Mouthwash could eliminate caries

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This has popped up on several threads, both here and on dental town. It is a little concerning, but not enough so for me to jump into a DO program.

I think the general thought people have had on the subject was just that most patients would fail to use the wash anyway.
 
I don't think we'll ever get rid of microbs. If you look at history, microorganisms have always evolved and found ways against antimicrobials we've used on them. Many of them develop resistivity. It's been an ongoing "war" on these little creatures. It's safe to say Dentistry is here to stay.
 
Members don't see this ad :)
Yep. Although, by using competitive exclusion, the approach seems vastly more effective than using a traditional mouthwash. If it were to be widely used, I could see a decrease in the need for dentists. This is would be great, but not for the generation of dentists that were practicing when it first comes out.

Before I made the decision to go dental, I didn't realize that the bulk of the industry was based on a single strain of bacteria. If Streptococcus mutans goes, then most decay goes with it.

Sure is a clever product though, I looked up the research papers on the the active ingredient.
 
The mouthwash is only effective if patients use it. Hence, dentistry is going no where.

Patients could aid in avoiding the dentist if they brushed and flossed. Yet, they don't.

Since the 1960s people have been told that Cigarettes cause Lung cancer. Stop smoking and you probably won't get lung cancer. Lung cancer is still on of the most prevalent forms of cancer in the USA.
 
brushing teeth would also do the same. people use the dentist as a replacement for oral hygiene, not vice versa

(sorry if i'm off topic, i didnt even read your link before posting this)
 
LaFleur said:
What's the active ingredient? Xylitol?
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Nah. It's a designer molecule that, for now, goes by "C16G2".

It targets a species-specific membrane protein, and apparently increases membrane permeability for ATP and other important compounds. It was derived from a signalling compound produced by S. mutans.
 
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Impressive: A study involving twelve subjects over a four-day testing period. And this passes off as research?
 
Doc toothache,

Could you share your thoughts as far as your business if this mouthwash is shown to work?
 
doc toothache said:
Impressive: A study involving twelve subjects over a four-day testing period. And this passes off as research?
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Preliminary studies rarely include a large number of subjects. Also, there are multiple studies, both en vivo and en vitro.

I think it's fine research, and could lead to a very useful product.
 
I doubt that it will eliminate interproximal caries found between contacts.
 
Members don't see this ad :)
Mouthwashes will never remove the need for mechanical dental care. Even cyclohex doesn't remove the need for brushing.
 
hellopeople said:
Preliminary studies rarely include a large number of subjects. Also, there are multiple studies, both en vivo and en vitro.

I think it's fine research, and could lead to a very useful product.
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a study with less than 30 people wouldnt even pass as a statistical significance result.
 
Simiam said:
The mouthwash is only effective if patients use it. Hence, dentistry is going no where.

Patients could aid in avoiding the dentist if they brushed and flossed. Yet, they don't.

Since the 1960s people have been told that Cigarettes cause Lung cancer. Stop smoking and you probably won't get lung cancer. Lung cancer is still on of the most prevalent forms of cancer in the USA.
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People are lazy. Brushing teeth and flossing is hard. Mouthwash is easy. If I only had to swish my mouth twice a day and know that everything is gon' be okay... then I probably wouldn't brush again for the remainder of my life.

Although this is great news for patients, it looks like bad news for dentists. Resistant strains might take a decade or two to form... so if this research goes clinical... the 2010+ generation of dentists are gonna be screwed imo.
 
It seems like they need quite a bit more research. If the mouthwash does find its way on the market and is seen as "effective", then it will most likely be rather expensive and target a more affluent population. Also, what will irresponsible/misuse of the product result in? There might be a possibly it can lead to stronger strands of strep mutans. There are always people who will abuse these products.
 
wired202808 said:
a study with less than 30 people wouldnt even pass as a statistical significance result.
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OK, but again, this is fairly normal for a preliminary study, and is almost surely enough to secure more research dollars (not that they need it, colgate-palmolive is putting lots of muscle behind this research).

FLOSS UR TEETH said:
It seems like they need quite a bit more research. If the mouthwash does find its way on the market and is seen as "effective", then it will most likely be rather expensive and target a more affluent population. Also, what will irresponsible/misuse of the product result in? There might be a possibly it can lead to stronger strands of strep mutans. There are always people who will abuse these products.
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The lucrative side of dentistry comes from the more affluent middle class. Even if they were the only ones to use it, dentists in saturated areas may feel the pinch. Also, as the poster above mentioned, S. mutans probably wouldn't adapt by changing/losing this membrane protein for a very long time.
 
hellopeople said:
OK, but again, this is fairly normal for a preliminary study, and is almost surely enough to secure more research dollars (not that they need it, colgate-palmolive is putting lots of muscle behind this research).



The lucrative side of dentistry comes from the more affluent middle class. Even if they were the only ones to use it, dentists in saturated areas may feel the pinch. Also, as the poster above mentioned, S. mutans probably wouldn't adapt by changing/losing this membrane protein for a very long time.
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What would you base this on? What about the other harmful bacteria in the mouth such as Lactobacillus?
 
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accountants said:
Doc toothache, Could you share your thoughts as far as your business if this mouthwash is shown to work?
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You are likely to retire before you will need to worry the effect of the mouthwash on dentistry.

hellopeople said:
Preliminary studies rarely include a large number of subjects. Also, there are multiple studies, both en vivo and en vitro. I think it's fine research, and could lead to a very useful product.
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"Preliminary studies rarely include" visiting CBS news for a claim such as the one mentioned in the article.
 
Golfguy said:
What would you base this on? What about the other harmful bacteria in the mouth such as Lactobacillus?
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Just speculation. Bacterial adaptation is quick compared to larger, longer-lived organisms, but is not an overnight thing.

If I'm not mistaken (and I easily could be), Lactobacillus primarily becomes problematic by exacerbating dental carries. I don't think its nearly as important in initial carries formation as S. mutans.
 
Even if this miracle mouthwash supposedly works, some dental industry lobbyist group will purchase the patent and bury the research.

Don't sweat it.
 
doc toothache said:
You are likely to retire before you will need to worry the effect of the mouthwash on dentistry.



"Preliminary studies rarely include" visiting CBS news for a claim such as the one mentioned in the article.
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Agreed. Like I said, I'm not actually too worried about this product career-wise. I just think it could be a very effective tool. It looks like a huge improvement over a traditional mouthwash.

I'm not sure what you are implying by the second bit, but I seem to have agitated you. That wasn't my intention. I guess I should have been less blunt.
 
cleanup said:
Even if this miracle mouthwash supposedly works, some dental industry lobbyist group will purchase the patent and bury the research.

Don't sweat it.
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That is depressing.

I would hope that the worst the dental lobby would do is make it prescription rather than over the counter. That would make it unlikely that many would bother getting it, but still leave it available as a tool for those with high risk for carries to use.

In fact, this reduced usage might even drive down the speed at which S. mutans gains resistance. That would make it viable for high-risk patients for a longer period of time. Maybe that could even be the basis for it being prescription. I don't know how the regulations work, but having a dentist tell the patient that it is important to use the product exactly as directed might convince a small portion of patients to use the product more responsibly. For instance, it might prevent patients from diluting the wash with water before use.
 
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Ok, so toothbrushes and pastes have been around for centuries, fluoridated toothpaste and rinses for decades, and people think that this magical mouthrinse (even if it does work) will stop people from having cavities?

:laugh:
 
Hey guys! I just got into a dental school this app cycle and I have to say that this news does worry me.

Many of us will be in $300,000 debt... I would like to get more opinions from practicing dentist regarding this matter...

If these mouthwashes do become over the counter, then I could see it affecting our profession. So what do dentist foresee?
 
StarField said:
Hey guys! I just got into a dental school this app cycle and I have to say that this news does worry me.
Many of us will be in $300,000 debt... I would like to get more opinions from practicing dentist regarding this matter...If these mouthwashes do become over the counter, then I could see it affecting our profession. So what do dentist foresee?
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Quit while you are ahead and spare your debt.
 
StarField said:
Hey guys! I just got into a dental school this app cycle and I have to say that this news does worry me.

Many of us will be in $300,000 debt... I would like to get more opinions from practicing dentist regarding this matter...

If these mouthwashes do become over the counter, then I could see it affecting our profession. So what do dentist foresee?
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Don't loose any sleep over this. For starters, a "cure" or an inoculation against caries has been tossed around ever since S. mutans was discovered and named the main culprit in caries and one has yet to surface. Caries is a multifactorial disease process, and it's not going away. Also consider that other forces can be at work in patients' mouths, such as erosion/attrition/parafunctional habits/periodontitis/ethetic concerns. ;)
 
samueltak said:
Patent is owned by Colgate. Don't expect their lucrative research to be bought out.

http://www.updown.com/CL Buy, buy, buy!
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If it is in fact owned by Colgate, I don't think this will be mass marketed... If it did work as planned and if it did greatly reduce the need for a dentist, a lot of Colgate's consumer market would be cannibalized. If I were Colgate, I would buy this patent and bury it away haha
 
Mouthwash can reduce air pollution too.
 
samueltak said:
That's what phase 1 clinical trial is. 20-100 individuals are used. Phase 2 clinical trial involves ~300 individuals.
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Isn't twelve a little shy of the 20-100 individuals?

samueltak said:
Don't you think it would reckless to have a phase 1 clinical trial of a new drug on 1,000 patients only to find out the drug caused side-effects resulting in the deaths of a majority of the trial patients?
There's an obvious reason why FDA tests any new drug that manages to make it to phase 1 clinical trial on a small number of individuals.
And yes this is research at its finest.
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You can get as ecstatic about design of the study as you wish. Four days is not exactly long term. Incidentally, the FDA does not do any tests nor does it conduct clinical trials.
 
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s. mutans isnt the only microbe that causes teh acid buildup that leads to the formation of caries.........one of the most prevalent yes, but not the only one.
 
Umm. Even if this did cure cavities, there's still other things people need dentists for. Caries are a big part, but what about root canals, crown work, extractions, bleaching, orthodontia, gum grafts, implants, bone grafts, etc etc
 
OK OK people, I probably should have chosen my words a little bit better saying eliminate. But this thing is starting large scale phase I clinical trials and barring any unforseen side effects (unlikely as we have broad spectrum Anti Microbial Peptides in our mouth all the time) this will probably get approved and have a significant impact on the amount of tooth decay we see. I think overall this is a good thing that is an advancement for society. It just pains me when I see pre- dents on this forum sanguine about taking out 300k+ of loans to go to a private school and assume they can pay it off b/c they will be making 200k for the rest of their lives. Please every pre-dent on SDN register for dentaltown, type in financing education and see how PRACTICING DENTISTS feel about this. There will still be some need for dentists but even if this flops there will be mid-levels or something else that will come along and greatly reduce present dentist earnings. The profession is changing and all I'm saying is don't assume that past is prologue.
 
This mouth wash is laughable. We already have mouth washes, toothpaste, antibiotics, etc that target these microbes. Here's the truth, truth is that caries is preventable. If most people brushed and flossed after every meal they would not get caries. What were dealing with here isn't the battle of microbes, they will always be present and will always find a way to live in there niche, caries is a multifactorial disease, but rather PATIENT COMPLIANCE. This mouth wash won't be effective, because people are to lazy to use it as prescribed. Just like most people don't brush and floss as many times as they should. Just like the current epidemic in our country, obesity, is preventable. Given there are genetic components to increase caries risk and obesity, but for the most part it is laziness.
 
The patient compliance argument is a weak one. Only about 10% of Americans floss every day due to the difficult inconvenient nature of flossing while mouthwash and toothbrush use are significantly higher. If you just brush your teeth and don't floss regularly you will almost certainly develop caries in between your teeth. Using a mouthwash every four days on the other hand is extremely easy and convenient even if you're old and have arthritis wracked hands. This mouthwash does not work like traditional mouthwashes and antibiotics that indiscriminately target all bacteria. The elegance is in the targeted nature of this therapy that only targets S. Mutans (the leading caries pathogen) allowing benign bacteria fill in the vaccum to outcompete it for resources. Because most bacteria species are reduced with antibiotics/current mouthwashes, they all have to make costly adaptations and the playing field is relatively level from species to species. Could S. mutans get resistant to this therapy with time? Sure but it would definitely take a while and even when it did it would have a very difficult time reestablishing a significant foothold in the oral cavity. As for unaffected bacterial species that mainly lead to periodontitis, that is a separate disease process from caries and there is not enough demand for periodontitis treatments cosmetic procedures and orthodontics to support current levels of dentists. Delta Dental (country's leading dental insurer) has provided $80M in financing (ownership stake) to this development and that is likely a fraction compared to what the primary stakeholders of this product Colgate-Palmolive have paid. This is going to happen and this will have an effect.
 
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Very mature, keep on insulting me instead of actually focusing on the validity of my argument that's going to get you real far. I'm not saying everyone should walk away from dentistry, but if you are going more than 200K into debt because you couldn't get into a cheap state school then yeah don't go into dentistry. You won't be able to repay those loans. I know alot of dentists would agree with me on this point. Look at what's happened to optometry and pharmacy with all these new school openings. Dentistry is going down that path.
 
cut it out man ... if ur worried pick another profession... stop coming here to add onto the negatives... theres negatives in every job... if u dont feel like u can handle it, nobody is forcing you to do dentistry... btw just because something can stop cavities doesnt mean everyone will automatically start using it and it will abolish cavities for ever... just calm down and think of it as a tool for oral health ... not the end all be all
 
Picture what the ads for this product will say. "Specifically targets harmful bacteria!" and "kills 99.999% of bacteria in the mouth!" If that sounds familiar it's because that's what EVERY SINGLE MOUTHWASH COMMERCIAL SAYS. Don't give too much credit to the American public. Do you think they're going to read scientific literature about a new mouthwash? Lets all just step off the ledge here. Or use common sense.
 
I've been down this road numerous times in my search for a decent profession, and I've learned one thing... Don't listen to the pessimists.

Pilots, surgeons, and athletes are going to be replaced by robots or cyborgs, whichever is cooler. Musicians and actors will be replaced by digital animation. Watson is going to replace stock brokers, hedge fund managers, bankers, economists, and just about everyone else on Wall Street. Lawyers will soon be replaced by supercomputers. Now, I log into this message board, only to find that dentists are going to be replaced by something far simpler... mouthwash. If it's that easy to replace dentists, imagine how pharmacists must feel! :laugh:

It's funny though, that there are still pilots, lawyers, surgeons, musicians, pharmacists, actors, stock brokers, bankers, and... dentists. Not only do these people continue to carry out their duties from day to day despite the impending Armageddon(s) (as predicted by various journals, magazines, and newspapers), but more people continue to enter these professions year after year!

I suppose that I could ride out the impending storm of human obsolescence by working where I work now... an asphalt plant (after all, who would pay enough money for a robot to do the menial tasks that I do?). But you know what? I'd rather be going somewhere with my life - despite what various pessimistic elements may say - than spend any more time trudging around in 350 degree tar, earning just enough money to live somewhat comfortably... Say what you will about the debt and the pressures of future technologies which threaten to make us ALL irrelevant, but this journey should be deeply personal and not based on the whims or fancies of the latest scientific breakthroughs. You should go for it (as with ANY career) with everything you have; because at the end of the day, that's the only thing that makes anything worth it.

Like s. mutans itself, dentistry will adapt to the ever-changing job market, like we all must, no matter the profession.
 
just talked to Dr. Shi

he told me not to worry.
 
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