This article will define ozone and the practical applications for
the dental practice. This information will enable the dental pro-
fessional to answer questions from patients and decide if this is
a therapy that can be adopted into their armamentarium.
After studying this course, the dental professional should
be able to:
1. Define medical/dental ozone
2. Understand how ozone is generated and the modes of application
3. Identify clinical applications for ozone in the dental practice
4. Answer potential questions raised by patients about ozone
With health-care costs on the rise, patients are becoming more
aware of their treatment options and are looking for dental care
that is cost effective and minimally invasive. Dental offices may
receive calls from patients requesting information about or asking if the office provides ozone therapy. This article discusses
ozone therapy and the practical applications for the dental office to prepare practitioners and staff to serve the needs of this
What is ozone?
Ozone is a naturally occurring gas that contains three atoms of
oxygen versus two atoms in a normal oxygen molecule. This
extra atom of oxygen acts as a hunter, killing pathogens such
as bacteria, viruses, fungi, and parasites.
1 Healthy cells are
enveloped with an enzyme coating consisting of antioxidants
that prevent them from being penetrated by ozone. Bacteria
and viruses lack this protective coating. When subjected to
ozone therapy, the cell wall of bacteria is disrupted, making it
vulnerable to oxidation of the phospholipids and lipoproteins.
This peroxidation process interrupts the reproductive cycle
of viruses, damaging its viral capsid, and in the case of fungi,
ozone inhibits cell growth.
2 Destruction of the cell membrane
of pathogens results in a disinfecting or sterilizing effect.
Due to its ability to eliminate pathogens, ozone is most
commonly used in the sterilization of public water systems, the
food and bottled beverage industry, as well as in air purification.
3 Ozone therapy is being used in the medical, veterinary,
and dental fields to prevent and treat many diseases and conditions.
4 Use of ozone in controlled applications has been found
to be safe and free from side effects.
History of ozone
The discovery of ozone in 1840 happened by chance from a
strong smell produced when Professor Christian Schonbein
was exposing oxygen to electrical charges in his lab. He realized
that the odor was being caused by a gas, which he named ozone.
During World War I, Dr. Hans Wolff used ozone to treat sol-
Generation of ozone
diers with gunshot wounds, inflammations, and abscesses; he
published the successful results of his work in 1915. The first
dentist to use ozone gas and ozonated water in his practice was
Dr. E. A. Fisch in 1932. One of his patients was surgeon Dr. E.
Payr, who was so impressed with the therapy that he applied its
methods to general surgery and published “Ozone Treatment
in Surgery” in 1935. The first medical ozone generator was
presented in 1958 by Joachim Hansler, which made it possible
for the therapeutic modalities of ozone used today.
In nature, ozone gas is present in atmospheric air. Reproducing
this gas in industry and medicine involves three methods:
1. The ultraviolet method produces a low concentration of
ozone and is used to purify air.
2. Cold plasma is used to purify water and air.
3. Corona discharge is used in medical and dental therapies.
The operator is able to control the production rate, and
this method is capable of generating high concentrations of
Application of ozone in dentistry
Ozone for dental therapies is administered to patients in three
forms: gas, water, and oil. Ozone gas is created by taking pure
medical grade oxygen and electrically charging it through a
generator. It is delivered to the patient via a handpiece fitted
with a small cannula, small cup, or by injection.
Ozonated water is used in water supply bottles to disinfect
water lines that supply ultrasonics, high speed handpieces, and
air/water syringes. Used as a pretreatment patient rinse, it re-
duces aerosol contaminants during procedures.
Ozone gas changes into ozonides when diffused into oil.
When ozone gas is bubbled through different types of vegetable
oils, it retains its healing properties for many years. Ozone oil
is used topically for oral lesions, in endodontics to lubricate and
disinfect canals, in periodontal therapy to treat pockets, and
after extractions to promote healing.
Unlike many disinfectants available in dentistry, ozone has
no side effects such as a bad taste or smell and is safe for the
environment, making it an excellent treatment modality for
every aspect of dentistry.