CATEGORY 72 AUSTRALASIAN DENTIST Home use of ozonated water for preventive therapeutic oral care: GENERAL GUIDELINES Introduction Since its discovery by Christian Friedrich Schönbeinin 1839 by water electrolysis (Rubin, 2001, Rubin, 2002), ozone is used in various fields of medicine (Madrid declaration on ozone therapy, 2020, Serra et al., 2023). Its application in dentistry is gaining more attention (Néri et al., 2017, Tiwari et al., 2017,Suh et al., 2019, Chaudhry et al., 2021, D’Amarioet al., 2022), and is the second most researched field of application in ozone therapy (Zotero ISCO3database), (Figure 1). Ozonated water is used in medicine (Martínez-Sánchez, 2019) and a literature analysis showed 89% of significant positive results in dentistry (Sabbah et al., 2018). Conventional preparation of ozonated water requires the use of an ozone gas generator, diffuser, contact vessel and oxygen gas cylinder (Sabbah and Domb, 2021). The complexity of this method might be a challenge for non-trained users and there is a need for a practical, efficient, and safe method for home use. Electrolytic ozone generator (EOG), in its simplest form, both anode and cathode electrodes are immersed in water without a separating membrane. Advanced EOG employs a proton exchange membrane (PEM) which separates the electrodes, and the generated ozone gas concentration can be extremely high. The membrane-less EOG needs water with a minimum of 50 mg/L dissolved solids, and the evolved gases (O2-O3 and H2) are dissolved in situ according to their respective solubility ratios. PEM EOG can work with ultra-pure water, O2-O3gas mixture and H2 have separate outlets (Da Silva and Santana, 2003, Stucki et al., 2005, Okada andNaya, 2012, Christensen et al., 2013, Okada et al., 2019), (Figure 2). The scope of this article is to evaluate the performance, practicality and safety of a direct electrolytic ozone generator and to propose general guidelines for at-home use of ozonated water for preventivetherapeutic oral care regimen. By Fadi Sabbah1, Cris Duval2, Mark T Weiser3 1 Private dental practice, Vice-president, International scientific committee of ozone therapy; Hamra, Beirut, Lebanon https://orcid.org/0000-0002-8066-1495 2 Registered dental hygienist, Founder, The LifeGuard Approach; Peoria, Arizona, U.S.A.- https://orcid. org/0009-0002-8595-8455 3 Private dental practice, Founder, Ozone Therapies Group and Frontiers Ozone Conferences; Santa Barbara, CA, U.S.A. https://orcid.org/0009-0002-5914-3295 ABSTRACT Background: Ozone therapy in dentistry is gaining more attention and is the second most researched field after musculoskeletal in clinical studies. Dentists routinely prescribe oral antiseptics for home oral care and after in-office interventions. Ozonated water is well known for its antimicrobial, anti-inflammatory and accelerated wound healing properties, as well as for its extremely low cytotoxicity and side effects. To our knowledge, this is the first article to evaluate the performance, practicality and safety of a direct electrolytic ozone generator and to propose general guidelines for at-home use of ozonated water for preventive-therapeutic oral care regimen. Methods: A direct electrolytic ozone generator was tested and the concentration of ozonated water, total oxidants, dissolved molecular hydrogen, and ambient ozone gas levels in air were measured. Results: Ozonated water concentration reached a range of 2-5 mg/L, and ambient ozone gas levels in airwere not detected. Conclusion: Practical implications: At-home use of ozonated water is more convenient for both dentists and patients, especially when multiple applications are indicated. Water electrolysis is a safe and easy-to-use method to prepare ozonated water at efficient concentration. Figure 1 Top six fields of clinical research in ozone therapy. Figure 2 Membrane-less EOG (a); PEM EOG (b) – Legend. EOG: Electrolytic ozone generator. PEM: Proton exchange membrane. DC: Direct current. Materials and Methods A battery-operated direct EOG tumbler (BiotekEnvironmental Science, New Taipei, Taiwan) was evaluated with bottled drinking water (Table 1) at three different time settings. Ozonated water concentration was measured with an aqueous ozonemonitor (2B Technologies, model UV-106-W, Boulder, USA) which uses a sparging technique to remove ozone gas from water, followed by UV (ʎ 254 nm) measurement of ozone in the gas phase. This mode of measurement is highly specific to ozone, without any interference from otheroxidants which can be present in the tested water. Total oxidants concentration (TOC) was measured with a photometer and potassiumiodide (KI) / N, N-diethyl-pphenylenediamine(DPD) Vacu-Vials kit (Chemetrics SAMK-7423, USA). KI/DPD test is not specific to ozone, and measures CLINICAL A B
RkJQdWJsaXNoZXIy MTc3NDk3Mw==