
Dentists reveal new tooth decay treatment - sethbannon
http://www.theguardian.com/society/2014/jun/16/fillings-dentists-tooth-decay-treatment
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yogipatel
This headline is overly sensational — this treatment does not apply for what
most people consider cavities (i.e. caries, bacterial decay). It only applies
for the very early stage caries process where enamel is just beginning to
become demineralized.

Tooth enamel is essentially a matrix that is hardened by mineralization.
Caries initially demineralize the enamel, but as they progress they destroy
the enamel as well. Once that enamel is gone, there is _nothing left to
mineralize_. You can throw as much calcium, phosphate, electricity, etc at it
and you won’t end up with any more enamel. The decay has to be removed and
filled with something.

This proposed treatment only works for the very initial stages of
demineralization, which are referred to as white spot lesions, since
demineralization causes the enamel to become opaque. The current conservative
treatment for white spot lesions is to be judicious with cleaning and possibly
apply some additional fluoride, as the tooth simply needs to be remineralized.
The researchers are claiming to be able to accelerate that remineralization,
which is great, but is very, very far from saying that patients won't need
fillings.

Source: I’m a 2nd year dental student.

Edit: formatting

~~~
saidajigumi
> The current conservative treatment for white spot lesions is to be judicious
> with cleaning

And I'll point out that my current dentist is the only one I've ever had (or
known of) who actually bothers to rigorously teach his patients how to clean
their teeth well. Most apparently don't believe this is possible or worth
their time. Obviously that's not going to take with every patient, but it's
really quite amazing the difference between _thinking_ you're doing what needs
done (yet having the hygienist grumble all the same), and actually getting the
plaque off every time. Put another way, diligence != skill when it comes to
dental hygiene.

~~~
e40
Care to elaborate what the techniques your current dentist taught you?

~~~
devbug
Off the top of my head:

* Modified Stillman's

* Floss properly; "scrape" gently with the floss.

* Water rinse after acidic drinks (like red wine). Brush a half hour after that.

~~~
lukeschlather
One thing that has done a lot for me is I've been doing more brushing without
toothpaste. I do use toothpaste, but when I do it I treat it more as a
fluoride treatment than as a tool to get off plaque. When I'm trying to get
off plaque I use a dry brush.

~~~
Scoundreller
Toothpaste is more than fluoride, it contains surfactants and mild abrasives
to aid in the cleaning process.

~~~
dualogy
Abrasives on enamel! Yay..

~~~
Scoundreller
It's all about differences in hardness.

If everything goes as planned: The abrasive is more likely to scratch what's
on the teeth; and the teeth are more likely to scratch the toothpaste if
everything goes as planned.

------
benjaminwootton
In a few years I think we will look back on how today's dentists look after
teeth with shock, similar to how we do now knowing that they used to treat
depression with a frontal lobotomy.

"They used to DRILL your teeth? And if that didn't work they yanked them out
of your jaw?"

It all seems so low tech.

~~~
atom-morgan
People still get their wisdom teeth taken out without being put under. I heard
one person describe the process inside your mouth sounding like a tree trunk
being snapped in half.

~~~
wpietri
I am one of those people. The oral surgeon offered me the option of being put
under for an extra $600 for the 45-minute operation. There are probably things
I'd pay $800/hr for, but that wasn't one of them. He seemed kinda irritated;
that meant he had to give me something like 16 shots to properly numb
everything.

Personally, I didn't mind it. It was an interesting experience. I knew I was
made of meat, but the smell of bits of it cooking really brought it home. And
as you say, the sound was kinda freaky. But it was a good opportunity to
practice keeping the mind centered and following the breath. Plus now I can
joke that I learned to transcend dental medication.

~~~
j2bax
I also recently had my wisdom teeth removed without sedation. I took some
pills that the dentist prescribed to me that were supposed to really put me
out of it, but I was 100% with it until about the time we got in the car to
leave the dentists office. I pretty much hate having my teeth worked on. It
causes me quite a bit of anxiety when normally I'm not very anxious. Whilst
numbing my face, he hit a nerve 2-3 times that sent what felt like a powerful
electrical jolt through my body. After that, it was a quite a physical process
with the dentist even propping himself against my arm at one point to rip
those suckers out. I had put the process off for about 6-8 years, but I am
really happy its done and in the past. Now every time I have to get a filling,
I wince quite a bit waiting for that poked nerve sensation...

~~~
ElComradio
I have always been a champ at the dentist probably because I was used to it
growing up with all the orthodontic work. As an adult I had a wisdom tooth
removed. At one point he said he had to crack it, brought out an awl-type
device and leaned on it with all his weight. A tremendous crack; I saw blood
squirt out of my mouth like a jet, and thought it was hilarious.

However, I can't put things into my eye at all. Karmic.

------
lukeschlather
More recent article says they still haven't actually used the technique on a
human being, only on extracted teeth.

[http://www.reuters.com/article/2015/08/25/us-dental-
device-i...](http://www.reuters.com/article/2015/08/25/us-dental-device-
idUSKCN0QU21C20150825)

Still, sounds very promising.

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mixmastamyk
Interesting.

There was another unique treatment that hit the news perhaps ten years ago,
but didn't happen apparently? The idea was awesome, they genetically re-
engineered the "tooth-decay" bacteria in your mouth to stop producing acid,
combined with a mild antibiotic to out-compete the original form. I've been
waiting a long time for it, unfortunately.

I think this was it: [http://www.oragenics.com/?q=cavity-
prevention](http://www.oragenics.com/?q=cavity-prevention)

~~~
kbutler
I've read about this previously, and would love to see it take place.

But would kissing spread the non-tooth decay version of the bacteria, or the
tooth decay version? Testing must be done!

Also, TIL that bottled water promotes tooth decay (by displacing flouridated
tap water consumption)

" there are several factors that are likely to increase the incidence and
frequency of tooth decay, including increasing consumption of both dietary
sugar and bottled water. Bottled water generally does not contain fluoride,
and thus does not impart any of the protective effects of fluoridated water
from public systems."

~~~
yourapostasy
> TIL that bottled water promotes tooth decay (by displacing flouridated tap
> water consumption)

The elite-branded bottled water that go to lengths to set themselves apart
from tap water (spring-fed-only, or rain-only, or some other esoteric,
"natural" source) will not have fluorine. But many a budget-brand is simply
expensively-packaged municipal tap water, and about 2/3 of municipal tap water
supplies in the US are fluoridated. I suspect it is a relatively safe bet that
when at a department/grocery store, if you simply pick up the house brand
bottled water, it will be sourced from municipal tap water and fluoridated.

~~~
triangleman
Serious question: How does fluoride in the tap water help mineralize tooth
enamel? Does it enter the body through drinking and then carried to the teeth
via the bloodstream? Or is it somehow helpful for teeth by simply being
present in the mouth when you drink tap water?

~~~
yourapostasy
Good layperson overview:

[https://en.wikipedia.org/wiki/Remineralisation_of_teeth](https://en.wikipedia.org/wiki/Remineralisation_of_teeth)

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Mithaldu
Important bit: "It could be available within three years."

So it might be available in 10 years or so.

~~~
teddyh
20 years. You have to wait for any patents to expire.

~~~
happyscrappy
Are waiting for patents to expire to use a cellphone?

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maxgee
Article is from June of 2014. Any updates on this technology?

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adrianpike
Looks like they're working on bringing it to market;
[http://www.reminova.com/faqs](http://www.reminova.com/faqs)

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Ianvdl
> A two-step process first prepares the damaged area of enamel, then uses a
> tiny electric current to push minerals into the repair site.

Does anyone know how long this process takes compared to the current solution?

~~~
goldenkey
Novamin is a great way to remineralize teeth. Similar to Recaldent (found in
Trident Extra Strength.) It's basically a type of micro-glass that slowly
remineralizes teeth with continued use.

GSK bought Sensodyne a couple years ago and removed it from all the US
Sensodyne toothpastes. Only way to get it in the US is to order from overseas,
or to get a prescription from a dentist.

As much as I don't like to be that "conspiracy guy" it's kind of convenient
for them to buy the product, remove it from over-the-counter, mark it up, and
allow insurance to pay for a prescription strength version..

[https://en.wikipedia.org/wiki/NovaMin](https://en.wikipedia.org/wiki/NovaMin)

~~~
angersock
Why'd GSK do that, I wonder?

~~~
theworstshill
money.

~~~
mikeash
Well, obviously. But how does it make them money? I can't imagine the market
for prescription toothpaste is very large.

~~~
goldenkey
I would imagine that the margin on a 150 dollar toothpaste is quite a bit more
than a 6 dollar toothpaste. It's possible that the margin makes up for the
smaller number of sales.

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EGreg
I am 32 and have never had to havea filling or root canal. I do not brush my
teeth very often or do anything special, except possibly limiting sugar intake
somewhat, and maybe rinsing once in a while.

I went to a dentist a year ago and they said I am developing a cavity _inside_
one of my upper treth, and should get it treated. Since then it's been a year
and I feel no pain there and nothing is visible on the outside. I don't know.

Is this at all typical?

~~~
rsynnott
> have never had to havea filling or root canal

> they said I am developing a cavity inside one of my upper treth, and should
> get it treated.

So, in fact, you DO have to have a filling, you've just declined to have it.
And if you keep on that path, you'll probably end up needing a root canal (far
higher cost, much more annoying procedure, far higher chance of eventual
failure) as well.

I'm 30, and had never previously needed fillings, but was recently told by the
dentist I needed a few. So I got them. Just because you didn't have much tooth
decay until now doesn't mean you're immune; you really should get it treated.

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sea2summit
That's neat. If it's just a few microamps, I wonder if they could create a
mouthguard to remineralize your teeth while you sleep?

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Kluny
I've often heard conspiracy theorists say that if dentists ever learned of a
way to cure cavities more cheaply and without drilling, they'd suppress the
information as it would endanger their business. I think this is insane, but
can anyone offer a sound economic argument for why dentists would embrace the
new technique instead of cartelling up to suppress it?

~~~
tjr
Why don't dentists recommend drinking more soda and eating more candy?

~~~
Pyxl101
For the same reason a real estate agent does not try to sell you the first
house they show you: their motives would be way too obviously transparent if
they did that and people would see through it.

~~~
Pyxl101
I don't understand the downvotes. I'm not suggesting that dentists actually
want to harm peoples' teeth. I'm simply pointing out that dentists
recommending sugar and soda is too obviously nonsensical a position for anyone
to actually take, regardless of their true position.

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ak39
This is amazing news. I wonder if this can be extended to treat osteoporosis.

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kleinsound
The article is from over a year ago, and the project has since been stopped. I
was told it apparently does not work in humans.

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jensen123
In 1939, the book Nutrition and Physical Degeneration was published. In it
Weston A. Price explains that you can avoid cavities by eating a good diet. I
wonder if most people will ever become aware of this. Probably not - they
don't read much, and certainly not non-mainstream stuff like that book.

Edit: I would also recommend reading The China Study by T. Colin Campbell,
since Weston A. Price did not get everything right.

~~~
lps41
I'm really confused by your comment - isn't it general knowledge that poor
diet causes cavities? I remember being taught this in public school as early
as kindergarten, and having my dentists reinforce it my entire life.

However, I do believe that genetics also plays a large role in predisposition
to cavities, with or without a healthy diet.

~~~
jensen123
Ok, it's probably general knowledge that soda, candy etc. can cause cavities.
What obviously is not common knowledge is that, with a good diet, it's
possible to go through your whole life without getting a single cavity. Weston
A. Price travelled around the world and looked at the teeth of many primitive
tribes (still quite a few of them back in his days) and they had perfect
teeth.

~~~
takeda
I would say genetics have larger role in this, you can have good diet and
still have cavities.

Just example, a person with hyperthyroidism will have much more issues with
teeth than someone who doesn't.

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limaoscarjuliet
"It could be ready in 3 years." Yup, right with flying cars. Move along,
nothing to see here.

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exabrial
If this turns out to be cheaper than fillings, I get the feeling my dentist
probably won't adopt it haha.

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transfire
Not to worry, our duty-bound ADA/FDA cronies will make sure this never sees
the light of day.

P.S. There is something you can already do btw. If your teeth are still good
then go get them _sealed_. Most dentists won't do it, and will give you some
lame excuse. Just go find another dentist. There are a few out there that
aren't full of sh*t and they will do it and it will save you thousands of
dollars over the course of your life (and a lot of pain too).

~~~
Estragon
Wow, I've never heard of this option before. What are the potential drawbacks?

~~~
kbutler
Primarily just limitations - only applies to chewing surfaces, not sides or
between teeth, and can only be applied to non-filled healthy teeth. Approx
5-year lifespan, should be checked at regular dentist visits.

[http://www.webmd.com/oral-health/guide/dental-
sealants](http://www.webmd.com/oral-health/guide/dental-sealants)

~~~
Estragon
Thanks.

