A simpler alternative is xylitol. Not a drug, no FDA approval required. It's a plant-based sweetener that cavity-causing mouth bacteria love to ingest, but which provides no sustenance to them. It essentially fills them up and then causes them to starve them to death, helping maintain minimum mouth bacteria. No bacteria, no cavities. Get it in mints or gum like Zellies or PUR (the only two I've found that don't include Titanium Dioxide). Take one a day after brushing in the evening so it kills bacteria overnight.
Not just xylitol but also mastic gum, which, in addition to cavities prevention, kills H. pylori and strengthens your jaw muscles as it's a bit harder than regular chewing gum.
I can attest to its effectiveness against H. pylori. I've suffered from canker sores most of my life. The two things that have helped were avoiding sodium lauryl sulfate in toothpaste, and chewing mastic gum at least once a week.
+1 for mastic, completely nontoxic and it's been used for thousands of years. My cavity problems have pretty much disappeared since discovering it several years ago.
Please be careful pushing xylitol, "sugar alcohols" are neither a sugar or an alcohol. This, of course, is exactly the thing that makes them desirable as a sweetener substitute, the body doesn't really know what to do with the stuff, and, presumably, neither do common mouth bacteria. Sugar alcohols are known for causing digestive troubles, for this very reason, with the most notorious example being the Haribo "sugar free" gummies that caused diarrhea.
Small quantities in gum may be fine but sugar alcohols are increasingly being added to foodstuffs, and I'm increasingly dubious about it.
Very much this. Specially if any relative has to watch their weight or sugar intake and a lot of "No sugar added" products are getting in the house, a very worrying amount of them are loaded with maltitol and its -ol friends. People don't understand why they are felling sick eating "health food" and go through a substantial amount of grief.
There are also Xylitol-containing toothpastes (e.g. Epic; be aware that they also make a flouride-free version that you likely want to avoid!), although I suspect the dosage of Xylitol is below the effective level.
What is the recommended daily dosage of xylitol for oral health?
"The recommended amount for cavity protection is 6 to 10 grams. And it's best to spread doses out throughout the day. So, if you want dental benefit from chewing xylitol-added gum, you should chew the gum for at least 20 minutes to extract the xylitol. That can be a lot of stress on the temporomandibular joints (in the jaw), so if you have problems with your TMJ, it's not a good idea to excessively chew gum."
That's a lot of Xylitol. It got expensive quickly, and I was heading towards TMJ dysfunction. Xylitol is also considered a high FODMAP, so if you are on a low FODMAP diet its best to avoid.
Three a day seems like overkill. I think if you brush at least twice a day, then one xylitol gum at night after brushing is probably sufficient. Kills the bacteria that grew during the day and kills bacteria that try to grow in your mouth overnight.
I've been using a mouthwash with xylitol for around 5 years now and haven't had a cavity in that time. I hadn't heard about any concern with ingesting xylitol before reading this thread, but I imagine if it's a problem, a mouthwash would be a good way to avoid ingesting much.
Also it's alkaline in ph, unlike many mouthwashes on the market. Caries need an acidic environment to do their thing, so you want your mouth to be inhospitable to them. Acidic mouthwashes may kill off the bacteria, but they make it a nice environment for any that remain to attach your teeth.
i haven't found in xylitol gum that doesn't taste like ass. My nanohydroxyapatite toothpaste does use some in its formula tho, so I guess there's that.
Gives some of us rocket powered shits though. I’ve been known to hit escape velocity at the border mall in Basel. Well contained within the inverted engine bell and served well by powerful flush mechanism.
There is a huge difference in dose between “bacteria in your mouth producing an antibiotic” and “taking an antibiotic for an infection”. Bacteria, even the normal bacteria currently present in your mouth even without taking BCS3L-1, constantly produce antibiotics to kill competing bacteria. But they only produce tiny amounts, enough to affect the competitors in their immediate vicinity, but not nearly enough to cause any kind of systemic effect. If they did, you would already be experiencing these effects right now from all the other antibiotics produced by other bacteria in your mouth. In contrast, antibiotics for medical use are usually given in doses measured in the hundreds of milligrams or even grams, far more than mouth bacteria could ever possibly produce.
Whenever this topic comes up on HN it strikes me as bizarre that anyone thinks they can genetically modify a bacteria, release it into the wild - and that it'll stay genetically modified? Like the author mentions, bacteria are constantly swapping genes via horizontal gene transfer. Surely the bacteria in our mouths have found the optimal metabolism for their environment? Why wouldn't we expect our genetically modified bacteria to adopt the same strategy?
I imagine that you could, at least on paper, create a Rube Goldberg machine in their genes that, say, killed them if they produced lactic acid, and made it very difficult to delete these genes without destroying their ability to reproduce. But you'll probably also handicap them in the process and make it difficult for them to adapt to competitive adaptations from other bacteria.
There are obviously numerous locally-optimal strategies for bacterial colonies in one's mouth (and gut, etc) as the population of bacteria varies widely across individual people.
That's not to suggest that knocking out one or two specific functions is going to accomplish recolonization, or that we should even trust the effort to be wise in the medium-/long-term in light of gene transfer or migration into the gut and elsewhere, but the broad idea of pursuing recolonization by less destructive bacteria isn't without merit in itself.
On that note, I wonder how kissing affects our mouth bacteria. Like, does making out with someone transfer enough bacteria between the two people to make a difference?
>Whenever this topic comes up on HN it strikes me as bizarre that anyone thinks they can genetically modify a bacteria, release it into the wild - and that it'll stay genetically modified?
Hubris?
I'm all for progress and innovation. We need to couch such progress through the lens of thinking through the potential impacts of such progress though.
$$$ is a much easier explanation. People selling things that they know won't work in the way they claim is as old as time. Never attribute to incompetence that which can be attributed to malice, when it involves earning a ton of money.
I honestly think the play here is to have customers continually inoculate with the same, or even improved, versions of their modified bacteria. Possibly with a very strong antibiotic course in between if a clean slate is needed. That would provide ample room to stay on top of mutations and gene swapping in-situ. Otherwise, you don't have a continuous revenue model or a successful product.
But how do your re-inoculations colonize the teeth that have been fully colonized by your now-mutated old strains? Is the plan to require a full antibiotic mouthwash every few days, and then fresh inoculation? Ugh.
Fair enough but I do feel like our everyday experience with biology informs this. If you cultivate a certain color of rose and release it into the wild, you wouldn't expect that color to persist, right? Maybe I'm out of touch but I feel like that's intuitive. Maybe the technology is sexy and dazzling and that makes it more difficult to engage critically.
You can, however, build machines using genes. Eg I met someone who was working on research to come up with sets of genes that implemented low level programming primitives, like "if". When some chemical concentration reaches a certain level, a gene is turned on or off. This is fundamental to how cells work, they're just trying to repurpose the machinery that's already there (if you'll forgive the metaphor).
The research I've heard of that I was thinking about here was about splicing genes in such a way that in order to remove it, you will also need to remove genes necessary for reproduction.
I'm not a geneticist and it's been a long time since I've read about this type of thing, so if I'm mistaken or if you know more, I'm all ears.
That's a technique used since the 1950s with great success against the parasitic screw-worm; it's now gone from North and Central America. Every year we release millions to keep them in South America.
> In February 1991, after 15 years of production and the sterilization of 220 billion insects, Mexico was declared screwworm free. The screwworm rearing plant in Mexico, the only one of its kind, continues producing flies on a large scale for the eradication efforts under way in Central America and now provides FAO's Screwworm Emergency Centre for North Africa (SECNA) with sterile flies to combat the recent outbreak in North Africa.
I got a tube of this probiotic. They asked me not to sequence it, but I'm a little suspicious of putting it in myself, so trust-but-verify (probably Nanoporing). I literally cannot see why sequencing it is a "dick move", so I think I'll be doing it anyway.
I do not buy that it is dangerous. However, I haven't seen any statistics showing the frequency of mutacin-1140 or its efficiency. Back in 2015 when I was a teen I did an experiment using colicin V (an E.coli one - I was planning on engineering E.coli Nissile to replace my current gut E.coli with something more fun. Got kicked out of the science fair for that one - https://keonigandall.com/posts/colicins.html ). Turns out, you need a sizable portion of the population to get takeover. I haven't seen ANY data on the population percentage necessary for takeover with this strain. Nor have I seen statistics of its natural occurrence percentage.
I wanted to modify the strain to have GFP expression, so I can have my own little engineered biome for myself that is showable at parties and such, but it looks like they removed comE :( will have to start from an original strain instead, I guess.
I guess I am going to die from making my own kombucha, kefir, and yogurt because the FDA isn't regulating it.
WHAT IF... the mass increase in colon cancers in young people is due to gut bacteria colonies being taken over by a strain of bacteria in mouths that also survives stomach acids? What if that is causing the huge increase in IBS? What if the high carb diets and alternative sugars being consumed at mind boggling rates is a root cause? That the oral bacteria has been overtaken by a strain optimized for these carbs but is actively harmful to our bodies?
And what if fixing it is a treatment like this?
I'm willing to gamble.
Signed,
older millenial who has suffered with IBS for years
edit: If I could get a fecal transplant procedure in the USA to replace my gut colony I totally would.
edit2: fun fact -- did you know Sucralose accumulates in the environment because almost nothing breaks it down? it's pretty close to being a forever chemical. We can tell how much treated sewage injected into the water table is leaking into the ocean by measuring the amount of Sucralose in the ocean waters near the shoreline. That and nitrogen. But glug glug drink up those sugar free sodas and energy drinks!
"In addition, xylitol has a number of other effects on
S mutans that may account for some of its clinical effects
in caries reduction. Short-term consumption of xylitol is
associated with decreased S mutans levels in both saliva
and plaque.15 Long-term habitual consumption of xylitol
appears to have a selective effect on S mutans strains. This
results in selection for populations that are less virulent
and less capable of adhering to tooth surfaces and, thus, are
shed more easily from plaque into saliva."
Relating to fluoride's effect on bacterial biofilm - There are several different kinds of fluoride available in toothpaste, and they do not all have the same efficacy against bacterial plaque. Stannous fluoride is considerably more effective than sodium fluoride or sodium monofluorophosphate, but you may need to pay a small amount more for it and actually read the packaging to find it.
I use Crest Pro-Health, from the grocery store. It also happens to be what my dentist hands out in their goody bag, but she did not know about the difference between different forms of Fluoride when I brought it up at a check-up. Probably picks the goody bag contents based on who gives the best kickbacks/perks.
I'm sure that there are other studies out that that compare the active ingredients in isolation rather than as a part of a commercial preparation, that's just the first one I came across that looked to be from a reasonably independent source, rather than a disguised advertisement.
Update: I went to the drug store and is seems "stannous fluoride" is quite common in Crest brand toothpastes. All the "high-end" toothpastes had it, so it's not a rare thing at all, just have to read the medical ingredients as you said.
It drives me nuts that many toothpastes make big claims about what they do but don't clearly link that to the ingredients they contain. One of very few new ideas was the incorporation of Triclosan into Colgate Total which certainly takes a bite out of biofilms
> I think this is a terrible idea, as well as probably illegal. Unlike most people in the Bay Area, I think formalized safety and efficacy trials are a must for health products. In fact, I told Aaron Silverbook this when he asked me for my advice about his product last fall.
No one is going to want to consult you, if you might blog about it, attacking them by name, so... if it was serious enough to burn professional bridges, why not go to the FDA, an Attorney General, a public health authority, an academic-professional society or journal, a Congressperson, or some other channel more official and credible than Substack?
Readit News
https://zellies.com/
https://thepurcompany.com/
https://www.healthline.com/nutrition/xylitol-101
(Also if you have pets, make sure they don't get any, xylitol isn't good for them, especially dogs)
Small quantities in gum may be fine but sugar alcohols are increasingly being added to foodstuffs, and I'm increasingly dubious about it.
(Personally I can eat an entire bag of sugar free gummies w/o any ill effect, ymmv!)
https://edition.cnn.com/2023/02/27/health/zero-calorie-sweet...
what does that mean? does it produce toxic chemicals? is it carcinogenic? or is this just fear mongering?
swishing a xylitol solution around your mouth is also different than pouring it in every drink you have.
Deleted Comment
https://www.fda.gov/consumers/consumer-updates/paws-xylitol-...
Merck Vet Manual:
https://www.merckvetmanual.com/toxicology/food-hazards/xylit...
Also sold as bisindole which is a class of natural products derived from oxidative dimerization of tryptophan.
https://medicalxpress.com/news/2024-04-qa-xylitol-teeth-swee...
What is the recommended daily dosage of xylitol for oral health?
"The recommended amount for cavity protection is 6 to 10 grams. And it's best to spread doses out throughout the day. So, if you want dental benefit from chewing xylitol-added gum, you should chew the gum for at least 20 minutes to extract the xylitol. That can be a lot of stress on the temporomandibular joints (in the jaw), so if you have problems with your TMJ, it's not a good idea to excessively chew gum."
That's a lot of Xylitol. It got expensive quickly, and I was heading towards TMJ dysfunction. Xylitol is also considered a high FODMAP, so if you are on a low FODMAP diet its best to avoid.
The product I've been using is this: https://carifree.com/product/maintenance-rinse/
Also it's alkaline in ph, unlike many mouthwashes on the market. Caries need an acidic environment to do their thing, so you want your mouth to be inhospitable to them. Acidic mouthwashes may kill off the bacteria, but they make it a nice environment for any that remain to attach your teeth.
Edit: One can easily find various papers like this: https://microbiomejournal.biomedcentral.com/articles/10.1186...
I imagine that you could, at least on paper, create a Rube Goldberg machine in their genes that, say, killed them if they produced lactic acid, and made it very difficult to delete these genes without destroying their ability to reproduce. But you'll probably also handicap them in the process and make it difficult for them to adapt to competitive adaptations from other bacteria.
That's not to suggest that knocking out one or two specific functions is going to accomplish recolonization, or that we should even trust the effort to be wise in the medium-/long-term in light of gene transfer or migration into the gut and elsewhere, but the broad idea of pursuing recolonization by less destructive bacteria isn't without merit in itself.
It’s like Jurassic Park’s “Lysine Contingency”, but in your mouth
I have a friend who started having a lot of teeth issues after moving in together. She swears nothing else has changed (i.e. food or stuff)
Hubris?
I'm all for progress and innovation. We need to couch such progress through the lens of thinking through the potential impacts of such progress though.
I honestly think the play here is to have customers continually inoculate with the same, or even improved, versions of their modified bacteria. Possibly with a very strong antibiotic course in between if a clean slate is needed. That would provide ample room to stay on top of mutations and gene swapping in-situ. Otherwise, you don't have a continuous revenue model or a successful product.
Bacteria are not machines, DNA is node code. Life is very different from mechanics
The research I've heard of that I was thinking about here was about splicing genes in such a way that in order to remove it, you will also need to remove genes necessary for reproduction.
I'm not a geneticist and it's been a long time since I've read about this type of thing, so if I'm mistaken or if you know more, I'm all ears.
https://en.wikipedia.org/wiki/Sterile_insect_technique
https://www.fao.org/4/u4220t/u4220T0g.htm
> In February 1991, after 15 years of production and the sterilization of 220 billion insects, Mexico was declared screwworm free. The screwworm rearing plant in Mexico, the only one of its kind, continues producing flies on a large scale for the eradication efforts under way in Central America and now provides FAO's Screwworm Emergency Centre for North Africa (SECNA) with sterile flies to combat the recent outbreak in North Africa.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795774/
I do not buy that it is dangerous. However, I haven't seen any statistics showing the frequency of mutacin-1140 or its efficiency. Back in 2015 when I was a teen I did an experiment using colicin V (an E.coli one - I was planning on engineering E.coli Nissile to replace my current gut E.coli with something more fun. Got kicked out of the science fair for that one - https://keonigandall.com/posts/colicins.html ). Turns out, you need a sizable portion of the population to get takeover. I haven't seen ANY data on the population percentage necessary for takeover with this strain. Nor have I seen statistics of its natural occurrence percentage.
I wanted to modify the strain to have GFP expression, so I can have my own little engineered biome for myself that is showable at parties and such, but it looks like they removed comE :( will have to start from an original strain instead, I guess.
WHAT IF... the mass increase in colon cancers in young people is due to gut bacteria colonies being taken over by a strain of bacteria in mouths that also survives stomach acids? What if that is causing the huge increase in IBS? What if the high carb diets and alternative sugars being consumed at mind boggling rates is a root cause? That the oral bacteria has been overtaken by a strain optimized for these carbs but is actively harmful to our bodies?
And what if fixing it is a treatment like this?
I'm willing to gamble.
Signed,
older millenial who has suffered with IBS for years
edit: If I could get a fecal transplant procedure in the USA to replace my gut colony I totally would.
edit2: fun fact -- did you know Sucralose accumulates in the environment because almost nothing breaks it down? it's pretty close to being a forever chemical. We can tell how much treated sewage injected into the water table is leaking into the ocean by measuring the amount of Sucralose in the ocean waters near the shoreline. That and nitrogen. But glug glug drink up those sugar free sodas and energy drinks!
https://undark.org/2018/11/08/my-diy-fecal-transplant/
from https://www.aapd.org/globalassets/media/publications/archive...
"In addition, xylitol has a number of other effects on S mutans that may account for some of its clinical effects in caries reduction. Short-term consumption of xylitol is associated with decreased S mutans levels in both saliva and plaque.15 Long-term habitual consumption of xylitol appears to have a selective effect on S mutans strains. This results in selection for populations that are less virulent and less capable of adhering to tooth surfaces and, thus, are shed more easily from plaque into saliva."
It's hard to find a website discussing it that is not paid for by a toothpaste company, but here's something. https://pubmed.ncbi.nlm.nih.gov/24660268/
From that paper, the brand they used as example of stannous fluoride was "oral-B pro expert all-around protection" Do you know of any other brands?
I wonder if we can conclude it was the stannous fluoride that made the difference and one of the other ingredients.
I'm sure that there are other studies out that that compare the active ingredients in isolation rather than as a part of a commercial preparation, that's just the first one I came across that looked to be from a reasonably independent source, rather than a disguised advertisement.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220381/
but who knows if it is good for the rest of you.
No one is going to want to consult you, if you might blog about it, attacking them by name, so... if it was serious enough to burn professional bridges, why not go to the FDA, an Attorney General, a public health authority, an academic-professional society or journal, a Congressperson, or some other channel more official and credible than Substack?