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.
Having worked at a dental implant startup in Vienna (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?
If I was in your boots I would talk to Health insurance companies.
They fight hard to reduce health costs (and increase their own revenues). They also know how to lobby, which is certainly mandatory in the health industry.
Some of them have their own clinics and can even fund research.
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?
I got a titanium implant a couple of years ago, and I've never heard of your company.
I had a look around your website and I really hope you're successful with it.
If I had heard of you when I was getting the implant, I would certainly have considered your service (assuming it's available where I am - there's no obvious way to find out?).
The announcements of new treatments and new discoveries in various healthcare fields astronomically outstrips the real ones that you can actually make use of.
The easy money is in the hyping of potential cures, and it's easy to see why. Even in this HN thread where you'd expect the level of scientific understanding and healthy skepticism to be fairly high, you see a lot of "Wow, it's about time" type responses. Now imagine the response of the politician controlling grant money who has no background in science.
Generally speaking, politicians don't control grant money for research. They set the budgets for agencies who solicit proposals that are reviewed by domain experts. The exception is what is known as "pork", but that usually involves large projects.
Novamin is a bioglass that is fortified in Sensodyne, which coats the enamel (a fluoride rival, but better), and was sold to GSK. After that, it suddenly disappeared from shelves in the US.
You can still buy it online (it ships mainly from Europe), but not in the stores.
I used to watch Shark Tank a lot, and they talk about this with patented products. That a big company will buy out a better solution just to shelf it because the current solution is more profitable. As a person that just spent $10k on oral care the past year this makes me incredibly sad and angry. Gov't is already so cheap that we (US) have fluoride in our water, that was planned to be cheap dental care =(.
I understand the need for IP to make the investment worthwhile. But when buying it out like this, it should be a use it or lose it situation with the patent. Depriving people of a better solution to make a profit ain't right.
(Living in continental Europe) That's funny. After reading your comment I went to the grocery store and found that brand and that 'model'. As I never know which kind of toothpaste I should buy I am eager to see if I am going to like this one.
The lasers also came out. Check out waterlase, it is widespread now.
But we are talking about regrowing dentin and enamel! And Kings College London seems to have been working on this for a while. Your article from 2014 is about it.
What I want to ask any dentists here is why is PHOTO ACTIVATED DISINFECTION not being used? Where can someone get it instead of drilling and filling???
These articles sadly derive from institutional press releases that invariably oversell the underlying work.
We have an unsustainable systemic problem arising from the need to convince governments filled with anti-science politicians to fund expensive science. The institutions therefore feel the need to oversell every tiny paper so voters and politicians believe we're getting somewhere fast and won't kill funding, but the pace of real science is always fits and starts. You see a lot of people who have somehow figured out how to search the literature and cherry pick a paper they don't like as evidence of wasteful spending, and the system believes (falsely in my view) that overselling and oversimplifying results in a language that voters and politicians can understand.
Edit: I should have also said that the other big motivating factor for institutional press offices is to market the institution to other potential donors.
Could you recommend a particular dentist there? Do they have the Solea 9.3 µm laser? From what I've been able to find, it's the only one that directly removes enamel and dentin. The other kind is erbium lasers which vaporize a water jet which then removes the material, but it's vastly less precise.
Seriously though, it really is just announcements that state something is available now that people outside of a particular profession should care about.
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.
Interesting to see this. In the hazy midst of a spell of bad food poisoning last month, I took the first dose in a course of levofloxacin that a pharmacist had given me. I had begun reading the Wikipedia entry on it before, but right after taking it I came to the section on spontaneous tendon rupture... since I'm an athlete, I freaked out and forced myself to vomit moments later. I'm glad I did. I personally try to avoid antibiotics as much as possible in general, but I had caved at the moment due to being in a lot of discomfort.
Just based on my own experience I never take fluoroquinolone antibiotics. I had one dose of Avelox and the next twelve hours were like a waking nightmare. They were twice a day pills, so I had to wait until that evening for the effect to pass. When I reported the reaction my physician told me to stop the drug immediately. She was quite vehement and sounded alarmed. The experience reminded me of the reaction I'd had to Cipro some years before, but worse. It was then that I looked them up and found they were in the same class.
Now I check. A few months ago I rejected a prescription of Levofloxacin from a new physician, and had him replace it with an antibiotic from a different class that I knew I tolerated well. My pharmacist agreed with my decision. She had taken Levofloxacin for a few days several years ago and it gave her permanent neuropathy in her hip and leg and balance problems. Actually, she said the neuropathy was permanent "so far." For all she knew it would go away, but after three years she wasn't expecting it.
Note that I'm reporting an n of 2 here. My brother says Cipro doesn't bother him at all. Do your research and make your own decisions.
There are literally thousands of studies on fluoroquinolones. Unfortunately none directly show tooth decay but the private support communities have. Simply Googling for "fluoroquinolone mmp" will return many studies to start from.
Tendon rupture and retinal detachment are well documented.
There are also many reasons why side effects from these drugs are under-reported and under-studied. For example, fluoroquinolones have been around since the 70s, but the first case report of tendon rupture did not appear until 1983. After all, who would believe an antibiotic would cause a tendon rupture up to years after taking it? Doctors to this day do not usually believe that patients' spontaneous ruptures are caused by fluoroquinolones, despite being well documented in the scientific literature now.
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.
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 ?
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.
> 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.
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).
I'd suggest bone broth too. I don't know why my teeth are less sensitive when I have that regularly, but it's a clear effect, remineralization would be the obvious guess, and my dentist said to keep doing it.
Yup, you could also tackle your diet. Given the multifactorial aetiology of dental caries; Host, Plaque, and diet. I would highly recommend the least invasive approach; changing your diet. In addition to the noted vitamins, sucrose should not be included in your dietary program seeing as how it is a cariogenic constitute. There are other compounds that play a major role in the development of dental caries, but sucrose has that special something about it. Also, fluoride either in water (1.13ppm) or topical. Lasty, Xyiltol gum, it helps to rebalance oral pH. And of course brush and floss. This way, you prevent the development of dental caries--fingers crossed--and help in the reminiralisazion process.
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 )
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
> "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."
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.
I know about that. It will be years before it becomes available. The only way this will come to market faster is if the emerging market as China or some other country, Japan for example, adopt it and start using it. Japan comes to mind as I heard that they actually try to treat root canals overthere.
There's Silver Nitrate / Silver Diamine Fluoride [1] which appear to be as effective as drilling + filling cavities. Of course, they are also much, much cheaper, so they will cut into that average $160K/yr salary for dentists in the US...
> Of course, they are also much, much cheaper, so they will cut into that average $160K/yr salary for dentists in the US...
I doubt that this makes much of an impact. Cavities aren't really a money maker for dentists and inadequacies inherent to the repair process mean that you'll almost certainly need more expensive work later on. The only way to really "beat" the dentists is to avoid enamel loss and calculus formation through proper cleaning technique and regular dental cleanings.
Most dentists in the US are private practice which makes for a competitive market that prides itself on the quality of its customer care. If you really want to be worried about someone coming to take your hard earned money I'd be concerned about the growing incorporation of dentistry offices in the US.
Readit News
2014 - "No more fillings as dentists reveal new tooth decay treatment" https://www.theguardian.com/society/2014/jun/16/fillings-den...
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...
2004 - "No drilling, no filling in painless dentistry" http://www.telegraph.co.uk/news/uknews/1477044/No-drilling-n...
1998 - "Dental lasers – are they the safest way to fill your cavity?" http://judyforeman.com/columns/dental-lasers-are-they-safest...
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?
Some of them have their own clinics and can even fund research.
For example in France: https://www.lamutuellegenerale.fr/qui-sommes-nous/fondation/...
I had a look around your website and I really hope you're successful with it.
If I had heard of you when I was getting the implant, I would certainly have considered your service (assuming it's available where I am - there's no obvious way to find out?).
The easy money is in the hyping of potential cures, and it's easy to see why. Even in this HN thread where you'd expect the level of scientific understanding and healthy skepticism to be fairly high, you see a lot of "Wow, it's about time" type responses. Now imagine the response of the politician controlling grant money who has no background in science.
Novamin is a bioglass that is fortified in Sensodyne, which coats the enamel (a fluoride rival, but better), and was sold to GSK. After that, it suddenly disappeared from shelves in the US.
You can still buy it online (it ships mainly from Europe), but not in the stores.
It's all one big racket.
I understand the need for IP to make the investment worthwhile. But when buying it out like this, it should be a use it or lose it situation with the patent. Depriving people of a better solution to make a profit ain't right.
https://www.amazon.com/Sensodyne-Repair-Protect-Whitening-To...
The lasers also came out. Check out waterlase, it is widespread now.
But we are talking about regrowing dentin and enamel! And Kings College London seems to have been working on this for a while. Your article from 2014 is about it.
What I want to ask any dentists here is why is PHOTO ACTIVATED DISINFECTION not being used? Where can someone get it instead of drilling and filling???
We have an unsustainable systemic problem arising from the need to convince governments filled with anti-science politicians to fund expensive science. The institutions therefore feel the need to oversell every tiny paper so voters and politicians believe we're getting somewhere fast and won't kill funding, but the pace of real science is always fits and starts. You see a lot of people who have somehow figured out how to search the literature and cherry pick a paper they don't like as evidence of wasteful spending, and the system believes (falsely in my view) that overselling and oversimplifying results in a language that voters and politicians can understand.
Edit: I should have also said that the other big motivating factor for institutional press offices is to market the institution to other potential donors.
https://xkcd.com/678/
Seriously though, it really is just announcements that state something is available now that people outside of a particular profession should care about.
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.
Now I check. A few months ago I rejected a prescription of Levofloxacin from a new physician, and had him replace it with an antibiotic from a different class that I knew I tolerated well. My pharmacist agreed with my decision. She had taken Levofloxacin for a few days several years ago and it gave her permanent neuropathy in her hip and leg and balance problems. Actually, she said the neuropathy was permanent "so far." For all she knew it would go away, but after three years she wasn't expecting it.
Note that I'm reporting an n of 2 here. My brother says Cipro doesn't bother him at all. Do your research and make your own decisions.
Deleted Comment
Tendon rupture and retinal detachment are well documented.
There are also many reasons why side effects from these drugs are under-reported and under-studied. For example, fluoroquinolones have been around since the 70s, but the first case report of tendon rupture did not appear until 1983. After all, who would believe an antibiotic would cause a tendon rupture up to years after taking it? Doctors to this day do not usually believe that patients' spontaneous ruptures are caused by fluoroquinolones, despite being well documented in the scientific literature now.
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
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
[2] http://www.oragenics.com/technology-pipeline/lbp/smart
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.
The researchers also have filed for a patent https://www.google.com/patents/US20140186273
https://www.theguardian.com/science/2005/feb/24/5
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
http://www.smile-store.eu/prevdent-re-whitening-and-enamel-r...
> "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...
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.
We won't be seeing anything in practice for another 50 years by what some of them claim.
1: http://www.dentistryiq.com/articles/2016/07/the-dos-and-don-...
I doubt that this makes much of an impact. Cavities aren't really a money maker for dentists and inadequacies inherent to the repair process mean that you'll almost certainly need more expensive work later on. The only way to really "beat" the dentists is to avoid enamel loss and calculus formation through proper cleaning technique and regular dental cleanings.
https://www.animated-teeth.com/dental_insurance/a-dental-cos...
Most dentists in the US are private practice which makes for a competitive market that prides itself on the quality of its customer care. If you really want to be worried about someone coming to take your hard earned money I'd be concerned about the growing incorporation of dentistry offices in the US.
http://www.dentaleconomics.com/articles/print/volume-105/iss...
Think of the lawsuits :(