

Dentists to replace drills with plasma jets - cwan
http://www.crunchgear.com/2010/02/07/dentists-to-replace-drills-with-plasma-jets/

======
verisimilitude
I'm currently in the middle of dental school, and unfortunately this
technology can't completely replace 500,000 rpm air turbine drills (a
technology that is, to correct the article, NOT from the 1880s).

Here's the problem: bacteria (specifically, the acid they produce from
metabolism of sugars) demineralize the hydroxylapatite of enamel (the stuff
covering your teeth). Enamel is not biologically viable and therefore does not
have the ability to _regenerate_. But it can, under certain circumstances,
_remineralize_. SO, eliminating harmful bacteria using plasma technology WOULD
give portions of enamel the opportunity to remineralize.

Unfortunately, if a caries lesion ("cavity") penetrates to the point that it
reaches underlying, vital tooth structure (dentin, pulp), then surgical
removal of the infected tooth tissue is the only way to effectively treat the
growing lesion. Bacterial control by plasma at this point would be
insufficient to keep the structure of the tooth crown sound. Thus, you need a
drill to cut away tooth structure.

Furthermore, I object to the article's use of "sterilize". It's important to
understand that epithelial or mucosal surfaces covering the human body can
never be sterilized ("all living organisms eliminated except prions"). The
bacterial load can only be reduced, never eliminated.

Then again... this article is a TechCrunch production, so what do we expect?

~~~
petercooper
_Then again... this article is a TechCrunch production, so what do we expect?_

Expecting the author of a bit piece on a tech site to have knowledge of
dentistry is a bit of a stretch (don't get me wrong - I loved your insight).
Even the BBC's writeup - <http://news.bbc.co.uk/1/hi/health/8470827.stm> \-
doesn't go into such detail.. but this feels like yet another trendy, but
baseless, snipe at TechCrunch.

~~~
dminor
Nobody expects a journalist/blogger to have a knowledge of dentistry. But at
what level of professionalism do we expect them to track down a dentist for a
quote?

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maggit
I took the liberty of following the link to slashdot and from there to
livescience.com where I found a much more interesting article:

[http://www.livescience.com/technology/plasma-jets-dental-
dri...](http://www.livescience.com/technology/plasma-jets-dental-
drills-100204.html)

<http://news.ycombinator.com/item?id=1108455>

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tempacct
Am I the only one here who's never been to a dentist? From my perspective, it
seems like they do more harm than good with the drilling, scraping, filling,
etc. People I know who go seem to end up "repeat customers", with all kinds of
"problems".

~~~
mechanical_fish
I tried not going to the dentist during grad school, yes. (More out of absent-
mindedness than with any definite plan.) I spent perhaps four or five years
dentist-free.

My reward was a series of extremely painful toothaches followed almost
immediately by a bunch of _very_ expensive root canals and crowns.

Let me assure you: Once your toothache starts, your time as a dentist-denier
_is going to come to a fast end_ , one way or another. They hurt a _lot_. Not
to mention the fact that if you get an abscessed tooth it can literally
threaten your life.

Of course, you don't necessarily have to have the dental insurance and the
well-paying job that I had when my dental emergency arrived. Instead you can
elect the more traditional option: Have all the offending teeth pulled out.
Then you may eventually need dentures. [1] I'm told that dentures are no fun
whatsoever. I have had no reason to regret spending money on dentistry
instead.

Of course, if you literally never touch soda or sugar, brush your teeth
carefully, and are blessed with better genetics than mine you might get
lucky...

\---

[1] Pulling one tooth can have a negative effect on neighboring teeth, as the
bone loss under the empty space causes the neighbors to loosen and slip.
That's why people who lose permanent teeth tend to get crowns or bridges.

~~~
coffeemug
I think genetics is the main factor. I've known a few people who never floss,
brush once a day in the morning, eat pretty much whatever they want, go to
dentists once every five years, and never have cavities. On the other hand,
I'm very careful to floss before sleep and brush twice a day, but I still end
up with a cavity or two every year.

~~~
verisimilitude
In my continuing review of the dental primary literature and frequent
consultation with dentists (my professors), I have found that genetics
actually play a minor role in the frequency that an individual develops dental
caries lesions.

More important factors include: (1) frequency and dose of fluoride (2)
bacterial ecology of the mouth (possibly related to genetics, but also
inextricably linked to the environment to which the individual has been
exposed since birth) (3) FREQUENCY of meals -- look up "Stephan Curve" or the
unethical "Vipeholm Study" if you are interested in this...

~~~
JangoSteve
I tend to get cavities every now and then, but always have very little plaque
build-up. In fact, when I went on one 4-year hiatus from the dentist, the
assistant cleaning my teeth said it looked like I had just recently had them
cleaned. She said it probably had to do with the chemical makeup of my saliva
being more plaque-resistant that average. Funny thing is my mom always gets
similar comments when she goes to the dentist. We live very far away from each
other and have very different diets. Based on that, I would conclude that the
bacterial ecology of the mouth and related chemical composition of saliva, are
probably quite genetic.

Also, based on the fact that my dad has horrible luck with his teeth
(cavities, root canals, etc), and dminor's comment
(<http://news.ycombinator.com/item?id=1108895>) in this thread saying that
they have very different luck with their teeth from their brother, I would
venture to guess that it may have a lot to do with the mother's side of the
genetics (being linked to the X chromosome that gets passed down). In dminor's
case, they could have received one X from their mother and their brother have
received genetic makeup from the other X, which could explain their
differences in dental hygiene at least partially. If it were Y-linked, then
I'd obviously have much closer luck to my dad's, and those two brothers would
be much closer in results to each other, since there is only one Y to be given
from one parent.

Of course, this is all nothing more than educated conjecture. I'm probably
totally off base and it's likely much more complicated than that. For all I
know, these results could be all coincidence, and the genetic characteristics
could be totally unrelated to the sex-giving genes. (In other words, I have no
dental training and nothing more than a curious, inquisitive disposition.)

------
CapitalistCartr
Crunchgear is just re-writing the article here:
[http://www.livescience.com/technology/plasma-jets-dental-
dri...](http://www.livescience.com/technology/plasma-jets-dental-
drills-100204.html)

------
kellishaver
Having undergone some fairly extensive oral surgery just last week in order to
combat a major infection that got out of hand before I was even aware of its
existence, and also having a fear of dentists in general, I'm not sure if I
find the thought of plasma jets being fired into my mouth comforting or
terrifying. Either way, I think I prefer to remain unconscious during the
procedure.

Really though, even if it's not a good solution for serious dental problems,
if it can provide a pain-free, fear-free (that drill just terrifies a lot of
people, honestly), quick means of dealing with minor tooth decay, then perhaps
more people will seek treatment earlier, before things get out of hand.

I still think the number one factor in individuals not seeking proper dental
care, however, is cost and the fact that it's just so hard to get good,
affordable dental insurance (or any dental insurance at all). We could go on
for hours about the flaws in our healthcare system in the US and about how
hard it is for many people to get insurance, but getting dental insurance is
even more difficult in a lot of cases.

Sadly, I don't think adding plasma and lasers is going to drive the cost down
any, at least not for several years. Not that this, in any way, means I think
we should stop innovating, because innovation is going to lead to better care
and, hopefully, eventually, more affordable care.

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ordinathorreur
A good friend of mine was part of the pioneering team that initially
researched this stuff over at the Technical University of Eindhoven in the
Netherlands. See this article from 2006:
[http://www.newscientist.com/article/mg19125586.200-plasma-
ne...](http://www.newscientist.com/article/mg19125586.200-plasma-needle-could-
replace-the-dentists-drill.html)

I can remember getting pretty freaked out when he was explaining it to me.

------
sheraz
There have been alternatives to the drill for quite some time. My dentist uses
"air abrasion" to clean out the cavities before filling them. This is a pain-
free and numbing-free method of dentistry.

Per WebMD: <http://www.webmd.com/oral-health/guide/air-abrasion>

