Assessing HealOzone

[letsconnect]

HealOzone is an extremely interesting new technology, except that credible, large-scale scientific studies are non-existant, as a recent Cochrane report pointed out. The fact that this report came to the conclusion that the effects of HealOzone cannot be proven at present does not mean that it doesn't work. My own personal opinion on the matter is that I do believe in the efficacy of various remineralizing agents used in conjuction with HealOzone, but I'm still undecided on the effects of ozone itself. It may well work, but maybe it's very technique-sensitive and dependent on achieving a good seal etc., I don't know.

Anyway, I decided to ask a long-term user of the HealOzone unit to share his opinions, which I found to be very thoughtful and well-balanced - hence I'd like to share them here:

"it is not the panacea that some dentists would have us believe. We have had everything from no results to very good results with Ozone treatment. I think as a treatment modality it at present lacks predictability but like any new technology I think this may come with time.

We deliberately downplay Ozone on our web site as it has a tendency to raise peoples hopes and they are then disappointed when they find out that it is not suitable for use in their situation. I think dietary considerations and eliminating the true causes of decay are an important first step after which the Ozone may well haev a role to play. Alas it is human nature to want things to work the other way around.

My main concern is that the ozone protocols have evolved rapidly and patients treated early on may require practitioners to re-visit these areas. Almost every dentist stresses the need for long term follow-up with Ozone so this should not be a problem but I don't want to see this treatment modality get a bad reputation on the basis of the early learning curve that we all have to follow with any new treatment.

Generally I see it as a useful tool to have available to me but I do not think it should be used as a marketing aid to anxious patients as typically at presentation someone who has not been for a while may have more extensive decay that ozone can cope with. That said if Ozone is suitable then this can be a really pleasant surprise that no needles are required during treatment.

Our current approach to care focuses on identifying the causes of tooth decay and gum disease in our patients first and showing them how to stop the disease process themselves before we go on to any major restorative work in the practice. This seems to work really well especially for our more anxious or phobic patients as once the disease process is controlled we generally have much more time then to deal with any necessary fillings etc at a pace that genuinely suits our patients."

[letsconnect]

Interesting post on sci.med.dentistry today by Alexander Vasserman DDS:

"The ozone machine works.
after 40 seconds per site and 1 month later caries which gavúe the
explorer a stick becomes rock solid 8/10 times.
The dentin can be bonded to without problems and this was tested.
Although the company claims the ozone penetrates 4mm into dentin,
realistically it is only 2mm.
It also is affective against apthous ulcers and herpies. The pain associated with these lesions goes away after 2-3 days.
Recommended cost is similar to a composite filling.

I can't go into how I know this because of legal concerns.

The chemistry behind this has to do with oxidation inside the dentinal tubules and killing of strep mutans by creating an alkaline environment inside the tubules. The exact mechanism has not been documented and is poorly understood at this time.
If you are treating a tooth you want to place a very crappy leaky temporary filling so that reminiralization can occur.
The machine is being used in CANADA by a handful of dentists who can afford to spend the big bucks. George Freedman in Toronto being one of them. He is also a big name but then again he will buy any new toy just for marketing
It looks like the cost of the machine in the US will be $28k US due to
the delays by the FDA.
I was told that in CANADA the cost of the machine can be negociated to $24K CANADIAN. I guess they had to put up with less crap.
The machine is actually made in California but is sold for export only.

Despite all of this I am not going to spend that kind of money for a $50-$350 ozone generator(made in China) inside this unit.
The good news about this ozone thing is that it is great for replenishing the ozone layer and having that fresh smell in your office. Although I've seen it eat through latex gloves since the gas is very corrosive and therefore precautions need to be made. "


Apparently they're talking about 2006 for FDA clearance in the US. Healozone (which will be marketed as Curozone in the US) is available in the UK, Canada, and quite a few other places at present. Although some dentists in the US use it anyways . Pssst - it's supposed to be a secret .

Anyway, the thing I'd personally like to see is a study comparing the effects of a healozone only, healozone and remineralization, remineralization only, and control group. Preferably a large-scale study. If it's shown that healozone has a significant effect compared to remineralization+fluoride application (Fuji something-or-other) alone, I'll buy it. I love the whole idea, though, and the design is great, too.

[letsconnect]

Looks like I'm not alone in my ponderings - some recent snippets:

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" I've had a Healozone since XXXX and was one of the first in XXX to have the machine. It has been a great experience having it and my knowledge of dentistry has come on in leaps and bounds through researching caries and remineralisation . However and theres always a however, it's not the answer to caries on its own. It also requires a thorough understanding of the caries process. It is quite a sensitive machine as its not long on the market. The ozone concentration has to be at the optimal level and this requires regular services of the machine. I still think Kavo has a lot of work to do in this area. The running costs are also high and recently one of my handpieces at $1000 has been sent back to me as unrepairable, Kavo don't want to replace it s it's out of warranty. They initially sold it enthusiastically and I believe oversold it. You can't remineralise soft mushy rot. However you can remineralise early caries and I feel as a profession thisis where we should be going.  <br>We need to focus more on diagnosis of the disease not the holes. We need to treat the disease and not the holes on their own.
I recently viewed a DVD of Hien Ngo and was blown away with this concept.

All the studies involved in the Healozone show that ozone is a potent bactericide and will be of immense benefit in the preservation of tooth structure which will form a necessary part in our treatment of the patients disease. One guy who has a good handle on it is Graham Milicich who very early on told me he felt the clinical trials were a bit skewed because they included two variables, the use of ozone with the use of Fuji VII. While I agree I also am a wet fingered dentist rather thana researcher and I think We need to use every weapon in our armoury.
I hope GC and Kavo link up to involve each other in uniting Healozone and the GC Fuji products with the MI paste to help us as a profession."

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"I am whole-heartedly in agreement with the treatment philosophies of Ngo Hein etc.
The trouble with all these multiple treatment modalities is that it is not possible to see which ones are essential and which ones are redundant. There is ample evidence that effective sealing of carious lesions arrests them (Handelman, Mertz-Fairhurst and a study by XXX).
In addition, there are also many other potent bacteriocides other than Ozone that do not cost thousands of dollars to purchase. For example, a dab of isopropyl alcohol or povidone iodine.  Both are potent broad-sprectrum bacteriocidal chemicals that cost cents to apply.  There are also some new technologies that light-activate bacteriocidal dyes.
IMHO, this is the nub of the issue.  It is not that ozone works or not (although that does still seem to be in question), but is it thousands of dollars better than a dab of alcohol?  Are there any studies that compare ozone with alcohol or povidone iodine?  Not to my knowledge but hopefully some independents studies could be done to address this issue."
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(spotted elsewhere)

[O3]

"The good news about this ozone thing is that it is great for replenishing the ozone layer and.... "



Pretty funny comment and sorely misleading.

Buying one for environmental concerns - or even under the impression it is "great for replenishing the ozone layer" - is just plain silly - and wrong.

I'm sure this was added like an afterthought, but it's very very wrong. Using .01 liters less of gasoline a year would have a bigger effect. Actually NOT using it is technically better for the environment THAN using it.

- Ozone is heavier than air.

- Ozone is very unstable.

- Ozone reacts with many, many molecules in the air. (Pollutants, bacteria, viruses, even water vapor)

- If ozone doesn't react with anything, it would probably only last around 30 minutes or so before it broke down.

- Too much Ozone (at ground level) in very high concentrations is actually a bad thing. FDA (USA) even has regulations in place for ozone-generating devices, since it can be a health risk. (Again, in high concentrations). Maximum recommended "residual level" for health is around .1 PPM. You can "smell" it around .01 - .05 PPM.

- A single lightning strike I would wager creates more ozone than a thousand of these devices would do over the course of their lifespan. (Unless you consider Ozone the pollution).


The energy expended and pollution created using and manufacturing the device would grossly outweigh any *possible* benefit of the unstable ozone in an office. It certainly will never make it to the "ozone layer".


Maybe if someone gets an ozone particle in a jacket pocket in a dentist office where it hovers, hopefully encountering no other molecules it can react with, and then immediately you go to an Airplane and while flying the cabin depressurizes and the ozone goes flying out of the plane, then somehow catches some serious updrafts for a dozen km, during which it never contacts with water vapor or virtually any pollutant.... well then it might make it to the "ozone layer" and be happy there for a few minutes.




Anyway... Sorry to get all nerdy on you. Just didn't want anyone to have any misconceptions whatsoever that these were "good for the environment" or "great for the ozone layer".

They provide no benefit to the environment - and if anything the manufacturing process and energy use harms it.

That's not to say they aren't great for eliminating smell in a room - or for medical applications - I'm sure they can be. The drill is also a good tool for dentists, but there shouldn't be any misconceptions that the drill helps the planet(environment).

I'd bet the person who said that did it more like a tongue in a cheek comment or an idle afterthought, but just thought I'd point it out


Secondly, the DDS commented that:
"Despite all of this I am not going to spend that kind of money for a $50-$350 ozone generator(made in China) inside this unit. "

I'm not a dentist - but obviously the cost isn't from the generation of ozone. It is quite easy to make Ozone.

I suspect the cost comes from three things.
1)the pre-treatment of air to make it acceptable. (removal of pollutants, water vapor, etc)
2) Delivery of the ozone
3) Elimination of the ozone that has been delivered (to meet FDA guidelines)

I see on the website they've done studies to measure the Ozone emissions in 10s and 20s applications, because the gas inside the cup is suctioned out and destroyed before the seal is broken. That's probably where most of the cost goes, I would imagine.

Given that so much of the cost of the device goes into eliminating the Ozone it uses, I also find it ironic the guy has been using it as an air freshener and to zap latex gloves =P

[letsconnect]

O3 said:

I'd bet the person who said that did it more like a tongue in a cheek comment or an idle afterthought, but just thought I'd point it out

Yeah, I'm sure it was meant as a joke - but thanks for pointing these things out (there may have been smilies in the original text which didn't copy and paste - didn't realize this might lead to some confusion .