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Comment by dgrin91 | Hacker News Reader

The question I always have with this type of stuff is: why is it not _already_ huge. Cavities were a big thing already in 1985. If this was a miracle cure in 1985 then I do not believe that this study would have ended in 'ok that was fun, back to normal life'. This has huge commercial potential if true, so the apparently implications is that there is something blocking that commercial application.

Was it FDA? Was it side effectives? Is it impossible to scale this up? What is it that made this "miracle cure" just stop.

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They say it was because of FDA approval. As it was GM, in order to prove it is safe they wanted a study done on healthy people who are completely isolated from the human race so that they can't spread it. As nobody lives in a place where they are completely isolated from the human race it wasn't a very realistic. Then the patent ran out so it wasn't worth it for any drug company to proceed with approval because everyone else would just wait until they've paid the fee and then sell it too.

The average time from scientific discovery to commercial success in biotech is measured in decades. Barry Werth's book The Antidote goes into why it's so slow and complicated: https://www.amazon.com/Antidote-Inside-World-New-Pharma/dp/1...

Ok its been just about 4 decades. There appears to be 0 progress on this front.

It costs a ton of money to bring a treatment to market, and this one has roughly zero commercial value. Presumably once in the world it would naturally spread just by people kissing or whatever.

I don't think it's totally impossible that this really works and everyone gave up on it.

But I'd probably still put my money on this not really working (or having unwelcome side effects) and people quietly shutting down the project without publicly documenting the issues.

Don't want to get too conspiratorial, but dentists make their money on cavities, not cleanings.

You're just an anti-dentite! :)

But it wouldn't be surprising that there's pushback against any technological breakthrough where established industries had something to lose. The FDA is not a stranger to corruption[1,2], so it wouldn't be far-fetched for lobbyists in the dentist industry to grease a few palms in their favor. Big Pharma is an ugly business.

[1]: https://www.businessinsider.com/fda-chief-approved-oxycontin...

[2]: https://www.science.org/content/article/hidden-conflicts-pha...

US dentists make their money on cavities.

Some other countries have healthcare systems where the primary goal is the patient outcome, and lowering the need for treatment is considered a win. If this were a thing, you'd expect that it might have been picked up and trialled in one of those places.

I don't know any place in the world where that's the case.

I can tell you publicly funded eu hospitals all want more treatments so they can justify bigger budgets. Rinse and repeat.

Universal healthcare systems very often don't extend to dentists. This is part of the reason British and Japanese stereotypically have bad teeth.

Meanwhile in the capitalist US, I haven't seen mine in months because her husband does her bookings and seems to be unable to remember to call me back. Small business owners usually don't profit maximize, and unfortunately it'd be better if they did.

If you want to more or less permanently stop gum bleeding pre-brush with a dilute (50 to 200 ppm) solution of hypochlorous acid generated from vinegar acidified salt water (0.8-2%) with salt concentration (saline is 0.8-0.9%) then hit it with a $5 Aliexpress USB electrolyzer for about 30 seconds. The biofilms come right off, your toothbrush ceases to accumulate biological matter, and hypochlorous acid does not begin to show toxicity in keratinocytes until 10,000 ppm. It is extremely unpleasant in the mouth above 200 ppm so it is relatively easy to guesstimate.

Or just rinse (water pick even better) with a dilute bleach solution (0.25%). Make the solution fresh each time or every 24 hours, since sodium hypochlorite tends to decompose easily.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9292655/

Don't use bleach when you can easily make hypochlorous acid. Hypochlorous acid is bleach but acidified and much safer to the human body than bleach. Bleach is thousands of times more toxic to humans at the same HOCl concentration. You suggest using an OCl- concentration of 2500 ppm which would be extremely high for an equivalent therapeutic use of hypochlorous acid. You can easily use a 10 times lower concentration of hypochlorous acid for the same purpose, and it would still be total overkill. You can easily make hypochlorous acid with electrolysis safely or by mixing highly dilute bleach with highly dilute acid (vinegar) with a target pH range of 4-6. If your solution pH falls below about 4 there may be chlorine gas evolution which is generally undesirable. Above pH 4 it is not significant. Given the desired HOCl dilution hardly any chlorine gas will be emitted even if working in a confined space and using an excessively low pH. I recommend the electrolysis route for use in and around the body because the route is generally free from potentially harmful contaminants which may be in your bleach products. The bleach and acid method is useful to make a general purpose deodorant and disinfectant or if you trust your bleach to be free from harmful contaminants. https://www.dstec.com.my/wp-content/uploads/2020/04/pH-for-H...

Hypochlorous acid is hundreds of times more effective than bleach as a biocide because it is uncharged and can far more readily diffuse past the lipid bilayer of microbes to wreak havoc. Somehow, humans are generally much more immune to these effects. Whereas 0.1 ppm HOCl can kill most bacteria it takes approximately 10,000 ppm to damage most human cells. It is not recommended to use much over a handful of ppm in the nose and eyes.

Do you have any research papers supporting those assertions? At least with low-concentration bleach, it's been tested numerous times in RCTs without any harmful effects, besides bad taste. It's also proven effective, or at least as effective as prescription-based chlorhexidine mouthwash.

I'm interested in reading more, because I find diluting the bleach solution to be annoying and would obviously damage dyed fabrics if spilled.

Any thoughts on brushing with a concoction of peroxide and baking soda as recommended in this yt video?

https://www.youtube.com/watch?v=Cow6wNRJqoo

Yeah, hydrogen peroxide is more toxic than hypochlorous acid.

I just brush and floss once a day before heading off to bed and have none of these problems...

Yes, sometimes it takes time, like in Japan the birth control pill ..

"Campaigners here joke that it took the country 30 years to approve the contraceptive or birth control pill, but just six months to approve the Viagra pill for male impotence. Both became available in 1999, but the latter came first."

https://www.bbc.com/news/world-asia-62515356

Well you have to take birth control constantly and a lot of very young women end up having it. You could easily wipe out a generation of fertile women if you didn’t do it correctly. On the flip side, old men (usually) that sometimes need to use a pill doesn’t seem all that dangerous.

Yes but, Women in the whole world took the pill since decades.

Why are they not pushing against fluoride en masse, then?

Because they can charge $40-$80 (or more) for a fluoride treatment. It's actually how they make money on cleanings. If you don't opt for the fluoride treatment it's a wash.

> they can charge $40-$80 (or more) for a fluoride treatment. It's actually how they make money on cleanings

This is nonsense. Many dentists, mine included, don’t apply fluoride. (They trust you to use toothpaste.)

It's not nonsense. Perhaps many don't, but most ask (at least where I am). They literally ask you when you go in for a cleaning if you want fluoride and then charge you. My current dentist charges $40. My last dentist (Orange County) charged $80, which was a total scam place I only went to once.

Hell, my dentist doesn't ask: they just assume I want it ($80, SF bay area) unless I tell them otherwise.

I'm honestly kinda meh on my dentist, but getting me to go to the dentist at all is a slog (and I very much appreciate that they make me a new appointment for next time while I'm still there); the idea of expending the effort to find a new dentist feels paralyzing.

I end up just letting them do it. My teeth aren't exactly in the best shape. Unclear if the fluoride treatment actually does all that much, but it certainly doesn't hurt, and I don't want to look back when I'm older and regret not spending $160/yr for better teeth. I'd much rather look back and regret (but in reality not particularly care) that I wasted $160/yr.

Some years ago, maybe 25, no dentists in the USA applied fluoride. Yet somehow they stayed in business.

I don't think it's inconceivable that the economics of running a dental practice have changed over that time period.

My old dentist would give me a pump of it and have me swish for a minute. Billed insurance $20. Insurance always said "$5," then they "forgave" the rest, probably because I'd be asking some questions about how that costs them $20.

I think that's something else, just a fluoridated mouthwash? At my dentist it's something they "paint" on my teeth with a q-tip, and then tell me not to eat or drink for a few hours.

And fluoride treatments likely don't do much. The main benefit of fluoride is from ingestion by children, while their teeth are forming.

That is absolutely not true. Flouride varnish helps prevent cavities and remineralize enamel in all ages.

Here's a meta analysis for you: https://www.ncbi.nlm.nih.gov/books/NBK401516/

It's the exact opposite

There are no benefits from ingestion - it's actually harmful and linked to a series of terrible stuff (cognitive development issues and neurological problems in primis). The only benefits are from topical application.

Source: my parents fed me fluoride pills for my entire childhood

I’ve never heard of fluoride treatment. I never had it, I don’t think that’s common in Europe.

I was referring to fluoride in water and toothpaste.

A different generalization is that dentists make more money on treatments, and less on diagnosis or preventive care. It's hard to say if this is really a conspiracy theory since the diagnoses from different dentists aren't always consistent.

https://news.ycombinator.com/item?id=37022911

A one time cure for cavities is just bad for business!

Same with RISUG, a cheap semi-permanent reversible male contraceptive made with a tiny piece of plastic (which would destroy condoms and female hormonal pill - never got to the western world) or ocumetics, the bionic eyes promising 20/20 for everyone with a simple cataract surgery (which seems to be stuck in a endless cycle of getting bought, and doing trials).

No, that hardly ever matters.

1. There's always new people.

2. If you don't do it, someone else will, because they'd rather be paid once than not have any business.

Now this topic has a huge grain of salt, but imagine something that one cheap treatment of basically wipes out an entire industry do you think that industry and associated ones wouldn't fight tooth and nail to buy it an bury it? I know it's been said the same thing about various engine designs, but just for the sake of argument I believe that's what they're saying here.

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