A vaccine against cavities has been a dream pursued for over 30 years by researchers and the National Institutes of Health. Fluoridated water supplies, instituted in the United States and Canada in the mid-1940s, have gone a long way to decrease cavities at a cost of approximately one dollar per recipient per year.
Despite this cost effective preventive measure, those in developed countries still receive cavities at an alarming rate, with 70% of us receiving three or more by the age of 17. Could vaccines help us get rid of dental cavities for once and for all?
Why do you get cavities?
Dental cavities are started by two bacteria - Streptococcus mutans and Lactobacillus. These bacteria feed off of carbohydrates you consume that stray around your teeth, and over time a nice little hole (known as dental caries or, more commonly, as "cavities") is formed due to lactic acid secreted by bacteria as a waste product. Tooth enamel is made up of calcium phosphate, and the calcium phosphate is constantly being removed and replenished by your saliva.
Lactic acid dissolves the calcium phosphate that makes up your tooth enamel, allowing further damage to the tooth itself (tooth enamel is roughly 2.5 mm at its thickest point) and halting the equilibrium process by which the minerals in your tooth are removed and replaced. Streptococcus mutans not only causes oral problems, but has been shown to damage heart valves if the bacteria enters the bloodstream.
A vaccine for cavities?
The International Association for Dental Research and American Association for Dental Research recently announced a study performed by the Chinese Academy of Sciences which looked at using an inhaled vaccine that uses a protein filament as a delivery vehicle. Trials performed in rats showed an increase in antibody response along with a decrease in the amount of Streptococcus mutans adhering to teeth, leading to significantly fewer cavities observed among the test population.
The filament delivery system is widely believed to be the reason this vaccine will succeed. The vaccine still needs a bit of tweaking before being implemented in humans, but other technologies are advancing to protect your teeth from cavities, including a genetically modified strain of Streptococcus mutans incapable of producing lactic acid that is currently in clinical trials.
Implications for Third World Countries
I don't need to tell you that tooth pain sucks. If you are lucky, your dentist works you in as soon as possible, dials up the nitrous oxide, and you leave with a little bit of soreness and a prescription for Vicodin. But what if you could never go for the dentist? The cavity grows, eating away the enamel and moving inside of your tooth, destroying the roots, all the while moving on to the surrounding teeth. Every time you bite into even the softest of foods you flinch with pain. Third World countries often lack a clean water supply, let alone a fluoridated water supply, leaving them without a first line of defense. A vaccine against cavities would go a long way to improve the quality of life and level the medical playing field of those without access to dental care.
The map at left shows how much, on average, cavities shorten the disability-adjusted life spans in each country, according to World Health Organization estimates. Countries in yellow lose less than 50 years per 100,000 people, countries in orange lose 100 years per 100,000 people, and countries in red lose over 150 years for every 100,000 people.
A vaccine is not economically viable for manufacturers
Pharmaceutical and medical manufacturers are not jumping at the opportunity to provide funding for a dental cavities vaccine. This lack of cash-based enthusiasm is for several reasons, including the fact that cavities are treatable, the countries most needing the vaccine do not have the means to support research, and a vaccine would take a lot of work out of the hands of local dentists.
Technological advances loom heavily over the dental profession, not just due to a potential cavity vaccine, but also with advances like a topical gel that could heal cavities already present in a patient. While that latter would still need to be applied by a dentist, the profession is changing, and emergency drill-on-tooth action might be a thing of the past within decades. Dentists will still have plenty of work within the declining $100 billion a year sector, with cosmetic dentistry as an income replacement source.
A cheap & easy way to fight Streptococcus mutans
Although a vaccine is not available, and probably won't be available for quite a while, you can take some steps to kill the Streptococcus mutans currently secreting acid onto your teeth. Xylitol, a standard substitute for sucrose in gum, cannot be used by Streptococcus mutans to create lactic acid. A half a pack of xylitol infused gum a day could keep cavities away and save a lot of money in dentist bills. Just keep the gum away from your pets, as the sugar substitute is poisonous to dogs and other small creatures.
Top image courtesy of Funny Junk (Mr. Texas), with other images from the World Health Organization and American Chicle. Sources linked within article.