You MUST read this!

At this stage of my knowledge growth, it’s rare that I learn something that is a revolutionary advance beyond my information base. The office is now implementing just such an advance, and we couldn’t be more enthusiastic. Caroline, Lynn, and I attended a course on “Ozone Use in Dentistry” in late February, and returned from a long weekend in rainy California more excited than after any course in our memories.

So what’s the big deal? Every one of you has encountered ozone in its industrial use. It disinfects municipal water supplies, the water in hot tubs and in the Coca Cola you drink, and the air in public rest rooms. The same ozone that can be an EPA-labeled pollutant in large quantities is extremely safe if used in a controlled environment in calibrated doses. Where the U.S. lags behind the rest of the industrialized world is in the medical uses of ozone. Ozone can be injected into joints to kill bacteria that may be linked to certain kinds of arthritis, and can have tremendous benefits in wound healing. It is the safest and most potent killer of bacteria, viruses, and even prions (those annoying little things that cause Mad Cow Disease). The FDA has classified ozone as a “new drug” (I know this to be true at least for dental use, and it may also be a roadblock to its medical use; I’ve been following ozone’s dental use for years, but am far from expert about its medical use), which severely impedes ozone use in the U.S.. This “new drug” has been in medical use since the 1850s. Medical and dental ozone research is way ahead of the U.S. in England, Ulster (Northern Ireland if you like), South Africa, Australia, New Zealand, Germany, Russia, and even Cuba! And we lag behind. I believe that I am one of only three dentists in Pennsylvania, and one of only two in the Philly metro area, who is trained to use ozone. 

How can ozone help you? Every day, our office waterlines are disinfected with ozonated water. This is the most effective killer of waterline biofilm ever developed. OK, so what is biofilm? Biofilm is the gunk that builds up inside thin-diameter tubing. It consists of zillions of bacteria. Did you ever look at an ice cube from your fridge’s icemaker and see a dark, almost black, spot in the ice? That’s a piece of biofilm that has broken off from the inside of your thin copper water tubing (your icemaker wouldn’t work without water, and the water gets there through thin tubing; the thinner the tubing, the higher percent of its insides are biofilm). You just had a zillion bacteria in your martini! Many of these bacteria can be relatively harmless to you unless your immune system is compromised. Is your immune system in perfect shape? How do you know? Why chance it, especially if ozonated water can kill off the biofilm in dental water unit lines, which consist of very fine tubing—and lots of it?

The link between gum disease and heart disease is many times stronger than the link between high cholesterol and heart disease! When your doctor told you to lower your cholesterol, it was definitely time to worry. Now, for the first time, your dental team has the ability to fundamentally change the kind of bacteria in your mouth. Think about it: if you added up the gum tissue lining all your teeth, you’d have a bacteria-infested area bigger than the size of your palm. From now on, every time we’ll clean your teeth we’ll be using ozonated water in our Cavitrons (the ultrasonic devices we’ve used for many years to break up bacterial plaque and tartar). We’re using the most advanced methods available to fundamentally change the balance of germs in your mouth from good (usually aerobic, or oxygen-loving)-and-bad (mostly anaerobic, or oxygen-hating) to almost completely good. Your daily home care helps prevent the return of anaerobic bacteria, which take about three months to rebuild in the mouth after a professional cleaning under normal circumstances, but whose return will be minimized with daily brushing and flossing. Simple steps to health.

How does ozone do this?  The oxygen we breathe has two atoms of oxygen hooked together, or what is referred to as O2, Ozone has an extra atom of oxygen, so it’s O3. That extra atom of oxygen makes for an unstable compound; the O3 wants to shed its extra oxygen atom and become O2 again. So, how do anaerobic (oxygen-hating) germs react to all that extra oxygen being given off when your teeth and gums are cleaned with ozonated water? They die, and they die in large quantities.

When you have a teeth-cleaning in our office, ozone-water is pumped through the cavitron (the device that vibrates tartar off your teeth and removes biofilm). You get the benefits of the Cavitron PLUS the germ-killing abilities of ozone.

Here’s a good analogy for the women who are reading this newsletter: did you ever take an antiobiotic and then get the dreaded yeast infection afterwards (you don’t have to email me your answers. I already know. A dentist is actually a kind of a doctor, remember?). The yeasts grow wild because the antibiotic kills good and bad bacteria. The yeasts fill the void where good bacteria used to be. Ozone kills the anaerobic germs, and, equally important, it kills their waste products; what is scientifically known as “germ-poop.” What fills in the void when the bad germs are gone? Good germs. What do your coronary arteries say to that? “Thank you from the bottom of my heart.”

Let’s sum up what we’ve shared so far. Ozone kills bad germs and germ-poop. There’s a strong correlation between gum disease (a contagious BACTERIAL infection) and heart disease. So, for the first time, we have the capacity to modify what’s in your mouth to make your entire body more conducive to a state of health. That’s why we’re so excited! I became a dentist to help people, because my terrific-role-model childhood dentist so obviously wanted to help me and his other patients. He lived for that, as do I. Now, I can help people more than ever before in a way that I never dreamed could be. I’m totally jazzed by this!

Now for the obligatory legalese. If ozone has not received FDA approval, can it legally be used in the U.S.? The answer is an unequivocal “YES.” Dr. Atkins, of the famous Atkins Diet, used ozone in his medical practice. He told his patients of the potential risks and benefits; in other words, he received what the law calls “an informed consent.” He was prosecuted over his use of something not approved by the FDA. The court ruled that he had the right to use what he felt could help his patients as long as he informed them of the risks and benefits. And I have that right, too. The court ruled that the FDA did not have the legal right to interfere in this process. Every day, doctors prescribe drugs for what is called “off-label” use, that is, a use that has not been approved by the FDA but has been shown by research and/or experience to be potentially beneficial to the patient. Sodium hypochlorite has been used by thousands of dentists on millions of occasions as a germ-killer during root canal treatment, and that is a perfect example of an off-label use; the FDA has not approved sodium hypochlorite for this use, yet it is used safely every day in dental offices across the country. It is, in fact, almost universally accepted in dentistry specifically for that use.

So, it’s time for a little more legalese. What are the risks to you of my using ozone in my dental practice? Well, I wouldn’t jet the stuff into the air in huge quantities or squirt it down people’s noses or into their lungs; it can cause mucho coughing if abused that way. For that reason, I use ozone in a “closed system,” e.g., ozone gas is applied to teeth under a sealed silicone “dome:” our high-speed suction (the vacuum-cleaner thing, to our child patients) sweeps away ozone that might escape the seal. Ozonated water poses no risks I can think of, as it rapidly releases plain old oxygen, the stuff you breathe anyway. Ozonated oils have had ozone gas bubbled into an oil (olive oil is very commonly used; Rachel Ray and Mario Batali would be proud!). They contain no ozone, but do contain ozone derivatives that can be stable for YEARS. So, ozone as used in my office poses no significant risks, and my team and I have taken great care to make it so.
Gum and bone disease: a silent dental problem

Gum and bone disease, also called periodontal disease, is a leading cause of tooth loss in adults. This disease is a gradual process; how fast it spreads and how much damage it causes are dependent on your genetic susceptibility, your home care level (fanatics tend to do well; non-flossers don’t), whether or not you smoke (smokers are at higher risk), hormonal issues (pregnant women are more likely to develop gingivitis), and how often and how well you have your teeth professionally cleaned. This disease frequently is entirely painless.

X-rays, visual examination, and periodontal charting are the key tools in diagnosing periodontal disease. Many of our adult patients have told us that they’ve never had a periodontal charting before, and that no one ever sat down and explained to them the importance of home care and showed them how to brush and floss. My profession has failed the public in these cases; early diagnosis and treatment of this disease is crucial.

Gingivitis is the first stage of gum and bone disease. The gums become inflamed and swollen and may bleed easily. Fortunately, the jawbone that anchors the teeth has NOT been damaged yet, so gingivitis can be completely reversed to healthy gums. It usually takes a good cleaning (and sometimes an even more thorough procedure called root planing), good home care on your part, and, sometimes, the use of antibacterial rinses.

Periodontitis is the more severe form of gum and bone disease. In periodontitis, the inflamation has spread to the bone. The bone rots away, cell by cell and layer by layer. The more severe the process, the more bone you lose. Eventually teeth become loose and may have to be removed because there is no bone left to hold them in. The bone loss can be so severe that precious little bone is left to hold a denture in place. Periodontitis can be arrested—its progress can be stopped and the inflammation substantially reduced or even eliminated—but the lost bone will never grow back. The treatment for periodontitis is root planing, sometimes followed by minor surgery performed by a periodontist (a specialist in gum and bone disease).

Much research has linked gum and bone disease with whole-body health. Untreated periodontitis can make you much more likely to have a heart attack or stroke. In pregnancy, this disease has been linked to an increased chance of premature and low-birthweight babies. People with untreated gum disease can get mouth bacteria traveling throughout the body just from chewing food!

The goal of all periodontal treatment, including routine cleanings, is to see that the turtleneck sweater-like collar of gum tissue around your tooth can be totally cleaned by your brushing and flossing. Research has shown that the average person can only clean these crevices to a depth of about 3 millimeters…about an eighth of an inch. Obviously, the best “treatment” is to prevent this disease before it starts and before the crevices deepen to a point where they’re difficult to clean.