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Comment by otakucode | Hacker News Reader

About a decade ago there was a tremendously promising discovery. A genetically modified variant of the caries bacteria that is the major cause of tooth decay was created which, instead of metabolizing glucose into acid, metabolized it into something inert which also happened to be poisonous to the caries bacteria that excrete acid. A 45 second rinse with a small amount of liquid doped with these bacteria would mean permanent lack of tooth decay.

This would, of course, eliminate 90% or so of the entire dental industry in a single blow. I don't know if that had anything to do with it or not, but the doctor researching it lost funding and the pursuit of turning it into a product or available treatment was abandoned.

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This would, of course, eliminate 90% or so of the entire dental industry in a single blow.

This overstates the case. The prevalence of caries really depends on the patient population. There are some populations for whom most dental work is caries-related: e.g. poor children in USA [0]. Even so, fillings are not the biggest moneymakers for any dentist here. There is far more money to be made on e.g. implants, prosthodontics, orthodontics, etc. Other nations probably would have a bigger focus on caries.

[0] Incidentally, dentists deserve much of the credit for the fact that we can't leave out the adjective "poor". They have encouraged pediatric oral health at every opportunity. Apparently they weren't too worried about losing this important demand for their services.

Without S Mutans, there wouldn’t really be a need for implants, prosthodontics, etc. Sure, you’ll have orthodontics left, but pretty much anything else (including even routine cleanings) would be wiped out.

It’s no surprise the FDA has suppressed this industry-changing research that would save so much pain and suffering in the world.

You have an incomplete understanding of the causes of tooth loss. Anyone who gets old enough will lose her teeth for a panoply of geriatric reasons that do not include caries or periodontitis. In addition teeth are lost for other reasons including drug use, injury, dietary deficiencies, etc.

You also profoundly underestimate the cashflow from dentistry that is purely cosmetic or otherwise unrelated to replacing missing teeth.

I'm as critical of FDA as anyone but this is straight conspiracy theory. Why has no one started selling this miracle cure over the internet?

You have a fair point. Still, if S Mutans was nullified, I do believe this will significantly impact dental practice cash flow that I wouldn't be surprised if most goes out of business (over a long timeframe, as more people get this treatment).

If your practice has margins of 20%, then a 25% drop in procedures will mean you go out of business.

And why hasn't anyone started selling this? Well, large-scale synthesis and reproduction of genetically modified bacteria has significant upfront costs; no one is going to invest $20m in a production line if all they can do is sell it on darknet markets.

Any bio hackers doing this DIY?

Once upon a time one could have been forgiven for thinking the dentists had this type of political control, just by comparing the cars they drove to the cars driven by e.g. physicians. However, the recent boom in dental-school-openings is a much bigger threat to their individual earnings than a potential bacterial wonder treatment.

I don't know much about bacterial treatments, but one can buy them for the garden for like $10. They do a number on the hornworms. This is a "natural" bacteria rather than an engineered one, but bacteria reproduce rather than requiring manufacture. If someone has this miracle bug in a lab, she could start selling small quantities pretty easily.

This is actually true. The rights were brought by Oragenics, who’s well known for dental probiotics, and they started trials. I was quite excited to be following along.

Once the FDA realised the impact, their requirements were inexplicably hiked to be impossible to meet, and the research had to be shelved.

From Wikipedia[0]:

Jeffrey Hillman from the University of Florida developed a genetically modified strain of Streptococcus mutans called BCS3-L1, that is incapable of producing lactic acid – the acid that dissolves tooth enamel – and aggressively replaces native flora. In laboratory tests, rats who were given BCS3-L1 were conferred with a lifetime of protection against S. mutans. BCS3-L1 colonizes the mouth and produces a small amount of a lantibiotic, called MU1140, which allows it to out-compete S. mutans. Hillman suggested that treatment with BCS3-L1 in humans could also provide a lifetime of protection, or, at worst, require occasional re-applications. He stated that the treatment would be available in dentists' offices and "will probably cost less than $100." The product was being developed by Oragenics, but was shelved in 2014, citing regulatory concerns and patent issues. In 2016, Oragenics received a 17-year patent for the product.

[0]: https://en.wikipedia.org/wiki/Caries_vaccine#Attempts_using_...

[1]: https://www.newscientist.com/article/dn1941-gm-bacteria-may-...

[2]: https://www.ncbi.nlm.nih.gov/m/pubmed/12369203/

You left out the next paragraph which is may be one of the reasons it's not used:

> On rare occasions the native S. mutans strain escapes into the blood, potentially causing dangerous heart infections. It is unclear how likely BCS3-L1 is to do the same.

That would be a really weird reason. The natural bacteria has the exact same problem. The engineered one is uncertain to have the problem. Why would you opt for the one that definitely carries the risk and ALSO causes expensive tooth decay?

Because the engineered caries might behave differently and unexpectedly. Regular caries has a pretty hard time getting into the bloodstream and won't infect other regions. Can the immune recognize the new strain? Can the new strain infect other regions of the body? Does it permeate into the bloodstream more often? There are more questions to be answered, experimentally.

Actually they stopped clinical trials because of difficulty with FDA approvement

https://www.oragenics.com/technology-pipeline/lbp/smart

a) Since there is a patent (Replacement therapy for dental caries [1]) it means many/some people should be able to make the product on their own.

b) How many more stories (and what kind of stories) of nefarious obstacles erected by the FDA are required until there is a large-scale sentiment to either abolish that agency or severely limit its (unconstitutional) powers? [2]

[1] https://patents.google.com/patent/US9260488

[2] https://fee.org/articles/abolishing-the-fda/

I read about that way back and wondered what happened to it. I guess now I know why it never came to anything. Such a shame!

Do you have any more detail about this? It sounds extraordinary.

Pretty crazy how much misery (and even death!) it would cure. There was also a "vaccine" targeting s. mutans, but there were some concerns about that having unwanted systemic effects. And there was a neutered version of the same bacteria, and a peptide, ...

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