It’s all starting to get a bit ‘long in the tooth’ – Dr Michael Sultan

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  Posted by: Dental Design      6th February 2018

I’m certain that many of you would be able to relate to the feeling of déjà vu I’ve been having recently. Last month, I read an article about a new ‘fusion protein’ that’s being developed in China that may prove to be an efficacious vaccine against dental caries. Essentially, researchers from the Wuhan Institute of Virology at the Chinese Academy of Sciences have spliced together two separate proteins to create what they are calling KF-rPAc.[1] While KF-rPAc provided prophylactic and therapeutic efficiency against caries, it also demonstrated possible side-effects, such as high antigenicity and potential inflammatory injury, that restricted its clinical usage. Despite this, experts are positive about its future applications in oral care – and it has wholeheartedly been picked up by the nation’s media as the cure for dental decay.

If you, like me, thinks this all sounds a bit familiar, it’s because it is. In fact, there have been a myriad of supposed ‘cures’ that have been developed over the last few years that all purport to be the end of dental caries – and while this is something that we all surely want, I don’t think we should put all our hopes and dreams on any of them.

That isn’t to say I am not fully supportive of any developments that assist help us dentists save our patients’ teeth – I am. It’s important for our profession to continue to push boundaries and make new discoveries, especially with the ever-changing norms of the people we treat. I simply do not think it is profitable to fixate on the latest medical fad that the media points out – and I certainly do not think it is positive to let our patients do so either.

There are several reasons for this. First of all, I am concerned that when patients hear about a special drug that can either cure them of their dental decay or prevent it altogether, they will forget all about the advice we all try so hard to give them about maintaining a healthy oral lifestyle. After all, if they don’t have to worry about the consequences of eating sugary foods and neglecting their teeth, safe in the knowledge that they will simply need to be given a vaccine, why would they? I foresee, and I don’t think it is being too cynical to say so, that if a vaccine did exist, it would be abused and a culture of reliance would lead to overall poorer oral health.

The second reason I have for mistrusting these new wonder drugs is simply because there is already an effective way of avoiding caries – and we all know it! Reduce our sugar consumption, maintain a good oral hygiene routine and visit our dentists regularly. For the majority of people this is more than enough to significantly reduce the risk of dental caries. Of course, we must acknowledge that some people are more predisposed to dental decay than others – perhaps even on a genetic level – and so there are those who do require an extra bit of help. But for the large majority of the UK’s population, a good diet and good advice from us is enough. They simply do not need a drug that can ‘cure’ them.

What they do need is better education, better access to dental care and better support from the wider dental health community. Unfortunately, all of these things are hard to come by at present. Spending cuts in the NHS have severely compromised the efficacy of the service – and with Brexit just around the corner, and its astronomical bill for the health service, things are likely going to get worse.

But we cannot let this happen. We cannot give up and ourselves become reliant on drugs that could ‘cure’ dental caries – because it would likely spell our profession’s end. Indeed, the day that we start advising patients to take such medicines is the day we give up on true preventive care.

And so I for one think that these recurring news reports about the next dental wonder drug are getting a bit long in the tooth. It would be, in my mind, far more fruitful to highlight the importance of better dental care, good home care and the ways in which people can improve their oral health with ease and good practice, rather than risking it on the hope of a potential future cure.



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