efficacy of ozone has continued over the last twenty
years and has conclusively shown the ability of both gaseous and dissolved
ozone to eradicate a wide range of bacteria, bacterial spores and viruses
(Baysan and Lynch, 2001; Ishizaki, 1986; Katzeneleson, 1974; Vaughan, 1987;
Whistler and Sheldon, 1989).
- A clinical guide for the use of ozone in dental and medical
practice is included with every Ozi-cure device sold.
- Abu-Salem OT, Marashdeh MM, Lynch E: Ozone Efficacy in
Treatment of Occlusal Caries in Primary Teeth. IADR Abstract 2003
- Baysan A and Lynch E: Management of root caries using
ozone in-vivo. Journal of Dental Research 2001; 80:37
- Bocci V: Autohaemotherapy after treatment of blood with
ozone, a reappraisal. Int Med Res 1994; 22: 131-144.
- Chang H, Fulton C, Lynch E: Antimicrobial Efficacy of
Ozone on Enterococcus faecalis. IADR Abstract 2003.
- Clifford C: Reversal of Caries Using Airbrasion and Ozone-
Nine Month Results. IADR Abstract 2004
- Dahnhardt JE, Jaeggi T, Scheidegger N, Kellerhoff N,
Francescut P, Lussi A: Treating Caries in Anxious Children with Ozone:
Parents' Attitudes after the First Session. IADR Abstract 2003
- Domingo H, Abu-Naba'a L, Al Shorman H, Holmes J, Marshdeh
MM, Abu-Salem AT, Freeman R, Lynch E: Reducing Barriers to Care in Patients
Managed with Ozone. IADR Abstract 2004.
- Domingo H and Holmes J: Reduction in treatment time with
combined air abrasion and ozone compared to traditional 'Drill & Fill'.
IADR abstract 2004.
- Holmes J: Clinical reversal of root caries using ozone,
double-blind, randomised, controlled 18-month trial. Gerodontol 2003: 20
- Holmes J: Restoration of ART and Ozone treated primary
root carious lesions. IADR Abstract 2004.
- Holmes J and Lynch E: Arresting Occlusal Fissure Caries
Using Ozone. IADR Abstract 2003.
- Holmes J and Lynch E: Reversal of Occlusal Caries using
Air Abrasion, Ozone, and Sealing. IADR Abstract 2004
- Ishizaki K: Inactivation of bacillus spores by gaseous
ozone. J Applied Bacteriol 1986; 60: 67-72.
- Johnson N, Johnson J, Lynch E: Cost Benefit Assessment
of a Novel Ozone Delivery System vs. Conventional Treatment. IADR Abstract
- Katzeneleson E: Inactivation of viruses and bacteria
by ozone. In chemistry of water supply, treatment and disinfection. Ann
Arbor Science Publishers Inc., Ann Arbor, Mich, 1974,