Toothless No More – Researchers Using Stem Cells To Grow New Teeth | Hacker News Reader

Toothless No More – Researchers Using Stem Cells To Grow New Teeth

singularityhub.com

94 pointsolalonde40 comments

Dentist here. You're probably wondering if this is a disruptive threat to the established business of dentistry -- I have no idea. However, I can say that throughout the field I consistently run into dentists who will advocate for the health of the patient over the profit of the business. Consider the fluoridation of water throughout the world, one of the single greatest public health advances, when you take into account the benefits versus the cost of fluoridation.

But the science of it: I'm excited by the tooth growing possibilities, but it's important to understand that getting these teeth properly integrated into the body is quite a challenge. I'll give you an example: the periodontal ligament is like a very precise shock absorber attaching bone to tooth, and gives some flex to the tooth. (It's also the thing that makes orthodontics (moving teeth) work in the first place.) Sometimes, (usually in younger folks) if you knock a whole front tooth out, you can immediately replace it and the PDL will regenerate. Sometimes, however, the PDL fails to regenerate, and you end up with a situation where the tooth is ankylosed -- the ligamentous connection is gone, and the tooth is essentially fused to bone. This is one of the difficulties that will need to be overcome when regenerating teeth -- if that PDL fails to develop, you're stuck with a newly regrown tooth fused to bone. Thus, the tooth is more susceptible to breaking and _really_ difficult to extract from the mouth if it becomes infected.

I would be very surprised if dentists saw this as a disruptive threat-- since these are real teeth, these are still subject to needing to be cleaned on a regular basis, unlike just dropping your dentures into a cup before you go to bed at night. If people got these, you've essentially guaranteed that people above a certain age would continue going to the dentist until the day they died.

It'll probably create more business. Many people are careless with their teeth and they lose them. Getting a second chance will probably encourage them to pay a yearly visit to the dentist.

Right. It's not like they are going to just grow themselves magically.

However, endodontists may have yet another thing to fear. The first thing being implants

Well, this is just one constrain that will not make treatment impossible. After all, osteointegrated titanium dental implants do not have a PDL as well...

I found this rather amusing comment on a Russian dental forum a while ago. Sorry for possible mistranslation, I am neither a dentist nor a native English speaker.

----

I spent some time contemplating the future where this tech would be widely available. What this New Dentistry would be like? Pretty much the same thing we have with implants today. We will have all the same problems with crooked teeth. With lack of bone and gum tissue. Plus aesthetics, and decay of new teeth. Periodontal issues, calculus, etc, etc...

Growing new teeth won't be a real breakthrough.

Imagine a patient missing some teeth. He sees a... what's his name... an toothgrowologist for a consult.

"Hey Doc, what would you recommend?"

"We need to grow you 9 new upper teeth and 8 new lower teeth, correct malocclusion with braces, possibly add some veneers for aesthetics... This will add up to $30-$50K."

"$30K???"

"Might be up to $50K."

"Don't you have cheaper options?"

"Well, you could get implants..."

"Nuh-uh, I don't want implants, I want real teeth. Maybe you could grow me just a few, and put bridges on top?"

"Uh... uh.... Whatever you like..."

Here are some quotes from a future internet forum on dentistry:

"My toothgrowologist has grown me a tooth, and apparently I didn't have enough bone and gum tissue, now the root is bare and I've got cervical decay... What do I do now?"

"My toothgrowologist has grown me a tooth, and it turned out a premolar instead of an incisor. He told me this happens sometimes, and now I have to get it devitalized, and cover it with a crown..."

"My toothgrowologist has grown me a tooth, and it points toward my cheek. Now I have to get braces. Can I make the toothgrowologist pay for the braces?"

"My toothgrowologist has grown me a tooth, it's just erupted and it is already decayed".

"My toothgrowologist has grown me a tooth, and it is loose and bleeding".

"My toothgrowologist has grown me a tooth, and I've got foreign body sensation in my jaw. I think he's grown me someone else's tooth."

Off topic, but I just remembered that when I was a kid there was some snippet on the news about a new treatment which would allow the gums to be softened (??) which would give the doctor/ortho time to reform the teeth. This was supposed to be the quick and fast answer to braces. I never heard of it again and when I've searched for it I've come up empty. Have you heard of this?

You may be thinking of Wilckodontics. From what I could tell, they don't really go into depth on their website, but what they do is place braces and then irritate the bone (essentially drill holes ("scar" the bone) in strategic spots). During the healing from this insult, osteoclastic activity is increased... accelerating the remodeling of bone. As the bone remodels, it can respond more quickly to PDL forces than it normally would. I think I first heard about this in the context of military folks who needed orthodontics, but needed results quickly.

Well, the way I see it, it would create as many jobs as it destroys. Why would you fill in a tooth when you could just replace it by a grown one? You'd need to have your tooth pulled, then get your skin scraped for the cells to start the tooth bud. You'll have to have another appointment to implant the tooth bud, and followup visits to check on the progress of the growth.

I doubt it. It would probably just one more treatment option in the arsenal of the modern dentist (probably replacing some of the less natural options like implants).

Hrm, I am mostly bald and use a beard trimmer for the remaining lint. If that baldness was fixed, it wouldn't be a bad thing for people cutting hair!

(I don't really care about being "topless" -- teeth otoh are important.)

Hah. This reminds me of a conversation I had with my dentist.

I was there for yet another appointment to work on a root canal and wondered out loud why I don't hear more about efforts to regrow actual teeth as opposed to the gruesome practice of modern dentistry. His take on this was that it just wasn't worth it: teeth are mostly mechanical. They just exist to bite through food, and an artificial crown isn't going to develop any more cavities. His take was that it's much simpler for humanity to just replace teeth with metal and porcelain than spend research dollars and scientists trying to grow teeth.

Then again, he makes his living drilling into jaws.

I would agree with this, although I'm in the unenviable position of needing a lot of dental work after not having had any for awhile. I'd far rather have research be done into making longer-lasting and/or cheaper or easier to implant permanent fake teeth that don't require thousands of dollars of upkeep throughout your lifetime.

That said, on a conceptual level, the idea that you can regrow teeth with stem cells is pretty damn cool.

It cuts both ways. I did have a lot of dental work done when I was younger, after a couple of unlucky events damaged many of my teeth. Today, I expect to spend hundreds of pounds on dental work every year or two, mostly repairing and replacing that earlier work, even though I have excellent oral hygiene and eat/drink sensibly.

I would spend a great deal of money, or even accept significant pain and making do without proper teeth for a few weeks, if it meant that I could have a new set of natural teeth at the end that I could brush and floss normally and that didn't keep hurting somewhere every few months anyway. Sadly, it turns out that all the fillings and braces and crowns and bridges in the world can't keep up with what nature gave me.

I knew someone who had a genetic defect that meant that he had a malformed face and only had 2-3 natural teeth ever grow in. We discussed his issues, and that the implanted teeth would need /more/ meticulous care than regular teeth, because there is so much that can go wrong with them, being non-natural parts of the body.

Though I feel your pain of dental work. As I'm writing this, the lidocaine is wearing off after my second to last dental visit to repair rather significant dental problems myself. Definitely worth the pain in the long run.

The real disrupting tech would be the thing that can kill that 1 strain of bacteria responsible for eating the sugar on your teeth and pooping acid all over them in return.

Its this acid discharge that dissolves tooth enamel. So, neutralizing that acid (like we try to do with baking soda) on a more _permanent_ basis would be super effective. As would simply targeting the 1 funky bacteria that turns sugar into acid (as opposed to nuking all the 1000s of beneficial bacteria too). It would seriously eat into dentists' coffers.

Can't we engineer viruses on a high level to do stuff like this for us yet? Virus vs Bacteria-- a match for the ages.

We already did. S. mutans has been genetically modified to excrete water instead of the acid that normally wears away enamel.

http://abcnews.go.com/Health/Dental/story?id=98080&page=...

Recently they tweaked the bacterium again so it would only survive if fed a particular nutritional supplement. That ensures the bacterium won't spread from one person to another while kissing or sharing utensils.

AKA vendor lock-in.

It's still rather experimental. At this stage, I'd rather have the bacterium require supplements than risk more widespread problems. Once proven safe, then hell yeah, open the floodgates.

On a somewhat related note, my dad (a dentist and scientist) recently discovered that there are stem cells that are almost as easy to manipulate as embryonic ones .. in our mouthes [1][2]. He always wondered why our gums heal so quickly, even as we age.

[1] Sorry for the PR-ish link (I'll ask him for the actual paper) - http://singularityhub.com/2012/05/10/toothless-no-more-resea...

[Edit 2] Here's the original publication (free) from Stem Cells Journal http://onlinelibrary.wiley.com/doi/10.1002/stem.425/abstract

They only got a grant for $1.5M to work on this? These dentists are in the wrong business! They should make an iPhone app to share pictures with your friends then they will really cash in!

Maybe they could create an app that was a virtual mouth. You'd have to brush and floss regularly. Every clean checkup would get you 100 points . When you get a cavity, you lose 200 points. Make it for kids.

If you make this app, I want 5% ;)

Does anyone know why these kind of things always seem to need a scaffold? When our original teeth grew there was no scaffold needed. Why can't we trigger that kind of growth?

Your growing jaw provided the scaffold.

A quote from the article: "So far, teeth have been regenerated in mice and monkeys, and clinical trials with humans are underway, but whether the technology can generate teeth that are nourished by the blood and have full sensations remains to be seen."

I understand the vital importance of pain as a signal that damage has occurred or is occurring. One of the real design flaws in the body, however, is the inability for humans to consciously shut off pain (at least temporarily) after they are aware of it.

The pain from a severe toothache is one of the worst sensations possible, and doesn't seem to accomplish much. If dental regeneration can become commonplace and relatively cheap, I think I would prefer new teeth without nerve endings and "full sensations."

Oh man, I would love this. For some reason, every so often, a tooth of mine starts hollowing out from the inside and I need a root canal. Then a few years after that, the hollowing out resumes and the tooth eventually distintgrates, and then I need an implant. This has happened four times already, and it looks like #5 is beginning.

This is still pretty experimental, although it's worked for mice and monkeys, and apparently they're working on human testing.

Is there any reason the fashion industry couldn't use this to produce, say, a coat with teeth for buttons? I would totally wear that, especially to my D&D game.

And maybe, if the Nerve Ending Fairy leaves them enough $100 bills, Americans can afford one of these new teeth!

Toothless stem cell researchers. Getting crafty.

I have nothing "scientific" or explanatory or "insightful" to offer. I've always found dentistry to be barbaric. And I've lived in terror of dentists. As a youngster, I, without guidance, stumbled onto using electric toothbrushes through my own devising. I did not brush properly, on the assumption that the technology I was using, and using it in a way I thought best of it, was the way to properly brush teeth, as opposed to the dentist's recommended methods.

My mistake, whups. But within a year's time (age 10-11), I developed 13 cavities. I was devastated. For years I have lived with a slip-up in my formative years, and am still living with that mistake, stupidity, etc.

But THIS excites me extremely. Daily I live with empty, squishy graves where two upper canines on each side used to LIVE. The "grave" analogy is not mine. I sought sympathy from a friend one day, as I confessed to him my difficult decision to have the teeth removed.

But I agreed with his words. And I felt a kind of bereavement. Daily I feel it, and it affects my work. I feel declawed. Detuned. Constantly I question my competence based on my linguistic performance, as the procedure has re-introduced my lisp. (I wouldn't dare give presentations on HTML5 and advancing technologies to corporateheads in this state now.) I'm sure millions of others would be liberated if they could regain those portions of their minds that their teeth or lack thereof distract them from.

I will follow this science, and try to understand it.

This is pretty cool because I recently learned that you can also HARVEST stem cells from wisdom teeth and get it put away. From teeth they came and to teeth they may go.

"To date, the NSU researchers have received about $1.7 million in grants for their dental stem cell research."

They should have done a kickstarter.

How much did facebook pay for instagram again?

Quack Alert

I'm just relaying what I've heard, so take it with a grain of salt, but on an episode of No Agenda, Adam Curry says that he had dinner with a guy who worked in stem cell research in Germany (I'm fairly certain it was Germany) the guy said with confidence that the technology exists to regrow fingers. The guy expressed frustration that such technology will never be released.

I know that most people will be highly skeptical, but it doesn't sound all that unreasonable to me.

Stem cell biology and synthetic organogenesis (not sure what the term for this will eventually be) are not my fields. However, we are getting excited about regrowing myocardium from stem cells when sitting on top of a pre-existing scaffolding. That's one tissue-type.

A finger requires afferent and efferent nerves, bone, cartilage, synovium, tendons, ligaments, vasculature, interstitium, muscle, dermis, and epidermis. It seems highly unlikely that we can regrow a finger given current technology. Each individual piece? Maybe. Each of those pieces in their proper place coalescing into a functional whole? I don't buy it.

You argue against building the tissue. I buy your argument.

Small children can regrow fingertips, yes? Couldn't it be possible to use that mechanism for fingers?

My understanding is that there is research in what you suggested. I'm just saying that I don't believe we yet have the technology to grow a finger. Someday, almost surely we will. Just, not for some time. Or so I think.

They can already regrow a fingertip in an adult, though I think that is (as you said) still in research stages and not available to the general public. Having regrown lung tissue of my own using info available online and no fancy gizmos to speak of, presumably we aren't terribly far off from bigger accomplishments.

> such technology will never be released.

What was the reason given?

I think he was talking about this:

http://www.dailymail.co.uk/sciencetech/article-437215/Scient...

If I remember correctly, this isn't widely used because of cancer risks.

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