We recently read about some interesting new research out of NYU, meant to solve a problem with a compound called silver diamine fluoride, or SDF for short. Used by conventional dentists, SDF can be painted onto teeth to reduce sensitivity and keep decay from progressing. It’s cheap, it’s easy to apply, and it’s seen as a “good” alternative to drilling and filling, especially for those who have trouble getting dental care.
SDF also has the less-than-wonderful side effect of turning the teeth black. “That stain”, explained NYU chemistry professor Marc Walters, “is permanent, which is a barrier for many people wanting to use the product.”
You don’t say!
So Walters and his team started exploring zinc-based compounds and ultimately developed one that works through a dual mechanism: It physically blocks the microscopic dentinal tubules (the layer of tooth just below the enamel), providing fast relief from sensitivity, and slowly releases antimicrobial zinc to fight decay.
Like SDF, the zinc compound – called zinc tetramine difluoride – is meant to be painted onto the tooth. Once it’s absorbed by the dentin, conditions inside cause a chemical change that quickly solidifies the compound, plugging the tubules and cutting off access to the tooth’s nerves. Walters described it as
like putting a cork in place that shuts off the lower portion of the tubule from the outside environment – and this happens within a minute or two.
Yet as effective as that sounds, it also sounds very like a treatment we already have that does this – safely and without fluoride and without staining. That treatment is dental ozone.
Like our patients, regular readers know we use ozone in many ways here in our office, from periodontal therapy to supporting healing after oral surgeries such as extractions or ceramic implant placements. It’s key to our minimally invasive approach to care. For we believe in starting with conservative care, preserving as much natural tooth structure as possible while still getting good clinical outcomes.
Using ozone to treat sensitivity and early decay is one great example of that, as science continues to show.
For instance, one study published earlier this year looked at the impact of ozone gas on dentin hypersensitivity. Its authors used a split-mouth design for 132 teeth from 44 patients, treating some with either ozone or a diode laser, while a control group had no treatment at all.
Sensitivity decreased in both the ozone and laser groups immediately afterwards, as well as at 3-, 6-, and 9-month followups. But that’s not to say that both treatments were equal in all ways.
After 6 months from the therapy, the sensitivity values in the teeth treated with ozone gas remained statistically lower than those treated with diode lasers.
In other words, both treatments worked, but ozone’s effects lasted longer. As the researchers concluded, “Ozone maintains an invariable effectiveness after 6 months.”
Like zinc, ozone works by blocking the dentin tubules. It also neutralizes acidic proteins produced by cavity-causing bacteria and promotes mineral deposition. This kind of antimicrobial activity is exactly what makes ozone so effective for managing dental caries (decay), too – often eliminating any need of drilling.
Another study earlier this year looked at the impact of using ozone to treat decayed baby teeth. Its authors’ analysis of 7 clinical studies found that ozone was “comparable to other interventions in terms of clinical outcomes and antibacterial activity.” It wasn’t that ozone was necessarily better than other treatments, but it held its own – and that’s significant, especially for young patients.
Being able to arrest or reverse early cavities without putting a child through the stress and discomfort of conventional dental treatment? That’s a game-changer.
The most recent comprehensive overview came out just last month in BMC Oral Health and reviewed clinical trials on ozone therapy across all areas of dentistry from 2018 through 2024. The authors found that
Ozone therapy is effective in improving periodontal health, healing soft tissue after dental implant surgery, and reducing postoperative discomfort. The combination of scaling and root planing with gaseous ozone therapy showed superior periodontal response rates. The use of ozone during endodontics procedures resulted in reduced post-treatment pain, while ozonated materials showed promise in the management of dentinal hypersensitivity.
“Current evidence,” the authors concluded “suggests that OOT [oxygen-ozone therapy] may offer some advantages as an adjunctive or alternative treatment option in certain clinical conditions.”
You know, sometimes the most powerful tools aren’t the ones that are still in the lab being developed. Sometimes they’re tools we’ve been using for years, freshly supported by solid new research.
