Dentistry Uncensored with Howard Farran
Dentistry Uncensored with Howard Farran
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167 Using Ozone To Treat Decay In South Africa with Julian Holmes : Dentistry Uncensored with Howard Farran

167 Using Ozone To Treat Decay In South Africa with Julian Holmes : Dentistry Uncensored with Howard Farran

9/28/2015 12:00:00 PM   |   Comments: 0   |   Views: 1027

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AUDIO - HSP #167 - Julian Holmes

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VIDEO - HSP #167 - Julian Holmes

Julian Holmes, BDS has a wealth of experience--on more than one continent. Listen as he explains his approach of treating tooth decay with ozone.


Julian Holmes, BDS:


Qualified 1985

Worked in UK, Gibraltar in Private Dental Care

Researcher and publisher, over 80 journal, abstracts and articles published

Lives in Cape Town, and runs GreyCell, with ozone products as the core business

Howard: It is a huge honor today to be interviewing my friend, Julian Holmes, who's a dentist from the United Kingdom, who's had a extremely interesting life. He left the United Kingdom. He went to the Strait of Gibraltar, which I guess used to be part of Spain and now it's part of the United Kingdom. Then eventually I think went back to the United Kingdom. Then ended up in South Africa, and you're calling in today from Cape Town area, is that correct?

Julian: That's right. Absolutely, Howard. That's why we don't have any video for which I apologize but the bandwidth down here is appalling, so sadly it's voice only.

Howard: Another shocking place that has appalling internet is Australia, and they tell me it's because Australia is the same size as the United States or China, but 90 percent of our population is just on a few coastal areas, and the message has got to go all the way back to Dental Town 15,000 miles and Phoenix.

Julian: Something like that, yes.

Howard: The speeds are just atrocious. Basically, Julian, how long have you been a dentist?

Julian: Over 30 years now. In fact, I've just had the notification of our 30-year reunion at Sheffield University. I was intending on being there, but we seem to have inherited in this part of the world the worst of the ex-British paperwork and my Visa now has expired. If I actually leave the country, I get banned for five years, so I'm sort of trying to hang on in here, sort it all out and then hopefully, I'll be able to travel again.

Howard: How many countries have you lectured in dentistry?

Julian: Just about everywhere apart from South America.

Howard: Yeah, and you've been publishing over 80 journals, abstracts, articles. You're a legend. I want to start off with just a macro view. I mean, I'm 53. How old are you, Julian?

Julian: I was 60 in June.

Howard: I think this is a really fun opportunity. My podcast viewers, probably it's over weighted the most in young dentists in America. If you're out of school the first five years, that's the ones who jumped on smartphones and apps and podcasts before any of us old-timers did. I think this would be a great opportunity for you to tell all the young ones under 30 that have probably just been out five years ... You've seen dentistry in probably five of the continents better than anyone. You've been published forever. Walk them through dentistry. How has dentistry changed from when you got out of school to now 30 years later? How is it like also over all these countries? Is dentistry the same in South Africa, London and the United States and Gibraltar? Just give us give us your big macro economic views, and then hopefully we'll go into where do you think it's all going? Where do you think it's been? Where do you think it is now? Where do you see dentistry going in 10 to 20 years from a research ... Are we still just going to be drilling out the holes in teeth?

Julian: Okay. Let's start real basic ...

Howard: Is that enough questions for the intro? Can I just shut up for the rest of the hour? 

Julian: I think so, yeah. Christ, you're going to have me rushing around like a blue air flight quite soon. Okay. Where did we start? I qualified at the time where we didn't wear gloves, or we wore gloves but really only in a hospital setting. General practice was all about barehanded dentistry and knuckle rides. Then when I went to to Gibraltar I started treating some of the seamen that were on ships with real problems. It was how many layers of marigolds could I get on to actually, first of all, to actually what to do any treatment for these people. That was where I really changed my practice of dentistry. 

Then, of course, the HIV scare came along which really changed the face of how we clinically manage, not just people who were ill, but people in general. Now to actually treat or even touch a patient without a pair of gloves, actually feels very strange and very odd. I started off ... I remember sitting in a dental chair as a child where this guy had to treadle away quite hard to keep his rotors turning. I've seen dentistry move from a treadle mill, moreover, like a pedal sewing machine, go through to be electric motors to then the turbines. Sad to say, I've actually suffered from it too, in that I have now middle ear deafness because of the actual high frequency that some of our turbines work at. 

If I was talking to newly qualified dentists, I'd be saying, "Look after your health. Really do a lot of online research to take the right nutrients. Protect your ears. Protect your eyes. Don't go for fancy small glasses. Go for a pair of glasses which look like huge goggles because if you lose your eyesight, you're really screwed as far as dentistry is concern. Look after your health. Do exercise. Make sure you have time away from the practice." I remember I built a practice. I sold it. I built another practice, and I sold that, and actually made myself quite ill, because I didn't spend enough time out, just enjoying life. I was so locked into either making the practice work, or building the practice, or having to meet bills that you actually lose sight of having a life. I would urge young dentists to try and balance your life as much as possible, because if you don't then ... You don't want to wind up like me, and you certainly don't want to wind up ill. I think both of us, Howard, have lost a lot of hair because of stress in dentistry. 

Materials have changed as well. I grew up in an area where we actually still hand mixed amalgam. Then it went to encapsulated amalgam, and then we abandoned amalgam altogether because quite a lot of us decided it was unsafe. Then we started putting in plastics and composites. Then along comes a whole bunch of research, certainly which I've published around, which showed us the plastics and composites are really probably no better from the bisphenol aspect of poisoning the human reproductive system. If you look at some of the research which was published from the Netherlands, the researchers there have suggested that the decline in the birth rate in the western world is purely down to plastics and the pseudo hormones which we've actually put into our patients and into our bodies as well. 

I'll be looking to ... I mean, if you have to do a filling, if you have to drill a tooth, look at something like using either gold or go back to looking at some of the newer milling machines where you can mill an inlay and just prop it straight in. That I think, would be a fantastic way, and if I were starting, I would be definitely looking at that sort of technology. In terms of fillings, I still like the minimal invasive technique where we're using air abrasion. I think it's very undersold. I think it's very underused. It's a very old technology which still, I believe, has a fantastic place in the management of people. Of course, if you combine that with advanced detection system, maybe DIAGNOdent, even though it's relatively old now, probably hasn't been superseded in any real way by any of the other technologies for diagnosing early decay, long before you can see it on x-ray. 

If I can share quite briefly with your audience that I've been up before professional councils in the UK, and part of their case against me was I didn't take x-rays. Yet I knew that if I did take an x-ray, it would actually add to my diagnosis, and it wouldn't actually add to the way that I was going to treat the patient, because I'd already taken the DIAGNOdent readings. To take an x-ray, I wouldn't have seen anything. I sometimes look at some of the things we're told we should do, or we have to do to protect our backs, and as part of informed consent, and as part of our protection against being sued, I think sometimes we've created an atmosphere where patients are invited to sue us. 

We probably deserve everything we get because as a profession, we're not very good at sometimes talking to our patients. At times, I believe that we do set ourselves up for failure. It's trying to teach young dentists how to avoid some of those pitfalls, and certainly that's where some of my lectures have now moved to. Quite a part from the course, ozone which you know ... I've been publishing now research articles about ozone for the last 20, 25 years, that and tooth whitening. It's actually quite nice now to be in a position where I can share that information, and I can share that experience, and hopefully show younger practitioners that dentistry has a fantastic future. 

As far as I'm aware, there's no real evolution which has allowed man to develop without teeth. We've still got 32 teeth. We've still got 32 opportunities, 3 or 4 times a year, or however you wish to set your practice up, not only to look after patients, but also as a specialist community to actually have an income as well. 

I think that would be my macro overview, Howard, of sort of where dentistry has been for me, and where I feel it's going. I think we fail our patients a lot of a time in that we don't diagnose early enough. We do have some really advanced technology which can help us. Where we do have to intervene, we still have horrendous aspect of the dentistry, which is tooth extraction. One of the reasons why ... If you look at Pankey, one of the reasons he set up the Pankey Institute was he just got tired of taking teeth out. Likewise, when I was working in dental school, I took a lot of teeth out. In my first year of practice, I took a huge amount of teeth out, and it was very nice to step to one side and to private practice, and say, "There are alternatives to actually having to take teeth out." I think that's pretty much sums sort of what I've seen.

Of course, implants. Implants have changed people's lives. They've gone from being edentulous to suddenly having a new set of teeth, and of course, they come with their own set of problems. Research is still continuing as to how do we save the implant, which is not looking quite so good. We have failures as well as we do successes. At this stage, I would say I am quite biased in some of the research which I've been involved in. Because once I took ozone on into practice, the level of failure basically disappeared. We had cases of putting implants in where we didn't even come close to the five percent failure rate which was being talked about in the dental journals for the upper and lower arches. We were like so one or two percent, and the cases which were starting to fail, we managed to rescue. 

Again, when I talk about implants in some of the lectures and presentations, ozone forms part of that treatment management. I guess in having moved with one foot out of clinical dentistry and into actually manufacturing dental equipment, part of the protocols for ozone in general dental care is that ozone has a part to play in every single facet of a patient management. Not just in dentistry, but also in medicine and veterinary care. Of course we all live in modern towns where all our water supplies are ozone treated anyway. You can't get away from ... My favorite area of research, which I guess is ozone.

Howard: Why don't we start from scratch there. I'm sure there are a lot of kids who got all the way out of dental school, in a US dental school where all your work on ozone might not have been taught. It might not be part of the curriculum. I feel sorry for dental schools. A lot older dentists, they're always complaining that the dental schools don't teach this, the dental schools don't teach that. I'm in dental schools a lot, and to take 100 kids off the street and four years later turn them loose on root canals, fillings, and crowns, and implants ... The dental schools are overwhelmed. Why don't you start ... Basically the premise is that we basically fight two Gram-negative facultative anaerobes, Streptococcus mutans, Odizonoxygen, and P gingivalis, Odizonoxygen, and you were the first person that I ever heard about that was actually instead of trying to kill these bugs by drilling and filling, you were putting ozone on them. Why don't you walk us through the beginning and did it take off in more countries more so than others? Where is it at now? Do you see it making a rebirth?

Julian: Okay. I wasn't the first, Howard. 

Howard: Who was the first?

Julian: The guy who actually made that essential link with ozone was a dentist called Edwin Fish, and he was back in the early 1900s. 

Howard: How do you spell his last name? 

Julian: F-I-S-H.

Howard: Like the fish, and he was a dentist?

Julian: Yeah. He was a dentist in Switzerland and Germany. He really started the ozone movement within dentistry in a very small way. How myself and Edward Lynch, who's now at Warwick University, really stepped into this. We were doing quite a lot of research around tooth whitening. At one of the conferences we were chatting away over dinner, discussing who had asked what question, and somebody came along to the table said, "You know you really ought to go and have a see what's happening in the next door conference center because they're all talking about ozone." I went, "Oh, that's very interesting," and then carried on with my conversation. The next minute I know Edward is sort of digging me in the ribs saying, "This is what we need. This is what we need. This is what we've been looking for." 

He made that essential link which I guess is why he's prof, and I'm just an ordinary dentist. He made the link where he could see that ozone would kill the biofilm. If you could kill the biofilm and the bugs which cause decay, you could then put in place for chemistry, which would cause remineralization, without the need to drill and fill. Our first premise was can we show that ozone kills bugs? We have the special machine, which is called H NMR, and we can actually look inside the chemistry of what happens. We knew the dental research community would have an enjoyable amount of fun to completely dismantling the research, unless we went back to basics.

We went right back to basics of the chemistry, with the bugs, what happens to tooth samples before and after. What we showed was the profile of all the bacterial byproducts and bio acids are completely neutralized. They go from a pH of about 2, 2.5 to a pH of about 6, 7. If you change the pH, and you take away the biofilm and the bio acids, the only thing that's left for that tooth to do, is actually suck up minerals again because you've changed the whole environment. Then we took it into Belfast University, where Edward was working at the time, and a whole team of PhD students, of whom I was just one, we started looking at different facets. My facet was looking at tooth whitening, but I very quickly got distracted and along came ozone dissolved in various oils. I went off in one direction and the ozone research on hard tissue services went in a different direction. Now we're just looking at ozone in health care in general. 

Where we are now is that we know that we can reverse decay. We know that we cannot allow remineralization to occur. One of the questions I was asked a few years ago now by an American dentist was, "How could I be so sure that it worked on American teeth?" Because we've got ... All the studies we've done in Europe about the stage, and I just looked at this guy and said, "Where do you think most Americans have their ancestors?" I think that put that very neatly back into context for that particular gentleman. Ozone really started, as far as the clinics in the UK, that was where KaVo was. That was where Edward was, and we had the HealOzone which was made by KaVo. We had the foundation user group which was actually 20 selected practitioners. We started publishing papers. This was back in 2002, 2003. 

From there, Edward and I went to lecture in Europe, and we started teaching in Europe at various meetings. We traveled to Hong Kong together. I've done an interesting trip around New Zealand and Australia. Edward has traveled in virtually every single country, I think again apart from South America. Then I got invited to one of Chris Kemmer's and to the Generation Next group. I started promoting ozone at those meetings, and that was really where we started to see users start to take that research and actually put it into practice, in the USA and Canada as well. Now we actually have a very strong footprint in Canada, in the US. It's very strong in Europe. We still have users in Australia and New Zealand. We have people I know who are using homemade machines in India. 

Bill Domb, who is current chairman and president of the International Association of Ozone and Health Care, that used to be dentistry ... He took a group of people and went to China a couple of months ago. Late last year the International Association had a meeting in Cuba. I had lectured in Cuba. I've been exposed to some of their early research back in 2003, 2004. I brought that back into the UK, and I brought that into my own research. Now we're working quite closely with some of the Cuban scientists, really progressing the research in terms of general health care, wound healing. There's quite a lot of research now which is looking at facial and basically body rejuvenation. It's really moved ... 

I guess I have taken one foot ... I used to have two feet industry. I've now got one foot in medicine, and one foot in dentistry. It can be fairly uncomfortable at times, but I think I'm probably having more fun now than at any other time in my professional career. Because I have been around at the time where ... It's almost being at the right place at the right time, Howard, and I'm sure you've had experiences like this for you, where you've been able to make a difference, in not just one or two peoples' lives, but in a huge number of different lives. 

I now, in this country, I have set up an ozone clinic, and I work with ozone therapists. I also work with doctors who treat with ozone. I've been able to help people whose legs have been scheduled for amputation. We've actually managed to save the leg, so we've been able to combat the infection. We've actually healed the ulcer, and we can now manage that patient for the rest of his lifetime. 

Likewise, we have patients with cancer who we can actually show that no longer have that huge growth of uncontrolled tissue which is going to kill them. We've lost patients as well. It's not a 100 percent cure, but we do offer hope for some people who've been told, "You've got four months," and yet we've been able to extend their lives usefully or maybe 3 or 4 or 5 or more years. For me, ozone has opened a new dimension, a new area of my training where it's almost being off service and giving back to a community. As a private dentist, I certainly feel that I exploited the opportunity to make money. Here in South Africa people don't have a lot of money, and it's very nice to actually be able to offer something of myself and say, "We have a system which doesn't cost very much money. We can treat you with this." hat's where I am now.

Howard: Now you're treating decay mostly with the ozone in South Africa?

Julian: In South Africa it's everything from decay. I work with a couple of dentists in Cape Town and around South Africa, but I also work with medical people where we're treating ulcers. We're treating skin disease. We treat malaria. We treat HIV patients, so it really is completely across the board. That's why I said earlier I don't consider myself a dentist strictly any longer. I am in health care. I firmly believe that dentists, even though we train, and we become very focused on what we do, dentistry is not about 32 teeth. It's actually about the overall health of a patient. Because remember, there's a lot of medicine that presents tours, and we see disease long before the general practitioner, the general medical practitioner even gets a chance to step in. It's that aspect of dentistry which I'm actually enjoying at currently. In that, I've moved away from dentistry, and I'm now in health care. I'm offering a suite of services. It does include dental work. I do offer dental advice. I work with dentists here, but I'll probably do more medicine related work now. I've moved away from strictly being a dentist, Howard.

Howard: Tell our viewers ... My fans in the podcast, they're all dentists, so they're probably not as interested in malaria and what have you. How do you actually treat a cavity with malaria and also back to your early comment on DIAGNOdent. I think most people think DIAGNOdent diagnoses occlusal pit and fissure. How do you use that for interproximal without the need of x-rays?

Julian: DIAGNOdent is just an aide to diagnosis so you need to use it with other tools. Occlusal pit and fissures I think everybody doesn't have an issue with DIAGNOdent because we all know that it works on a laser system. The light shines into tooth. It measures what comes back and gives you a number, and it also gives you a call sign as well. That tone you can virtually track how the decay is tracking. Where you have interproximal decay, or where you have the beginnings of interproximal decay, transillumination I've always found to be really useful, and I will still use that. What I would probably do ... If I know that I've got occlusal decay, I can probably guarantee that at somewhere along the line I've got interproximal demineralization. 

I am probably already thinking in terms of, unless we've got a frank hole which I can find, I'm looking to remineralize those teeth as fast as I possibly can. To do that, traditionally what you do is you can't remineralize. You basically open up a large hole. You dig a class I or class II cavity, and then you put something in it, whatever that may be. For me, what I tend to do more for my dental patients now, is I build a full mouth shield, and we hook them up to an ozone machine, and we pump ozone into that full mouth tray for between 10 and 20 minutes. That has a number of effects. First of all, Howard, it will kill all the bacterial content around those teeth. Good guys, bad guys, the lot. It sets up the complete arch for remineralization. As a byproduct it also whitens the teeth as well. We've got now the biochemistry has been set up for remineralization. 

As all dentists do, we give them a nice pep talk on oral hygiene, continuing care at home, and what toothpastes currently are the best out there. There are a number of really good toothpastes, but probably the ones which I recommend most are Sensodyne Repair because it contains novamin. Although there are more modern versions of novamin which are coming through, novamin has such a brilliant pedigree, that it will act not only in acid, but also alkaline conditions. We know that the remineralization systems work and irrespective of how you feel remineralization works or doesn't, we can actually chemically, and from the research, show that remineralization with novamin is probably the best way forward for the majority of patients. It's all about diet or hygiene, keeping the mineral content of the saliva as high as possible. Keeping teeth clean as possible. Again we're going to be going to be talking about flossing. 

There's a new system which I can actually talk to you about now, I couldn't a couple of weeks ago, where we have microencapsulated ozonated oils so we can impregnate a dental floss with ozonated fluids in a micro capsule, which then become active as you start to floss between teeth. This allows the ozone treatment to continue as an at-home basis as well. That's your diagnosis. Treating it ... I would use ozone in virtually every single instance because it's a technology which I'm used to using. I've used it for 20 plus years now. I would totally agree with you that the vast majority of dentists coming out of school, the way they've heard of ozone is probably there is diminishing amount of it above their heads, and they're going to fry, and so you need to put some extra head protection on.

Ozone has been around in medicine now for nearly 200 years, so it's not a new technology from that point of view. The FDA in your country still has a problem with ozone, which I think is very sad. We don't have a similar prescriptive organization in Europe where ozone is used almost on an everyday occurrence in general health care. The American Association of Ozone Therapists, AAOT, led by Frank Shallenberger, probably is your greatest promoter along with the International Association of Ozone in Health Care, which is a group which I helped founded three, four years ago. I've stepped down from the presidency of that and Bill Domb has now taken that over. We're planning a conference next year which will be in 26th to 30th of October in Tampa, in Florida 2016, where we will be progressing how ozone is used in dentistry, but also opening it up to health care therapist in medicine, and also in veterinary and industrial care. 

Remember as I said earlier, we're in health care. We're not just dentists. There's an opportunity to actually talk with colleagues from a number of different specialties. Howard, it's something which I've just been ... I have one of the committee members of the International Association here is actually on vacation at the time, and we'd like to extend an invitation to you to come and talk to us. If you have time, I'd like you to make a note in your diary, Tampa, Florida 2016, 26th to 30th of October. 

Howard: What will you be teaching there at that conference? 

Julian: We're going to have vets, we're going to have doctors, and we're going to have dentists who will be talking about their experience with the use of ozone in general health care, and within their sub specialties. We're also going to be running workshops to actually show people how ozone can be used in those specialties as well. I'm running a workshop on the use of ozonated oils. For me, ozonated oils have pretty opened up a completely different area of my practice in that I can now treat gum disease. I can treat failing implants. I can treat ... I can't remember the last one I saw of dry socket, certainly not one that I'd created. We treat wounds, herpes, basically you name, the ozonated oils or the ozonated liquids have a role in that patient management. 

We'll be opening that whole facet of research up to show people how to make these oils. If they don't want to make them, who makes the best oils. How to apply them, what protocols to use. Opening this up too as a general forum for practitioners to come along, listen to some of the world experts on ozone, not just from the US but also from Europe, and from the UK, and myself from South Africa. We'll be there giving delegates 30 plus years of clinical experience with some of these technologies so that we can actually progress its use within healthcare itself.

Howard: Tell the viewers who are listening from around the world now ... we have people downloading this podcast from 206 countries ... What is it like being a dentist in South Africa? Do they use water fluoridation? Do they drink a lot of Coke or soda? What is the decay like? What is the delivery system? Give us a first world report on dentistry in South Africa.

Julian: Dentistry in South Africa is, for the clinician, quite difficult. Most of the material we use is imported, and at moment just to set the scene ... The pound-rand exchange rate about six or seven months ago was about 15. Now it's 21, 22. Per dollar it was about 10, and it's now about 15. Everything which is imported suddenly becomes 15, 20, 30 percent more expensive. That goes for implants as well. Running a business which is totally reliant on importing product from other parts of the world is a challenge. Dentists are governed by various rules in this country about what they can charge. 

Private practice is relatively rare in that private practice is actually controlled by the government and by the health committees. There is a public service which is available, very basic. In general terms, in the poorer communities, it's extraction and nothing else. I remember about 30 years ago when I worked in Spain, you'd walk along the beach and this really pretty Spanish girl would come up towards you, and you would smile, and she would smile, and you thought, "Holy shit," when you saw basically whole series of class IV holes going from 3 to 3. That's the sort of thing which is more prevalent in this country in the poorer populations. 

Howard: How many people live in South Africa and how many of those would you say are poor versus how many are those that would be considered a typical middle-class you would see like in London or Germany?

Julian: Okay. We've got about sixty million people here. There are probably about, I would say between 30 and 40 percent of those will be classified as poor, in terms of that they would seek the government style dental treatments. They would predominantly be classified as black, Asian, colored and of mixed ethnic origins. 

Howard: That's 30 to 40 million out of 60? Half to two-thirds?

Julian: Yep. I mean in the same way that Europe is suffering an influx of refugees, South Africa has a set of refugees which come from the northern borders. Those people tend to come from the poorer countries seeking an economic relief. Basically, most of the people that I see are of European origin, so I tend to see people who have really good oral hygiene, who have well solid grounded dental knowledge, and who are well versed in what they can find on the internet. That is not the majority. If I go out to say Khayelitsha, which is one of our townships, the vast majority of the people I see there, especially if they're from 30 or older, they will probably have dentures, and if they don't have dentures, they'll be missing probably between 20 to 30 percent of their teeth.

Howard: Is that because they have a high sugar diet too?

Julian: Yeah. 

Howard: Do they have water fluoridation? Is it just a lot of soda? Why ...

Julian: We have numerous fast food companies down here who are promoting very heavily their products. The number one drink is Coca Cola, Coke or Coke look-alikes. Pardon me. The effect of that has been devastating in terms of ...

Howard: When did you first see that? I mean were you in South Africa ...

Julian: When I first came here. 

Howard: Coke was there before you were there?

Julian: Oh yeah, absolutely. I remember when Coke first came to the UK, and we all went crazy about it until we suddenly realized what it was actually doing to teeth. This country still hasn't actually got around ... If I compare say in the schools where a lot of fizzy drinks are now banned. In this country they're still actively promoted. I was at a hospital about six, seven months ago, and this huge container of Coca Cola rolls up, and I'm actually sitting with one of the leading dental pathologists who just looked at this and said, "I have tried so many times to get this stuff banned. It causes so much decay and so much illness with my patients."

Howard: When I was doing charity dentistry to an orphanage in Tanzania, some of the healthcare professionals there were telling me that a lot of health care professionals were recommending to drink Coke because the alternative might be dirty water with cholera, and death from diarrhea has put out nearly four million earthlings a year. Does the South Africans all have clean chlorinated water, and is therefore fluoride in it, or are they drinking Coke because they don't want to drink dirty water?

Julian: We do have bottled water as well, Howard. There is clean tap water is actually taken into these townships, but you're right. Certainly in the rural areas there is a huge problem with pollution. It's not just pollution from a bux, but it's also industrial pollution from the old gold mines and from the old copper mines as well which exists in this country. From that point of view, you're quite correct. If you're drinking a bottled drink of whatever origin, you're probably less likely to wind up with a very nasty infection or disease. The issue now becomes is how do you control that, and how do you control an emerging population of people that actually has an obesity issue, that has health issues, and also that has decay issues? As a country, South Africa really hasn't got a grip on it. You're like a public funded look alike to either Obamacare or the NHS that exists in the UK. It's simply not there and as yet, there's no political will to actually put that in place either. 

It's left to health care providers like myself and to emerging dental students from various universities in this country to try and put together and formulate some sort of health care protocol, where hopefully we can actually manage the decay, we see we can manage BBC. We can actually manage the disease which we see too.

Howard: How long have you actually been in the UK, I mean in South Africa? 

Julian: I came here to lecture 25 years ago. I've been here full time since 2000.

Howard: You've been there full time since 2000? When was apartheid ended? 

Julian: That was was late 80s, early 90s that was dismantled ...

Howard: From 2000 to 2015 are you seeing South Africa in those 15 years, do you see it getting better, faster, easier ... Do you see it making progress to where you think another 15 years it'll be richer, better, higher-tech, etc. or do you see it plateaued or are the problems ...  How big are the economic issues in South Africa?

Julian: Interesting question. From my own perspective what I see is an emerging black middle class who will eventually drive out the ruling party, and we will see hopefully great changes for the positive. Currently, we have a group of politicians who are only interested in squirreling away as much money coming from the country as they can possibly get their hands on, usually in Swiss numbered bank accounts. The money doesn't get actually spent where it should do. It gets diverted into private private retirement funds. As a health care provider, it is distressing at times to see the levels of poverty, and the levels of infection and disease, which if they actually put their minds to it and used the funds correctly, we could address them in this country. That's my take. 

Howard: I've flown so many flights to so many countries and a couple of times I've sat next to people on airplanes that were a developers, United Nations, senators, etc. They always say the same joke, they always say, "I met a businessman in America, and he pointed to that bridge, and he says, 'See that bridge over there? Government contract, I pocketed 10%.' Then you go to China and the businessman says, 'See that bridge there?' You say, 'Yeah,' and he goes, 'I pocketed 25%.' I go, 'Yeah.' Then you go to Africa and the businesses says, 'See that bridge over the river?' The guy says, 'No.' He goes, 'Yeah I know, I pocketed 100%.'" 

Julian: Absolutely.

Howard: The economist has always said that if they could line up the success of the economics of all 206 countries, that law and order will predict economic outcome more than anything.

If the government is corrupt, if there's kickbacks, bribes, nepotism ... All that stuff is what hurts an economy more than any other variable. You just can't build a great economy if you can't have investment dollars come in there and invest it under the rule of law, and everybody knows what rules they're playing by to get the return on investment. Yeah it's a tricky situation.

Julian: I would totally agree with you. 

Howard: Why did you personally ... Out of all the places ... You've lived ... You've been all around the world. You've basically lectured in every major city, you said, except for most South America. Why do you choose to stay in South Africa?

Julian: I came here 25 years ago, Howard. I lectured first off in Joburg and then I went to Durban. I was brought up in the far east, Singapore, Malaysia back in the 60s, so Durban felt a little bit more like home than anywhere else that I'd actually lived. Then I came to Cape Town. Cape Town was for me like coming home. That's the only way I can describe it to you. As for plane, you sort of came in, and you have is fantastic view of Table Mountain on one side, and what at that stage was the sand dunes of Cape Flats stretching all the way down to Somerset West and Stellenbosch. I felt this incredible sense of ease. I stayed a week. I organized study groups so I had to come back. At least that was my entry excuse to come back. 

Irrespective of the problems which are here, for me, South Africa or Africa, is home. It's the only way I can describe it to you. I was warned as soon as you go to Africa, it gets under your skin, and absolutely. I came here once. I had to come back. Then I had to come back another time and then I moved here. I live here. This is my home. My wife is here. Our house is here. We have two dogs. A lifestyle which is dictated by sometimes a government which you rather wasn't in power. We all have issues irrespective of where we live with whoever is in charge of the time. Yes, it is an unsafe country in some respects in that life is very cheap in this country, and they will tend to shoot you for a cell phone. Then that happens also in London. It happens Europe, and it happens in the states. Personally, I don't see any difference in the dangers of South Africa to being in any other country. 

Howard: For the American listeners, who are some of the ozone champions in America? I know there's..

Julian: Chris Kemmer? 

Howard: Chris Kemmer. He's in Wisconsin, or where is at ...

Julian: Madison, Wisconsin. 

Howard: Madison, Wisconsin. He's also known as ... He's a great marketer too. 

Julian: Dr Chris. I've known Chris for 20 plus years. He's probably my number one friend in the states. I think he's an amazing guy. He's really passionate about dentistry, and very passionate about getting the best for his patients. I would put certainly Bill Domb. He's in Upland in California. Bill's just retired, but he has introduced probably more dentists to ozone than any other person in the US.

Howard: Bill Domb? 

Julian: Yeah. Then you have Eric Ziminsky, Marc Weiser, Sandra Leighow. She is down in Florida. There are literally hundreds of dentists. If you look at New York, you've got Jonathan Abenaim. He springs to mind. Peter Silver, he's in central New York. If you go on to one of the websites which I look after, which is, there's a huge list of people in the states who are on that site.

Howard: Bill Domb, he's a blogger too, isn't he?

Julian: Sorry, say again. 

Howard: Bill Domb. He does a lot of blogging, doesn't he? 

Julian: He might do but I haven't seen any of it, but I know that he certainly does a lot of publishing, and he does a lot of teaching. He's flying continually between North America and South America and taking ozone into South America to help communities which have high decay rates. 

Howard: Now I always associate your name also with Tim Rainey.

Julian: Down in Texas, yes. 

Howard: St. Refugio, Texas. 

Julian: Yeah. Tim and I have been friends for many years. He was probably one of the first people who came on board after Chris Kemmer with ozone. Tim has a beautiful system that he integrates ozone into an air abrasion system. So he actually ... Ozone treats the tooth as he's treating it. I think that's a fantastic application, but he's actually put together and invented. Tim would definitely be on my ... If you're going to be at the meeting next year, Howard, you'll meet Tim there as. 

Howard: Time Rainey is going to go there again?

Julian: Absolutely.

Howard: I actually took all four of my boys to Tim Rainey's course because I was talking to ... And for a hobby he likes to shoot machine guns and pig hunting. I have 4 boys and the oldest one likes to hunt. Dad and the other three boys, we just go with them. I won't shoot anything unless I'd eat it. I would have no problem shooting a cow, but I have no interest in eating a deer or an elk, or a pig or any of that stuff. Anyway we went down there, and Tim was so adorable to my four boys. He gave them these big old machine guns, and took them out there, and they were shooting that, and they still ... They probably remember that dentist more than any dentist around the world with those big machine guns. 

What is an ozone machine look like and how much is this? When you seal off a mouth and pump it full of 03 to be extra caustic to a gram negative anaerobe that can't live on oxygen ... How much is that machine? How portable is it ... Talk about the machine. 

Julian: Okay. The size of the machine is probably about the size of a shoe box to much bigger. It just depends on what sort of machine you're looking for and what you want it to do, and what else you want to do with it. Some something like the healOzone was the size, probably weighs about 15 kilos, and was quite heavy. The CMU3 which I helped design and which I now sell through grey cells, that's about the size of a shoe box, and probably weighs probably about 2 pounds, not much more than that. 

In terms of cost, anywhere from about $5,000 upwards, again depending on what you wanted to do. You can either have a low concentration stream of ozone, in which case you've got to expose the tooth a to slighter longer treatment. That allows you to have a cheaper machine. Or you have a much more concentrated ozone device where you need to seal off the tooth in some way. The healOzone and some of the other ozone systems work by forming a little ... Have a little cap that you put around the tooth. I always found that quite awkward and certainly for me, the key to the success of the healOzone was always going to about, how easy is it to actually make the seal around the tooth before the machine will actually operate? A lot of dentists found that very difficult so that was why we designed the CMU3 which was just an open stream, but you need to very carefully control how the ozone, or where it goes to. 

What it does to the bacteria? It instantly kills them. It's such a short treatment time, Howard, that it allows you to move on very predictably in dentistry from, you're not quite sure if you've left a little bit of infection, and is that filling going to fail at some stage in the future ... What ozone does is, it doesn't matter if you leave a little bit of infected dentine there because the remineralization will take place anyway. The bugs are all dead. The micro nutrients are all gone. They've all been oxidized. You've got an improved pH which is going to generate secondary dentine and secondly remineralization. Dentistry becomes incredibly more predictable. As I said earlier, ozone has a place in every single facet of dentistry, irrespective of what you want to quote in terms of a dental application, ozone has a part to play in it. 

For me the future of dentistry is all about infection control. Caries is just an infection of hard tissue. The issue becomes how do you have access to it? How can you get at the infection? How can you actually recognize what's going on? How can you diagnose it as such an early stage where you don't need to drill and fill? That's where DIAGNOdent and where air abrasion has a part to play because by combining these technologies, which is part of courses and part of what we teach, is that you don't have to drill and fill. 

If I take the listeners back to ... There's a beautiful scene of a little shop of horrors where the dentist gets on his knees, and he's got this lovely altar and instead of his momma, if you put your a couple of turbines there, that's where dentistry is a lot of people. They worship the dental drill because that's what they know. For me the real success is taking a dentist out of that shrine area and saying, "You don't have to drill and fill. All you need to do is sterilized it. Find a way to seal it successfully for a long term, and then that patient is probably much better treatment." 

Because remember, it's all about how much tooth tissue can we preserve? As soon as you make a teeny weeny hole in a tooth, you're going to lose the strength of that tooth. That's something which Graeme Milicich and Ray Bertolotti are talking ... Quite soon you've got the two key leaders of dental materials in the US talking together on the same platform. Graeme who is coming up from New Zealand. Ray who you know lives in Los Angeles, or the San Francisco Bay Bay Area. The two of them are doing a round robin meetings around the US later in the year. For me that is a golden opportunity for people who have never heard them before. Go and listen to Graeme. Go and listen to Ray because you will learn so much about where dentistry is, what we should be doing. Also, what the research is showing us how much we've destroyed in just making a teeny weeny hole in the tooth. It's frightening, Howard, it really is if you look at some of the research of how we set our patients up for failure. 

Howard: Well, I'm going to end on that note. First of all, I absolutely love and adore Raymond Bertolotti. I think he's a legend in dentistry. His wife, Mary, is beyond adorable, and he's just amazing. We are out of time. I just love the internet so much to be able to be talking to a dentist all the way from South Africa, bordering ... What do you border, Zimbabwe, Botswana, Namibia, Mozambique? 

Julian: Absolutely, and a lot of the South Atlantic and the Antarctica. You name it, it's somewhere down here.

Howard: I still ... If I had to name the most magical place I've ever been in my entire life, it's the Serengeti area, and the area around Mount Kilimanjaro to the equator. I mean, my God. When you're in the Serengeti, you just literally can't believe that places like this still exist on Earth. I have to tell you when I went to Tanzania, living if I didn't have four boys and a granddaughter living back in America, I could have stayed for the rest of my life. It was just amazing. 

On that note, do you think hopefully ... You should do search, Dr. Holmes, on Dental Town for ozone, there's literally ... We have 202,000 registered dentists on Dental Town, and they posted four million times and when I get a search for ozone, it pulled up 100 threads of dentists discussing ozone. I wish you and your friends would chime in and share your thoughts. Of course, it's hard to get two dentists to agree that today is Tuesday, so they're not going to agree on ozone. What I like to do is I like to give a voice to dentists from around the world. I don't work for the Centers for Disease Control or the FDA, and you've been publishing for 30 years. You've lectured all over. I've seen you lecture in various meetings, and it was an honor and a privilege that ... It's 10 o'clock in the morning here. What time is it in South Africa?

Julian: We're seven o'clock in the evening. 

Howard: You're nine hours ahead. On that note I just want to say, Julian, thank you so much. It was great to hear your voice again. Sorry the video didn't come through, but that's okay. Probably 85 percent of our listeners do sound only anyway, so no big deal. I hope you have a rocking good day, and I can't wait to see you in person. 

Julian: You too, Howard, take care.

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