OZONE in DENTAL CARIES

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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 anybacteria, 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.

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    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 ormore 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.

    ---------------------------------------------------------

    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

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    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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