In the past few months we have received several questions about ozone therapy for dental problems. A few patients have even installed ozonators in their homes to help with various medical conditions.

While I can’t speak of ozone in other medical fields, ozone therapy in dentistry is coming of age. It is used to disinfect teeth with cavities and is used to disinfect the root canal prior to filling it. While there is promising research to suggest it works, the difficult question is how long will the tooth or root canal stay disinfected.

Ozone treatment for cavities: There are currently three ozone machines that can disinfect tooth decay beneath the enamel. Certain protocols call for two or three one minute applications to kill the bacteria. Heavy remineralization therapy is also recommended.

Ozone treatment for root canal therapy and disinfection: The same ozone machines are being used to disinfect roots after cleaning out the nerves and blood vessels. There’s a problem with this scenario however. Root canal therapy is like putting a cork on an infection. Many bacteria are persistent and can flourish in the harshest conditions, including a root canal.

Dentin in teeth are made of tubes called dentinal tubules. If you line up the tubules end to end for the average tooth, it would extend 3 miles. What that means is that we expect a disinfection procedure during root canal therapy to clean 3 miles of tubes that may contain bacteria. Studies have shown that ozone (and laser therapy in dentistry) can disinfect canals and keep them clean for about a year. But after that first year, bacteria finds a way back into the tubes. These bacteria can change from aerobic to anaerobic bacteria. Since there’s no blood flow after filling the root canal space, there’s no way for the body to fight these bacteria. They produce toxins and can release these toxins out of the root (although not through the root canal).

Also, after you fill the root canal with gutta percha or even biocalex or endocal, there’s no way of going back in to re-disinfect the tooth without “opening the tooth” once again. Who would want to have this procedure — root canal therapy — done every year?

You also have to consider what’s happening to the bacteria surrounding the tooth root and in the bone. People, including dentists, forget about the tissues surrounding the tooth, instead focusing on what they can see, the teeth. These infections are sometimes more harmful than the bugs in the dentinal tubes. The abscess or infection in the bone can get into the bloodstream and travel elsewhere. It can also cause disturbances in the meridians (causing problems in distant organs).

Ozone and laser therapy do little to help with these infections (cavitations).

The only incidence where I’d routinely use ozone or lasers for root canal therapy is when the immune system is working 100% efficiently, the tooth can’t easily be replaced, there’s no infections around the root or if it is a front tooth (central incisor). Even then, I’d still recommend an extraction for long term health reasons. (and none this speaks to the potential side-effects of ozone therapy, which are still being researched and discovered).

In summary, ozone and lasers would be good for beneath the surface cavity disinfections, but not for long term root canal disinfections. The technology is promising but if overall health is your primary goal, the avoidance of root canal therapy through prevention is the key. Or if your choice lies between root canal therapy or extraction, choose extraction.