Halloween is over, but all of the candy remains!  Yet, some researchers aren’t too worried about people eating all of the trick-or-treat sweets.  Any dentist would be happy to remind these researchers that sugary treats can lead to tooth decay, but many now believe that ten or so years down the line we may be able to grow a whole new set of choppers!

There are a few companies whose research programs intend to grow new permanent natural teeth as alternatives for conventional prosthetic devices such as dentures and dental implants.  If successful, this groundbreaking whole-tooth regeneration process would dramatically change the current clinical landscape in dentistry.  Imagine losing a tooth and being able to grow a new one in its place!

Although human babies are born without visible teeth, they have “proto-teeth” hidden in their gums.  These “proto-teeth” known as primordial, are formed from an interaction between basic cell types called epithelial and mesenchymal cells (I know they are hard to pronounce, but I wasn’t there when they were naming the cells!).  These interactions eventually let all of us grow teeth.  Researchers are trying to duplicate that process.  To do so researchers start with undifferentiated cells which are capable of developing into a variety of cell types.  The cells are aggregated into small pieces of tissue, and then overlaid with a piece of oral epithelium (tissue).  The cells of the oral epithelium already know they are supposed to become part of a tooth and they “instruct” the cells to turn into oral mesenchymal cells.  When the resulting primordium is transplanted into a mouse kidney (a good environment for this sort of thing, since it is well supplied with blood and oxygen) it turns into a tooth!  Often called “regenerative dentistry”, researchers hope it will become possible to replace a lost tooth by implanting a primordial tooth into a patient’s gum tissue that would grow, form roots and eventually erupt into the mouth after only a few weeks.

Not only are researchers attempting to grow new teeth, they are also studying ways to regenerate and replace decayed tooth structure.  Dentin is the main component and second layer of a tooth.  It protects the inner pulp (nerve and blood vessels) and supports the outer enamel.  Dental decay often destroys part of the enamel and dentin, weakening the tooth and exposing the pulp to oral bacteria.  When this occurs, a root canal procedure is often performed.  Products are being developed that would allow a tooth with a vital nerve to regenerate and grow new tooth structure.  This could potentially eliminate 50% of the root canals that are done today.  It may be possible in the future to build new tooth structure in a diseased tooth rather than a restore it with a filling.

New inroads are also being made with the remineralization of broken down tooth structure.  Dental decay is initiated by acid produced by oral bacteria in dental plaque.  The acid removes the mineral (demineralizes) the enamel (or other exposed dental tissue such as dentin or cementum) and thereby weakens the tissue.  Such weakened tissue is vulnerable to further destruction by the acid-producing bacteria in plaque, a process that leads to cavities.  Under the appropriate circumstances, the demineralization of enamel is reversible, but this natural process is often unpredictable and slow.  Products are being developed to dramatically improve this natural remineralization process.  These products, applied to teeth by your dentist, would remineralize the early areas of demineralization.  This would enable the predictable reversal of the cavity producing process and reduce the number of teeth needing to be filled.  No one can predict the future, but many new things are definitely on the horizon!