What is Ozone & Ozone Therapy?
What is ozone?
Ozone is a chemical compound consisting of three atoms of oxygen. It is the elemental form of oxygen that occurs naturally as a result of ultraviolet energy or lightning, causing a temporary recombination of oxygen atoms into groups of three. In the clinical setting, an oxygen/ozone generator simulates lightning via an electrical discharge field. Ozone protects living organisms by surrounding the earth at altitudes of 50,000 to 100,000 feet. The ozone layer absorbs the sun’s harmful ultraviolet rays, thus allowing for survival of plant and animal life. Ozone forms near ground level as a result of the reaction of ultraviolet light with hydrocarbons, nitrogen oxide, and sulfur compounds to produce photochemical smog. Ozone is not the cause of smog, but it is a by-product. Since ozone is a powerful oxidizer, it actually helps clean the atmosphere of these dangerous compounds. Ozone is used as a measuring device for smog levels — to reiterate, it is not smog, but nature’s way of cleaning up the smog.
The properties of ozone are the foundation of what makes it work so well in dentistry. Ozone is a powerful oxidizer it effectively kills bacteria, fungi, viruses, and parasites at a dramatically lower concentration than chlorine, with none of the toxic side effects. One molecule of ozone is equal to between 3,000 to 10,000 molecules of chlorine and it kills pathogenic organisms 3,500 times faster! In a medical/dental ozone generator, the medical grade O² is converted to O³ in special tubes via a corona discharge reaction (similar to lightning). This type of generator is able to control the concentration of ozone critical to delivering the correct dose in micrograms/milliliters (mcg/ml). Concentration is determined by exposure and contact time of the medical-grade oxygen to the 5 to 13 millivolts [Bocci] sealed-corona discharge tubes. Because of ozone’s physical properties in the dental model, the ratio of ozone to oxygen is extremely low. The typical average concentration of ozone used in treatments is 25 micrograms of ozone per milliliter of oxygen/ozone gas mixture. That translates into 0.25 parts of ozone to 99.75 parts of oxygen. Evidence-based research has shown at this concentration, ozone effectively kills bacteria, fungi, viruses, and parasites.
A continual battle with oral infections
Dentistry is in a continual battle with infection, soft tissue, and/or hard tissue. These infections come from bacteria, fungi, viruses, and parasites. An infection can be of a single organism or a combination of all the above. In the developmental stages of oxygen/ozone therapy in dentistry, we philosophically took into consideration the “oral-systemic link.” Keep in mind the far-reaching implications associated with acute or long-standing chronic infections typically seen with periodontal disease and some teeth that have had root canals. The systemic effects of oral infections on the other areas of the body have been well documented in both medical and dental literature. Attempts to eliminate oral infections have been minimally successful due to the interrelated nature of the multiple causative factors. These factors include microorganisms, diet, saliva, and immune responses. Treatments such as prophylaxis, rinses, sealants, restorations, surgical procedures, diet, and lifestyle modification have altered risk factors. The result is the host adapts to the acute infection and the infection then converts to a subclinical chronic infection. These pathogenic organisms — being opportunistic — eventually clinically “reinfect” the afflicted tissue. Instead of treating the whole body with antibiotic, viral, fungal, or parasitic agents, why not treat the infection with a naturally occurring substance that is truly broad spectrum with no toxicity or side effects? That substance is oxygen and its energized form, ozone. The commonality of all the pathogenic organisms is the weak antioxidant/enzyme systems in the cell membranes of these organisms. The ozone will punch a hole in the membrane of the organism, thus resulting in the organism’s death. Now the contents of the pathogen are exposed to the internal environment that allows the immunologic system to start its physiologic cascade. One of the most amazing biochemical and physiological studies conducted at Scripps Institute recently showed how antibodies actually produce ozone to kill invading microorganisms. Now antibodies, in addition to identification of pathogens, also kill them with ozone. So in reality, we are now doing nature’s work within our dental standard of care.
Setting standard-of-care and therapeutic goals based on sound evidence-based science is critical. Therapeutic goals are inclusive and not exclusive of standard of care. In oxygen/ozone therapy in dentistry, our goals are:
- Elimination of pathogens
- Restoration of proper oxygen metabolism
- Induction of a friendly ecologic environment
- Increased circulation
- Immune activation
- Simulation of the humoral anti-oxidant system
Oxygen/ozone therapy in dentistry contains a multiplicity of protocols to deal with dental infection. Three basic forms of application to oral tissue are applied 1) ozonated water, 2) ozonated olive oil, and 3) oxygen/ozone gas. Ozonated water and olive oil have the capacity to entrap and then release oxygen/ozone, an ideal delivery system. These forms of application are used singly or in combination to treat dental disease. Periodontal disease is defined by the American Academy of Periodontology as “chronic bacterial infection that affects the gum and bone supporting the teeth.” But we now know that this “infection” can also be viral, fungal, and parasitic. When treating periodontal disease, standard of care is a must. All standard diagnostics are utilized, including radiographs, pocket-probing, and clinical exam.
How treatment works
As an example, let’s say a patient has generalized Type III moderate periodontitis. Using the standard protocol for oxygen/ozone therapy, the patient is placed on a four week protocol, with follow-up after one month, and then scheduled for three-month recalls. Each week corresponds to a quadrant of dentition for anesthesia, root-planing, scaling, and curettage. Starting with the first visit — while anesthesia is established — the sulcus/pockets are irrigated using a cannula with a syringe of ozonated water. This process reduces and eliminates the pathogenic load within the pockets and sulcus areas. Now mechanical removal of debris can be more safely performed, lessening the infection burdening the entire body. After the quadrant is completed, reirrigation is performed for the entirePocket/sulcus of all quadrants. The next procedure is what we call the “rocket fuel.” Each pocket/sulcus is insufflated with a mixture of oxygen/ozone gas. Due to the physics of a gas entering into a liquid, the crevicular fluids and the epithelial tissues lining the sulcus absorb the oxygen/ozone mixture, ensuring complete anaerobic pathogen load elimination. In addition, the tissue responds with increased perfusion and immunologic activity, allowing for enhanced healing. The patient is given standard home-care instruction with one added item— ozonated olive oil. After the patient performs all home-care hygiene, he or she applies the oil to the soft tissue. Once the oil melts, it again releases oxygen and ozone supporting the current therapy. If the dentist has any stubborn areas, the oxygen/ozone can be injected directly into the area, and the gas goes immediately into solution. This resolves the local issue. The methods applied are safe and efficacious with no toxicity or side effects. Usually, by the third visit, the infection is resolved and the dentist is performing mechanical debris removal and continuing-supportive therapy. If we had to use pharmaceuticals to resolve a multi-type pathogenic microbe infection, it would have to include many different Agents with their known side effects.