No fill, no drill? Not comfortable seeing your dentist for some dental fillings and extractions? Don’t fret as new study finds that a certain drug given to treat Alzheimer’s patients can also help repair cavities, regrow teeth, and prevent tooth decay even without the traditional “fill and drill” approach.
According to recent statistics, more than 86 percent of adults aged 20 to 39 are affected by tooth decay. This means that most people have had at least one or two cavities filled in their lifetime, and probably more than that.
Ideally, a silicone-based cement is used by dentists worldwide to fill holes that remain in teeth when a dentist clears out the infected, decayed part with a drill. These dental fillings for cavities do the job, but wear and tear, as well as hard or chewy foods, can loosen them, increasing the risk of infection and decay over time.
Teeth are composed of two different types of minerals. The outer covering is a thin layer known as enamel, which protects the tooth. Underneath the enamel is a thicker layer, similar to bone, called dentine, which forms the inner core of the tooth and protects the soft tissue or pulp underneath. This thicker layer is alive with nerves and gives the tooth its sensation.
Teeth have limited regenerative abilities. They can produce a thin band of dentine – the layer just below the enamel – if the inner dental pulp becomes exposed, but this cannot repair a large cavity.
An emerging field in dentistry known as regenerative endodontics is on the hunt for a natural solution that could do away with such fillings. Researchers in the U.K. might have found one—they have used a drug to stimulate the regrowth of teeth – using mice as their subjects. The study was led by Paul Sharpe, a professor of craniofacial biology of the Dental Institute at King’s College London, and his colleagues, and was eventually published in the January issue of Scientific Reports, showing it led to “complete, effective natural repair”.
The team figured out that the drug Tideglusib stimulates the stem cells contained in teeth so that they generate new dentine, the material under the enamel. Teeth can already regrow dentine if the pulp inside the tooth becomes exposed by trauma or infection, but it can only naturally make a very thin layer and not fill deep cavities of tooth decay. Classified as a potent, selective, and irreversible small molecule non-ATP-competitive GSK-3 inhibitor, the said drug also switches off the enzyme called GSK-3 which prevents dentine from carrying on forming.
The scientists also mentioned in their study that their team drilled tiny holes in the mice’s teeth small biodegradable sponge with the drug inserted into a cavity, where it repairs the damage within six weeks. The sponges melt away over time, leaving only the repaired tooth.
“The simplicity of our approach makes it ideal as a clinical dental product for the natural treatment of large cavities, by providing both pulp protection and restoring dentine,” said Prof Sharpe. “Using a drug that has already been tested in clinical trials for Alzheimer’s disease provides a real opportunity to get this dental treatment quickly into clinics.”
Tideglusib has been studied extensively and has already passed rigid safety testing as a treatment for symptoms of Alzheimer’s disease. The drug activates the Wnt signaling pathway, which appears to be involved in stimulating cellular-based repair of all tissue. They found that by as early as the fourth week, the dentine had filled out and the sponge had effectively disappeared.
Prof Sharpe said a new treatment could be available soon: “I don’t think it’s massively long term, it’s quite low-hanging fruit in regenerative medicine and hopeful in a three-to-five year period this would be commercially available.”
“It greatly enhanced what the tooth tries to do naturally, but it does it in a much more robust way and much quicker,” Sharpe added.
Normally, dentists have to repair tooth decay or caries with a filling made of a metal amalgam or a composite of powdered glass and ceramic to treat cavities but these fail to disintegrate, meaning the mineral level of the tooth is never completely restored. The said new technique could reduce the need for fillings, which are prone to infection.
The team likewise says that “Electrically Accelerated and Enhanced Remineralization” can strengthen the tooth and reduce dental caries.