More Learning

Dr. Coker spent a long week-end in Upland, California at the office of William Domb, DMD, studying a new treatment that has been used successfully in Europe for years. As we know, Dr. Coker loves to stay on the cutting-edge of his profession.

Upland is a city about the size of Tyler in Southern California near Los Angeles.

The topic at the workshop was the use of ozone for decay and periodontal disease. Here’s an article written by Dr. Julian Holmes, the world’s #1 dental researcher and developer of ozone technology which will explain the miracle of ozone dentistry.

Miracle Ozone Dentistry –
A New Anti-Decay
Dental Practice
By Dr Julian Holmes

Let me paint you a picture. Every Monday morning, dental practices over the world power up for a week’s worth of drilling and filling, tooth removal, and reconstruction work. Queues of fearful patients, tearful children being comforted by anxious parents, people in considerable pain, line up outside the doors to their dental surgeries. Once inside, these patients are subjected to the traditional smells of oil of cloves, disinfectants, and the noises of the high pitch whine of the dental drill; the odd scream or two filters through the hushed, usually silent waiting room into the street outside. It is a sad fact of life that every dentist is trained that if there is an area of decay in your tooth, the only way to treat this is to drill the decay out or amputate it, and then place a filling that will have to be replaced at some stage.

For a small minority of patients, where their dental practices have chosen to invest in a new technology, the opposite happens almost every day. The queue is one of bright, cheerful adults and children; there are few smells to associate this practice with the traditional one down the road. The noise of the drill is seldom heard, and happy smiling faces emerge from the treatment room.

Since 1998 researchers, lead by Professor Edward Lynch from Queen’s Dental Hospital and Belfast University, Ireland, have opened a radically and revolutionary way forward. The dental profession no longer has to destroy tooth tissue to eliminate bacteria. A simple 60 second (average treatment time) treatment with a device that delivers a burst of ozone will destroy all the bacteria that caused the infection and the decay. It destroys all the organic effluents that are produced by these bacteria. By effectively sterilising the lesion, minerals from the patients own saliva will re-enter the areas of mineral loss to harden them. Once hardened, it is more resistant to future bacterial attack and mineral loss.

There is in all our mouths a natural balance. Your tooth surface loses minerals into your saliva at certain times, usually just after you start to eat. These acidic conditions favour mineral loss. The normal acid/alkaline balance exists in the oral cavity. When bacteria attach themselves to a tooth surface, they set up a complex community of some 450 different bacterial types over a period of time. If patients skimp on using a tooth brush, or forget to use dental floss on a regular basis, these communities of bacteria evolve into one which produces large volumes of acids. These acids attack the tooth surface, dissolving out the minerals, leaving a hole or cavity. As this cavity now gives the bacterial colonies a degree of protection, tooth brushing cannot remove the bacteria and so the process of decay accelerates.

Yet decay is only an infection process that leads to the softening of the tooth, and the formation of a cavity, so could this infection be treated with, say, antibiotics? The bacteria that cause tooth decay are often found deep within the structure of the tooth, so their removal has to date only been by amputating the infected part of the tooth. Antibiotics and other pharmaceutical agents cannot penetrate deep enough through bacterial pellicle and tooth structure to eliminate acid niche environment. This teaching and technique is based on sound engineering principles that originate from the Victorians! Despite modern advances, there is no simple test that can be applied to a cavity to tell the dentist if they have removed all the infection! And if areas of infection are left behind, there is a good chance that the filling placed will fail at some time in the future.

In an attempt to prevent further infection and to restore the tooth to its original shape and function, a filling is then placed. Studies over the years have shown that fillings do not last very long, any where from 6 months to several years. But once a tooth has had part of it amputated, there is no going back. For each time the filling needs to be removed and replaced, there is a little less of the original tooth left and a larger filling. A point is reached where there is no option but to opt for expensive reconstruction work with advanced dental care or have the tooth removed.

The dental professions goal is to help and educate the patient, how to avoid them entering into this cycle of tissue amputation and periodic filling replacement. Oral care education and modern toothpastes have helped reduce the number of cavities, but in poorer communities, those with disabilities and in long term institutions, as well as our aging population, decay is still prevalent. And diet advice is often lacking, so although patients may think they are doing well at home, the process of decay continues! The days of ‘Wait & Watch’ are over ­ the profession is not entirely sure of what it is watching unless clinicians are using advanced clinical diagnostic tools.

Dental Ozone is a completely new way to look at decay. In the early stages of mineral loss, no use of the drill is required. The treatment is simple, inexpensive (certainly less than the cost of a filling), and requires no injection of anaesthetics. This does of course depend on the use of modern diagnostic equipment, such as the DIAGNOdent (KaVo GmbH). This laser is more accurate than x-rays, and far superior to the traditional mirror and probe that dentists often use. The mirror and probe are tools that can find holes, not diagnose areas of first stage decay. And research has shown that x-rays are very poor to visualise decay in a tooth surface, until it is 2-3 mm inside the inner layer of the tooth.

When Ozone is combined with traditional care, then there are a number of advantages that patients and the dental profession can make use of. Ozone can be used to sterilise a cavity before a filling is placed, so there will be virtually no sensitivity after the local anaesthetic wears away. It can be used to eliminate sensitivity after new crowns or veneers are placed. And where wear facets have produced sensitive areas at the necks of teeth, in most cases a simple 40 second application with ozone can eliminate this sensitivity. There are many more applications for Ozone in a general dental or medical practice, and the studies for some of these can be found on

There is not a single facet of a medical, dental or veterinary practice where ozone cannot be used in some form for the benefit of patients ­ from the general to specialist practice and health care centre all can take advantage of this new technology.

So, perhaps a Monday morning at a dental practice that has invested in modern technology is no longer the stressful, painful and anxious visit that it used to be. The waiting room in this practice are full of smiles, people chatting to the dental team members as they wait with happy anticipation at being called through for their turn in the treatment room. Mums and dads with children have no fear or anxiety, as they are reassured that modern technology has opened a door for them, that most of the older population had never believed possible. For both the patient and the dental practice, it is a technology that has a winning solution for both; the treatment is fast, it is predictable, it is painless, and also reduces the long-term cost of the treated tooth. For the dental practice, the treatment times are reduced, it is profitable, and the treatment less stressful. For the patient, modern technology has allowed them to have a 21st century treatment, rather than one that is old fashioned, and out-dated.