Author; Jane Vorster & Dr Julian Holmes, Published in "YOU" 2004.

NOT so long ago when he needed to go to the dentist his mother had to drive him there and then (drag!) lead him by the hand into the surgery. He then had to be strapped into the chair and given a general anaesthetic to knock him out cold before his dentist could work on him.

Quite understandable really for someone who is a toddler, except the only problem is that Johnny Lange* isn’t a child -- he’s a strapping man in his early 20s.

"I know it’s weird. Some people fear spiders or heights but I have a phobia about going to the dentist." Johnny says. "Ever since I was a child I associated dentists with excruciating pain so even just walking through the door into the waiting room was enough to reduce me to a jibbering wreck."

"Johnny's experiance is not unique" says Dr Julian Holmes, a dentist and researcher who has been working in this field for over 20 years now. "Research published 30 years ago showed how a traumatic experience at the hands of a health care worker can mentally scar a patient for life. The problem is then it does not stop there - this traumatic experience is passed from one parent to their clildren, and so on, perpetuating the myth that health care = pain. These traumatised people will go to extraordinary lengths to avoid a visit to see a dentist or clinician".

But these days it’s a different story. The last time Johnny went for a check-up, he sat in the chair looking the picture of calm even after he’d been told he had a cavity that needed to be filled. And when his dentist set to work no anaesthetic was needed. This is because his dentist was using a revolutionary new procedure that only recently arrived in South Africa.

Instead of administering painful injections and lengthy drilling dentists can now treat an infected tooth by simply delivering a blast of ozone to the area. Ozone – that pongy stuff we can smell in the air during thunderstorms -- is the strongest natural bacteria-zapper known to man, which makes it perfect for use in the treatment of dental cavities and also to heal infections in other parts of the body.
It’s quick, effective and painless. Another plus is that your dentist may not need to fit an unsightly filling – if it’s a smallish hole all you’ll need is a tooth-coloured sealant or "smart filling" which will help your tooth heal itself until it looks as good as new.

SEEMS a lot has changed over the past few years. Gadgets that would once have sounded as though they belonged in the realm of science fiction are now standard fixtures in many dental practices.

These days instead of an old-fashioned mirror and probe, lots of dentists are making use of new technology to diagnose problems. Many use computers to take digital x-rays which are not only quicker and more efficient but also release 10 to 20 times less radiation per exposure than conventional x-rays. But even with digital x-rays a cavity needs to have eaten through three to four millimetres of enamel before it becomes visible. Many dentists are now also making use of laser diagnostic tools which when passed over a tooth are able to pinpoint early decay.
These days even if you do have a big cavity, drilling to "amputate" the infected area of the tooth may not be necessary. In fact even if a cavity is several millimetres deep it may still be possible to completely avoid the age-old drill and fill technique.

This is where ozone treatment comes in. Your dentist can use a hi-tech device to deliver a 20-to-60 second blast of ozone to kill all the bacteria around your tooth.

Ozone has been described as being a very toxic gas, but recent research suggests that earlier workers in this field were looking at pollution combined with ozone, not pure ozone that has many benificial qualities.
You won’t taste the ozone. The entire procedure will be completely pain free, removing the need for local and more importantly general anaesthetics which often leave patients, particularly children, feeling extremely groggy and can even pose a real risk in certain instances.
Once the tooth has been cleared of bacteria any leftover ozone is sucked back into the machine. If it’s a small cavity, your dentist will coat your tooth with a mineral wash which will encourage the tooth to repair itself by remineralising the surface that has been damaged by decay.
After two months you’ll need to revisit your dentist who’ll assess how well your tooth has healed and perhaps deliver another ozone blast to the affected area. Instead of a conventional filling he may apply a sealant or "smart filling" to close the fissure created by the cavity. This is good news because although these days most dentists are using composite resin fillings rather than risky mercury-based alloy amalgam ones, whenever you have a tooth filled you are weakening it, meaning that there’s a chance that in five or 10 years time you’ll need to have the filling replaced or worse, get a crown fitted. The "smart filling" releases fluoride and calcium which helps your tooth heal itself until it’s stronger than it was before. Smart fillings can also take up minerals from mouth-rinses, and then release these back into the protected tooth surface.

Ozone can also be used to treat deeper, more serious cavities. While some cleaning may be necessary to remove the contaminated tissue, if your dentist uses ozone he will not need to excavate as much as before. He may however still need to fill the gap with a conventional filling.
Ozone treatment isn’t the answer in all cases but for early decay it provides a painless alternative, says a Cape Town dentist who’s used it to treat about 200 cavities since introducing the system into his practice last April.

AT the moment the one serious drawback to ozone therapy is the cost of some of the equipment. As it’s not covered by medical aid expect to fork out between R150 to R300 per tooth. However additional costs such as the consultation fee, infection control and the application of the smart filling should be covered by your medical aid.

The South African Dental Association regards the treatment as being in its experimental stage and would want to see conclusive results from rigorous scientific studies before it would endorse it, despite ozone therapy being approved in all countries except the USA. Dr Holmes comments; " It begs the question on how much research do you need to provide before change happens. In some scientific fields, once the break through occured, it took over 50 years before the break through was hailed as just that! How many patients will these various associations around the world condem to "drilln'fill" before they wake up to the fact that the research shows beyond any reasonable doubt that ozone is here to stay? Tooth decay is an infection - in medicine we use pharmacology to treat infections - we don't amputate a finger or a leg any longer! Surly we sould be more respectful of our patients? Our first dictum should be; "Cause no harm to the Patient". Ozone allows every profession to move away from Victorian principles of amputation, and move towards a more holistic healing basis for our patients".

It’s still a relatively new technology – although ozone has been used in medicine for over 150 years, it's use in dental care is only about 8 years in Europe and it arrived in South Africa 5 years ago. Right now only 37 dentists are using this equipment in their practices. There are two ozone devices on the market now - the HealOzone from KaVo Germany, and the "Ozi-cure" unit that is built here in South Africa. A problem with the HealOzone unit from KaVo Germany is that it’s only suitable for use on the top or the side of the tooth – because the HealOzone uses a cap to create a vacuum; it can’t treat cavities between the teeth, although research in the UK has shown ways to treat these flossing cavities (holes between your teeth caused by not flossing!). The South African product called the "Ozi-cure" from O3, Johannesberg delivers ozone via a small probe. Dr Julian Holmes, who is also O3's Clinical Director says that the Ozi-cure has a much widerapplication in dental, medical and vetinary care. "My early research was carried out with the HealOzone. Now, with modern electronics and new research looking at how ozone is generated, O3 has built a unit that is compact, light, and can out perform every competitor in the market for this application and treatment". Looking to the future, Dr Holmes says "O3 is committed to bringing new technologies and openiing up new treatments. We have new research starting in Africa and Europe looking at long-term prevention and other diseases. One of the real problems all ozone researchers have is the poor level of understanding in the non-research community. The USA Surgeon General and the Head of the USA FDA both believe that ozone is a dangerous gas and has NO place in the home or medical place. Yet both live in towns where ozone is used to sterilise their polluted water supplies!"

This is why many dentists are cautioning that although it is a wonderful therapy, ozone treatment should not be regarded as a miracle cure.
"If there’s a big hole in your tooth, you’re not going to be able to heal it using ozone. You’re still going to need conventional dentistry," says Professor Yusuf Osman of the University of the Western Cape’s Department of Restorative Dentistry. Yet Yusuf is excited about this latest development. "This is a great time to be a dentist," he says. "We previously thought the bacteria that cause caries and cavities were something that could only be treated with fillings. Now we realise the bacteria are a living ‘community’ that develops over nine months. We can interact with these and stop them – either with ozone therapy, fluoride treatments or basic brushing and flossing."
Right now if you have a serious dental cavity there’s no getting around the fact that some drilling and scraping may be necessary. But it’s only a matter of time before this changes, says Dr Julian Holmes, the UK dentist who helped conduct the initial research that led to the development of the HealOzone system. Dr Holmes is based in Cape Town these days, conducting additional research into the uses of ozone. And apparently there are plenty – from providing pain relief to sterilising root canals to the treatment and prevention of cold sores.

The thing Dr Holmes is most excited about is ozone’s potential to completely eradicate tooth decay. Within the next year he and his team hope to release a patented mouthguard system that will fit snugly around patients’ upper and lower jaws, allowing the safe and effective delivery of ozone to all parts of the teeth. "Ozone treatment is a major breakthrough for the dental profession," Dr Holmes says. "Up to now the standard practice has been to drill or amputate the infected area and then place a filling. Yet tooth decay is just an infection so our research has concentrated on targeting and eliminating the bacteria responsible and then allowing the body to heal in a natural way. You may still need a filling, as once destroyed, the tooth cannot ‘grow’ again. Healing in this context is the hardening of the previously soft area of decay that traditionally has been drilled away."

Dr Holmes predicts that in future we will be visiting our dentists every three months to have "an ozone spa" – a two-minute preventative treatment which will get rid of decay and gum disease while also whitening and cleaning teeth.
"We have only begun to scratch the surface of what this technology can do. It’s going to change the face of dentistry completely; Why? Because no longer will we be known as the "drill-and-fill merchants"; it will instead allow us to offer disease control in a simple fashion that is totally safe and cost effective."

But even now Dr Holmes believes that all cavities are avoidable. "The key is early detection of decay," he says, " and the traditional mirror, probe and x-rays are not sensitive enough to detect early mineral loss that will lead to cavity formation. This has been proven by the research time and time again. Yet what are dental students taught? - Out moded and old technolgies that have been shown to be ineffective. The problem here is one of cost, and that is a much more difficult hurdle to over come".

If you want to avoid having injections or being subjected to drilling it’s important to have regular checkups so problems can be detected at an early stage. And these days there’s no need to feel terrified because thanks to all the latest developments a trip to the dentist has become a whole new drill . . . If you want to find a dental practice near to you that offers HealOzone treatment, please log into www.rainbow-smiles.co.za, where you will also find a useful Frequently Asked Question sheet.

* Not his real name.

What the future holds