Drilling Down to the Nanoscale of Tooth Enamel May Help Patients Avoid the Drill

A September study published in the journal, Science Advances, by the University of Sydney, took a deep dive into the science of dentistry – right down to the subatomic particles that make up the tooth’s enamel. Working with material and structural engineers, scientists and dentists working on this research were able to identify nanoparticles of the tooth. This identification aids in determining exactly how these nanoparticles play a role in the development of the tooth’s enamel. This research is of significant value to dentists because it brings further understanding of the chemical structure of the tooth’s enamel and how it gets its strength. Dentists can use this knowledge to better fight cavities and prevent tooth decay.

The Australian researchers used atom probe tomography, a process that creates cross-section maps of solid objects like the teeth. Tomography uses X-ray or ultrasound technology to create high resolution, three-dimensional maps showing the sub particle map that makes up the tooth’s enamel. These maps were the first three-dimensional models ever produced showing the human tooth’s subatomic structure.

Through this mapping, areas rich in magnesium were located throughout the enamel’s atomic structure, instead of just being isolated along certain parts of the enamel as initially thought. For many years, dentists knew that magnesium likely played a critical role in developing the tooth enamel, but this research provides direct evidence of magnesium’s importance during tooth formation.

The study also allows dentists to take a further look into how teeth remineralize. Remineralization is the restrengthening of tooth enamel and can happen naturally when the saliva carries minerals like calcium and phosphates to the teeth. Remineralization can also occur prophylactically through the use of fluoride treatments.

Understanding the tooth’s structure down to the nanoscale is elemental for treating what is happening on its surface according to Dr. James Erpenbach, D.D.S., a Knoxville, Tennessee, dentist. “An increased understanding of the structure of tooth enamel, even going down to the nanoscale, will help further develop processes that dentists can use to assess better and understand the causes of tooth decay, and ultimately assist in creating better products to treat tooth decay,” says Erpenbach.

Erpenbach treats tooth decay using biomimetic dentistry. Biomimetic dentistry is a relatively new specialization of dentistry that is concerned with preserving the structural integrity of the tooth. Erpenbach uses materials that are biomimetic, or lifelike, to fill cavities and repair teeth. These materials are similar in structure to the tooth’s enamel and can be applied more easily to the tooth than traditional treatments, like metal amalgam fillings.

In biomimetic dentistry, the need for the drill is minimized. If patients have to have decay removed, Erpenbach uses air abrasion to remove the impacted area. Air abrasion uses a particle spray to gently remove decay. This spray can be targeted directly at specific areas, allowing the rest of the tooth to remain untouched. This a benefit that is attractive to most patients, according to Erpenbach. He explains that while patients naturally want to avoid the pain of the drill, the greater benefit of avoiding the drill is minimizing the opportunity of damage to the tooth. “When teeth are drilled, there is a higher risk of fracture or other damage,” he says.

Biomimetic dental restorations allow the natural function and aesthetic look of the teeth to be maintained. Erpenbach also explains that when materials that are used match the structure of the teeth, it’s easy to see results. “The treated tooth can function as nature intended it to function when biting and chewing, he says.”

Biomimetic materials used to treat tooth decay are sealed tightly to the tooth, which reduces that chance of bacterial growth that can cause further decay. Reducing further decay can help patients avoid more restorations, like root canals, and ultimately allow patients to retain their teeth.