The rise and impending fall of the dental cavity | Hacker News Reader

The rise and impending fall of the dental cavity

cremieux.xyz

104 pointswalterbell47 comments

Article gets weird at the end. Says to listen to the Cochran reviews, and includes one that says "High fluoride toothpaste prevents carries" and then immediately writes there's no difference between brushing normally and using high-fluoride toothpaste.

Then wraps it up by trying to sell preorders for his own product.

Cochran is right.. high fluoride toothpaste works. Had half dozen cavities during my 20s a year apart, and finally found out about this from my dentist, and it immediately halted any progression. Not one cavity in 10 years since starting it. Ask your dentist.. its not even expensive. Just dont let your kids use it.

I’ve been waiting for years (more than a decade at this point) for this to be commercialized, and have had to have most of my teeth repaired due to cavities. $250 is a cheap experiment, depending on your financial situation.

(Preordered, no other affiliation)

The only cavities I have had formed before my 25th year. 6 of them. I haven't had any other since then.

After I had them filled, I started going to an odontologist for a checkup every 4 years. The odontologists says she doesnt see cleaner teeth from patients who checkin once a year.

My personal conclussion is that adults can be more careful with their health than teenagers.

I don't eat between meals (mostly). I eat twice a day. I brush after meals. I only floss before going to sleep.

I've been using a Xylitol based toothpaste for 3 years now, which my dentist highly recommended, it works better than fluoride with my teeth too.

I eat xylitol mints throughout the day. Not quite sure if there is a difference

Manual cleaning is still required for it to apply properly, same with usual toothpaste.

Which high fluoride toothpaste do you use? My dentist recommended that I use one, but none of the options seem to give an indication of how much fluoride they actually contain.

I've used Prevident 5000 and Clinpro 5000. The first is gel, the later is paste. Both have 5000ppm fluoride, which is the same as 1.1% sodium fluoride (compared to 1100ppm or 0.243% sodium fluoride in otc).

It definitely works, the discovery was a godsend for industries looking to get rid of their fluoride waste.

The main issue, for the conspiracy-minded, is what other effects it may have.

Looking into vitamin K2 (not K1) along with vitamin D is interesting as well -- I got my bone mineral density to 99th percentile (DEXA measured) without changes in physical activity (which has just been walking) with lots of K2 and vitamin D; with the vitamin D from sunlight and a UVB phototherapy lamp when I wasn't getting lots of sunlight. My sense is that bone and teeth health are at least significantly related and I bet having excellent bone density carries over to caries, or to a lack thereof.

My guess is that typical Western diets are pretty subpar in terms of vitamin K2 intake (modern Westerners aren't usually fans of liver etc) which makes teeth pretty vulnerable to physical/chemical insult.

A good article describing most of the concerns in this thread is:

https://www.astralcodexten.com/p/defying-cavity-lantern-biow...

Their application instructions are worth reading as well (linked from that link but worth highlighting):

https://docs.google.com/document/u/0/d/1m2SEWL_rrlQLEi1OiD9K...

Among other things they mention the possibility of it disrupting gut microbiomes.

An Astral Codex Ten article is no substitute for clinical trials and measured experimental data. The ethanol concerns are dismissed by ACT with no real analysis, when the data presented is from an in-vitro thesis that didn't study the actual genetic modified bacterium at all, and feeding it nutrients which aren't found in the mouth of Western diets: that is, a very low sugar blood agar/DNB broth. It's quackery to make comparisons on that kind of flimsy evidence. This bacterium produces ethanol from sugar!

Further, ACT has their facts wrong, citing an average blood alcohol level of 1 mg/dl when it's actually 0.039. 1 mg/dl is the 95th percentile. So, according to the cited source, average blood alcohol levels go up 5.6x, and that is somehow not a risky chronic condition because there are people in the population with higher levels of that toxin in their bloodstream at the 95th percentile. ACT should know better, but is biased because his wife takes it. Probably knows the principals socially in Berkeley.

> This bacterium produces ethanol from sugar

you sound like it's bad, this is genius

From: https://www.who.int/europe/news/item/04-01-2023-no-level-of-...

“Alcohol is a toxic, psychoactive, and dependence-producing substance and has been classified as a Group 1 carcinogen by the International Agency for Research on Cancer decades ago – this is the highest risk group, which also includes asbestos, radiation and tobacco. Alcohol causes at least seven types of cancer, including the most common cancer types, such as bowel cancer and female breast cancer.“

There is no safe dose.

This is wrong. There are plenty of safe doses.

I suppose the idea is that this is legal to sell in the US based on its categorization as a probiotic?

The actual product's site makes few claims; I imagine that's because actually saying "this prevents cavities" invites FDA regulation of it as a drug.

I have been watching this with considerable interest since I first learnt about it.

I personally have never had ANY cavities so things have worked out well for me but there are multiple family members with enamel hypoplasia so I would be interested in knowing if this could be a solution.

Disclaimer: I have zero financial interest but I would love to see this actually work. I do have that odd feeling of distrust as I read through the responses so definitely wary.

That said, this is what I've seen cremieux claim so far in response to some of the questions that others have in the comments.

  * cremieux claims zero conflict of interest: https://twitter.com/jeremy_b12345/status/1777893469627072686?s=61
  * it is being sold as a "cosmetic" (no idea what that means in this context): https://twitter.com/cremieuxrecueil/status/1777885660407370063?s=61
  * claims to eliminate morning breath: https://twitter.com/cremieuxrecueil/status/1777854752635691247?s=61
  * claimed to be a one time thing: https://twitter.com/loobah_l/status/1777896253499887813?s=61
  * claimed not to be affected by mouthwash but I can't find the reference right now
  * caries vaccine??: https://en.wikipedia.org/wiki/Caries_vaccine

YMMV

I wonder if using mouthwash that kills "99%" bacteria make this product useless over time?

Also, does using mouthwash daily negate the need for this product?

Probably, but the difference I see is that single application of this product is enough (as opposed to buying mouthwash and other stuff that's often discussed here like toothpaste with Novamin for the rest of your life).

I mean, weren't you going to buy mouthwash anyway...?

I'd hope not. I mean, what would be the point? Get your mouth colonized by this "harmless" bacteria and then kill it?

Fix my bad-smelling breath, which I am guessing this stuff doesn't fix.

The author says it does fix it:

https://twitter.com/cremieuxrecueil/status/17778547526356912...

Brushing, flossing, and mouthwash doesn't kill all of the bacteria in your mouth. Your entire mouth is coated with a biofilm... and after cleaning, your mouth gets recolonized by bacteria from between your teeth, beneath the gums, plaque, and other small crevices in your mouth.

In their application instructions they mention that rinses such as chlorhexidine might eliminate the new bacteria:

https://docs.google.com/document/u/0/d/1m2SEWL_rrlQLEi1OiD9K...

Talk about burying the lead. The whole article is interesting and worth a read, but the final section is about the first ever vaccine for dental caries which can be pre-ordered now and is scheduled to ship to the US in June: https://www.luminaprobiotic.com/

Does it really work? I guess we'll know soon enough.

> Talk about burying the lead.

Burying the lede.

Lede is an alternate spelling (dating only from the 70s) of lead-the-intro to distinguish from lead-the-metal which was also an important word in printing at the time.

Interesting if true but I can't help but be a little skeptical when the article writer so obviously wants to sell me something.

This sounds so cool and great, but no mention of FDA approval anywhere.

Sounds like it's being sold as "cosmetic".

It changes my body chemistry. It gets described as a vaccine.

Not sure humans should be the test subjects and very concerned anyone can just buy this.

And I know people will. I want to and am having to exert will to use my better judgement.

In the safety section, it makes it clear it can't be reversed without serious effort and no evidence anyone has successfully reversed it.

Modifying mouth bacteria to remove cavities

https://news.ycombinator.com/item?id=39744430

US only :(

According to wikipedia:

"In 2023, the startup Lumina Probiotic began offering BCS3-L1 application in Próspera, Honduras."

https://en.wikipedia.org/wiki/Caries_vaccine#Attempts_using_...

Per company's web site (NOT an endorsement from me):

https://www.luminaprobiotic.com/in-honduras

HN ranking history for this thread: https://hnrankings.info/39986589/

Ethanol (alcohol) is toxic; do I want bacteria producing ethanol in my mouth constantly, poisoning my brain? If I swallow this bacteria, will it start producing ethanol in my gut? If it does, how do I get rid of it? I don't want to have a low level of cognitive impairment 24x7.

If I have this in my mouth and then have a baby, will the baby be contaminated with alcohol-producing bacteria during critical periods of development (up to age 18?) Will that alcohol damage their central nervous system?

So much wrong here.

EDIT: some data from their FAQ: "The endogenous alcohol concentration in the blood of sober people is 0.39 ± 0.45 μg/mL or 0.039 mg/dL (Antoschechkin, 2001)." Further down: 5. Then you’ll end up with 11mg/5L of blood. This is, in more familiar units, 0.22 mg per dL 0.22 / 0.039 = a 5.6x increase in chronic blood alcohol concentration under pessimistic assumptions [1]. No thank you. There's no telling what that will do to a person over 50 years.

[1] I'm not sure it's so pessimistic. This number comes from culture on blood agar, which isn't exactly the sugar level of a Western diet. Blood agar contains almost no sugar.

The claim on Twitter has been the amount of ethanol produced is small on the order of eating a piece of bread a day but I have not seen any further evidence.

See https://twitter.com/cremieuxrecueil/status/17778867655896187...

"The claim on Twitter" is why the FDA exists, and that's a good thing. Bread can be a bit alcoholic, yes. I try to avoid it for other reasons. I would prefer that everything I eat over 50 years not be turned into fractional bread by my saliva.

You have hundreds of varieties of bacteria in your mouth, many of which already make ethanol. You have one that makes lactic acid and causes tooth decay; by making a variety of it that makes ethanol and can outcompete the tooth-decay causing variety, you improve the situation: drastically lower lactic acid and not much more ethanol.

When ethanol is added to saliva, bacteria in the mouth produce acetaldehyde, which is known to be carcinogenic. I need less ethanol in my mouth, not more!

>I need less ethanol in my mouth, not more!

Said no one ever.

This is pretty low effort. You contract yourself in the same sentence, because clearly I just said it!

"The average person has enough of these bacteria in their gut to have a natural blood alcohol level - even after zero drinks - of about 0.1 mg/dl. Under pessimistic assumptions, BCS3-L1 will add another 0.2 mg/dl, bringing the total to 0.3. This is still a pretty normal number that some people have naturally (it would bring the average customer from the ~50th to the ~80th percentile of natural blood alcohol). It’s also far from the usual threshold for feeling tipsy (30 mg/dl) or too drunk to drive (80 mg/dl).

Under more realistic assumptions, the amount of alcohol produced by BCS3-L1 probably isn’t significant even by the very low standards of natural blood alcohol concentrations."

(From https://www.astralcodexten.com/p/defying-cavity-lantern-biow...)

From the source: "The endogenous alcohol concentration in the blood of sober people is 0.39 ± 0.45 μg/mL or 0.039 mg/dL (Antoschechkin, 2001)."

Further down: 5. Then you’ll end up with 11mg/5L of blood. This is, in more familiar units, 0.22 mg per dL

0.22 / 0.039 = a *5.6x* increase in chronic blood alcohol concentration, albeit under pessimistic assumptions [1].

No thank you. There's no telling what that will do to a person over 50 years.

[1] I'm not sure it's so pessimistic. This number comes from culture on blood agar, which isn't exactly the sugar level of a western diet. Blood agar contains almost no sugar.

This strain was found in the wild. Some humans already have it. It would take finding those and figuring out if they have any issues.

"BCS3-L1 has four main genetic modifications:

    It produces a weak antibiotic, mutacin-1140, which kills competing oral bacteria.

    It’s immune to mutacin-1140, so it doesn’t kill itself.

    It metabolizes sugar through a different chemical pathway that ends in alcohol instead of lactic acid.

    It lacks a peptide that its species usually uses to arrange gene transfers with other bacteria."

A strain with modifications 1 and 2 was found. 3 and 4 were added to it. This means we could check for mutacin-1140 health issues by tracking those people but not the increased alcohol in blood.

https://www.astralcodexten.com/p/defying-cavity-lantern-biow...

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