CATEGORY AUSTRALASIAN DENTIST 75 Table 4 Soft tissue lesions. General guideline Table 5 Post-surgery general guideline Dose Frequency Cw: 5 mg/L Four times per day High Vol. 50 mL Reduce to Medium/Low as healing progresses. Cw: 5 mg/L Medium Vol. 50 ml Two times per day Cw: 2.5 mg/L Low Vol. 50 mL 2-3 times per day Swish/Gargle for 30-60 s Legend. Cw: Ozonated water concentration Dose Usage & Frequency Cw: 5 mg/L Day 1-2: Fill a 50 mL disposable sterile syringe and gently rinse the surgical area. Volume: Dip a soft toothbrush in ozonated water and gently clean the wound. 50 mL Repeat after each meal. 3-4 times per day. Day 3-10: Same as above or gentle swish. Legend. Cw: Ozonated water concentration. Numerous studies showed ozonated water had good results in prevention and management of dental caries and periodontal diseases, as well as during orthodontics treatment, pregnancy, and halitosis management (Ramzy et al., 2005, Kshitish andLaxman, 2010, Bialoszewski et al., 2011, Dhingraand Vandana, 2011, Syed et al., 2012, Katti andChava, 2013, Hayakumo et al., 2014, Sadatullah etal., 2014, Anumula et al., 2017, Jose et al., 2017,Hirai et al., 2019, Su et al., 2021, Tecco et al., 2022,Do Amaral et al., 2023). (Table 3). Soft tissue lesions Ozonated water showed beneficial results for the management of chemotherapyinduced oral mucositis (Hayashia et al., 2019, Lazaro et al., 2020,Ghorbani et al., 2021), lichen planus (Mostafa andZakaria, 2018, Veneri et al., 2020), ulcers (Miao etal., 2017), recurrent aphthae and herpetic lesions(Gawish and Bahammam, 2014, AlOmiri et al.,2016), and methicillin-resistant staphylococcusaureus skin infections (Song et al., 2017). As a rule, especially in infected cases, start with a high ozonated water dose and reduce to medium/low dose according to the healing phase progression Post-surgery interventions Ozonated water was shown to reduce post surgery inflammation, pain, and to enhance healing(Frascino et al., 2013, Ghosh et al., 2020, Glóriaet al., 2020, Kogila et al., 2022, Romary et al., 2023). Good home oral care is essential to avoid postoperative infections. Home use of ozonated water after surgical interventions is highly indicated to maintain the surgical wound clean and minimize potential postsurgery complications (Table 5). Removable dentures – oral appliances disinfection Oral appliances and dentures can harbor bacteria and fungus (Glass et al., 2011) if not regularly cleaned and disinfected, and may cause stomatitis, staph or strep throat, as well as bad breath. Ozonated water is effective in eliminating the biofilm adhering to removable dentures and oral appliances (Arita et al., 2005). Clean and soak the appliance or dentures in ozonated water (5 mg/L) daily. Conclusion Ozonated water was shown to be highly effective and biocompatible in medical and dental applications. Its use as a mouthwash for preventive– therapeutic home oral care can be beneficial without causing undesirable side effects as seen with common mouthwash formulations. For home use, direct electrolytic ozone Table 3 Caries and Periodontal diseases: General preventive guideline Risk Dose Three-month cycle* Usage Factors Low First week: every other day Week 2-4: twice per week Cw 2.5 mg/L First week: once daily Swish/Gargle for Week 2-4: twice per week 30-50 s. A waterjet can also be used for its beneficial effects on Medium dental plaque Volume 50 mL breakdown and First week: once daily removal. High Second week: every other day Week 3-4: twice per week *: Re-assessment at dental office follow-up visits Legend. Cw: Ozonated water concentration. generation is practical, easy-to-use, and safe in comparison to the traditional ozonated water preparation and can reach an efficient concentration range suitable for home oral care. To our knowledge, this is the first article to propose general guidelines for at-home use of ozonated water. It is hopeful that future studies will be conducted, and to evaluate potential effects of long term at-home use of ozonated water on normal oral microflora. Conflict of Interest CD and MW declare no conflict of interest. FS is a scientific consultant to Biotek Environmental Science. Biotek Environment Science donated the electrolytic ozone generator and had no role in the study design, in data collection and analysis, nor in writing the manuscript and submitting it for publishing. Funds All testing equipment and disposables used in this study were covered by FS personal funds. This research did not receive any specific grant from funding agencies in the public, commercial, or not for-profit sectors. Authors’ contribution FS contributed to the design of the study, to the data acquisition, analysis, and interpretation, and to the writing of the manuscript. CD and MW contributed to the data analysis and interpretation, to the revision of the manuscript and final approval of the version to be submitted for publication. Acknowledgments The authors would like to express their gratitude to Gregorio Martínez-Sánchez, Pharm. Dr., Ph.D.,for the valuable contributions in the reviewing of the manuscript. Cite the journal article Fadi Sabbah, Cris Duval, Mark T Weiser. Home use of ozonated water for preventivetherapeutic oral care: General guidelines. Giornale ItalianoOzonoTerapia. 2023; 16: 2329. ttps://nuovafio. it/riviste-scientifiche/ u For a full list of references email: gapmagazines@gmail.com CLINICAL
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