Many people are under the impression that dentists earn a lot of money. Hence, whenever there’s any news that dentists may suffer a huge loss of income from some disruptive technology, the public would appear to have reason to celebrate. Here’s one. Researchers at King’s College London found that the drug Tideglusib stimulates the stem cells contained in the pulp of teeth so that they generate new dentine – the mineralised material under the enamel. This new drug has been touted as something that will end restorative dentistry with filling materials.
The Telegraph has the details here.
Not surprisingly, the article went viral, but exactly what was it trying to say when it suggested that “Teeth already have the capability of regenerating dentine if the pulp inside the tooth becomes exposed through a trauma or infection”
Any person with a basic knowledge of tooth development would know that this statement is untrue. First of all, the pulp forms secondary dentine all the time. However, the pulp does not push outwards as it forms the secondary dentine. It pushes inwards, painting itself into a corner if you will. That’s why young teeth have comparatively large pulp chambers while older teeth have smaller ones. As the tooth grows older, the pulp shrinks and becomes smaller and smaller. Meanwhile, the external surface of the tooth continues to wear out. No actual “regeneration” occurs.
A young, healthy tooth has a relatively large pulp chamber. The growth of new dentine forces the pulp inwards. There can be no change in the external dimensions of the tooth.
A young, healthy tooth has a relatively large pulp chamber.
The process of secondary dentine formation can be sped up when the pulp senses decay and mild irritation coming from the surface of the tooth. This is a protective measure and not a very ingenious one if you ask me. However, if the highly sensitive and fragile pulp tissue becomes exposed through trauma or infection, it almost always becomes non-vital. It is simply untrue that exposed, infected or injured pulp can still generate dentine as suggested by the article. Once the pulp has been exposed due to caries or trauma, root canal treatment is seldom avoidable.
Unless the evolution of human cell biology has taken a drastic turn, I don’t see how inserting a collagen sponge impregnated with some miracle drug can cause the pulp to build dentine outwards and fill up the cavity.
Dental Phobia by Chan Joon Yee