How long will it take to discover an anti-cavity agent?

[Cold Front]

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I know most of the dentists I know would not be happy if an agent that prevents cavities indefinitely is discovered - questions is, how long will it take for that happen?

There are companies and scientists out there that dedicated themselves to this cause, and they are getting very close. 🙄

Here is an example:
Clarkson University Researchers Discover New Tooth Cavity Protection

 

[DrJeff]

I want a different poll option! e) It will happen, but not be widely accepted/used because of cost factors!

I don't doubt 1 bit that there will be an effective vaccine for s.Mutans. The realistic factor about whether or not it succeeds and becomes a significant factor will be the cost assocaited with it.

Like it or not, dentistry in the US is highly driven by dental insurance, and unless some dramatic change occurrs in the dental healtcare system, this will be the case for a longtime to come. The insurance industry has a HUGE amount of utilization/cost data about the people it covers, and its from this data that the fee schedules they offer to dental providers are generated. These fee schedules that they offer ARE geographically specific, to the point where if there's a practicing dentist in a specific zipcode that treats a patient with dental insurance, the insurance company will have a "fee profile" of that zipcode. From all this fee information the insurance company has, they can easily determine what their average enrollee will spend on denatl care per year.

Now in the case of a caries vaccine, its a pretty safe assumption that given the reproduction rate of s.Mutans that the vaccine would need to be administered on some type of regular basis(bi-annually??, yearly??, every other year?? - who knows) and with each administration of the vaccine there presumably would be a fee for that service. It's also a safe assumption that patients would still need the accepted norm of the bi-annual cleanings/exams/appropriate radiographs for perio reasons, with the associated fees for those services.

Bottomline, the insurance company will determine if they choose to cover this caries vaccine if their costs for the vaccine are LESS than the "average" annual restorative costs they pay out for their enrolled members. If the vaccine would cost them say $100 a year for it's memebers, vs. them paying an average of say $50 for restorative a year for their members, then I'd say that it's a safe bet that they WON'T cover the vaccine and it would then default to an out of pocket expense for the patient. Some people would choose to pay for it, but generally speaking overtime, most would decide not to pay for it. That's the reality of many patients and dental insurance, they'll do things if it's covered, but if it's not, their interest often is lost as soon as they have to open up their checkbooks.

 

[Cold Front]

I want a different poll option! e) It will happen, but not be widely accepted/used because of cost factors!

I don't doubt 1 bit that there will be an effective vaccine for s.Mutans. The realistic factor about whether or not it succeeds and becomes a significant factor will be the cost assocaited with it.

Like it or not, dentistry in the US is highly driven by dental insurance, and unless some dramatic change occurrs in the dental healtcare system, this will be the case for a longtime to come. The insurance industry has a HUGE amount of utilization/cost data about the people it covers, and its from this data that the fee schedules they offer to dental providers are generated. These fee schedules that they offer ARE geographically specific, to the point where if there's a practicing dentist in a specific zipcode that treats a patient with dental insurance, the insurance company will have a "fee profile" of that zipcode. From all this fee information the insurance company has, they can easily determine what their average enrollee will spend on denatl care per year.

Now in the case of a caries vaccine, its a pretty safe assumption that given the reproduction rate of s.Mutans that the vaccine would need to be administered on some type of regular basis(bi-annually??, yearly??, every other year?? - who knows) and with each administration of the vaccine there presumably would be a fee for that service. It's also a safe assumption that patients would still need the accepted norm of the bi-annual cleanings/exams/appropriate radiographs for perio reasons, with the associated fees for those services.

Bottomline, the insurance company will determine if they choose to cover this caries vaccine if their costs for the vaccine are LESS than the "average" annual restorative costs they pay out for their enrolled members. If the vaccine would cost them say $100 a year for it's memebers, vs. them paying an average of say $50 for restorative a year for their members, then I'd say that it's a safe bet that they WON'T cover the vaccine and it would then default to an out of pocket expense for the patient. Some people would choose to pay for it, but generally speaking overtime, most would decide not to pay for it. That's the reality of many patients and dental insurance, they'll do things if it's covered, but if it's not, their interest often is lost as soon as they have to open up their checkbooks.

You have made very good points, Dr. Jeff.

There is a topical preventative vaccine currently undergoing Phase 2 FDA clinical trials, they call it CaroRx. It can be administrated by both dental hygienists and patients following a thorough cleaning and intervention for any existing decay. So the cost of vaccine might be equivalent to getting a regular prophies, as oppose to a restoration. Studies have shown that the vaccine can effectively eliminate the S. Mutans bacteria for up to two years.

There are also other approaches to create a vaccine that can provide a life-time protection, using genetically-modified strains of S. Mutans (one that cannot produce lactic acid). They are already estimating this type of vaccine will be available at every office for less than $100 to patients. This type type of vaccine will be in FDA Phase 2 clinical trials soon.

There are other therapeutical approaches that end up at NIH's Panel on Caries Vaccine desk, and they are getting sponsored by private donors (not sure if dental insurance companies are involved) to get the vaccine through to clinical phases.

This could well be the beginning of an end to tooth decay.

 

[KOM]

Agreed, there will be a viable vaccine against S. Mutans. However, as Dr. Jeff stated, this vaccine will need to be administered on a regular basis.

This will not only prove to be expensive, but moreso will create a situation where the bug will develop immunity against said vaccination. Not only that, one of the other cariogenic organisms will be primed and ready to compete for the vacancy left by S. Mutans and thrive off all that residual Mountain Dew.

Caries isn't going anywhere.

 

[Darksunshine]

I want a different poll option! e) It will happen, but not be widely accepted/used because of cost factors!

I don't doubt 1 bit that there will be an effective vaccine for s.Mutans. The realistic factor about whether or not it succeeds and becomes a significant factor will be the cost assocaited with it.

Like it or not, dentistry in the US is highly driven by dental insurance, and unless some dramatic change occurrs in the dental healtcare system, this will be the case for a longtime to come. The insurance industry has a HUGE amount of utilization/cost data about the people it covers, and its from this data that the fee schedules they offer to dental providers are generated. These fee schedules that they offer ARE geographically specific, to the point where if there's a practicing dentist in a specific zipcode that treats a patient with dental insurance, the insurance company will have a "fee profile" of that zipcode. From all this fee information the insurance company has, they can easily determine what their average enrollee will spend on denatl care per year.

Now in the case of a caries vaccine, its a pretty safe assumption that given the reproduction rate of s.Mutans that the vaccine would need to be administered on some type of regular basis(bi-annually??, yearly??, every other year?? - who knows) and with each administration of the vaccine there presumably would be a fee for that service. It's also a safe assumption that patients would still need the accepted norm of the bi-annual cleanings/exams/appropriate radiographs for perio reasons, with the associated fees for those services.

Bottomline, the insurance company will determine if they choose to cover this caries vaccine if their costs for the vaccine are LESS than the "average" annual restorative costs they pay out for their enrolled members. If the vaccine would cost them say $100 a year for it's memebers, vs. them paying an average of say $50 for restorative a year for their members, then I'd say that it's a safe bet that they WON'T cover the vaccine and it would then default to an out of pocket expense for the patient. Some people would choose to pay for it, but generally speaking overtime, most would decide not to pay for it. That's the reality of many patients and dental insurance, they'll do things if it's covered, but if it's not, their interest often is lost as soon as they have to open up their checkbooks.

It is sad how much insurance controls health care. Definitely a lot of good points here.

 

[rarm1]

First and foremost - none is needed if:
oral hygiene, brushing, flossing, fluoride, sealants,etc are used
diet is followed limiting sweets and acids(soda)
getting additional oral hygiene aids when medically needed.

but no one follows the above.

A vacination would be nice,,, but not against all bugs, and not against local factors like "milk bottle syndrome" , "coke(soda) mouth"...
but research is going on.

 

[HuyetKiem]

First and foremost - none is needed if:
oral hygiene, brushing, flossing, fluoride, sealants,etc are used
diet is followed limiting sweets and acids(soda)
getting additional oral hygiene aids when medically needed.

but no one follows the above.
.

We even give out Best Buy, Toy R Us gift cards to kids who have 3 consecutive no-cavity stickers on their charts on top of their goodie bags full with toothbrushes, pastes and floss. hoping they will follow your above recommendations. 😎😎 Any of you have any plan for Feb month - Dental Awareness month ? My office has scheduled with 3 elementary schools for our hygiene presentation.

 

[rarm1]

We even give out Best Buy, Toy R Us gift cards to kids who have 3 consecutive no-cavity stickers on their charts on top of their goodie bags full with toothbrushes, pastes and floss. hoping they will follow your above recommendations. 😎😎 Any of you have any plan for Feb month - Dental Awareness month ? My office has scheduled with 3 elementary schools for our hygiene presentation.

that's the best anti-cavity agent - PREVENTIVE - congrats to you and your office

 

[cobalt31]

why didn't anyone respond to the OP's article? it suggests a possible method for curing caries that has nothing to do with a vaccine.

what if a method is developed to cheaply and significantly reduce the risk for caries as the article suggests? even if it does happen, i don't understand how dentists could be unhappy of such an advancement, as the OP suggests.