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Ozone Treatment for Dental Caries

Ozone Treatment Publicised Widely

UK, August 9, 2002

Ozone treatment for dental caries has been publicised widely in this week's national press, which has heralded the new technology as the beginning of the end for the dentist's drill.

Stories have promised that large numbers of patients would benefit from the technology, which requires no drilling, fillings or injections. It involves putting a plastic cap on a tooth and applying ozone for 10 seconds. The ozone gas readily penetrates through decayed tissue, eliminating any bacteria, fungi and viral contamination, removing the ecological niche of cariogenic microorganisms, as well as priming the carious tissue for remineralisation.

Earlier this year the research behind the technology was awarded at the annual meeting of the International Association of Dental Research (IADR) in San Diego.

Mirror & probe and x-rays are inaccurate In many dental practices worldwide, caries detection depends on visual recognition with the aid of a mirror, probe and x-ray analysis. However, studies have shown that these traditional systems can be inaccurate. Computerised analysis of digital radiographs, dyes and tests to look for the propensity of the individual to decay may offer more accuracy. As a profession, we are taught to amputate the diseased tissue from a tooth, and we have a wide range of systems to help us, such as the traditional turbine, diamond coated and carbide burs, ultra-sonic tips, air abrasion, and chemicals. All are very effective, but they all amputate tooth tissue.

The theory of the development of a carious lesion is crucial to the understanding of the new treatment to be discussed. The 'niche environment theory' is now accepted to explain the process of initial colonisation through to the development of acidophilic microorganisms in a specialised niche environment. As the bacteria collect, for instance in a fissure, they produce acid that leads demineralisation. To some extent this may be offset by the host's normal neutral oral environment, but as the numbers of acidophilic bacteria increase, the niche becomes predominately acidic. This attracts more acid-producing bacterial species, and over time a cavity forms. The process of niche development may take many years. We already know from previous studies that decay can be reversed by improved oral care and the use of mineral mouthwashes and dentifrices.

Caries removal has always relied on the amputation of diseased lesions. There has been no simple way to eliminate caries without amputation therapy for several reasons. About 450 bacterial species are involved in a mature carious lesion and, over time, there is a change in the type and species of the microorganisms involved from the process of colonisation, developing, and mature carious lesion. Additionally, the acidic metabolites of these bacteria are difficult to denature in the depths of a lesion. In most cases, it is impossible to define the exact limits of a lesion, so we tend to remove far more tissue than is actually required. In so doing, we severely weaken the entire tooth structure.

Caries removal with ozone

The new caries elimination system, based on ozone (O3) gas, is delivered through a hose and handpiece into a polymer cup that is placed around the tooth surface to be treated. The ozone penetrates through the decayed tissue, eliminating any bacteria, fungi and viral contamination. It also denatures the acid metabolites of the bacteria.

When delivered in 10-second bursts, ozone gas at a concentration of 2,200 ppm can eliminate 99 per cent of the micro-flora, and so halt the decay process.

The 'cleaned' lesion is then able to remineralise. Once remineralisation begins, the naturally restored tissue has been shown to be far more resistant to decay. As the acidic carious niche environment can take years to establish, it is unlikely that the niche will redevelop before remineralisation takes place. One important factor that needs to be remembered is that during the initial stages, the treated areas of decay will be relatively soft, and will not support any restoration.

Therefore, if a restoration is planned after ozone treatment, it should be planned at the review appointment. By that time, the research data suggests the remineralisation process will be well advanced, and the tissue hard enough to support a restoration. In addition, waiting 3 months or more will decrease the amount of tooth tissue that may have to be removed to obtain a cosmetic result. This in turn preserves as much of the original tooth as possible.

The medical profession has used ozone for over 100 years. Ozone has also been used in commercial applications for over a century, and is used to purify public water supplies in cities worldwide. Ozone is also used to eliminate pollution in air supplies in hospitals and other buildings. Research is being conducted to see what other applications it could have within dentistry - from purifying waterlines to tooth whitening.

Our experience

To date, our results mirror those achieved by the team researching the ozone treatment in Belfast. Our patients are as astounded as we have been at the success of this painless technology.

We promote ozone treatment to our patients because it allows natural remineralisation of decayed tooth tissue without the need for, in most cases, an injection, drilling or filling. It is quick, non- invasive, and the instant bacterial elimination is painless and less traumatic for the patient.

Dental care is changing and there is a need for practitioners to change their practice of dental care. As this technology becomes a topic of interest in the national media, patients will begin requesting it. The scientific research shows that the technology is effective. The mindset of 'amputation of tooth tissue' has to be changed. Every practitioner has a duty of care and should therefore rethink their management of the detection and management of decay in light of this new treatment.

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Ozone gas invention may stop tooth decay

Tuesday 6th August 2002

Dentists are testing a new system using ozone gas which may stop tooth decay. The method uses a probe to deliver ozone gas to the decaying tooth. It kills off bacteria inside the cavity, restoring the tooth to a more healthy state. The procedure can take just 10 seconds and involves no injections or drilling.

An airtight rubber cap is fitted around the affected tooth and the ozone causes 'soft decay' to turn into harmless 'hard decay' which doesn't spread.

Scientists at Belfast University developed the technique. They say 10 seconds of ozone gets rid of 99% of micro-organisms.

The patient can then have a white filling straight away if the remaining cavity is unsightly.

The university's Professor Edward Lynch said: "I experimented with a vast array of chemicals and substances which didn't work. But, by trial and error, I discovered ozone which eliminates the decay in a matter of seconds."

Dr. Peter Murray, of James Hull Associates in Cardiff, is taking part in the trials. He said: "This system is a real Godsend for those people who have always had a fear of visiting the dentist. If we can identify the decay in time, there will be no need for them to experience the drill in their lifetime.''



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