When thinking about treating tooth decay, most people think about fillings. Fillings then make them think about the drill. The drill may lead them to think about pain. Pain makes them want to skip their next dental checkup. But, what if dental technology advanced enough to allow the teeth to heal from within, thus giving patients the ability to skip the drill and the noise and pain associated with it? Researchers at King’s College in London have unlocked the power of dental stem cells found in tooth pulp to heal the tooth from within.
When teeth become damaged from decay or injury, the body does begin to repair the damaged tooth by signaling the pulp to begin producing dentin. Dentin is the hard, bony material under the enamel of the teeth that serves to protect the sensitive pulp. The production of dentin is a slow process, and in many cases, does not adequately cover large areas of decay or damage, leaving the patient susceptible to infection and more damage. Researchers from King’s College set out to boost dentin production. They did so by applying a unique fuel for the stem cells – they used a medication clinically proven to treat Alzheimer’s disease and dementia patients.
The medication, called Tideglusib, is known as a GSK-3 inhibitor. It reduces the production of certain proteins that cause inflammation and decay. When researchers applied Tideglusib to study participants’ teeth, they noticed a reduction in decay.
"Tooth decay can be downright painful, especially if it goes untreated for a long time. Teeth that are decayed at risk for cavities, but also for cracks and fractures. These situations often put patients in situations that require dental restorations, which may spiral down to root canals and other types of restoration to try to save the tooth," says Dr. James Erpenbach, D.D.S. "These situations are often precursors to a patient losing their teeth completely and needing an extraction," he continues.
Erpenbach is especially interested in this research study. He practices biomimetic dentistry at his Knoxville, Tennessee, practice, and is an advocate for tooth preservation versus restoration. "Biomimetic dentistry works to preserve the tooth by neutralizing bacteria that cause decay, and then apply lifelike materials similar to the tooth’s enamel to the affected area if necessary to fill in areas that may have been lost," he explains. This process is in contrast to traditional dental methods that drill out a hole larger than the area decay and fill this space with a filling. A traditional filling is often made of a material that is unable to bond with the tooth, such as mercury amalgam. This can cause more damage and decay to the tooth.
"Some dental restorations are intended to cover a hole in the tooth, and to keep bacteria and food debris out of the tooth," says Erpenbach. "Unfortunately, foods and bacteria often make their way underneath the restoration, causing infections."
Tooth infections put a patient’s health at risk, and if untreated can result in heart damage and lung infections, among other things. By speeding up the rate of dentin production, the tooth can heal itself faster, and because the resulting dentin is mineralized or fortified, the tooth actually becomes stronger.
Promoting self-repair in the teeth is an exciting topic for dentists like Erpenbach who have the goal of impacting the tooth as little as possible. This is also exciting for patients who may have dental phobia that keep them from getting the necessary dental treatments they need. "Many patients choose pain over treatments because they’re simply afraid," says Erpenbach. "But with new technologies and advances in how we practice dentistry, more painless interventions are being developed – and put into practice."