Ozone in Dentistry

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One simmering controversy in dentistry has to do with ozone, but nothing to do with the layer that surrounds our planet. Rather, it’s a new and controversial alternative form of dental treatment. Some dentists are convinced that delivering ozone gas, a powerful naturally-occurring oxidant, into a decaying tooth can halt or even reverse the process altogether.

Dental caries, otherwise known as cavities, are bacterial infections that erode and destroy tooth structure due to the acid that is produced every time food is consumed. Ozone is toxic to certain bacteria, so the theory goes that injecting ozone into a carious lesion might reduce the number of cariogenic bacteria.

Ozone (O3) is formed from oxygen (O2) splitting into two oxygen molecules (O1) under various conditions, including an electrical discharge like a lightning strike. Then these single molecules collide with O2 oxygen to form ozone. If you have ever noticed a different scent in the air after a lightning storm, it is likely that you are smelling the higher concentration of ozone. In fact, the word ozone is derived from the Greek word “ozein,” which means “to smell.”

Ozone can exist in gas, liquid or solid form, and has long been used in industrial and medical applications. The extra oxygen molecule on ozone is loosely bound, excited and readily available to jump off, attach to, and oxidize other molecules. This oxidation process can destroy a variety of microorganisms. Ozone-based sterilizers are often used for some instrument and equipment sterilizing applications in hospitals. Ozone is also used by some municipal water systems to kill bacteria in the water.

Proponents argue that dentists can use ozone to start a process that removes bacterial waste products, halts dental cavities and begins a process of repair through accelerated remineralization of damaged teeth. According to them, bacteria, viruses and fungi lack antioxidant enzymes in their cell membranes, so those harmful antibodies are destroyed when ozone ruptures their cell membrane. Healthy cells, on the other hand, are unaffected by therapeutic levels of ozone because they have antioxidant enzymes in their cell membranes.1 Those in the dental community in favor of ozone therapy say dentists are utilizing it for periodontal therapy, root canal treatment, tooth sensitivity, canker sores, cold sores and bone infections, among other things.1

It’s an interesting idea and a pretty straightforward concept. Any treatment that not only saves or protects a tooth from decay but avoid the use of needles and anesthetic would be a welcome addition to a dentist’s treatment options. Unfortunately, despite some promising evidence of effectiveness against decay-causing bacteria in laboratory studies, the current evidence base for ozone therapy in dentistry is insufficient to conclude that it is an effective or cost-effective addition to the management and treatment of caries. At this time, the U.S. Food and Drug Administration (FDA), which assesses new drugs and medical devices for safety and efficacy and regulates their use and marketing in the U.S., has not cleared any ozone-generating devices for use in dentistry.

Ultimately, not enough is known as this time and some high quality clinical trials research is necessary. Biased research and inconsistent outcome measures have made researchers unable to confidently conclude that the application of ozone gas to the surface of decayed teeth halts or reverses the decay process. Therefore, at this time, ozone therapy for treatment the prevention and control of tooth decay is not considered a viable alternative to current treatment methods in the world of evidence-based dentistry.2

1 American College of Integrated Medicine and Dentistry. http://www.ozonefordentistry.com/DentalO.html Accessed July 10.

2 National Center for Biotechnology Information. Ozone Therapy for the Treatment of Dental Caries. http://www.ncbi.nlm.nih.gov/pubmed/15266519 Accessed July 10.

3 Rickard GD, Richardson RJ, Johnson TM, McColl DC, Hooper L . Ozone therapy for the treatment of dental caries.  Cochrane review.   2008 http://summaries.cochrane.org/CD004153/ozone-therapy-for-the-treatment-of-dental-caries#sthash.qfFibqsE.dpuf

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