Ozone Therapy in DentistryOzone Therapy in Dentistry

Super Activated OxygenSuper Activated Oxygen

ByBySteve Tatevossian DDS,FAACPSteve Tatevossian DDS,FAACP

History of OzoneHistory of Ozone

Discovered late 17Discovered late 17thth Century (1740) Oxford Century (1740) Oxford UniversityUniversity

Widely used in Europe & every other developed Widely used in Europe & every other developed country except UScountry except US

Fell out of favor in USFell out of favor in US

Dental research in whitening pharmaceuticals led Dental research in whitening pharmaceuticals led to 03 techniquesto 03 techniques

Walberg 1925, 1940 received Nobel prize for Walberg 1925, 1940 received Nobel prize for discovery that cancer can not grow in pure oxygen discovery that cancer can not grow in pure oxygen

Uses in DentistryUses in Dentistry

Main idea is to enhance a better outcome in everything we Main idea is to enhance a better outcome in everything we do!do!

Caries Caries

Periodontal DiseasePeriodontal Disease

Infections/Trauma/LesionsInfections/Trauma/Lesions

Prosthetic LongevityProsthetic Longevity

Tooth/Root HypersensitivityTooth/Root Hypersensitivity

Teeth WhiteningTeeth Whitening

RCT Disinfection/SterilizationRCT Disinfection/Sterilization

TMJ/TP InjectionsTMJ/TP Injections

Orthodontic Decalcification PreventativeOrthodontic Decalcification Preventative

PrePre--surgical mouth rinsesurgical mouth rinse

Smile!Smile!

ResearchResearch

Over 726 articles in 2007 on clinical uses of Over 726 articles in 2007 on clinical uses of Ozone in DentistryOzone in Dentistry

Healzone unit by Kavo available in every Healzone unit by Kavo available in every country except U.S. for another 2 years due country except U.S. for another 2 years due to FDA designating ozone as a drug and to FDA designating ozone as a drug and requiring clinical trials. CMU3 by lime requiring clinical trials. CMU3 by lime technologies.technologies.

Ed Lynch (England) & Julian Holmes (South Ed Lynch (England) & Julian Holmes (South Africa) Top researchers in the field.Africa) Top researchers in the field.

Characteristics of OzoneCharacteristics of Ozone

BactericidalBactericidal

VirucidalVirucidal

FungicidalFungicidal

Paracital Paracital

BiofilmBiofilm (gelatinous aggregation of microbes) is (gelatinous aggregation of microbes) is the Biggest Issue in Dentistry and its Oral the Biggest Issue in Dentistry and its Oral Systemic Link to cardio, pulmonary, diabetes & Systemic Link to cardio, pulmonary, diabetes & premature births. premature births.

Bacteria in Biofilm are 1000X more resistant to Bacteria in Biofilm are 1000X more resistant to antibiotics than the same bacteria not in Biofilm!antibiotics than the same bacteria not in Biofilm!

If you donIf you don’’t get rid of the pedicle (biofilm) & biot get rid of the pedicle (biofilm) & bio-- molecules all the other adjuncts wonmolecules all the other adjuncts won’’t help t help (fluoride, Ca, Phosphate, Zinc etc(fluoride, Ca, Phosphate, Zinc etc……

Mechanism of ActionMechanism of Action

O2 +O = O3 (activated by ozonater)O2 +O = O3 (activated by ozonater)

O3 = O2 + O (reactive oxygen molecule)O3 = O2 + O (reactive oxygen molecule)

Ozone is an oxidant (negatively charged)Ozone is an oxidant (negatively charged)

Infected tissue (positively charged)Infected tissue (positively charged)

Therefore itTherefore it’’s drawn into the infected tissue s drawn into the infected tissue changing an anaerobic environment to an aerobic changing an anaerobic environment to an aerobic one!one!

Our own antibodies naturally produce O3 during Our own antibodies naturally produce O3 during bacterial killing in Inflammatory tissues. (Scripps bacterial killing in Inflammatory tissues. (Scripps research institute)research institute)

Mechanism continuedMechanism continued

All healthy tissues have AntiAll healthy tissues have Anti--oxidants/enzymes thus are oxidants/enzymes thus are protected from oxidants like O3. They contain super oxide protected from oxidants like O3. They contain super oxide dismutase, cellulase, catalase etcdismutase, cellulase, catalase etc……so they can quench so they can quench that reaction versus pathogenic cellsthat reaction versus pathogenic cells

Therefore, O3 gets rid of mixed infections via this process Therefore, O3 gets rid of mixed infections via this process of disinfection & differentiation into stem cells & new tissue of disinfection & differentiation into stem cells & new tissue growthgrowth

Oral Microbiology & Immunology Article: low dose Oral Microbiology & Immunology Article: low dose 4mg/liter 10 sec exposure to O3 H2O in mouth revealed no 4mg/liter 10 sec exposure to O3 H2O in mouth revealed no sign of bacterial life!sign of bacterial life!

Causes cell wall membrane death in 120 sec vs. distilled Causes cell wall membrane death in 120 sec vs. distilled H2OH2O--no difference in bacterial colony.no difference in bacterial colony.

NatureNature’’s antibiotic with no byproduct/residue that s antibiotic with no byproduct/residue that stimulates immune system achieving homeostasisstimulates immune system achieving homeostasis

Absorption Into TissuesAbsorption Into Tissues

O3 gas injection goes into solution instantly O3 gas injection goes into solution instantly with plasma and interstitial fluids.with plasma and interstitial fluids.

Breaks down to O2 and O (reactive oxygen)Breaks down to O2 and O (reactive oxygen)

Then into H2O2 and lipid oxidation products Then into H2O2 and lipid oxidation products causing causing Apoptosis ( cell fragmentation Apoptosis ( cell fragmentation with no damage)with no damage) and immune response and immune response versus Necrosis which is a damaging versus Necrosis which is a damaging sudden deathsudden death

Vascular Enhancement ProcedureVascular Enhancement Procedure

In periodontium O3 stimulates vascular In periodontium O3 stimulates vascular plexus plexus

Opens compromised vascular bedsOpens compromised vascular beds--makes makes Nitric OxideNitric Oxide--(highly reactive)(highly reactive) via gas via gas infusion!infusion!

Enriches Anoxic tissue via oxygen infusionEnriches Anoxic tissue via oxygen infusion

Stimulates local release of Cytokines to Stimulates local release of Cytokines to activate & regulate Immune responseactivate & regulate Immune response

Supports lymph drainageSupports lymph drainage

Stimulates Antioxidant systemStimulates Antioxidant system

PrecautionsPrecautions

Only two tissues in our body are not Only two tissues in our body are not protected with antiprotected with anti--oxidant enzymes to oxidant enzymes to quench O3. (quench O3. (eyeseyes and and nasalnasal membranes)membranes)

Maximum exposure to O3 gas can causes Maximum exposure to O3 gas can causes rapid breathing and chest irritation lasting 30 rapid breathing and chest irritation lasting 30 minutes then subsides (use fan in the room)minutes then subsides (use fan in the room)

If exposed can give Vitamin C 1000mg with If exposed can give Vitamin C 1000mg with water and O2 as neededwater and O2 as needed

Dental Modes of DeliveryDental Modes of Delivery

Irrigation with O3 waterIrrigation with O3 water

Insufflation O3 gas Insufflation O3 gas

Infusion(Injection) O3 gasInfusion(Injection) O3 gas

Total Saturation technique with custom traysTotal Saturation technique with custom trays

Application with O3 Olive OilApplication with O3 Olive Oil

P s: also works well to kill biofilm in dental unit P s: also works well to kill biofilm in dental unit water lines if mixed 50:50 in water bottle water lines if mixed 50:50 in water bottle attachment!attachment!

Can sterilize operatory with Ozone Air PurifiersCan sterilize operatory with Ozone Air Purifiers

Ozone as a pharmaceutical way of Ozone as a pharmaceutical way of dealing with carious infectionsdealing with carious infections

No need for numb, drill and fill anymore!No need for numb, drill and fill anymore!

Once a tooth has a Once a tooth has a ““holehole”” or cavity it wall always or cavity it wall always have a holehave a hole-- cancan’’t regenerate a hole.t regenerate a hole.

However, we can use O3 to eradicate & arrest However, we can use O3 to eradicate & arrest disease then influence a sterile tooth to take up disease then influence a sterile tooth to take up minerals (MI Pasteminerals (MI Paste--plus or nonplus or non--fluoride Novamin fluoride Novamin paste) paste)

In the 21In the 21stst century we can harden a soft tooth!century we can harden a soft tooth!

ItIt’’s not pulpal exposure that kills the nerve, its not pulpal exposure that kills the nerve, it’’s the s the bacterial infection! Prevent carious exposures.bacterial infection! Prevent carious exposures.

Deep Caries Treatment with OzoneDeep Caries Treatment with Ozone

Remove decay keep the leathery infected dentin Remove decay keep the leathery infected dentin after you O3 gas(40after you O3 gas(40--60 sec) remineralize it place 60 sec) remineralize it place fuji triage or glass ionomer wait 3fuji triage or glass ionomer wait 3--4 months to get 4 months to get hard remineralized tissue. Then remove fuji and hard remineralized tissue. Then remove fuji and place restorative resin.place restorative resin.

Leathery dentin will remineralize thru fuji or Glass Leathery dentin will remineralize thru fuji or Glass Ionomer and pulpal tissue whereby we are Ionomer and pulpal tissue whereby we are preserving pulp tissue and vitality at the same preserving pulp tissue and vitality at the same time.time.

We have all seen decay halt ,arrest, reverse but We have all seen decay halt ,arrest, reverse but didndidn’’t know exactly why?t know exactly why?

J Holmes study showed O3 treated lesions got J Holmes study showed O3 treated lesions got 100% reversal in 18100% reversal in 18--24 months. A remineralized 24 months. A remineralized lesion will never relesion will never re--decay in the same spot!decay in the same spot!

Treating root sensitivity with O3Treating root sensitivity with O3

Treat buccal root with O3 gas 40 secTreat buccal root with O3 gas 40 sec

Place remineralizing solutionPlace remineralizing solution

Treat again for 40 secTreat again for 40 sec

Immediate relief lasting yearsImmediate relief lasting years

O3 use to sterilize teeth before O3 use to sterilize teeth before cementing crown and bridge, cementing crown and bridge,

sealants, & fillingssealants, & fillings

Eliminate post op sensitivityEliminate post op sensitivity

Ability to bond to hard tooth surface not Ability to bond to hard tooth surface not mush!mush!

If we whiten teeth must wait 2 weeks to do If we whiten teeth must wait 2 weeks to do filling due to hydroxyl ion decreasing bond filling due to hydroxyl ion decreasing bond strength by 80% but if you use O3 increase strength by 80% but if you use O3 increase bond strength/desensitize and can bond bond strength/desensitize and can bond same day as whitening.same day as whitening.

O3 use in arrestment of periodontal O3 use in arrestment of periodontal diseasedisease

Synergy of therapeutics (Vit B12,folic acid, Synergy of therapeutics (Vit B12,folic acid, Ozone, Nutritional therapy, and structural Ozone, Nutritional therapy, and structural therapytherapy

Keeping the balance between water, Keeping the balance between water, probiotics and enzymes by probiotics and enzymes by manipulationmanipulation of of oxygenoxygen

See Dr Mollica videoSee Dr Mollica video

Protocol for Periodontitis treatmentProtocol for Periodontitis treatment

Sulcular pathogenic reduction lavage (Dr. Sulcular pathogenic reduction lavage (Dr. Kennedy protocol) irrigation with O3 water in Kennedy protocol) irrigation with O3 water in perio pockets to reduce septicemia/bugsperio pockets to reduce septicemia/bugs

Srp/quads & re irrigate pocketsSrp/quads & re irrigate pockets

Insufflation of sulcus with O3 gas Insufflation of sulcus with O3 gas (maxiprobe) stops bleeding & pus.(maxiprobe) stops bleeding & pus.

Total saturation technique (10 minutes)Total saturation technique (10 minutes)

Make custom trays with evacuation port.Make custom trays with evacuation port.

Other soft tissue applicationsOther soft tissue applications

Tonsil infusionTonsil infusion-- inject O3 gas into tonsilsinject O3 gas into tonsils

Apply Ozonated olive oilApply Ozonated olive oil-- no longer ozone no longer ozone when in oil form. Becomes ozonide and when in oil form. Becomes ozonide and doesndoesn’’t irritate mucous membranet irritate mucous membrane

In bone marrow get stem cell releaseIn bone marrow get stem cell release-- building new cartilage and bone.building new cartilage and bone.

Bisphosphonate induced osteonecrosis of Bisphosphonate induced osteonecrosis of the jaw can be influenced by O3 in the the jaw can be influenced by O3 in the balance of osteobalst/osteoclast changesbalance of osteobalst/osteoclast changes

O3 treatment of Soft tissue injuryO3 treatment of Soft tissue injury

Apthous ulcers and herpes sores can be Apthous ulcers and herpes sores can be resolved in 3 days and become pain free in resolved in 3 days and become pain free in 20 minutes by using O3.20 minutes by using O3.

Mersa infections and skin burns can use O3 Mersa infections and skin burns can use O3 gas and olive oil application at site.gas and olive oil application at site.

In Russia and Cuba we donIn Russia and Cuba we don’’t see many t see many cases of Mersa since they are not overusing cases of Mersa since they are not overusing antibiotics.antibiotics.

So why arenSo why aren’’t we using O3 in western t we using O3 in western world?world?

What Ozone WonWhat Ozone Won’’t Dot Do

It wonIt won’’t regenerate a tooth but will t regenerate a tooth but will regenerate nerve tissue.regenerate nerve tissue.

Replace lost enamel/dentinReplace lost enamel/dentin

Revitalize nonRevitalize non--vital teethvital teeth

Remove dark carious staining in 60 Remove dark carious staining in 60 secssecs

Reach deeper into teeth than 5Reach deeper into teeth than 5--6mm6mm

Eliminate need for rotary instrumentsEliminate need for rotary instruments

Make everyone younger?Make everyone younger?

Benefits of OzoneBenefits of Ozone

ItIt’’s cost effective s cost effective

Saves tooth tissue vitality & avoid exposuresSaves tooth tissue vitality & avoid exposures

DoesnDoesn’’t interfere with dentin bond strength or t interfere with dentin bond strength or material retentionmaterial retention

No anesthetic neededNo anesthetic needed

Patients prefer itPatients prefer it--non invasive as drillingnon invasive as drilling

Bacteria can never develop resistance to O3Bacteria can never develop resistance to O3

Key to itKey to it’’s predictability is the elimination of acid s predictability is the elimination of acid niche environment, bacteria & their bioniche environment, bacteria & their bio--moleculesmolecules

*Holmes/Lynch clinical removal of occlusal fissure *Holmes/Lynch clinical removal of occlusal fissure caries using ozone. >95% caries reversed at 24 caries using ozone. >95% caries reversed at 24 monthsmonths

FDAFDA

1978 FDA report:1978 FDA report:

1.5 million people hospitalized by 1.5 million people hospitalized by pharmaceutical side effectspharmaceutical side effects

140,000 deaths from prescription drug usage140,000 deaths from prescription drug usage

1980 German Medical Society report on O3:1980 German Medical Society report on O3:

5.6 million ozone treatments carried out5.6 million ozone treatments carried out

40 reported cases of side effects(.000007%)40 reported cases of side effects(.000007%)

No deaths from ozone ever reportedNo deaths from ozone ever reported

Which report are you happy with?Which report are you happy with?

In conclusionIn conclusion

Take a course to get certified and trained Take a course to get certified and trained

Purchase or build the equipment that uses Purchase or build the equipment that uses pure medical grade oxygen to generate O3pure medical grade oxygen to generate O3

Dr. Bill Domb in Upland Ca. Contact info on Dr. Bill Domb in Upland Ca. Contact info on disc provided.disc provided.

IntrospectionIntrospection