Ozone therapy has become increasingly visible in biological and integrative dental settings. It is used in several different forms and has been studied for periodontal therapy, cavity management, endodontics, wound healing, and dental disinfection.
It is also a topic where marketing can get ahead of the evidence.
Ozone has real antimicrobial properties. That does not automatically mean it can replace established dental treatment, cure every infection, or eliminate the need to remove diseased tissue.
At Complete Health Dentistry, the most responsible way to discuss ozone is as a potential adjunctive tool within an appropriate treatment plan.
What Is Ozone?
Ozone is a molecule made of three oxygen atoms, written chemically as O3.
It is highly reactive. That reactivity is why ozone can interact with microorganisms and why it has been studied in disinfection and healthcare applications.
In dentistry, ozone may be delivered in forms such as:
- Ozone gas
- Ozonated water
- Ozonated oils or gels
The delivery method matters. Different studies use different ozone concentrations, exposure times, devices, and clinical protocols, which makes it difficult to treat every study as though it evaluated the same intervention.
Why Do Dentists Use Ozone?
Researchers have explored ozone in areas including:
- Periodontal treatment
- Caries management
- Endodontic procedures
- Dental surgery
- Implant-related procedures
- Wound healing
- Local disinfection
The common thread is ozone’s antimicrobial and oxidative activity.
But a laboratory effect does not necessarily translate into a meaningful clinical improvement.
That difference is critical when evaluating any dental technology.
Ozone and Periodontal Disease
Periodontitis involves microbial biofilms, inflammation, and destruction of the tissues that support the teeth.
The foundation of nonsurgical periodontal treatment remains mechanical disruption and removal of deposits below the gumline. Ozone has been studied as something that might be added to scaling and root planing.
The research has produced mixed findings.
A 2020 systematic review and meta-analysis indexed by PubMed found no significant additional clinical benefit when ozone was added to nonsurgical periodontal treatment and concluded that available evidence did not support its use for that purpose at the time.
A newer 2025 systematic review and meta-analysis found statistically significant improvements in some measures, including probing depth and gingival index, when ozone was added to scaling and root planing. (PubMed)
Another 2025 meta-analysis also reported improvements in certain inflammation-related measures. (PubMed)
When newer and older evidence points in different directions, the appropriate conclusion is not that one side must be ignored. It is that evidence is still evolving and protocols are heterogeneous.
That is why ozone is best described as a possible adjunct to periodontal care, not a replacement for mechanical treatment.
Can Ozone Treat Cavities?
Ozone has also been studied for dental caries because of its antimicrobial activity.
A 2020 systematic review and meta-analysis of randomized trials found very low-certainty evidence and concluded there was not enough support to recommend ozone as an established treatment for dental caries. (PubMed)
A 2024 review focused on primary teeth found that available studies suggested ozone could perform comparably to some other interventions in selected outcomes, but the evidence base was small and heterogeneous. (PubMed)
The practical takeaway is simple:
Ozone does not rebuild missing tooth structure.
If decay has created a structural cavity, the tooth may still require removal of diseased tissue and restoration through general and restorative dentistry.
Does Ozone Kill Bacteria?
Ozone has antimicrobial effects, and that is one reason it is being investigated.
But “kills bacteria” is not the same as “improves a patient outcome.”
A treatment can reduce microbial counts in a laboratory and still fail to improve long-term tooth survival, periodontal attachment, pain, or healing in a meaningful way.
This distinction is fundamental to evidence-based care.
Clinical outcomes matter more than a dramatic laboratory result alone.
Can Ozone Replace Antibiotics?
No.
There are dental and medical situations where antibiotics are appropriate and sometimes necessary.
There are also many dental situations where antibiotics are not the main treatment because the source of infection must be physically treated.
Ozone should not be promoted as a universal substitute for appropriately prescribed medication, just as antibiotics should not be prescribed unnecessarily.
The treatment should match the diagnosis.
Is Ozone a “Biological Dentistry” Treatment?
Ozone is often associated with biological dental practices because it can be used as an adjunctive local treatment and because of interest in reducing unnecessary chemical exposure.
But biocompatible dentistry should not be defined by one device or therapy.
A broader biological approach may include:
- Preserving healthy tooth structure when possible
- Thoughtful material selection
- Understanding the oral microbiome
- Reducing unnecessary treatment
- Considering airway, periodontal, and systemic factors
- Using technology when it meaningfully improves care
Ozone may fit into that philosophy in selected situations. It is not the philosophy itself.
Is Dental Ozone Safe?
Safety depends on how ozone is delivered.
Ozone gas is irritating to the respiratory system and should not simply be inhaled. Clinical dental systems are designed to control application and limit exposure.
Published dental trials vary considerably in how adverse events are reported, and the quality of evidence differs among procedures.
This is another reason ozone should be used within a clinical environment rather than treated as a home remedy.
Who Might Encounter Ozone in a Dental Office?
A dentist may consider ozone as an adjunct in selected cases involving:
- Periodontal therapy
- Local disinfection
- Certain restorative protocols
- Selected surgical or healing applications
- Specific endodontic protocols
Whether it adds value depends on the procedure, the device, and the patient.
Patients should always understand what the primary treatment is and what role ozone is expected to play.
For example, if a periodontal pocket contains calculus, ozone does not replace removing the calculus. If a tooth has a large structural cavity, ozone does not replace rebuilding the tooth.
How Should Patients Evaluate Ozone Claims?
Ask practical questions:
- What is ozone being used for in my case?
- Is it the main treatment or an adjunct?
- What outcome is it intended to improve?
- What happens if we do not use it?
- Is there clinical evidence for this specific application?
- Does it replace any established treatment?
A responsible answer should sound different from “ozone cures everything.”
Biological Dentistry Without Hype
Ozone is a good example of how modern dentistry can hold two ideas at the same time.
Ozone has real biological properties and legitimate clinical research behind it.
The research is also inconsistent in several areas, and certainty varies according to the procedure being studied.
At Complete Health Dentistry, a technology does not need to be either revolutionary or worthless. It needs to have a defined role in the patient’s treatment plan and be used with appropriate expectations.
Sources & References
- PubMed: Ineffectiveness of Ozone Therapy in Nonsurgical Periodontal Treatment—Systematic Review and Meta-Analysis
- PubMed: Effects of Ozone Therapy as an Adjuvant in the Treatment of Periodontitis—2025 Meta-Analysis
- PubMed: Effectiveness of Ozone Therapy in Non-Surgical Periodontal Treatment—2025 Meta-Analysis
- PubMed: Effectiveness and Safety of Ozone Therapy in Dental Caries Treatment
- PubMed: Ozone Treatment for Caries in Primary Dentition—2024 Systematic Review