Dental Caries Vaccine

[catinthehatsatonthemat]

http://www.researchgate.net/profile...al_Vaccine/links/02bfe50e005c6d8eb3000000.pdf

I am aware of the pre-existing discussions on this topic, but these researchers have achieved a much higher level of efficacy than ever before. The same team of researchers recently (April 2015, i believe) posted another article in which they were able to halt the progression of the cavity.

Any thoughts on this ?

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[Screwtape]

Promising but still rat trials. Still have a ways until we know if it will work effectively in humans.

 

[catinthehatsatonthemat]

http://www.c3-jian.com/c3-jian-completes-second-phase-2-clinical-trial-of-anti-cavity-drug/

Any thoughts on this ?

What sort of implications will this have considering a large corporate oral hygiene company is funding this, and will most likely use it in all of their products. I've read that strep mutans cannot even develop resistance to this.

Also, majority of researchers agree that strep mutans is the primary cause of dental caries and eliminating it would greatly reduce caries. (sorry, i don't have the links for the research)

From my understanding, a lot of dental work is related to this single bacteria manifesting itself as a pathogen to various degrees. So it seems as if eliminating it would greatly reduce dental visits.

 

[doc toothache]

Soon we will be able to throw out our toothbrushes/toothpaste/floss. Who needs dentists?

 

[catinthehatsatonthemat]

They haven't developed anything for Gingivitits, at least as of yet...

 

[dmdluffy]

If people will refuse vaccines for deadly diseases....

 

[catinthehatsatonthemat]

Yes, but they're making it as convenient as brushing with an anti cavity drug that happens to be really efficient in killing strep mutans.

The funding for this research is being provided by a large corporate "toothpaste" company.
You can just imagine what they plan to do with the "drug"....

 

[DentalLonghorn2014]

Yes, but they're making it as convenient as brushing with an anti cavity drug that happens to be really efficient in killing strep mutants.

The funding for this research is being provided by a large corporate "toothpaste" company.
You can just imagine what they plan to do with the "drug"....

I can already imagine what some of the public would think. "Convenient as brushing? That means no more brushing!"
Also, good luck with the anti vaxxer folks.

 

[dmdluffy]

But people don't brush and floss as is so what good is another drug in your dentrifice?

 

[Bis-GMA111]

so you see, there was a similar incident way back in the 80s when they thought they had discovered something similar in the form of a mouthwash. the fear was that within the next decade the profession would be severely impacted.....




we're still here though. and i think we'll be okay in the future.

 

[strep mutans]

http://www.c3-jian.com/c3-jian-completes-second-phase-2-clinical-trial-of-anti-cavity-drug/

Any thoughts on this ?

I'm against it.

 

[catinthehatsatonthemat]

so you see, there was a similar incident way back in the 80s when they thought they had discovered something similar in the form of a mouthwash. the fear was that within the next decade the profession would be severely impacted.....




we're still here though. and i think we'll be okay in the future.

Cosmetic dentistry and restorations will always be there, but we might see a reduction in the patient population coming in for caries, root canal, etc

 

[Bis-GMA111]

Cosmetic dentistry and restorations will always be there, but we might see a reduction in the patient population coming in for caries, root canal, etc

highly, highly doubt it. there's no silver bullet that will cure caries. there's more of a push for promoting dental education across various demographic and socioeconomic spectrums which may help the caries situation. consider the political and other ramifications that would result. do you really think the ADA, one of the most powerful lobby groups in the country would allow something like this to be highly accessible? we've seen some major pushes and a lot of money invested in preventative care, i.e. creating a subset within the dental profession (dental therapy) to address the need for more oral health care.

it would be professional suicide to allow such a thing to surface

@catinthehatsatonthemat so let's say this actually does get pushed through. cosmetic dentistry is usually fee for service. so you'll be catering to certain socioeconomic groups over others. an overwhelming majority of medicaid patients can't afford cosmetic procedures..they're elective and can cost you a pretty penny. and fyi, uncontrolled caries leads to pulpal contamination..meaning caries can get into the pulp and you would have to remove the infected pulp....therefore that would lead to a root canal.

 

[Incis0r]

We already have a 100% effective method to protecting from caries. It's called brushing, flossing, and mouthwash. It's also relatively cheap and if you have insurance then you get this protection for *gasp* free from your provider!!

Heck, we even fluoridate our water!

People don't care enough about their teeth or oral health. No vaccine is going to change that.

 

[strep mutans]

We already have a 100% effective method to protecting from caries. It's called brushing, flossing, and mouthwash. It's also relatively cheap and if you have insurance then you get this protection for *gasp* free from your provider!!

Heck, we even fluoridate our water!

People don't care enough about their teeth or oral health. No vaccine is going to change that.

http://www.scientificamerican.com/article/why-do-some-people-get-mo/

"The diet, hygiene and fluoride regimens are controllable. The strain of bacterial infection, salivary flow and morphology of teeth are less controllable."

 

[Incis0r]

http://www.scientificamerican.com/article/why-do-some-people-get-mo/

"The diet, hygiene and fluoride regimens are controllable. The strain of bacterial infection, salivary flow and morphology of teeth are less controllable."

If I read your statement correctly, it sounds like you are implying that people with the wrong strain of bacterial infection or with the wrong morphology can't defend themselves from cavities, and that they face an exponentially harder battle.

Don't make excuses for this.

I used to have 2 or 3 cavities A YEAR despite brushing when I was young. At that time, pain management wasn't as emphasized as it is now. Every visit to the dentist was torture for me. I'd spend 2 hours in the chair receiving multiple injections and taking lots of drilling. I had cavities on ALL surfaces: mesial/distal, occlusal, and lingual/buccal.

My dentist made the same observation that your article did: my grooves were just too easily susceptible to hosting cavities. I remember him looking at me with a pitiful look, as if I should accept the inevitability of a life filled with cavities.

After a few years of painful dentist appointments, I learned my lesson. I was determined not to suffer again. I added flossing after lunch AND dinner. I increased time spent brushing. I cut out almost all soda/candy from my diet except for the occasional/rare movie treat. And guess what? The morphology of my teeth are same. The bacterial strains are the same. But I have not had a single cavity in 5 years. Not even a little bit of decay on the enamel. My hygiene appointments are 20 minutes long because there is little to-nothing to scale.

If someone really wants to prevent dental disease, they can, and I'm the living proof of that. Don't give me an excuse that they have resistant bacterial strains or grooves that will host cavities easily. Yes they may have those disadvantages, but they also have the resources of a first-world nation: top-of-the-line (and low-cost) oral hygiene supplies, SOME coverage at least via Medicaid, CHIP, Community Health Centers, and professionals who are ready to educate them.

Also, note that the article said that "strain of bacterial infection, salivary flow, and morphology of teeth are less controllable." It didn't say impossible. If something is harder, put more effort into it. Unless you don't care. In which case, don't use "rough grooves" as an excuse.

 

[strep mutans]

If I read your statement correctly, it sounds like you are implying that people with the wrong strain of bacterial infection or with the wrong morphology can't defend themselves from cavities, and that they face an exponentially harder battle.

Don't make excuses for this.

I used to have 2 or 3 cavities A YEAR despite brushing when I was young. At that time, pain management wasn't as emphasized as it is now. Every visit to the dentist was torture for me. I'd spend 2 hours in the chair receiving multiple injections and taking lots of drilling. I had cavities on ALL surfaces: mesial/distal, occlusal, and lingual/buccal.

My dentist made the same observation that your article did: my grooves were just too easily susceptible to hosting cavities. I remember him looking at me with a pitiful look, as if I should accept the inevitability of a life filled with cavities.

After a few years of painful dentist appointments, I learned my lesson. I was determined not to suffer again. I added flossing after lunch AND dinner. I increased time spent brushing. I cut out almost all soda/candy from my diet except for the occasional/rare movie treat. And guess what? The morphology of my teeth are same. The bacterial strains are the same. But I have not had a single cavity in 5 years. Not even a little bit of decay on the enamel. My hygiene appointments are 20 minutes long because there is little to-nothing to scale.

If someone really wants to prevent dental disease, they can, and I'm the living proof of that. Don't give me an excuse that they have resistant bacterial strains or grooves that will host cavities easily. Yes they may have those disadvantages, but they also have the resources of a first-world nation: top-of-the-line oral hygiene supplies, SOME coverage at least via Medicaid, CHIP, Community Health Centers, free to low-cost dental equipment, and professionals who are ready to educate them.

Also, note that the article said that "strain of bacterial infection, salivary flow, and morphology of teeth are less controllable." It didn't say impossible. If something is harder, put more effort into it. Unless you don't care. In which case, don't use "rough grooves" as an excuse.

Eh I'm not going to argue with you. You said that caries are 100% preventable and inferred that people who get them are just lazy and/or don't take care of themselves. I'm just pointing out that it can be harder for some than others due to factors beyond their control. I never said impossible. I just don't think it's nice to immediately judge someone with oral health issues as lazy/unhygienic. It shows a lack of empathy for other's possible struggles.

People with chronic dry mouth -- which can be caused by genetics, medications, or even cancer treatment -- often have a hard time with their oral health. People suffering from bulimia also have difficulty due to frequent acidic conditions (stomach acid) weakening their enamel.

I'm happy for you that you haven't had any cavities lately, but your story is anecdotal. You don't know which bacterial strain you had. (And your mesial/distal/lingual/buccal cavities wouldn't have been related to deep occlusal grooves.)

I've never heard of "rough grooves" but I have heard of very deep occlusal grooves. I have them. I'm lucky that I was able to afford sealant as an adult (after sealant placed when I was a child gradually wore away) - it's not covered by insurance. The dentist I went to for sealant agreed that it was a great idea because of my tooth morphology. We can trade anecdotes all day, but it would be a waste of our time.

 

[Incis0r]

Eh I'm not going to argue with you. You said that caries are 100% preventable and inferred that people who get them are just lazy and/or don't take care of themselves. I'm just pointing out that it can be harder for some than others due to factors beyond their control. I never said impossible. I just don't think it's nice to immediately judge someone with oral health issues as lazy/unhygienic. It shows a lack of empathy for other's possible struggles.

People with chronic dry mouth -- which can be caused by genetics, medications, or even cancer treatment -- often have a hard time with their oral health. People suffering from bulimia also have difficulty due to frequent acidic conditions (stomach acid) weakening their enamel.

Go on over to Dentaltown and look at the case reports. Look at the reports where a patient of age 25 is going to need full dentures in a few years because s/he likes to drink seven-up or coke with every single meal. Look at the reports where dentists share that some of their new patients never wanted to go to the dentist and neglected regular six-month dental follow-ups, and as a result, their mouth needs serious help now. There is a thread floating around over there...the "GTFOOMO" thread....where there are plenty of examples of patients who just don't care.

The fact of the matter is, that there are far more people who neglect their teeth/are ignorant over the importance of oral health than there are people who are genuinely suffering from the conditions you described.

In an ideal world, yes everyone would be proactive about their dental health and would care. However, this is not an ideal world. You need to be realistic: dental care is just not a high priority for many people because they don't know the value of it. They don't know about the link between Endocarditis and plaque. They don't know the link between Diabetes and gum disease. And as a result, they don't care.

As for "lack of empathy for other's possible struggles," I do have empathy. But I don't go out of my way to make excuses for people's "possible" struggles. I've volunteered at community health centers. I've shadowed at dental clinics. And yes I do empathize when people are suffering from an unfortunate turn of events. But if you're expecting me to say "Oh, I'm so sorry that you have a cavity" to a patient who likes to drink Fanta with every meal, eats candy at night, and doesn't give a damn otherwise, don't hold your breath.

 

[strep mutans]

I guess I'm just happy that I'm not as jaded and cynical as you are this early in our respective careers.

 

[SenoritaKorea]

Go on over to Dentaltown and look at the case reports. Look at the reports where a patient of age 25 is going to need full dentures in a few years because s/he likes to drink seven-up or coke with every single meal. Look at the reports where dentists share that some of their new patients never wanted to go to the dentist and neglected regular six-month dental follow-ups, and as a result, their mouth needs serious help now. There is a thread floating around over there...the "GTFOOMO" thread....where there are plenty of examples of patients who just don't care.

The fact of the matter is, that there are far more people who neglect their teeth/are ignorant over the importance of oral health than there are people who are genuinely suffering from the conditions you described.

In an ideal world, yes everyone would be proactive about their dental health and would care. However, this is not an ideal world. You need to be realistic: dental care is just not a high priority for many people because they don't know the value of it. They don't know about the link between Endocarditis and plaque. They don't know the link between Diabetes and gum disease. And as a result, they don't care.

As for "lack of empathy for other's possible struggles," I do have empathy. But I don't go out of my way to make excuses for people's "possible" struggles. I've volunteered at community health centers. I've shadowed at dental clinics. And yes I do empathize when people are suffering from an unfortunate turn of events. But if you're expecting me to say "Oh, I'm so sorry that you have a cavity" to a patient who likes to drink Fanta with every meal, eats candy at night, and doesn't give a damn otherwise, don't hold your breath.

I think I'm inclined to agree with you, but I would be careful with intonation, here. I also work in a low-income clinic, and I definitely understand how it's easy to roll your eyes at patients when they just can't understand why they have persistent cavities. But keep in mind that a lot of people in these populations are largely uneducated, they don't have educated friends posting health/wellness articles on their Facebook feeds, and what appears to be common sense to us is not so intuitive to them. Th average person sees a dentist twice a year (in California, DenitCal insurance only covers a prophy once a year). When they're drinking soda with their dinners, the last thing on their mind is, "Oh, my dentist is going to hate me." Also, keep in mind that many areas are food deserts, and eating potato chips and soda is much more accessible than fresh fruits and vegetables. I know of families who have to take 3 buses to get to their nearest full-service grocery store. When mom is close to payday, it's difficult to get all 4 young kids and herself onto 3 buses, fare, and then carry it all back.

My family struggled quite a bit, and I was not able to see a dentist myself from the time I was 11-12 until I was 27. We just didn't have the means. I generally took care of myself, but I very much remember crying from embarrassment when I had 3 cavities and a root canal. I haven't needed any interventions since, but it's because I had access to regular cleanings after this time because of insurance, a car, and a steady job.

I get what you're saying, though. People want to get frustrated at me all the time when their interventions aren't covered, and that's extremely irritating--but they still need care, and having a "GTFOOMO" attitude is kind of toxic and transparent. I think @strep mutans point here is to just be careful to not get carried away with these thoughts, or working with patients with high need is going to be difficult. But then again if your plan is to work private practice in a nice area of town, maybe you won't need to even worry about it.

 

[Incis0r]

I think I'm inclined to agree with you, but I would be careful with intonation, here. I also work in a low-income clinic, and I definitely understand how it's easy to roll your eyes at patients when they just can't understand why they have persistent cavities. But keep in mind that a lot of people in these populations are largely uneducated, they don't have educated friends posting health/wellness articles on their Facebook feeds, and what appears to be common sense to us is not so intuitive to them. Th average person sees a dentist twice a year (in California, DenitCal insurance only covers a prophy once a year). When they're drinking soda with their dinners, the last thing on their mind is, "Oh, my dentist is going to hate me." Also, keep in mind that many areas are food deserts, and eating potato chips and soda is much more accessible than fresh fruits and vegetables. I know of families who have to take 3 buses to get to their nearest full-service grocery store. When mom is close to payday, it's difficult to get all 4 young kids and herself onto 3 buses, fare, and then carry it all back.

My family struggled quite a bit, and I was not able to see a dentist myself from the time I was 11-12 until I was 27. We just didn't have the means. I generally took care of myself, but I very much remember crying from embarrassment when I had 3 cavities and a root canal. I haven't needed any interventions since, but it's because I had access to regular cleanings after this time because of insurance, a car, and a steady job.

I get what you're saying, though. People want to get frustrated at me all the time when their interventions aren't covered, and that's extremely irritating--but they still need care, and having a "GTFOOMO" attitude is kind of toxic and transparent. I think @strep mutans point here is to just be careful to not get carried away with these thoughts, or working with patients with high need is going to be difficult. But then again if your plan is to work private practice in a nice area of town, maybe you won't need to even worry about it.

Look through my posts again. I never said anything about "rolling eyes" at patients. Doing that is rude and disrespectful. Our job as dentists will be to make patients feel welcome and cared for. Doing anything less is unprofessional. But that doesn't mean that one can't let off steam at the end of the day, far removed from patient's ears. It also doesn't mean that one has to bend over and reassure patients that their cavities weren't their fault, as so many want to do.

I don't know why you're interpreting that dentists from that thread would bring a GTFOOMO vibe to their offices. That is a thread for people to vent, and trust me, every dentist vents.

Also, with respect to geographic location hindering good diet, I think this is completely wrong. Where are they getting the chips and soda from if good food is not accessible? And healthy food tends to be priced similarly to junk food if you know what you're looking for. Get some carrots, lettuce leaves, cucumber, etc. chop and make salad. Hold the dressing. Bam, done. But where I live, people are more obsessed with the latest iPhone, getting the latest Koch bag, or driving the latest truck and buying those things on credit than paying attention to their oral health.

And with the point of people just not being aware of the importance of dental health, I agree- look at my previous post. I said the exact same thing when I wrote of the connections between diabetes and gum disease, plaque and endocarditis. The fact is though- as someone of underprivileged background myself- it's not hard to learn why dental health is important. This isn't some esoteric concept. And even with dentical, you get one full prophy a year... I see that as an opportunity to talk to the hygienist and develop a strategy to prevent further problems. People don't know about dental care's importance BECAUSE THEY DONT CARE. Sure there are exceptions to this. But the fact is- dental disease is completely preventive and could be taken out if society was proactive about educating people and providing low cost or free supplies, and if people took responsibility for their health.

 

[oralcare123]

Wait until you gain a full knowledge in the subject (dental school)
There are plenty in each group: the ones, who care and do not care, the ones who know and the ones who do not. Our mission is passive: we educate and offer treatment, they are free to do nothing, unless children are suffering from neglect. In which case you must report it
Caries is here to stay and it is good for us

 

[oralcare123]

Look through my posts again. I never said anything about "rolling eyes" at patients. Doing that is rude and disrespectful. Our job as dentists will be to make patients feel welcome and cared for. Doing anything less is unprofessional. But that doesn't mean that one can't let off steam at the end of the day, far removed from patient's ears. It also doesn't mean that one has to bend over and reassure patients that their cavities weren't their fault, as so many want to do.

I don't know why you're interpreting that dentists from that thread would bring a GTFOOMO vibe to their offices. That is a thread for people to vent, and trust me, every dentist vents.

Also, with respect to geographic location hindering good diet, I think this is completely wrong. Where are they getting the chips and soda from if good food is not accessible? And healthy food tends to be priced similarly to junk food if you know what you're looking for. Get some carrots, lettuce leaves, cucumber, etc. chop and make salad. Hold the dressing. Bam, done. But where I live, people are more obsessed with the latest iPhone, getting the latest Koch bag, or driving the latest truck and buying those things on credit than paying attention to their oral health.

And with the point of people just not being aware of the importance of dental health, I agree- look at my previous post. I said the exact same thing when I wrote of the connections between diabetes and gum disease, plaque and endocarditis. The fact is though- as someone of underprivileged background myself- it's not hard to learn why dental health is important. This isn't some esoteric concept. And even with dentical, you get one full prophy a year... I see that as an opportunity to talk to the hygienist and develop a strategy to prevent further problems. People don't know about dental care's importance BECAUSE THEY DONT CARE. Sure there are exceptions to this. But the fact is- dental disease is completely preventive and could be taken out if society was proactive about educating people and providing low cost or free supplies, and if people took responsibility for their health.

You need to slow down with your desire to save the world, because if you continue, you are up for a huge disappointment. People do not care, period.
You are about to enter into profession, where you will meet a lot of people who have no desire to change and will blame you for everything. There will be a lot of grateful people as well. Try to treat both groups the same way and if you do something out of ordinary for them, do not expect anything in return, again not to loose faith in good and become bitter

 

[Incis0r]

You need to slow down with your desire to save the world, because if you continue, you are up for a huge disappointment. People do not care, period.
You are about to enter into profession, where you will meet a lot of people who have no desire to change and will blame you for everything. There will be a lot of grateful people as well. Try to treat both groups the same way and if you do something out of ordinary for them, do not expect anything in return

A voice of wisdom. Thank you.

 

[Iwanttopulloutteeth]

People do not care, period.

I think this sentence should be /thread right here.
Everyone knows that not taking care of their teeth will lead to problems. You can't label these people as being uneducated, because that's simply not the case. The same applies to people who smoke cigarettes despite knowing the risks. Willful ignorance might be more fitting than uneducated.

Some of the people in this thread need to chillout and take off the superhero capes lol. Most people want quick fixes from dentists, not a lesson on morality.

 

[oralcare123]

I think this sentence should be /thread right here.
Everyone knows that not taking care of their teeth will lead to problems. You can't label these people as being uneducated, because that's simply not the case. The same applies to people who smoke cigarettes despite knowing the risks. Willful ignorance might be more fitting than uneducated.

Some of the people in this thread need to chillout and take off the superhero capes lol. Most people want quick fixes from dentists, not a lesson on morality.

The problem is not the lack of education. Some people simply do not believe the science. I had patient, who said, that he did not have cavities until he started brushing teeth and blamed me for his cavities. People also say that their grandpa smoked until his death at 101

 

[strep mutans]

People don't care enough about their teeth or oral health. No vaccine is going to change that.

I guess I just don't understand the logic behind this statement. It's like saying that people are too ignorant or risky with their sexual health and nothing will change that so we shouldn't bother developing an HIV vaccine.

And if I then point out the people who were raped, unknowingly sleeping with a cheating spouse, or are ignorant of safe sex practices because of culture / lack of awareness in certain areas, you reply with "that's a small percentage of people who get HIV, most are just too horny and don't bother to use condoms" ...So you don't think a vaccine will help? Or you want to punish people for not living up to your standards of oral / sexual health? This thread was about a potential vaccine before it was twisted into "vaccines won't help because too many people suffer from this ailment because they don't care"... again I just don't understand the relevance.

Anyway, this is my last post on this thread. Have a good day, everyone.

 

[Iwanttopulloutteeth]

The problem is not the lack of education. Some people simply do not believe the science.

Yep. Sadly there isn't much dentists can do about that. Some people will always be stuck in their ways, that's just life. If people still don't believe that the Earth is round or that we landed on the moon, it can't be expected that everyone will believe/listen to their dentist either.

 

[OSUkid]

They haven't developed anything for Gingivitits, at least as of yet...

Actually, they have its called brushing your gums.