
Researchers create gel that regrows tooth enamel (2015) - mad_dev
http://www.dentistryiq.com/articles/2015/11/researchers-create-gel-that-regrows-tooth-enamel-eliminates-pain-associated-with-tooth-decay.html
======
stephanheijl
Is it just me, or does it feel like we've been hearing about advances in
dental treatment for decades, without them actually having any effect on the
practice? From my personal experience as someone living in the Netherlands,
where standards of health care are pretty high, I would expect these
advancements to make at least _some_ impact on the field. Instead my
(admittedly anecdotal) experience as a patient has been basically the same
over the years.

2014 - "No more fillings as dentists reveal new tooth decay treatment"
[https://www.theguardian.com/society/2014/jun/16/fillings-
den...](https://www.theguardian.com/society/2014/jun/16/fillings-dentists-
tooth-decay-treatment)

2011 - "An end to the dentist's drill: New painless cavity filler could be on
the market in two years"
[http://www.dailymail.co.uk/health/article-2077816/Scared-
den...](http://www.dailymail.co.uk/health/article-2077816/Scared-dentist-New-
painless-cavity-drill-market-years.html)

2004 - "No drilling, no filling in painless dentistry"
[http://www.telegraph.co.uk/news/uknews/1477044/No-
drilling-n...](http://www.telegraph.co.uk/news/uknews/1477044/No-drilling-no-
filling-in-painless-dentistry.html)

1998 - "Dental lasers – are they the safest way to fill your cavity?"
[http://judyforeman.com/columns/dental-lasers-are-they-
safest...](http://judyforeman.com/columns/dental-lasers-are-they-safest-way-
fill-your-cavity/)

~~~
fractallyte
Having worked at a dental implant startup in Vienna
([http://www.bioimplant.at/](http://www.bioimplant.at/)), I've experienced
first-hand the obstacles that prevent new treatments and technology from
reaching the patient.

In summary: here is an 'immediate' dental implant requiring no drilling or
bone augmentation (ie. surgery-free), that can be placed in minutes, and -
once healed in - has no risk of future infection (peri-implantitis).
Clinically proven over 10 years. Revolutionary, right?

No top-end journal is willing to publish papers on this topic. (We surmise
that the implant industry profits too much from existing treatments.) We've
approached several popular science magazines with article proposals; declined.
Reached out to journalists, no response.

The only real publicity so far has been through word-of-mouth and SEO. It's a
baffling (and somewhat disgraceful) situation. There are hundreds, if not
thousands, of patients suffering needlessly every year, and a solution
_exists_ \- but where is the bridge that can connect them?

~~~
threatofrain
For what reasons were top-end journals unwilling to publish on even just the
topic, and for what reasons were researchers completely ignoring communication
attempts?

~~~
fractallyte
The articles - follow-ups on anatomic implant cases - were rejected mostly
with the excuse that they didn't fall into the journal's area of interest. (I
don't have access to the actual letters at the moment; I hope they're
eventually published on the website.) We're talking here about top journals
such as the International Journal of Oral & Maxillofacial Surgery. (Not their
area of interest? Seriously?!)

More worrying yet were responses from implantologists and dentists on
community sites such as Dentaltown. There was a shocking level of ignorance
about osseointegration and zirconia, and a belittling attitude to such a
'newfangled' treatment. (Of course, it didn't help that the CEO on our side
has a _very_ low tolerance threshold, and expresses himself with typical
Austrian directness - to put it mildly...)

------
stevebmark
Maybe relevant to someone: Fluoroquinolone antibiotics like Cipro
(ciprofloxacin), Levaquin (levofloxacin), *floxacin, etc, directly and maybe
permanently increase the production of MMPs, the enzymes this article is
talking about. That's (partly) why these antibiotics cause teeth to shatter at
the gum line spontaneously.

There are something like 40 MMPs and we don't know what they all do, but
they're generally responsible for destroying tissue in the body. Normally this
is a good thing, like when a wound needs to clear out cells for wound healing.
But fluoroquinolone antibiotics cause the "upregulation" of these enzymes,
possibly permanently through epigenetic changes, so the body literally eats
itself over time. This is why teeth shatter, hair falls out, collagen
disappears (wrinkles, skin damage), connective tissue dissolves (like the
optic nerve, leading to retinal detachment / blindness), and tendons literally
snap without use, which can lead to disability. All of this damage can be
irreversible even at low doses of fluoroquinolones.

~~~
rjurney
Got a source? I want to read it.

~~~
derefr
Not a source, but a corollary of the parent's claim that might be easier to
look up: doxycycline, an MMP _inhibitor_ , is used (under the trade name
"Periostat") as a prophylactic after dental root planing to prevent damage to
the enamel.

~~~
stevebmark
Your original question, "what happens if a drug downregulates MMPs" \- is a
great question and the tip of a largely unexplored iceberg.

MMPs are involved in many diseases, including fluoroquinolone insidious
poisoning. They are implicated in heart disease and neurological disease like
MS, for example. They are also implicated in general aging, because they
destroy collagen which is considered to be irreplaceable in the body (hence
why wrinkles are permanent).

Doxy is a known MMP inhibitor which may have benefits extending past its
antibiotic range.

An important related question is _why_ are MMPs upregulated by
fluoroquinolones? One answer is that TIMPs are downregulated [1]. TIMPs are
the antagonist to MMPs, they bind to MMPs and deactivate them. This is one way
your body maintains MMP control.

Researching TIMP upregulators and MMP downregulators may help people suffering
from permanent fluoroquinolone damage (like myself) deal with the constant
pain and tissue destruction. These also have implications in aging and anti-
aging technology. Notably, food from the ocean is well known to balance
TIMP/MMP regulation [2]. Some natural antioxidants may also have the same
effect [2]. This unexplored research is important both for tooth decay like
the original article (since MMPs eat dentin, the hard tissue in teeth, and
apparently enamel as well), and most tissue in the body, as fluoroquinolone
sufferers experience in a hellish, constant reality.

[1]
[http://www.mltj.org/materiale_cic/704_3_3/6081_new/article.h...](http://www.mltj.org/materiale_cic/704_3_3/6081_new/article.htm)
[2]
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707034/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2707034/)

~~~
graeme
Hmm. Took one course of cipro in early 2010. The year after that was the worst
of my life health wise. After that, have steadily improved.

I can't say it's cipro related. The stuff that happened was: very bad
digestion, chronic left arm pain due to typing in a poor ergonomic position,
and a bike accident + broken tooth (this clearly wasn't due to an antibiotic).
I did, however, likely acquire MRSA in a wound on my chin that I got during
the bike accident (I found out I had MRSA five years later; it had moved to my
nose and persisted there at an asymptomatic/occasional flare up level). MRSA
seems linked to cipro usage. I also acquired tinnitus at some point, most
likely after the bike accident. My liver enzymes also tend to be on the high
end of the normal range or slightly above it.

May have started bruxism that year or the one after, but it's hard to date
when teeth grinding started. That one could be something that developed after
the bike accident.

Nothing necessarily specific to cipro. But, supposing it did contribute to any
of that, is there a normal protocol to reverse effects? Beyond what you wrote
above, which would be: eat seafood and certain antioxidants (which?)

I'm in a pretty good state right now, and also nowhere near certain Cipro had
any impact on me. But, it was a _very_ rough year, and I had always been in
excellent health prior to that. So if there's some sort of low side effect
thing I could adopt such as certain foods, it's worth trying.

btw, here's the source on cipro and MRSA. I hadn't know about this link:
[http://www.news-medical.net/news/20120921/Ciprofloxacin-
use-...](http://www.news-medical.net/news/20120921/Ciprofloxacin-use-is-major-
contributor-to-MRSA-spread-in-hospitals.aspx)

~~~
stevebmark
FQs are some of the most powerful antibiotics in terms of destroying healthy
gut bacteria, and likely cause permanent gut flora changes after use. Some of
the bacteria it destroys are oxygen sensitive, so they aren't in probiotics
because they can't survive long enough to be manufactured into a pill.

Muscle problems, especially muscle twitches, are very common among FQ toxicity
sufferers. This is suspected nerve damage but there may be other factors.

FQs are well known to cause tinnitus, with the suspected biological mechanism
being nerve damage to the ear.

Unfortunately, the medical community is severely lacking in treating these
conditions, so there are no reliable tests for determining the underlying
damage. It may be impossible to definitively know if any of these things were
caused by the cipro.

~~~
graeme
Fair enough. So are there any further treatment indications, e.g. such as a
way to get oxygen sensitive bacteria other than a pill? Likely would help my
digestion whatever the cause.

A doctor who examined my tinnitus actually suspects it's nerve damage.
However, it may well have been due to the bike accident, so it's hard to tell.

No muscle twitches that I'm aware of. More tension.

~~~
stevebmark
Yes. A DIY home fecal transplant.

------
petra
The root cause of most dental issues , including dental carries is a simple
bacteria. We've been dealing with bacteria , extremely well, since the first
vaccine. And for 30 years , there has been research for a vaccine. So where is
it ?

Well, one company , oragenics was ready for clinical trials. But it seem[1]
that, due to a very restrictive enrollment criteria they couldn't enrol people
to their clinical trial.Due to that and to further uncertainity due to fda ,
they stopped the clinical trial waiting for "partnering opportunities".

Such a shame. I wonder how and what could restart that project ?

[1]hsprod.investis.com/site/irwizard/orni/ir.jsp?page=sec_item_new&ipage=8899679&DSEQ=1&SEQ=19&SQDESC=SECTION_PAGE&exp=&subsid=41

~~~
smallnamespace
Dental caries aren't caused by a single species of bacteria, but by multiple
species working together. They form an extracellular matrix called a 'biofilm'
that makes them resistant to immune system attack [1].

The link you cite is not a vaccine, but a supposed 'replacement' bacteria that
outcompetes the native bacteria [2]. This can definitely work, but I'm
doubtful it will be universally effective, for the same reasons that
probiotics don't always work: every person has different existing populations
of bacteria, and not every invading species will be successful at colonizing
or dominating that environment.

[1]
[https://www.ncbi.nlm.nih.gov/pubmed/20630188](https://www.ncbi.nlm.nih.gov/pubmed/20630188)

[2] [http://www.oragenics.com/technology-
pipeline/lbp/smart](http://www.oragenics.com/technology-pipeline/lbp/smart)

~~~
dualogy
> Dental caries aren't caused by a single species of bacteria, but by multiple
> species working together.

Yeah, but not many. Next to the ~half-dozen-hundreds-or-so of species
populating our oral cavity without issue (indeed contributing just fine), we
know of just ~under-half-a-dozen-or-so potentially dangerous ones. The very
ones who create the very few _actually_ damaging acids (among the many kinds
in the world that our initially-generally-robust dentition handles just-fine)
when fermenting carbohydrate leftovers. Brushing regularly disrupts or may
even destroy their biofilm, Xylitol accomplishes/contributes the same FWIW, or
absent dietary carbohydrate (read, ancestral ice-age hunters / traditional
inuit / Maasai warriors etc) the problematic sort doesn't even ever form.

------
neeleshs
Nice, I hope this hits mainstream in the next 10 years - I'm hoping my teeth
will survive without a lot of damage till then :).

The researchers also have filed for a patent
[https://www.google.com/patents/US20140186273](https://www.google.com/patents/US20140186273)

~~~
lj3
You can regrow tooth enamel on your own right now. It's much, much slower than
this and requires a criminally large amount of cod liver oil and butter oil
(ie: vitamins A, D, K2 and calcium).

~~~
rpedela
That claim needs a citation from a trustworthy source.

~~~
lj3
O_o

~~~
rpedela
Then please don't spread FUD.

~~~
FreeFull
Fear, uncertainty and doubt? I don't see how any of that applies to his
comment.

~~~
rpedela
1\. The original comment was deleted. My comment would make more sense in
context.

2\. FUD is using false information to spread fear, uncertainty, and doubt.
When someone claims nutritional supplements have some sort of miraculous
medical benefit, that is FUD. It is FUD because it is almost certainly false
information and it helps to create doubt and uncertainty of mainstream medical
science.

3\. If OP provides empirical evidence that using nutritional supplements
regrows enamel, I will admit I was wrong. The wider medical community would
also be very interested.

------
Puts
Wait? Didn't I see this exact same thing in 2005?

[https://www.theguardian.com/science/2005/feb/24/5](https://www.theguardian.com/science/2005/feb/24/5)

------
atxcrab
Dental technology comes out of stone age :) Most of 'innovation' was around
x-ray machines and nice chairs for last several years ( at least for most of
patients )

~~~
convolvatron
i didn't see a dentist for 30 years

when i came back, i had issues. but the imaging was really quite a bit better.
the adhesives were better. the crown construction process was a lot better.
cleaning processes much better. filling materials substantially advanced. mold
making considerably advanced.

everything was substantially less painful, cheaper, and more well understood.
maybe you can fault it for not being better faster

------
amelius
This toothpaste claims the same, not sure what to make of it:

[http://www.smile-store.eu/prevdent-re-whitening-and-
enamel-r...](http://www.smile-store.eu/prevdent-re-whitening-and-enamel-
repair-toothpaste.html)

~~~
colordrops
The key is nano-hydroxyapatite. Toothpaste with this ingredient is also sold
in Japan.

~~~
Terretta
Nano-hydroxyapatite and its applications in preventive, restorative and
regenerative dentistry: a review of literature --
[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252862/)

> _" The nano-hydroxyapatite is a revolutionary material with a wide use in
> dentistry. With regard to restorative and preventive fields, nano-
> hydroxyapatite has remarkable remineralizing effects on initial lesions of
> enamel, certainly higher than traditional fluorides used until now for this
> purpose."_

Apagard Premio toothpaste 100g | the first nanohydroxyapatite remineralizing
toothpaste -- [https://www.amazon.com/Apagard-Premio-toothpaste-
nanohydroxy...](https://www.amazon.com/Apagard-Premio-toothpaste-
nanohydroxyapatite-remineralizing/dp/B0016GCZSC/)

------
desireco42
Finally something to advance dental technology :)

I wonder how much existing practices, who are invested in repair and
especially cleaning of teeth feel about possibilities to permanently repair
teeth. There are other advances such as the one with laser stimulation.

~~~
Eric_WVGG
There’s also a new stem cell treatment that could make root canals obsolete.
[http://www.popsci.com/end-root-canals](http://www.popsci.com/end-root-canals)
[https://news.ycombinator.com/item?id=12026614](https://news.ycombinator.com/item?id=12026614)

~~~
lj3
This one is far more exciting to me. The idea that we can re-create dentin
from stem cells with functioning nerves and everything is crazy.

------
skc
The day it becomes possible to completely replace all my teeth with great
looking indestructible alternatives cheaply, sign me up.

------
smn1234
not enough longitudinal studies with statistical (significant) power... who
knows what the innovation's outcome truly is... lichen planus?

------
Hogg
The date on the article is November 23, 2015.

~~~
dang
Thanks. Added.

