Beyond Cavities: How Prebiotics, Ozone, and Laser Could Transform Prevention in Dentistry
If you tuned in to our recent podcast episode, you already know that Dr. Nelson sees prevention’s next frontier not just in cleaning teeth — but in reshaping the mouth’s microscopic world. https://youtu.be/oX7wNZqI6Sk
His idea? Use advanced tools like ozone and lasers to clear away harmful bacteria, then rebuild the mouth’s ecosystem by introducing the good ones. It’s a hopeful concept — one that could eventually expand dentistry’s entire prevention toolbox.
Rethinking “Clean”
For decades, dental prevention has centered on removal — scraping away plaque, disinfecting decay, and sealing enamel. These methods work, but they’re mechanical. Even after meticulous cleanings, certain bacteria quickly recolonize gum pockets and surfaces.
Dr. Nelson’s approach imagines a two-step upgrade:
Reset the environment using ozone and laser therapy to eliminate entrenched pathogens and biofilms.
Repopulate with beneficial bacteria that support a balanced oral microbiome.
In theory, this could break the endless cycle of infection and inflammation that drives gum disease.
1️⃣ The Science Behind the Reset
Ozone Therapy
Ozone (O₃) is a powerful oxidant that disrupts bacterial membranes and neutralizes inflammation.
A 2025 systematic review in BMC Oral Health found that ozone used alongside standard cleaning reduced bacterial counts and improved healing in periodontal pockets — though researchers noted the need for longer follow-ups and standardized doses.¹
Ozone’s potential: strong, broad-spectrum disinfection without antibiotics.
Ozone’s challenge: dose precision. Too little does nothing; too much irritates tissue.
Laser Support
Lasers like Er:YAG or diode systems can debride infected tissue and sterilize deep pockets that traditional instruments miss. They also appear to promote healing through photobiomodulation.
Combined, ozone and lasers could “clear the slate” — a cleaner, safer foundation for repopulating good microbes.
2️⃣ The Science Behind the Repopulation
Probiotics and Prebiotics for the Mouth
The idea of “good bacteria” isn’t new — it’s the foundation of gut health — but dentistry is only beginning to explore it.
A 2024 meta-analysis of randomized controlled trials published in Journal of Clinical Medicine reviewed probiotics as an adjunct to periodontal therapy.² Patients who used strains such as Lactobacillus reuteri showed measurable improvements in pocket depth and gum bleeding.
Other systematic reviews in Frontiers in Microbiology and Frontiers in Cellular and Infection Microbiology agree: probiotics can shift microbial balance and reduce inflammation, though the effects vary widely.³ ⁴
What works:
L. reuteri and L. rhamnosus strains demonstrate anti-inflammatory and plaque-reducing effects.
Lozenges or rinses seem most promising for local delivery.
What doesn’t (yet):
Long-term colonization is inconsistent — many strains fade after treatment stops.
Commercial products often differ in strength, purity, and shelf stability.
3️⃣ Reconstructing the Future Protocol
While no official protocol exists, the emerging science hints at a logical sequence:
Deep cleaning / scaling to remove debris.
Ozone rinse or application to reduce total bacterial load.
Laser therapy in deeper pockets to disrupt biofilms.
Immediate or short-term probiotic phase:
Rinses or lozenges containing Lactobacillus reuteri, L. rhamnosus, or other well-studied strains.
Possibly paired with mild prebiotics (xylitol, inulin) that feed beneficial bacteria.
Follow-up maintenance: dietary support, good hygiene, and re-application as research clarifies dosage.
Why it could work:
Mirrors ecological restoration — remove invasive species, replant with beneficial ones.
Competitive exclusion: good bacteria occupy binding sites first, starving out harmful microbes.
Early trials suggest immune modulation benefits.
Why it might not:
Introduced bacteria may fail to adhere in saliva flow.
Host immune response may limit colonization.
Oral microbiome diversity differs between individuals — a universal formula may never exist.
4️⃣ Staying Critical and Grounded
All current reviews share one warning: evidence is promising but premature.
Many studies are small (fewer than 50 patients).
Product quality and bacterial viability vary.
Long-term safety data are limited, especially for immunocompromised patients.
In short: fascinating science, not yet standard care.
But that’s how every innovation begins — as a well-reasoned hypothesis waiting for stronger data.
5️⃣ Why It Matters for Dentistry’s Future
If ongoing research confirms these effects, dentistry could soon move beyond mechanical cleaning and chemical disinfection into true microbiome management — a biological approach that treats the mouth as an ecosystem, not a battlefield.
This could mean:
Gentler, more lasting control of gum disease.
New prevention therapies for high-risk patients.
Personalized oral-health plans based on bacterial balance.
It’s not science fiction — it’s science in progress. And here at iDental, we’re watching every study with cautious optimism.
Because if repopulating the mouth with good bacteria works as well as early research suggests, it could become one of the most powerful tools in dentistry’s prevention kit.
References
BMC Oral Health (2025). Efficacy of Ozone Therapy in Dentistry: A Systematic Review.
Journal of Clinical Medicine (2024). Effects of Probiotics as an Adjunct to Non-Surgical Periodontal Therapy: Systematic Review and Meta-Analysis.
Frontiers in Cellular and Infection Microbiology (2023). A Comprehensive Review of Probiotics and Oral Health.
Frontiers in Microbiology (2023). Probiotics for Oral Health: Do They Deliver What They Promise?