Renaissance and remineralization: Home and abroad, two developing products could change dental landscape
Home and abroad, two developing products could change dental landscape
BY Bridget Conway, BA, RDH
Every now and then, the Europeans one-up us, so it pays to keep our dental ears tuned in to what's going on across the pond because the worthy trends will make their way over here eventually. The reverse is also true. Out of our universities and entrepreneuring American spirit also come innovative solutions to vexing dental problems.
This article will cover two such solutions. From King's College London comes a new remineralizing technique that could change the way carious lesions are healed. Meanwhile, from here in the United States comes a breakthrough formula for the treatment of periodontal disease. Both of these promising therapies are minimally invasive and more cost-effective than traditionally available therapies.
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First, let me tell you about Professor Nigel Pitts, BDS, PhD, who recently spoke during a sold-out event at the International Dental Exhibition and Meeting (IDEM) in Singapore. Dr. Pitts flew to Singapore from King's College London to unveil research and techniques regarding modern caries prevention and its system implementation. In an article in the Huffington Post, Dr. Pitts said, "The way we treat teeth today is not ideal. When we repair a tooth by putting in a filling, it enters a cycle of drilling and refilling, as ultimately, each repair fails."
Dr. Pitt's declaration is reflective of frustration with the current standard of care for caries. In Singapore during a lecture titled, "New Dimensions in Practical Caries Management: Pathways for Prevention and Control of Caries," Dr. Pitt outlines a new strategy in the arsenal of caries control and containment.
Sounds promising, but you may be wondering: what is his system?
Professor Nigel Pitts and Dr. Christopher Longbottom conceived a treatment for early carious lesions called Electrically Accelerated and Enhanced Remineralization (EAER). It's a mouthful, I know. The treatment, however, is less fraught and much less invasive for the patient.
"The damaged part of the outer layer of enamel is prepared first.1 After that, a tiny, painless electric current is used to "push" minerals into the tooth to repair the damaged site.1 As a result, the defect is remineralized in a painless process that does not involve drills, injections, or filling materials."1 While it may take a little longer for the technique to be brought to market in the United States, it could be used overseas in as little as three years.1
Reminova Ltd., the company that is on target to develop EAER, is a venture that was launched by the King's College London Dental Innovation and Translation Center in January 2013.1 "The idea of the King's College London Dental Innovation and Translation Center is to take research and new technologies and turn them into products, change practices, and inform policy, which will improve health and health care internationally."5
The advent of EAER is especially promising to our dental-phobic patients, as it removes some of the stimuli that trigger the majority of negative reactions and the most pain. Another important thing to consider is that electric currents are already being used in dentistry to check the pulp or nerve of the tooth. The EAER will use a far smaller current and definitely cannot be felt by the patient.
I can hear you saying, "Yes, but how does it work?"
Mechanism of Action
EAER works through something called iontophoresis. If you think about it, it's known that decay alters the electrical characteristics of a tooth. This happens when demineralization occurs, causing the porosity of the tooth to increase. As a result, the increased number of ions floating around increases the conductivity, the electrical transport within the tooth structure. So the demineralization results in an enhancement of the tooth's charge properties.
Iontophoresis is a noninvasive method of using an electric current to propel a charged substance, a bioactive agent, or a medication. The active agent may contain casein phosphopeptide - amorphous calcium phosphate, for example. The delivery method is enhanced with high-frequency ultrasound via a "healing handpiece" to deliver and drive nano-sized particles of bioactive agents (minerals), thus organically initiating remineralization to repair the tooth structure without any drilling, fillings, or injections.
The World Health Organization (WHO) estimates that 60 to 90% of schoolchildren and nearly 100% of adults worldwide have dental cavities. Now it seems that technology might be closing the gap in the growing demand for pain-free, effective dental treatments that do not discourage people from coming back to the dentist's office for other serious problems, such as gum disease.
A simple solution for perio?
Stateside, here is what's happening in the world of periodontal disease management. An innovation called Periodyne has been causing a lot of "word on the street" since it began to catch fire after an article about it appeared in the Journal of Periodontology during July 2009.
Fast-forward to 2014. In some offices, periodontal disease has a specific treatment protocol, and in other offices, the condition is only relegated to more frequent visits - a kind of hospice for the gingiva. There have been so many "causes" and "cures" proposed that it's difficult to keep track.
We have not seen a real game changer regarding periodontal disease treatment. We have, however, discovered systemic threats and implications that illustrate the real-time need for effective treatment.
Imagine you are an athlete who suffers from chronic back pain and inflammation. In your quest to hang on to your youth, you discover a cetylated oil product that provides wonderful therapy for your growing inflammatory joint problem. You are delighted with your discovery and also curious about the potential for other healing applications for this naturally sourced product.
A dear friend knows about your research and your interest in naturally sourced medicine and shares his dental woes with you - specifically, swollen gums and loose teeth. You suggest a month-long regime of the same capsulated cetylated oil, topically applied to the gingiva.
One month goes by, and you see your friend again after he has just had a visit with his dentist, who was quite surprised at the turnaround in his gingival health and the decrease in pocket depths. After confirmation of a positive result, your friend shares the cetylated oil therapy story with his dental professional. This is the birth story of Periodyne. It's been a long journey from birth to market, however, with many stops and clinical trials in between for validation.
Periodyne has been thoroughly researched and professionally evaluated by dental health professionals. It is an all-natural product, composed of cetylated oil sourced from the United States. The ingredient is a monounsaturated fatty acid, distilled and separated before being blended into the Periodyne formula. It is a completely natural product, deemed safe and effective, with no side effects. This product is food-grade and intended to be applied to the gingiva before the capsule containing residual oils is swallowed.
Periodyne LLC's president, Kim Vanderlinden, ND, explained how Periodyne works during an interview with DentistryIQ.2 "Designed for patients to use at home, Periodyne is a patented blend of natural cetylated oils, which are delivered in capsules that can be clipped open for the oils to be dispensed directly onto the gums."2
Mechanism of Action.
According to Dr Vanderlinden: "The appearance of labeled Periodyne within cellular membranes, especially those of the white blood cells, suggests that it influences the prostaglandin cascade and the resulting inflammation it creates." In addition to reduction of inflammation, evidence has been observed to suggest the possibility of bone regeneration after six weeks.3
Many periodontal patients desire a natural alternative to lasers, surgery, and/or expensive, site-specific antibiotics. Periodyne is a simple solution to the difficult problems inherent in treating, improving, and controlling periodontal disease.
The compliance rate associated with such a simple, effective, and affordable therapy should be a game changer in every dental office. This product will considerably reduce general dentists' referrals to periodontists and give hygienists an effective, minimally invasive, and affordable alternative to current periodontal therapies. Periodyne is available in the U.S. now, and the company offers specific programs for hygiene education and practice implementation.
These are just two of the bright stars in the galaxy of innovative thinking and application. Notice that both use minimally invasive and more organic methods of healing than traditional therapies. These forward thinking companies have far reaching implications, influencing access to care, affordability, and patient compliance. RDH
Bridget Conway, BA, RDH, in addition to clinical hygiene, has interests in organizational behavior, dental relationship marketing, and building company culture. Bridget is active in the Maine Dental Hygienists' Association, and she authored a continuing education course on innovative enamel therapies, as well as other subjects, for PennWell. Bridget credits her attendance at the January 2008 Career Fusion as her lift-off point in career development. Continuing to attend CareerFusion has enabled Bridget to hone skills and confer with industry leaders.
References
1. King's spin-out will put tooth decay in a 'time warp.' King's College London. Jun. 16, 2014. www.kcl.ac.uk/newsevents/news/newsrecords/2014/June/Kings-spin-out-will-put-tooth-decay-in-a-time-warp.aspx
2. Robinson E. Healthy gums, naturally: Periodyne launches new product for enhancing periodontal health. DentistryIQ. July 29, 2014. www.dentistryiq.com/articles/2014/07/periodyne-llc-releases-a-new-product-for-enhancing-periodontal-health.html
3. Hasturk H et al. 1-Tetradecanol complex: Therapeutic actions in experimental periodontitis. Journal of Periodontology July 2009; 80(7) 1103-1113.
4. Professor Nigel Pitts FRSE BDS PhD FDS RCS (Eng) FDS RCS (Edin) FFGDP (UK) FFPH, came to King's College London in January 2013 to set up the Dental ITC. At King's he is Director of ITC and Professor of Dental Health. Externally he is leader of the GCCM Global Collaboratory for Caries Management initiative and chair of the ACFF Alliance for Cavity Free Future. He is an Honorary Consultant in Dental Public Health to Guy's and St Thomas' NHS Foundation Trust.
5. dentalaegis.com/news.php?id=15411; dentfix.ro/en/2011/10/demineralization/; dentistryiq.com/articles/wdj/print/volume-4/issue-9/focus-on-orthodontics/demineralization-and-remineralization-the-battle-to-keep-teeth-strong-and-healthy.html
