Patients searching for biological dentistry in Richmond, Virginia, Northern Virginia, Washington DC, and Maryland often encounter discussions about ozone therapy in dentistry.
Ozone has been explored in dental research for its antimicrobial properties, oxidative effects on microorganisms, and potential role in supporting tissue healing. Because many oral diseases involve complex microbial biofilms and inflammatory processes, researchers have investigated whether ozone could play a role in reducing microbial burden or supporting healing in certain dental procedures.
At the same time, ozone therapy remains an area where scientific evidence varies depending on the application, and many researchers emphasize that ozone should be considered adjunctive rather than a replacement for established dental treatment protocols.
This educational FAQ guide reviews what research says about ozone therapy, how ozone interacts with oral tissues, and how the topic is discussed within biological dentistry and holistic dental care.
Ozone therapy refers to the controlled medical or dental use of ozone (O₃), a molecule composed of three oxygen atoms.
Unlike the oxygen we breathe (O₂), ozone is highly reactive and unstable, which means it must be generated immediately before use with specialized equipment.
In dentistry and medicine, ozone has been studied for decades because of its strong oxidative antimicrobial activity. When ozone comes into contact with microorganisms, it can damage cellular membranes and interfere with microbial metabolism.
A detailed scientific overview is provided in the peer-reviewed review article Ozone Therapy in Medicine and Dentistry: A Review of the Literature
This review summarizes decades of scientific research and notes that ozone has been studied in dentistry for:
dental caries
periodontal disease
endodontic infections
dentin hypersensitivity
implant dentistry
oral wound healing
dental unit waterline disinfection
However, the authors also emphasize: Although ozone demonstrates antimicrobial activity and biological effects in laboratory and clinical research, its clinical effectiveness in dentistry has not been consistently demonstrated across all indications.
For this reason, ozone therapy is generally described in scientific literature as a potential adjunctive technique rather than a replacement for conventional dental treatments.
Biological dentistry focuses on understanding the relationship between oral health and systemic health, often emphasizing approaches that reduce toxic exposures, address chronic oral infections, and support natural healing processes.
Within this philosophy, some biological dentists explore technologies that may help reduce microbial infections or support tissue healing.
Educational resources from the International Academy of Oral Medicine and Toxicology (IAOMT) discuss ozone therapy as one of the technologies used by some biological dentists for disinfection and healing support.
Similarly, the International Academy of Biological Dentistry and Medicine (IABDM) describes ozone therapy as an emerging modality explored in biologically oriented dental care.
However, both organizations emphasize that clinical decisions should remain grounded in scientific evidence and professional judgment.
Ozone’s biological effects arise primarily from oxidative reactions.
According to the 2023 scientific review referenced above, ozone interacts with biological tissues through a complex set of reactions involving:
reactive oxygen species
lipid oxidation products
hydrogen peroxide signaling
antioxidant enzyme activation
inflammatory mediator modulation
These reactions can activate the Nrf2 antioxidant pathway, which regulates cellular defense mechanisms against oxidative stress.
Ozone’s antimicrobial properties arise from its ability to oxidize microbial cell walls and disrupt membrane integrity.
Laboratory studies show that ozone can act against:
bacteria
viruses
fungi
protozoa
However, biological mechanisms alone do not prove clinical effectiveness. That is why many researchers emphasize the need for controlled clinical trials when evaluating ozone therapy in dentistry.
Scientific literature describes three primary forms of ozone delivery used in dental research.
Ozone gas can be delivered directly to a localized area of the mouth using specialized sealed delivery systems designed to prevent inhalation exposure.
This method has been studied in relation to:
caries lesions
periodontal pockets
surgical sites
root canal systems
Because ozone gas is highly reactive, precise control of concentration and exposure time is critical.
Ozonated water is created when ozone gas is dissolved into purified water.
Research suggests ozonated water may have antimicrobial properties and has been studied for use in:
periodontal irrigation
surgical wound cleansing
dental unit waterline disinfection
oral rinsing
The 2023 review reports that ozonated water exposure reduced biofilm formation and viable bacteria in dental unit waterline models by 57% and 65% respectively.
Ozonated oils are produced by infusing ozone into plant oils.
These oils can retain antimicrobial properties and have been discussed in relation to:
oral wound healing
soft tissue lesions
topical oral care
Ozonated oils are frequently referenced in biological dentistry literature, including educational materials from the IABDM.
One of the most widely discussed applications of ozone therapy is in the management of dental caries (tooth decay).
Research has investigated whether ozone might reduce bacteria within early caries lesions and potentially support remineralization.
Some studies cited in the 2023 review report reductions in microorganisms within carious lesions following ozone exposure.
However, the literature remains controversial.
A cited Cochrane Review: Ozone for treating dental caries concluded that there was no reliable evidence that ozone therapy stops or reverses dental decay.
More recent systematic reviews have reached similar conclusions, noting that while ozone demonstrates antimicrobial activity, the evidence does not currently support presenting ozone as a standalone treatment for cavities.
This means that advanced decay still requires conventional restorative treatment such as fillings or other procedures.
Periodontal disease involves complex microbial biofilms and inflammatory processes affecting the gums and supporting structures of the teeth. Because ozone has antimicrobial properties, researchers have explored whether ozone therapy could support periodontal treatment.
Research over the past several years has explored whether ozone therapy may provide benefits when used as an adjunct to conventional periodontal treatment such as scaling and root planing (SRP). Several clinical studies published since 2020 report improvements in periodontal parameters when ozone was incorporated into nonsurgical therapy protocols. For example, a randomized clinical study evaluating ozone therapy as an adjunct to SRP in patients with chronic periodontitis observed improvements in clinical periodontal indices and reductions in microbial load when ozonated irrigation was used in conjunction with conventional treatment (Vasthavi et al., 2020).
Similarly, a systematic review and meta-analysis examining ozone therapy in periodontics concluded that ozone may provide beneficial effects when used alongside scaling and root planing, particularly with respect to periodontal pocket depth reduction and clinical attachment level improvements, although the authors noted heterogeneity among the included studies (Deepthi et al., 2020). More recent clinical research has continued to investigate this potential adjunctive role. A 2023 clinical investigation evaluating ozone therapy in patients with stage II and III periodontitis reported improvements in periodontal parameters on the ozone-treated sites compared with baseline following SRP, although the study also emphasized that further trials are needed to determine long-term effectiveness and standardize treatment protocols (Alsakr et al., 2023).
Additional systematic reviews examining the use of ozone in nonsurgical periodontal therapy similarly conclude that ozone may influence clinical indicators such as bleeding on probing, probing pocket depth, and inflammation when used adjunctively, but that results remain variable and higher-quality randomized clinical trials are necessary before definitive conclusions can be made regarding routine clinical use (Pardo et al., 2025).
Collectively, these studies suggest that ozone therapy continues to be investigated as a potential adjunctive modality in periodontal treatment, but current evidence indicates that it should be viewed as a supplementary approach rather than a replacement for established periodontal therapies such as scaling, root planing, and ongoing periodontal maintenance.
Other systematic reviews similarly note that adjunctive ozone therapies may contribute to reductions in periodontal inflammation and microbial load but emphasize that the overall body of evidence remains heterogeneous due to differences in ozone formulations, concentrations, and delivery methods (Hashim et al., 2025).
Consequently, although several contemporary studies suggest potential adjunctive benefits, the scientific literature generally concludes that ozone therapy should be considered a supplementary approach rather than a replacement for established periodontal treatments such as scaling, root planing, and ongoing periodontal maintenance.
Ozone therapy has been investigated in oral surgery and soft-tissue healing, particularly to determine whether it may help improve postoperative healing, tissue repair, inflammation control, and pain reduction following procedures such as tooth extractions and dental implant placement. A recent systematic review of clinical trials, Saini R. et al., “Efficacy of Ozone Therapy in Dentistry With Approach of Healing, Pain Management, and Therapeutic Outcomes: A Systematic Review of Clinical Trials” (2025), reported that several studies suggest ozone therapy may contribute to improved soft-tissue healing after dental implant surgery and reduced postoperative discomfort, while emphasizing that the current evidence remains heterogeneous and that additional well-designed randomized clinical trials are needed to confirm these effects and establish standardized protocols.
Clinical research has also evaluated ozone therapy following tooth extraction. In the randomized controlled study Jain A. et al., “Topical-Ozonized Olive Oil – A Boon for Post-Extraction Cases” (2023), extraction sockets treated with ozonized olive oil demonstrated significantly improved wound-healing scores by the fifth postoperative day compared with the control group, suggesting that ozonized oil may support early socket healing after exodontia. However, the authors noted that postoperative pain differences between the groups were not statistically significant, and they recommended further clinical trials to confirm these findings in larger populations.
Ozone has also been studied in implant-site healing. In the randomized clinical trial Isler S. C. et al., “Evaluation of Postoperative Effects of Using Ozonated Water as an Irrigant on Soft and Hard Tissues Surrounding Dental Implants (2024), the group treated with ozonated water during implant osteotomy preparation experienced significantly lower postoperative pain levels at 48 hours and improved soft-tissue healing at eight days compared with the control group, although no statistically significant differences were found in long-term bone healing or implant stability.
Another randomized controlled trial evaluating ozone therapy after implant placement reported similar findings. In The Efficacy of Ozone Therapy on Pain and Soft Tissue Healing Associated With the Surgical Placement of Dental Implants (2024), patients receiving ozone therapy showed lower postoperative pain scores at 24 and 48 hours and improved soft-tissue healing at 7 and 14 days, with earlier resolution of inflammation and faster epithelialization around the surgical site.
Ozone therapy has also been explored in the management of alveolar osteitis (dry socket), a painful postoperative complication that can occur after tooth extraction. A randomized controlled clinical trial, El-Rashidy A. A. et al., “Investigation of the Clinical Efficacy of Concentrated Growth Factor and Ozone in the Management of Alveolar Osteitis” (2023), examined ozone therapy as part of a treatment protocol for dry socket and reported improvements in clinical healing outcomes and reductions in postoperative discomfort among treated patients.
Taken together, these clinical studies suggest that ozone therapy may have potential benefits in supporting soft-tissue healing and reducing short-term postoperative discomfort following certain oral surgical procedures.
However, systematic reviews consistently note that the available evidence is limited by variability in ozone formulations, concentrations, delivery methods, and study designs, as well as relatively small sample sizes. For this reason, current scientific literature generally describes ozone therapy as a promising adjunctive approach under investigation, while emphasizing that further well-designed randomized clinical trials will help clarify its role in oral surgical care and postoperative healing (see Saini R. et al., 2025 ).
Because ozone is a powerful oxidizing gas, safety is an important consideration. The scientific literature emphasizes the importance of:
sealed delivery systems
controlled ozone concentrations
prevention of inhalation exposure
trained clinical use
Reported side effects associated with ozone exposure may include:
respiratory irritation
coughing
headaches
nausea
fatigue
eye irritation
The literature also notes that G6PD deficiency may be a contraindication for certain ozone therapies.
Patients seeking biological dentistry in Richmond, Virginia, often search for dental care that focuses on the relationship between oral health and overall wellness.
Biological dentistry may involve:
minimally invasive dentistry
airway-focused dentistry
prevention of chronic oral inflammation
Patients from Northern Virginia, Washington DC, and Maryland frequently travel to specialized biological dental practices when seeking comprehensive care focused on the mouth-body connection.
Patients in the Washington DC metropolitan area, including Northern Virginia and Maryland, often seek biological dental care when looking for treatment approaches that emphasize:
systemic health considerations
biocompatible dental materials
prevention of chronic inflammation
minimally invasive restorative dentistry
Educational information about emerging dental technologies, including ozone therapy, may help patients better understand the evolving field of biological dentistry.
Most studies describe ozone application in dentistry as minimally invasive and generally well tolerated by patients. Because ozone can be applied as a gas, ozonated water, or ozonated oils, treatments often involve short, localized applications that do not require drilling or mechanical instrumentation. Clinical studies evaluating ozone use in dental procedures have also reported reduced postoperative discomfort and improved soft-tissue healing in certain surgical contexts, suggesting that ozone may contribute to patient comfort when used appropriately in dental care.
Ozone has been studied for its antimicrobial activity against bacteria involved in dental caries, and some research suggests it may help reduce bacterial levels in early lesions. However, systematic reviews have concluded that current evidence does not yet support ozone therapy as a standalone treatment capable of reliably stopping or reversing established cavities. As a result, ozone is generally discussed in the scientific literature as a potential adjunct to preventive or restorative care, rather than a replacement for conventional cavity treatment when tooth structure has already been damaged.
Research investigating ozone in periodontal treatment suggests that it may provide benefits when used alongside conventional therapies such as scaling and root planing, particularly in relation to antimicrobial effects and inflammation reduction. Some studies have reported improvements in periodontal parameters when ozone is incorporated as an adjunctive therapy. However, the scientific consensus remains that ozone should be viewed as a complementary approach rather than a substitute for established periodontal treatments, which remain the foundation of gum disease management.
Ozone therapy is frequently discussed in biological and integrative dentistry because of its broad antimicrobial properties and potential effects on tissue oxygenation and healing. Organizations such as the International Academy of Oral Medicine and Toxicology (IAOMT) and the International Academy of Biological Dentistry and Medicine (IABDM) provide educational resources describing how ozone has been explored in dental settings for infection control and tissue healing. While research is still evolving, the growing body of studies examining ozone in dentistry reflects a broader interest in technologies that may support minimally invasive care, microbial management, and improved healing outcomes.
Contact Dr. Olivia Hart of Virginia Biological Dentistry, Glen Allen, Richmond to learn more about biological and integrative dental care, including how ozone therapy has been understood in dentistry in relation to antimicrobial support, periodontal therapy, and tissue healing
Click here to make an appointment now or call (804) 381-6238 or email at info@virginiabiologicaldentistry.com to learn more.
