'Tooth repair drug' may replace fillings | Hacker News Reader

'Tooth repair drug' may replace fillings

bbc.com

410 pointsclouddrover214 comments

This is insanely cool, and I imagine there is no need for me to explain how useful this would be in comparison to the current dental approaches today.

But is this technology ever going to be available to consumers? I remember reading about similar advancements almost three years ago and haven't heard anything related until now. Maybe I'm pessimistic, but I think we won't see this in practice for a Very Long Time™.

I really enjoyed this thread from a recent (two weeks ago) post about another advance in the treatment of cavities (a year before) that touched on this feeling.

https://news.ycombinator.com/item?id=13274183

That discussion got me on a search spree. Apparently others have picked up on the root-analogue implant idea and it is now available in the Netherlands, maybe soon in the USA: http://www.replicatetooth.com/for-patients

This one is still made of titanium though, the Zirconia ones by BioImplant seem to make more sense.

Anyway, not a cure but at least you don't need someone drilling into your head when cavities win a match.

There are some major issues with the Replicate system: a paucity of actual cases (I also can't see any long term follow-ups); and the fact that the actual implant is a dark grey - this unpleasant discoloration will show through gums.

BioImplant has a long history, with comprehensive case histories and follow-ups readily viewable on the website. This is very important for medical credibility. (I worked with the creator of BioImplant.)

On the other hand, Replicate Tooth has a very nice website!

I actually find these articles depressing because it seems like nothing like this ever ultimately comes to fruition.

I'm guessing these "breakthroughs" have always been just around the corner. I recall having a conversation with my dentist almost 20 years ago about things that were up and coming that were about to make our lives a lot easier in terms of saving and strengthening and building tooth enamel but none of what he described ever came.

I would of liked to been told `Nothing is going to come on the market` instead of `All this wonderful technology is going to solve any problems you're going to have`. The latter results in careless behavior, the former results more careful behavior.

Personally as someone as a kid was going up out-back Australia who's parents and care giver didn't put fluoride tablets into the water because it caused the water to `taste bad`. As a result I have screwed up teeth. Discussed this with this with my parents years later. Their reasoning for my teeth problem was poor diet and eating sugary food (Completely ignoring the fact they tossed the tablets into the bin).

Fast forward into the future with a family and two children I don't have soft drink, fruit juice in the house. Who would of known, all the kids teeth are great since our last dentist visit.

Fluoride decreases IQ significantly, be thankful that at least you are intelligent, albeit with bad teeth.

Source?

The practice of fluoride in drinking water does seem to be getting some push back of late. I did a quick google scholar search for "fluoride drinking water" and found some articles on both sides.

So does the practice of vaccinations, and without strong evidence that it's not safe, I'm inclined to take the lack of such evidence as significant, in light of the abundance of evidence that it seems to be helpful.

While I can't source the IQ claim, the evidence "showing" that fluoridation is safe to drink (as opposed to measuring by tooth health) is fairly scarce.

OTOH I've heard teeth are especially poor around Portland Oregon where they don't fluoride the water. I'd simply say the jury is still out.

I tend to think of iq claims specifically with a particularly large grain of salt: it's an index of society that people follow closely and is related to many, many factors.

https://www.hsph.harvard.edu/news/features/fluoride-children...

Aw shucks, I'm merely intelligent, rather than a genius?

Regardless of whether fluoride is a serious risk or not, it seems ridiculous to take a topical drug systemically. Fluoride works by inorganic reactions with the teeth themselves. There's no benefit to flooding the whole body with it. It's reasonable to be suspicious of water fluoridation when the same benefit can be achieved with fluoridated toothpastes, which deliver the fluoride only where it's needed.

As someone who grew up on well water with no fluoride in it I can confirm that my teeth are looking fine after all these years of regular dental checkups and twice daily tooth-brushing.

Fluoride occurs naturally (in varying concentrations) in water. Water with high natural concentrations is how we found out fluoride prevents tooth decay in the first place.

That is a good point, but according to http://www.ada.org/~/media/ADA/Member%20Center/FIles/fluorid... (p.10)

"Systemic fluorides can also give topical protection because ingested fluoride is present in saliva, which continually bathes the teeth providing a reservoir of fluoride that can be incorporated into the tooth surface to prevent decay."

It also says fluoride ingested during teeth-formation is incorporated into the teeth.

i'd rather be stupid than have bad teeth.

Didn't you use toothpaste with fluoride? Or is that not enough?

Used toothpaste with fluoride. Though the fridge was constantly stoked with sugar, fruit juice, bread and bread toppings. Kid of ironic that my Mum is a dietitian who is mobility obese.

>mobility obese

morbidly?

Stupid auto correct, yes.

Reasearch indicates that fluorided water is better at covering the surface area of your teeth--brushing with toothpaste mostly removes the layer of plaque and allows the active ingredient to work better.

It's actually phenomenal how little dental research has ever reached consumer behavior or dental care.

Instead of fluoridated water, you can always just use fluoride mouthwash/rinse which many dentists now recommend to be used daily.

Personally I only drink RO water as tap water tastes bad to me, but I use a fluoride mouthwash (Crest) every night after brushing and flossing.

Most of Europe and Japan doesn't fluoridate their water and they don't have notably worse dental outcomes.

It really has to do with toothbrushing and diet. Water fluoridation is just a way to get to the people who refuse to brush their teeth.

I think genetics have a part too. My grandmother was deported to Siberia (https://en.wikipedia.org/wiki/Soviet_deportations_from_Lithu...) for 20 years where they have 200 grams of bread a day at best and never brushed her teeth in her life and never had a tooth filling or missing tooth before her retirement, and I have half my teeth missing and I am only 30 years old. Fuck my life.

Could that also be related to diet? I'm guessing your grandmother practically never ate sugar if she was living on 200 grams of bread a day.

I've also heard that early modern humans had fairly good teeth for their age despite the presumed lack of dental care, presumably also due to differences in their diet from us.

Diet is super important. I used to drink orange juice every day. I got a cavity every 6 months. I have stopped drinking orange juice and have not had a cavity since.

I just heard a radio piece about how basically all humans had Hollywood smiles (where the teeth lined up perfectly) until the Industrial Revolution, when our jaws began to shrink and there was no longer enough room for all the teeth. I didn't get to hear the part where they discussed/hypothesized whether the changes were due to diet or environment or something else.

Yeah, there is undoubtedly a genetic side to it. My teeth decay rapidly -- as an under-two toddler, I had to undergo full anesthesia for a dental rehabilitation. Though neither my siblings nor my parents have very bad teeth, I've always been the exception (I guess I got just the right mutation). My pediatric dentist was always expressing astonishment at how quickly my teeth decay.

You know how dentists say "Hey, I can tell you drink a ton of soda, you need to stop"? I would get told this every time I'd go in for a cleaning, despite not drinking any soda and very little fruit juice/other sugary drinks for many years, 90%+ water only.

Fast forward 20-something years, and 2 of my daughters have had to undergo a dental rehab similar to mine at very young ages (though not quite as young as me), despite the stringent dental regimen my wife enforces to prevent this fate. There's no doubt that they got my bad teeth genes.

We're talking young kids here, ages 2-3 at the time of the operation (I was 18 mos. when I went down). They don't eat an inordinate amount of sugar, and as I stated above, my wife is very thorough with their dental hygiene. The water is fluoridated where we live. A lot of kids this age surely have much worse diets and much worse dental hygiene, but their teeth seem to be problem-free for many years.

Personally, I've had tons of fillings, 7-ish root canals, two teeth fully extracted because they were past saving, and several that badly need work and I'm not even 30 yet. Pretty much the only people living with worse teeth are opiate addicts.

I hope I win the lottery some day so I can get a mouth full of implants and be done with it. I hear the going rate for this is about $75,000.

A lot of people refuse to believe that genetics play any role, but that's absolutely not consistent with my experience, nor the opinion of most of the dentists I've had.

You might want to pay Dr. Kim Kutsch a visit, or at least watch some of his webinars on YT. One of the things he recommends that could help you is ordinary bleach (sodium hypochlorite) heavily diluted to about 0.05% as an anti-microbial rinse.

Serious question. Why are you posting health-related advice from a throwaway account? If it's something you are recommending to others, posting from an established account would have much more weight.

I always use throwaway accounts and don't see why account karma should confer additional weight on anything I say.

Here's an article that reviews the literature on diluted bleach rinsing: http://www.rdhmag.com/articles/print/volume-35/issue-6/colum...

It doesn't have anything to do with karma. From a throwaway account, I have no basis to know who you are based on your other participation. HN is a community. Pseudonymity is fine, but anonymity is counter to the idea of community. I encourage you to establish yourself and be part of it.

I know the other guy is giving you a hard time about the throwaway, but I do appreciate this. I'll watch some of his stuff, it looks interesting. Thanks for sharing.

I feel your pain on this one. I have a very similar problem.

My parents enforced our dental care and we went to the dentist regularly when I was young. Always once a year checkup and twice a year cleaning and still I had regular dental issues.

In the second grade I can recall being brought out of class to a tooth-care specialist the school brings in to teach kids who seem uncared-for to brush their teeth. I brushed twice a day.

When I was fifteen I remember being yelled at by my dentist about how I don't look after my teeth because I had "16" cavities (the dentist, mind you, in my later years I realized was actually a bit of a hack -- all of his work fell out of my mouth and left me in terrible pain).

Around this time the dentist put me on regular fluoride mouth washes -- I went home with a bottle of some god-awful "cherry" flavoured stuff. I _still_ had repeated problems.

Fast forward to the present -- I've had one infected wisdom tooth, one infected molar -- both had to be removed. I have one half-decayed wisdom tooth that will be extracted soon. This fall I've had to have 4 fillings (some of them were put off for a while mind you).

The next year I am pending a root canal and a crown, and my dentist also has informed me that (at age 30) I require jaw surgery or I face the possibility of regular migraines due to molar wear.

I floss, brush, and use mouth wash daily. I don't eat much sugar. My parents actually raised us on a lot of raw vegetables (my mother grew, and I was raised in rural southern Ontario in Canada -- something of a agriculture belt).

The only neglect would be that my parents could not afford braces when I was young.

There has got to be some genetic aspect. Or does Hacker News as a consensus believe in shit luck?

Have you tried oral probiotics? Mind you, I have no reason to believe they'll help you, but at this point why not?

I think I first heard about them on HN. BLIS and K12 are the keywords, if I remember correctly.

So ¼ of your genetic material had a diet in which she never had a filling, and you on a different diet at age of 30 are missing many teeth, and you conclude that it's genetics?

Either some leap of logic or information is missing there or you're drawing the wrong conclusion from your data

I think your oral microbiome is also important. I've heard about experimental treatments which replace the cavity causing bacteria with other strains that don't produce acids.

I read about that in the 90's- did anything become of it?

I was astounded when Viktor Frankl reported the same thing in Man's Search For Meaning, observed in his time in a Nazi concentration camp. Your grandmother may well have superior dental genes, but there is something unique about that bread diet and camp/deportation life, too. Sorry to hear about your teeth.

You are completely missing the point. Many areas already have sufficient fluoride.

It depends on the natural amount of fluorine in the water, if there's sufficient, then it's fine.

It's only in the relatively few areas where there is a deficiency that it's a problem.

And of course it also depends on diet.

Offsetting your claim are studies which show that where people exclusively drink rain water, there is a higher incidence of tooth decay.

The countries that don't fluoridate their water don't have minimum levels of fluoride required. Whereas they have maximum levels of fluoride contamination allowed.

I'm not one of those "fluoridation is a government plot to make everyone pliable" crazies. Just saying that it's far, far more important to BRUSH YOUR TEETH than to have a fluoridated water supply. Just seems to me like water fluoridation is just one of those crazy things Americans and places America has influenced do (such as using the customary measure system and circumcising their male children - sure if you dig deep enough you can justify it, but plenty of people get along just fine without it)

> The countries that don't fluoridate their water don't have minimum levels of fluoride required.

I think the point is that fluoridation is often unnecessary because of the natural amount of fluoride in the water.

The active component of tooth-brushing is removal of mutans-type bacterial colonies from the teeth.

Cavities do not form without cariogenic bacteria, provided with a food supply of simple sugars. If you have such bacteria, there are several ways to inhibit cavity-formation, such as by chemically hardening bioapatite with fluoride ions, or by re-mineralizing tooth enamel.

Communities would be better served by mutans eradication efforts, even though they could cost far more than the $1/person-year that fluoridation costs.

If I had the cash and political backing, I would put mutans-specific bacteriophages and tricalcium phosphate in a municipal water supply. I'd then subsidize dental office visits for persons in the affected area, such that anyone desiring fluoride treatments can get them at no additional charge, and offer gratis chlorhexidine/xylitol mouth rinse after every visit.

Kill the S. mutans; end cavities.

Water fluoridation is just a way to get to the people who refuse to brush their teeth.

That's not really true in and of itself -- fluoridation won't fix damage done by bad hygiene or diet. As someone else mentioned, genetics and other factors all play a part too.

I grew up in rural Australia, my parents fed us fluoride tablets when we were young. 1-2 fillings between 3 siblings, although I'm fairly sure our bore had a bit of fluoride in it.

I'm sorry you missed out on that, teeth problems are shitty

Same here but in Switzerland. 4 fillings between 3 brothers (2 are mine).

I remember reading an article about these scientists experimenting with blue light and the larger capacity to store data. ~15 years later blu-ray came out. All hope is not lost.

I remember when SSDs were always around the corner.

It takes a lot of time to turn a laboratory discovery into a reliably working prototype, then longer still for the industry to agree on standards and branding, and even longer to ramp up mass-manufacturing and get the distribution chain working.

We could discover teleportation tomorrow morning and it would be twenty years before teleporters were common-place. Everything takes time to be fully realized.

If you want to know what the near future holds look at what was discovered thirty years ago.

> We could discover teleportation tomorrow morning and it would be twenty years before teleporters were common-place. Everything takes time to be fully realized.

I can appreciate this example, though in the specific context of teleportation, there'll probably be a few decades tacked on to resolve the ethical dilemmas arising from the question of whether or not the person arriving out of the other end is in fact the same person.

(I'm of the position that it doesn't matter, but still... anyway, this entire thought was just a tangent off an example)

You say that now, but when you step up to the machine with the knowledge that you are about to cease to exist, while somewhere else a perfect copy of you gets to go about living your life, I bet you change your mind.

Ah yes, the dilemma of whether the person on the other end having your memories means that the current you didn't cease to exist at the departing end.

I think it depends on implementation. I wake up every morning and I'm pretty sure I'm still me. I go in elevators and each time the doors open I'm still me. So, what sort of transportation experience would change that?

Admittedly, the closes to teleportation I've ever felt was my first trip on a cruise ship. I went to sleep in one city, and when I opened my eyes I was suddenly in a city hundred miles away. It was magic. I also still felt like myself.

Well, sleep and cruise ships don't destroy and copy your body. Teleportation would be equivalent to being killed the way I see it, until we get a better understanding of conscience at least.

Your body slowly replaces itself. I'm reasonably sure that when you die you have replaced almost all of its atoms at least once.

I've been using the same broom for 20 years! Never needed a new one and I'd never think of getting a new one. Of course I've replaced the handle twice and the brush four or five times.

Theseus' Meatbag?

Eventually, the constituent atoms themselves perform a complete cycle (at the slowest rates) every ~7 years. Some substances (e.g. water) cycle much faster, obviously.

http://www.npr.org/templates/story/story.php?storyId=1189358...

Which tells us that sentient consciousness and identity is mostly about the continuity of a signal across only some cells (nerves), and mostly rides on top of standing waves supported by those special cellular processes, at frequencies of oscillation faster than the underlying polarized/ionic chemical processes.

How do I know? I don't know what happened while on was sleeping. I fell asleep, and perpetually a few minutes later woke up, but my clock told me it was 8 hours. What happened??

You know what happens when other people sleep. It's not an issue.

Here's a great old animation on this topic

https://m.youtube.com/watch?v=pdxucpPq6Lc

Better quality (but with Flash requirement):

https://www.nfb.ca/film/to_be/

I can think of an experience. The kind of teleportation in which you (or your copy) is teleported too close in time and space and the original is not destroyed.

Then your copy claiming your job, your house, your wife and your children. Just as you would do.

Also if the transport process takes 20 lightyears, when do you send the ACQ? Will your original walk around for 20 years and then have an automated kill switch?

Why is it better if the original is destroyed? That's the whole issue here, the process in your example, when working as intended, just kills a person and makes an identical copy.

>Then your copy claiming your job, your house, your wife and your children. Just as you would do.

This sounds like a great scenario to me. I'm sure I would get along just fine with a duplicate of myself, and we could live together and get a lot more done. It sure would help a lot with avoiding burnout at work: we could take turns going to work, me one month and him the next month for instance. But two of us sharing one wife might be a bit much for her, so it'd be a lot better if we brought a second woman into the mix and lived as a polyamorous foursome (though this might be easier if we could create a teleportation clone of the wife too). It'd also be great having a double to help me on house projects, hobby projects, working on a side business, etc. And you mentioned kids: having an extra adult around the house to deal with them can only be a help, and since it's actually another me and not some other person, we're guaranteed to get along, have the same views on parenting, etc.

Honestly, I don't see any downside to this situation at all.

I would get a lot less [productive work] done if I had an exact duplicate of myself. My spouse would be jealous and disgusted at the same time.

But I am 90% certain that if my spouse had a duplicate, they would be yelling at each other all the time.

It would be interesting to correlate answers to the question "If you had an exact duplicate, with the same body as you, the same thoughts as you, and the same memories as you up until yesterday, how would you get along?" with various aspects of psychology.

The only problem I see here with your question is that no one really knows the answer, they can only speculate. I, for instance, think that I'd get along just great with my duplicate, and that we'd work together on getting more stuff done and enjoying more free time as a result. But I don't really know that; it's not like I've tried it before.

Why would your spouse be jealous of your clone? She'd now have two of you, so she's more likely to get attention when she wants it.

“I thought you said you could just read his brain electronically,” protested Ford.

“Oh yes,” said Frankie, “but we’d have to get it out first. It’s got to be prepared.” “Treated,” said Benjy. “Diced.”

“It could always be replaced,” said Benjy reasonably, “if you think it’s important.”

“Yes, an electronic brain,” said Frankie, “a simple one would suffice.”

“A simple one!” wailed Arthur.

“Yeah,” said Zaphod with a sudden evil grin, “you’d just have to program it to say What? and I don’t understand and Where’s the tea? Who’d know the difference?”

“I’d notice the difference,” said Arthur.

“No, you wouldn’t,” said Frankie mouse, “you’d be programmed not to.”

- Hitch Hiker's Guide to the Galaxy. Not actually about teleportation, but still apropos IMHO.

Think about that as you're taking also tonight. Is the person that wakes up the same person?

Why draw the line at sleep? Your consciousness, such as it is, is pretty fleeting and vague anyway. What reason do you have to think any self survives from one moment to another?

At least while awake, you may be fleeting but you exist in a near constant stream of "you", which make it feel constant. When you go to sleep your brain enters an altered state, which is only a subsection of yourself.

Who knows what will wake up from that?

Yes. You're not unconscious when you're asleep, you're just in an altered state of consciousness. Being actually unconscious is a very different experience; if you'd ever been through surgery with general anaesthesia you'd know about this.

Exactly. What if there's a bug and when your "copy" is created at destination original is not destroyed? Would you agree to be killed, should your copy agree instead? Even worse, what if there's an anomaly in transporting data, original is destroyed and copy emerges disfigured, dead or something in between? Teleportation scares the shit out of me.

As in the quite ancient https://www.youtube.com/watch?v=pdxucpPq6Lc

Original NFB source: https://www.nfb.ca/film/to_be/

https://en.wikipedia.org/wiki/Second_Chances_(TNG_episode)

Did you by chance read the short story "Think Like a Dinosaur" or see the episode of The Outer Limits based off it?

It presents this exact same dilemma. Up until that point I never really considered the potential ethical ramifications of teleportation.

Take full advantage of it?

I mean, cloning things has its advantages too. Could be a good idea for some people to deliberate screw up the process and drastically cut down on their daily workload. Or perhaps as a way for the less ethical to not kill or work alongside their accidental copies, but ship 'em off to join the army or something.

Teleportation going wrong can be just as exciting as prospect as it working out fine. Cloning has a lot of useful applications as well.

Damnit Jim!

It gets more fun when you start to think about it as different consciousness being created and destroyed, each with the same memories.

At what point do we start being afraid to fall asleep?

When you go to sleep your brain doesn't stop working. Comas, now...

This is why I have no problem walking through wormholes, but will never set foot in a teleporter.

Teleportation will not happen soon, if only because we've invested too much in autonomous cars already.

> it doesn't matter

There's a pun in there.

Teleportation would violate Relativity, so the good news is that the dilemma in question is actually impossible.

And when we're discussing medical care, the mandatory regulatory approvals are a significant cause of delay and cost. E.g. FDA approvals in the U.S.

They are a barrier to entry, and they are a measure to ensure safety of new cures. It's a tough balance.

Based on the history of drugs like Thalidomide, I'll pick safety.

https://en.wikipedia.org/wiki/Thalidomide#History

Safety is good, but it's not a dichotomy of "absolutely no safety" or "safety trumps all other things".

It seems to me that the safety aspect is currently very strong, on the expense of long time-to-market and high barrier of entry to market.

.....but we are talking about healthcare. Safety should trump all other things.

https://en.wikipedia.org/wiki/Primum_non_nocere

If safety absolutely trumps all other things, then there can be no trials of anything (because by definition, a trial is there to experiment and find out about possible safety issues) and there would be no development of new medicines at all.

That would not mean staying where we are, it would mean starting to slowly go backwards in the tools available for health care (because e.g. some antibiotics are slowly becoming inefficient and new ones should be developed - and currently the world is not doing enough of that.)

See e.g. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095020/

that is disingenuous... as you said "a trial is there to experiment and find out about possible safety issues". You have to test drugs before you can feed them to everyone safely.... but you obviously already knew that and just wanted to be contrarian.

..no. Treating sick people and improving the health of our species should trump all other things.

I will just cross my fingers that you eat a bunch of untested drugs then... for your health! :D

The flipside of that is the response to the AIDS crisis. If it hadn't been for activists from groups like ACT-UP and Queer Nation screaming, shouting and making a big stink about the need for a response from the FDA, the federal government more generally, and the pharmaceutical industry, there'd be a whole lot of people who wouldn't be alive today.

http://healthland.time.com/2012/09/27/how-to-survive-a-plagu...

https://www.opendemocracy.net/transformation/ray-filar/silen...

You are right, it takes time to invent and discover, and then time to roll down to consumers... But I think the second interval has been shrinking. It used to take much, much, longer between the time something is actually invented, and its use by the public (I think 80 years or something for some technologies). It doesn't take that long anymore for its use, not only in its home country, but globally. I live in Africa and touched an iPhone for the first time in 2007, the same year it came out. Why? Because I have a friend who used to watch Jobs keynotes (like wait for them)..and suddenly, the whole world knew about a product. Trade circuits have improved. Doing business with people you never met. All these shrink the time between the time Jobs wrapping up the show, and the moment it is available everywhere.

The first interval seems frozen, but I think this is Parkinson's law at work. Today's scientists and engineers have the best technology in History, and they're pursuing the boldest endeavors by that very fact.

I recall watching a man being interviewed in a swamp talking about finding some organisms there that had emit blue light. (?) years later we have OLED monitors.

I had a similar talk with my dentist, where I was optimistic about future and he put me back into reality. He took a piece of paper and started drawing tooth in its complexity - nerves, blood supply, several completely different and 'living' layers (somehow I pictured teeth as something rather simple, like a piece of hard stone inserted into gums), and then he said, do you think a simple chemical can rebuild all this interplaying complexity?

do you think bits and bytes can run the global economy .. plus maybe its a complex chemical ..

To be fair, fillings don't rebuild the complexity either.

Do you have a site for this 20 years ago claim? The first I've seen is one about 10 years ago, in the UK.

Previously, on HN: https://news.ycombinator.com/item?id=13274183 :)

It's funny. I often have the same reaction as you. Yet last summer I went to the dentist to have an old filling replaced with a crown. They took a 3D scan of my teeth and used that scan to mill a crown on site in about an hour. It fit perfectly and I could scarcely distinguish it from the rest of my real teeth.

20 years ago, all of this would sound like science fiction to me.

But I bet the cost of the procedure left a sizeable hole in your pocket ;).

On the plus side, drug patents are 20 years, so there is considerable incentive to get something out the door somewhere in that time frame. Hmm... maybe I'm not so anti-patent as I thought ;-)

I think it's only really depressing if an advancement is stuck idly behind something non-technical like lack of capital, or legal wrangling, or being acquired and shelved. Other than that, if there were real technical bumps that sidelined the advancement, well that's just part of the process.

What one really wonders at, is technology where there were technical failures, but were really a small distance away from success for lack of combination the right bit of information to push it over the edge - but are now locked away in storage in some proprietary corner somewhere.

You are not pessimistic. It's another one of those thing that have been only a few years away from commercialization for 20 years now.

This is happening so often, there must be a name or a law for that.

Pessimistically, that name is "Stagnation Hypothesis"

(edit, oops the term Peter Thiel/Tyler Cowen like is "Great Stagnation." See: https://www.youtube.com/watch?v=i_yJTCDU4uE)

Reminds me of a successful experiment where they caused mice to develop an immunity to plaque bacteria. I read about that in a dental training manual I found in a thrift shop about 20 years ago. Had photos of healthy rat teeth and everything.

According to a researcher on a recent Radiolab episode[1], 99.6% of results on mice don't replicate to humans. I assume for rats a similar figure applies.

[1] http://www.radiolab.org/story/bringing-gamma-back (about treating Alzheimer’s disease with light)

There are limits to its usefullness. Teeth wear down pver time. This may repair a cavity but cannot rebuild a tooth mechanically worn away with age or with fractures, often a result of cavities. Fillings may be less needed but crowns (i have three) arent going away.

Teeth are not perfect. If i was going to mars id have them all either crowned or replaced with implants. Teeth are strong, but not stronger than metal.

One way I filter my science news is to ignore all headlines that contains the word "may", "could be", etc. I don't recall in recent times seeing an actual product release corresponding to one of these headlines. Most of the time its just some research group doing some experiment in very narrow scope, working slowly towards 10 year horizon and doing some PR to renew the funding.

I think this is cool research and I hope they can bring it to market but in the "its cool stage" it just makes it harder to convince your kids to brush :-)

Parent: "Brush your teeth or you will end up with all this dental work like I have."

Kid: "Nah, we'll have regrowable teeth by then."

FWIW, I got an implant a couple of years ago and talked to my dentist about these sorts of things. On the plus side an implant is known to work, will likely last beyond my death, makes my remains easier to identify is an obliteration scenario and is available today. The down side is that you can never regrow that tooth once you've sealed a tungsten post into your jawbone.

I am only 30 years old and have shitty job, and half of my teeth are missing. Implants are my only hope so far. But compared to natural tooth, implants are so crude replacement. Fuck my life.

I thought implants only have a ten year lifespan?

At least in USA, there is a vast range in implant placement technique among practicing dentists. Improperly placed, they'll fail in six months. Properly placed, and with no later issues such as abscesses, they should get stronger and stronger over time.

Why not? What makes it more traumatic/infeasible than removing a tooth in the first place?

I distinctly remember seeing a story maybe 20 years ago about a university breeding a bacteria that out-competes the stuff in your mouth, but doesn't excrete the acid that wrecks your teeth. It was supposedly going into products that same year, but I never heard of it again.

This is what humanity really needs. The best part is that once it is out in the wild it should spread naturally, if slowly. Thus it will eventually penetrate to every human society and wipe out the current strains of the bacteria.

Pretty sure they covered time to market in the article

> Prof Sharpe said a new treatment could be available soon: "I don't think it's massively long term, it's quite low-hanging fruit in regenerative medicine and hopeful in a three-to-five year period this would be commercially available."

Paul Sharpe has been in the news for these kinds of announcements before.

His company, Odontis, failed to bring any new thing to market, and that was 10 years ago. Perhaps now there is a more mature product.

I feel like I've seen how fillings would be replaced with drugs for about 25 years now -- I might not have any natural teeth left by the time it finally arrives! :-)

Don't worry, by that time we'll be growing teeth out of stem cells or something.

The dissolving sponge thing reminds me of a video I watched years ago. They took a fully functioning organ (from a donor) and dissolved the material so that the only part left was the collagen scaffolding. Effectively, it looked like a transparent organ. They then flowed the recipient's blood into the organ and the tissue regrew around the scaffolding, yielding a fully operable organ with zero chance of foreign tissue rejection once implanted. Anyone recognize this and might have a link?

Is https://www.technologyreview.com/s/419358/old-livers-made-ne... what you mean?

Yeah that looks like it's the same research. Thanks!

Does anyone have good resources on non-behavioral factors that affect health of teeth?

Growing up, I never brushed and did pretty much everything a dentist advises against. I never have had a cavity. With seemingly no consequences, it was extremely hard for me to find any motivation to change my behavior. I've often wondered whether there was something genetic, and today I wonder if maybe I won some microbiome lottery.

I finally started taking care of myself due to (a) gum disease, (b) breath, and (c) yellowing of teeth, but I'm nowhere near as fastidious as some people I know who regularly get cavities and have to get all sorts of work done.

Out of curiosity, do you happen to have tonsil stones and/or a strong propensity to develop tartar?

Because all of that applies to me, and I've also been told that my saliva has a higher than average mineral content. I can't help but wonder if they're all related.

You likely have a stronger immune response to the bacteria that cause cavities than most people do.

Were you a natural birth or c-section?

To the person who downvoted this: natural birth is associated with transmission of bacterial flora from the vaginal canal, acting as a seed for a different composition of gut and mouth flora.

One of my dentists said yeah, there are genetic factors. Some people just have naturally lower levels of bacteria in their mouth.

There's fundamentally one cause of enamel decay: acidity. Typically these acids are produced by bacteria in a person's mouth as a waste product. Over time these acids wear down the tooth and create cavities. But enamel can also be worn away by acidic foods and drinks like wine, coffee, and soda.

Different diets can change the flora of bacteria in a person's mouth, just as it changes the flora in a person's gut. The bacteria that produce a lot of acids generally consume simple carbohydrates, so diets rich in simple carbohydrates are correlated with the presence of cavities. Brushing and flossing prevents the simple carbohydrates from staying in the mouth for too long, which slows bacterial growth. A diet low in simple carbohydrates also inhibits bacterial growth. (It might be more accurate to say that the bacteria don't produce acids when consuming things other than simple carbohydrates --- I'm not sure.)

Mouth flora tends to be similar between members of a family. Parents pass their own flora on to their children, and over time the flora of spouses tends to become similar as well.

It's possible that your diet was conducive to good tooth health, or it's possible that you lucked out with your mouth flora, or both.

(I got a cavity a few years ago and ended up reading a bunch about tooth health. But I'm not a dentist, so there may be some inaccuracies or oversimplifications in my comment.)

Edit: I forgot to mention that some people naturally have more acidic saliva than others, which is also correlated with cavities. As far as I know, that's purely genetic.

depending on your mouth, you end up with your teeth covered in plaque, which protects them from cavities, but also gets you gingivitis and eventually your teeth will fall out

your water might also have fluoride; when Calgary stopped fluoridating its water, i got a bunch of cavities.

Let's hope there will be some real progress in dentistry. I am probably doing the field injustice but there doesn't seem to have happened much progress in the last decades compared to other areas of medicine. When something is wrong the usual response is to remove it, no healing.

I personally hope that one day we will be able to regrow teeth. With all my crowns it's too late to repair cavities.

I think composites have advanced but then again I don't know the details :(

Dental implants are a pretty big breakthrough over the last couple of decades. Wether replacing individual teeth, or permanently anchoring dental bridges in place, it's gotten pretty darn close to the experience of having real teeth.

Dental implants are really cool, but they are also incredibly expensive.

Well in most civilized places, including where I live, ordinary people don't have to deal with dental costs on a one-off basis.

You just pay your taxes (or the state pays them if you can't afford it) and you're provided with healthcare.

Seems pretty reasonable if you ask me.

Anybody know why dental care in the US in not considered "healthcare", requiring a separate insurance policy?

In Canada our universal healthcare doesn't cover dental issues, and even private insurance that most people would have through work only cover what is essentially considered "necessary". I think an impant is probably considered a luxury and certainly wouldn't be covered through insurance.

And for the low low cost of between $3,000 and $6,000 per tooth, per decade!

Elephants starve to death once thier last teeth are worn away. Our teeth were never 'meant' to last as long as they do. Be happy with your crowns. Look at the countless skulls is museams with evidence of cronic infections. Out and/or crowned is always better than in and infected. This is a golden age compared to even 80 years ago.

Surprised no-one has chipped in here to say the same, but the top comment on Reddit calls bullshit: https://www.reddit.com/r/science/comments/5n14a9/a_way_to_na...

> heightened the activity of stem cells in the dental pulp so they could repair 0.13mm holes in the teeth of mice.

Very cool. And happy to see some numbers posted in the article to measure the success. I now understand this is very PoC, but proof none the less.

If there's one dental treatment I'd gladly pay for, it's enamel restoration to get rid of tooth sensitivity.

A few days ago I bought Sensodine with NovaMin. The NovaMin technology doesn't exactly restore the enamel, but does something similar. Here's how wikipedia describes it:

"Bioactive glass: Newer Sensodyne products contain calcium sodium phosphosilicate (brand name NovaMin). NovaMin sticks to an exposed dentin surface and reacts with it to form a mineralized layer. The layer formed bonds with the tooth, and is therefore strong and resistant to acid. The continuous release of calcium over time is suggested to maintain the protective effects on dentin, and provide continual occlusion of the dentin tubules. Sensodyne has removed the NovaMin ingredient from their US products"

So far I'm happy with this new toothpaste.

https://en.m.wikipedia.org/wiki/Sensodyne

"Sensodyne has removed the NovaMin ingredient from their US products"

Any idea why? The cited articles don't appear to mention that.

I gathered from Amazon and other user reviews that the NovaMin patent holder, GlaxoSmithKline (GSK), figured that it would make more money in the U.S. selling it as a prescription product rather than OTC.

IIRC, there may also have been some complexities regarding the FDA, and perhaps some cross-licensing issues, that figured into GSK's decision. The information is out there, it just requires sifting through the Google hits and piecing together the true story.

I buy European Sensodyne on Amazon for a family member with sensitive teeth, and only dug deep enough to satisfy myself that at least some EU sellers weren't scammers.

These look like a more reputable source regarding the NovaMin efficacy claims (linked from the Wikipedia article):

- http://www.dentistryiq.com/articles/2011/03/novamin-and-hype...

- http://journals.sagepub.com/doi/pdf/10.1177/0895937409335621

This is the complete paper: http://www.nature.com/articles/srep39654

I wonder why they almost never linked to the source.

Because it's easier to garner clicks for ad impressions by making bold claims about the amazing (unproven) future benefits of a minor scientific discovery than by presenting readers with the actual science.

Q: does this sort of labor destroying innovation ever get blocked by lobbying groups?

It would appear in this specific case, you would still need a qualified professional to insert the drug soaked 'sponge' and cover the hole. So if this makes it to market it would just be the latest and greatest new tool for dentists to repair tooth decay.

As far as lobbyists blocking innovation to protect their industries 'status quo.' Yes I imagine it happens quite a bit. For example there is a strong lobby to keep tax forms and processes complicated and unfriendly to normal people so that companies whose bread and butter is helping you fill out your taxes each year can stay in business.

I remember hearing about laparoscopic surgery and ultrasonic treatments for gallbladder and kidney stones while growing up. My dad was a surgeon and that was a large part of his "business", but he was really excited about the advances. However, the earlier surgery of opening up someone's abdomen often meant days of stress about your patient lying in the hospital and potential complications. It was a job where you were often working on people who first met you when they seemed relatively healthy, but with some pains, and were quickly getting worse. "Rounds", where you toured every patient in the hospital to check on their recovery, was a part of every day of the year, and it was nominally unpaid (though the time and attention was included in the "package" of treatment).

At things like holiday period cocktail parties I definitely heard, especially spouses, talk about how those changes would be dangerous since the surgeon wouldn't have a full picture of what was going on in the abdomen, etc. (Sometimes it's safer not to wear a seatbelt, too!)

Anyway, I think that at the same time that gallstones and kidney stones became less labor intensive there were so many new things than needed general surgeons than there was no impact on labor.

Back to your question, there seem to be stories about curing caries as a phenomenon somewhat frequently, and they've appeared regularly for decades.

Is this, instead, like developing a good cross-platform IMAP client? Anything that is good enough to replace the large email providers' own apps and web portals gets aquihired. Clearly the programmers must have been skilled enough to handle a large number of arcane edge cases and understood users well, so they'd be great people to have work for them. Plus, there's less likelihood that they continue to keep IMAP access normalized, and then also happen to provide a really effective and easy drop in encryption service.

No, it creates labor by making life cheaper and thus increasing purchasing power and real wages.

If this stuff can repair cavity holes, presumably it can replace enamel wherever it's been lost. If it could also extend enamel onto exposed tooth roots that lack enamel, that'd be great for us older folk with gum recession and vulnerable naked roots.

There is a medical device, designed and manufactured in California, that generates O3 in such a way that a single tooth can be isolated and bathed in O3. The result is bacteria death within any tooth crack or cavity. Following that the calcium in our saliva naturally fills in any bacteria free cracks and cavities. This functioning, successful medical device is a "hit" everywhere on earth except the United States because the FDA declared O3 to be a toxic gas with "no known medical properties" and ban its use... I know one of the engineer developers that designed it, and he's wealthy from it. He says the US is fucked beyond repair...

Have you any references for those claims?

Here's some references to the FDA's opinion of O3: https://www.google.com/search?q=salavia+&ie=utf-8&oe=utf-8#q...

I'm looking for references to the device. It's manufactured under different brand names, so...

Searching this stuff is like I'm looking for aliens - lots and lots of fake/fraud sites....

I see variations of this on both real and fake sites: "...the existence of FDA's ban of ozone therapy in the USA since the 1940s even after 60 years of prior successful ozone therapy in America. The FDA also ignores the fact that ozone therapy is currently used safely, effectively, and openly in Germany, Russia, and Cuba. Evidently, America's Medical Mafia is not fond of ozone therapy's proven efficacy for a wide range of diseases..."

Don't know how real this site it, but it contains much of the basic information http://www.dentaleconomics.com/articles/print/volume-99/issu...

99% of my information is from my friend; we were in graduate school together, and he worked at this medical device company at the time as a managing engineer.

It looks like the dental profession has a very serious fake news problem.

Its nonsense. Ozone therapy is a form of alternative medicine quackery that uses ozone generators and the FDA has cracked down on it because there's no evidence it works and the O3 gas is toxic. It is not banned by the FDA but marketing it as a clinical treatment is. In this sense all molecules that aren't approved drugs are "banned" by the FDA.

If it worked, the FDA would approve it as a Class III (high risk) medical device so my guess is that the OP's friend's company either doesn't have a working product or they just don't want to put in the work to get it approved (Class III devices are the most expensive to get through the FDA).

My buddy said they are making too much money with the rest of the world to care about kissing the bureaucrat's ass making unreasonable requests.

They're making "too much money" in the rest of the world, where most people are broke or covered by nationalized healthcare and price controls, to get their product approved in the most profitable medical device market in the world? Again, nonsense. If that were the case, pharmaceutical and biotech companies would be lining up to license the technology and to take care of regulatory approval and compliance, even if it wasn't covered by patents.

Your buddy is exploiting vulnerable consumers in less regulated markets to sell snake oil. I wonder how many people will suffer immense pain or pick up a life threatening infection because they were convinced by conartists that oxygen was a viable alternative to proper dental care and treatment.

>that generates O3 in such a way that a single tooth can be isolated and bathed in O3. The result is bacteria death within any tooth crack or cavity.

If you could prove that with a peer-reviewed paper, you'll revolutionize dentistry in the US, that's for sure. In other countries boner pills made from rhino tusks are a "hit" but that doesn't mean the FDA is corrupt for banning them as clinical treatment here.

You can still market O3 therapy as what it is, "alternative medicine." Just not clinical treatment.

Dentists are very conservative. About 10 years ago we did some compassionate use studies of dissolvable drug metering systems that would cause bone regeneration -- so that an implant would attach to the jaw just the same as your original teeth did (actually new bone would grow around it). The X-rays were amazing and folks who'd been in pain for decades due to wobbly tooth implants, bridges etc were thrilled.

Company decided not to go ahead with clinical trials after doing market research on dentists in the US. Went ahead with a different drug for a different indication instead.

This—on a somewhat similar treatment from Japan, unavailable in the US—seems relevant: http://marginalrevolution.com/marginalrevolution/2016/07/the...

https://en.wikipedia.org/wiki/Chlorhexidine toothpath/mouthwash prevents many tooth/gum diseases

Anything that enables me to spend less time in a dentist's chair is awesome. I hate dental work and need nitrous oxide to get through even minor procedures (cleanings, etc).

This is great news. Now what do you have for my shitty gums?

It sounds like they're sticking something in a small cavity and covering it. Like a filling. Minus the drilling.

Paul Sharpe, the same guy that had stem cells and created a startup to mkae new teeth grow.

Ten years ago.

I feel like I see this headline every 2 years and nothing seems to change.

I wish this become mainstream next year.

so btw you don't want to inhibit GSK3. Likely an academic only finding.

that would be a dream come true... most (all?) dentists are doing unnecessary x-rays that are a health hazard and this would of course help with that...

If you're worried about that, be sure to wear a hat when you walk outside.

Also don't ever fly.

Just yesterday I saw a documentary on the dangers of atomic radiation, and one of the numbers I remember is that the dose of radiation from a dental x-ray is less than the average daily dose of background radiation. So, entirely negligible unless you're getting a dental x-ray every week or more often.

You are probably talking about the low radiation bite-wing digital x-rays... But some type of dental X-rays have orders of magnitude more radiations, like the Panoramic X-rays (those are very common in dental offices) or the much worst Cone-beam computed tomography (3D). I agree that there probably isn't much risk but they give them out like candies.

I checked Wikipedia for the different types, and apparently I had a panoramic X-ray made last year.

A quick googling finds [1] which puts the maximum dose for X-rays at 0.17 mSv. Wikipedia [2] puts the average background radiation around the world at 3 mSv per year, or 0.082 mSv per day. So while 170 mSv is indeed "orders of magnitude more radiation" than an X-ray of a single tooth, it's still roughly in the order of magnitude I estimated (around a day's worth of background radiation).

[1] http://www.ada.org/en/member-center/oral-health-topics/x-ray... (section "Radiation Exposure in Dentistry")

Next time you go to the dentist, try to ask the person taking the x-rays what radiation setting they used or how much radiations you will be getting from the x-rays... in my experience, they don't know... Also ask them why they cover your torso with lead but not your brain...

Also, I think that you confused some units and you forgot to include link #2 ...

Serious question: is there any evidence that seemingly disruptive dental treatments like this are being suppressed by the dental industry?

No.

Like any new technology there are barriers entry erected by incumbent technology/equipment providers, but there is also a flow of new dentists and practices eager to try the latest technologies. In my visit to the dentist just now I was reminded yet again at the astonishing pace of technology change in their industry.

(Have advised early stage (IP) players in the space)

Don't mess with Big Toothpaste!

There are a few reasons more likely (and less asinine) than that. See https://en.wikipedia.org/wiki/Eroom%27s_law

Fusion, cheap solar cells, and this.

Battery tech - it's the next big thing that never was.

Ahh, except solar Is so cheap now it's driving fossil fuels out of business and utilities are replacing natural gas peaker plants with battery storage.

Y'all sleep through the last year?

That's the problem with exponential curves. At first nothing's happening, it's extremely boring, and slowly, ever so slowly, things start to pick up.

Then one day you blink and it's gone right past you.

Battery tech is improving by about 20% every 2 years. Batteries that cost about $1000-1200 in 2009-10 are expected to cost now around $200-300 this year. We have been getting incremental improvements in price and capacity but most people don't notice.

We don't notice because the Facebook app's battery usage grows faster than 20% every two years.

I recently got my wisdom teeth out because everyone said I should.

Now my jaw is suffers from paresthesia because of it. Most likely I will never get sensation back in that area. Spent money to become paralyzed...

I don't see the value in going to dentist for slightly less tooth pain so this sounds amazing to me.

> because everyone said I should.

Why? Wisdom tooth removal is still surgery, and you and your dentist should have been the ones to decide on whether it was necessary or not.

If the surgery went wrong because of other complications, that's a different issue, but you shouldn't get surgery just because other people are saying you "should".

Poor choice of words. Still had impacted wisdom teeth and was causing a decent amount of pain. I just would prefer pain over paralysis.

Also, I have had terrible medical assistance my whole life, so I have to figure everything out. Not the doctors/dentists. They're just the hired help I get to do the actual heavy lifting. I honestly don't know their purpose if I have to spend half my life doing their research

As someone with continual dental issues due to an unhealthy high sugar diet and low calcium due to lactose intolerance, I'll be super excited if this becomes a thing.

Any reason you don't pop a daily calcium and vitamin D supplement?

Calcium supplements are distinctly distasteful to me, and that makes it hard to make a habit of taking it. :) The tablets generally taste like chalk. (Extremely literally.) And even the adult gummy variety are far worse than their multivitamin counterparts. It's really hard to make chalk taste good.

I'd think continual dental issues would be a pretty good motivator. Getting dental work sucks. But if you're having continual issues, cutting down sugar and/or brushing more frequently during the day would probably have more impact.

There are also chocolate and caramel chews with calcium. They aren't great either but they're alright.

Can you get one you swallow without chewing? You'll probably have to take about 4 of them, but that might be easier for you.

Chalk is calcium carbonate, and so are many calcium supplements. So, no surprise on the chalky taste. I'd say it actually goes best with milk, I guess because it tastes "natural". A lot of milk substitutes are palatable and have calcium added, or likewise it's possible to buy milk with the lactose removed.

So get the calcium pills you swallow instead of chew?

Also, there's plenty of non dairy sources of calcium.

I've gotten four downvotes so far for admitting I have poor health habits! I honestly can't think of anything more Californian than that. Thanks, Silicon Valley!

It's not for admitting it, it's for your apparent utter indifference to doing even the slightest thing to fix it.

Seriously, life-hack your way out of this.

"Yeah, I know smoking is bad," he said while taking a drag on a cigarette. "But what would I do with all that free time and extra years of life?"

Lactose intolerance has nothing to do with low calcium, if anything it will help you. Super easy to get plenty of calcium, eat green vegetables!

One simple recipe: cook spinach (boil, steam, microwave), wring out water, add salt and sesame oil to taste.

A cup of spinach has about 30 mg of calcium.

A cup of milk has about 300 mg.

Also, most of the calcium in the spinach is in the form of oxalates, which are not readily absorbed (and if they are absorbed, may contribute to the formation of kidney stones).

You should be more excited about changing your habits.

Honestly, here in Chicagoland, health just isn't nearly as exciting. We're all going to freeze into human icicles anyways, so we might as well eat ice cream.

Take vitamin D, it increases your calcium absorption.

Try:

* Vitamin D3 + K2 (in its isoforms MK4 & 7) from food and synthetic

* Toothpastes with low RDA abrasion levels and without glycerine and silica

* Irrigate your teeth

* Take probiotics like Blis K12 bacteria

I sometimes dissolve cholecalciferol (vit D3) and menatetrenone (vit K2-MK4) with calcium ascorbate powder in my own saliva, and just swish it around in my mouth for half an hour or so. Then I swallow it.

My dentist is thoroughly impressed with my teeth. She can still tell that I don't floss, though.

If you want calcium from a dairy source, eat more hard cheese. Hard cheeses have very little lactose - just pick the one with the least sugar. Cheddar is pretty good. Parmesan too.

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