8 ms·

Drug Discovered to Regenerate Lost Teeth

167 points by awb 6y ago

zupreme 6y ago
While this article fails to meet the promise of the title, there have been several promising studies using: Lasers: https://slate.com/business/2014/05/scientists-have-figured-out-how-to-regenerate-teeth-with-lasers.html https://slate.com/business/2014/05/scientists-have-figured-o... Sound: https://jtultrasound.biomedcentral.com/articles/10.1186/s40349-015-0028-5 https://jtultrasound.biomedcentral.com/articles/10.1186/s403... And others.
dkarras 6y ago
If I'm not missing something from the article, this is not for teeth you had and lost, but for teeth that didn't appear to begin with (so you naturally have fewer than normal) due to a genetic condition.
- zadler 6y ago
  It’s a bit confusing and wildly misleading if that’s the case. The article uses the word “regenerate” quite freely, but the scientific language is “agenesis” I.e. it wasn’t there in the first place. And of course the title “lost teeth” facepalm.
- jorvi 6y ago
  Tangentially related but I know of a surgery where a man lost his nose, they grew a secondary nose somewhere else on his face (so it already has blood vessels going towards it vs transplanting it from in vitro), and then they removed the damaged nose and replaced it with the new nose. If this moves beyond animal tests, the potential is there even for people who got all their teeth.
- corobo 6y ago
  So less regenerate more generate
  - yreg 6y ago
    And less lost more lacking
- hwillis 6y ago
  Nope, that's the simplest use case but it can apparently be used to stimulate growth of completely new teeth. If you administer it locally it produces a specific tooth as well. First: the process, as far as I understand it. The hormones involved in growing teeth are hugely complex and have effects all over the body, so this group went after a protein that modulates the effect of those proteins to block tooth growth. They created an antibody that targets the protein, basically unlocking the production of additional sets of teeth. Obviously there is still a massive gap between this and human trials. First, using antibodies is never without risk because the immune system makes its own decisions and is... schizophrenic. Guillain-Barre occurs when the immune system starts attacking your nerves. If you tell the body that this protein is an enemy, god only knows what could happen- autoimmune disorders, uncontrolled tooth growth, all your teeth just falling out because of cytokines. You could make up potential rare side effects forever. Second, this required frequent re-administration and immunosupressants. You can't go giving people prednisone for a year just to fix a tooth. It's super dangerous and after only a week various glands are so suppressed they start to atrophy. This actually isn't the worst- as long as you can develop a chemical that binds to the protein like an antibody would without activating the immune system. But, and I'm just guessing here, that's probably really really hard. Third, teeth are different in humans and rodents. There may be (and probably are!) additional factors in humans- rodent teeth are meant to grow indefinitely, human teeth aren't. The teeth in ferrets weren't very well formed. That may be a deeper problem. Even if it's the simple problem -that dosage needs to be carefully regulated and stable so growth isn't interrupted- the solution to that isn't easy. And surely the dose is very important, as is the localization. You don't want to generate (malformed) teeth to the sides, or god help you multiple teeth in one socket (no clue if this is possible). Last, supernumary teeth are not usually problem-free. Permanent teeth are larger and there's not much/no room for teeth to develop behind them. If they do develop properly, they may be misaligned due to crowding. You aren't growing any more- I doubt supernumary teeth would come in cleanly even if you removed the old tooth. This isn't a child's mouth any more, and teeth are shaped so that they must come out in a certain order, otherwise you'll need braces. I've no idea if this treatment would cause the root of the old tooth to dissolve (or if permanent teeth can even do that!)- you may need to have it pulled and live like that until the new tooth can grow. That might have negative effects on the socket. Hell you might even be like me- my teeth are all around two inches long. I look like Venom in an x-ray; needle teeth going from just below my eye socket to just above the bottom of my jaw. I don't know how the hell I grew a second set (plus a few thirds) of teeth. I doubt I'd be a candidate even for a perfected procedure. > Last, to confirm that USAG-1–neutralizing activity affects BMP signaling to generate a whole tooth in a nonrodent model, we systemically administered antibody #37 to postnatal ferrets that had both deciduous and permanent teeth. We observed supernumerary tooth formation in maxillary incisor like the third dentition, although a five times higher concentration, three administrations of antibody #37, and immunosuppression were required (Fig. 6, A to D). The supernumerary tooth was likely to have a similar shape to the usual permanent incisor, located to the lingual side of permanent teeth, whereas a shorter root seemed to be growing (Fig. 6, E to G). Therefore, this supernumerary incisor might be categorized as the third dentition (32). https://advances.sciencemag.org/content/7/7/eabf1798 https://advances.sciencemag.org/content/7/7/eabf1798
the8472 6y ago
In mice.
bionhoward 6y ago
a nice candidate target for RNA interference, locally injected in the gums
runawaybottle 6y ago
Relevant Onion article: https://local.theonion.com/woman-s-subconscious-not-sure-how-much-more-clearly-it-1842215067 https://local.theonion.com/woman-s-subconscious-not-sure-how...
bredren 6y ago
I never had adult teeth grow in on my 25 and 24 lower incisors. That’s my smallest front middle teeth. This was a congenital condition as described in this article. I was fortunate enough to have access to implants, which I did not appreciate at the age of 13 and 14. The procedure was invasive. It required drilling out my baby teeth, (which did not fall out), and introducing a single peg which was fused into my lower jaw bone. There was a long time while my gum had to heal over this area which included stitches at first. I was given something called a flipper, which is like a retainer with two fake teeth on it. I wore this for what felt like an eternity. I recall one of the hardest parts about this was that I had become interested in girls and that I wanted to kiss my friend and this flipper was in the way of this. I was lucky that my friend Erin was accommodating and did not make me feel weird about both having to take out this dentures thing and that I was missing teeth while we made out. We are still friends so it must not have been too weird. Eventually, a mono tooth was made, (it’s probably not called this but that sounds fun) which screwed into the peg and had two “adult” sized teeth on the top. Over 25 year later, the teeth look real. The color was a good guess and unless you know to stare and look you do not notice them. I have yet to have a person identify them and I’ve had to tell partners, as they did not notice even after being close with me. I also do not notice them and have not had any real problems with them. That said, it would have been great to not have gone through all of that as an early teenager, though I came out just fine. Also, I can only imagine the fees that must have been associated with all of the work. I wonder if I could grow the teeth back now or if the fused peg has ruined the chances.
- Waterluvian 6y ago
  Are your cyborg teeth basically immune to tooth decay and other issues? Can you replace them longer term now that the foundation is in? Thanks for sharing your story.
  - hwillis 6y ago
    No- care is basically the same, but the risks can be much larger. Your gums etc. are still at risk from bacterial buildup, and plaque etc live on your teeth more than they use it as a food source. Implants still develop plaque and calculus. If the gum starts receding from a tooth or an infection occurs, there are still barriers between it and the bone, and the body can repair some damage. Implants pass the point of no return far more quickly. If you get an infection around the implant, the bone around the implant will start breaking down and the implant will reject.
spicyramen 6y ago
When I was 12 I lost my front teeth before my first communion. My mum took me to the dentist that day and ask him if adult teeth can re-grow. Dentist seeing my mum desperation said that in very rare cases it could be possible. I got implants obviously as my adult teeth never re-grow. The implants look so real and nicer that the original ones. I wonder how this process would look like and how long the new teeth take to grow.
- hwillis 6y ago
  > I wonder how this process would look like and how long the new teeth take to grow. It's a long, long way off- I can't understate how much you would not want to try this on yourself yet. It's far more likely you'll see gene therapy cures for lactose intolerance and things like that first. Currently the procedure shares a lot of risks with an organ transplant. Autoimmune disorders, months or years of medication with dangerous complications, long-lasting or permanent changes to your endocrine system and hormones. The best case is you get a new tooth that is malformed, misaligned and highly vulnerable to decay. The worst case is that your jaw dissolves and you're on immunosupressants + prophylactics for the rest of your life and you die 20 years early from pneumonia. So... there are some bugs to work out. If they do work it out, it'll probably look like either a weekly/monthly injection or a tiny implant. You might need invisalign afterwards, and you might need to have the old tooth pulled first. Risks will probably be quite low, but the process is long and complex enough that it might only be for exceptional circumstances. It will probably be much better than total dental replacement, maybe better than a single implant, but probably not better than a crown. Personally I'm most excited for the possibility of a third set of teeth for later-life people who would otherwise need dentures or who just have to suffer from tooth pain.
bitwize 6y ago
In mice with tooth agenesis. I'll get excited when it shows similar results in, say, a human hockey player.
- hwillis 6y ago
  And in adult ferrets, generating totally a new (albeit undersized) tooth to replace a normal permanent tooth! That's a big deal since ferret teeth aren't particularly different from ours, while rodent teeth do all kinds of weird things like growing nonstop. It would have been awkward if we started human trials and found that instead of growing new teeth, the treatment just made our teeth get longer and longer. Like fingernails. Needing trimming. > Last, to confirm that USAG-1–neutralizing activity affects BMP signaling to generate a whole tooth in a nonrodent model, we systemically administered antibody #37 to postnatal ferrets that had both deciduous and permanent teeth. We observed supernumerary tooth formation in maxillary incisor like the third dentition, although a five times higher concentration, three administrations of antibody #37, and immunosuppression were required (Fig. 6, A to D). The supernumerary tooth was likely to have a similar shape to the usual permanent incisor, located to the lingual side of permanent teeth, whereas a shorter root seemed to be growing (Fig. 6, E to G). Therefore, this supernumerary incisor might be categorized as the third dentition (32). https://advances.sciencemag.org/content/7/7/eabf1798 https://advances.sciencemag.org/content/7/7/eabf1798
dehrmann 6y ago
Aside: if you want to see something disturbing, look up "human child skull." Seeing the adult teeth below the baby teeth is a little terrifying.
- imalexsq 6y ago
  Ah, i just found out this is not exactly true: https://www.reuters.com/article/uk-factcheck-xray-hyperdontia-toddler-te/fact-check-x-ray-shows-hyperdontia-not-generic-toddler-scan-idUSKBN2342W5 https://www.reuters.com/article/uk-factcheck-xray-hyperdonti...
ivolimmen 6y ago
I was born with this exact defect. I only have 8 adult teeth. Most people hate going to the dentist, I needed to go really often between 18 en 21. I have 4 wisdom teeth, 2 up and 2 down. 2 molars and 2 front teeth on the upper side. My front teeth became my fangs using braces for a few years. So somewhere around my 21st they finished the work by creating a bridge using gold and porcelain on the upper side residing on my molars and the 2 fangs. On the lower jar, since I only have 2 wisdom teeth there, I got titanium implants. The weird thing is that my teeth feel real. Since teeth do not have sensors you feel everything in your mouth with vibrations that go through your teeth to your jaws. I only understood that when I got my false teeth. I am really pleased with this news, as I hope that no one has to go through what I have been through. Getting this extensive dental surgery on the age I was leaves a deep mark. I never had any confidence due to my bad (small) teeth. I never smiled on photos. I think the first time I ever did was a few years back; I am almost 45 now.
INTPenis 6y ago
Layman here but wouldn't a growing tooth be extremely painful and hard to eat with? How exactly does it grow? Does the root grow and then the "tooth material" after, or does the tooth grow with the root protected inside of it? I'd rather see us just replace all the teeth with something artificial that won't break. Teeth seem like a problem area.
dang 6y ago
https://news.ycombinator.com/item?id=26641989 https://news.ycombinator.com/item?id=26641989
hyko 6y ago
You can make a decent living coming up with new and exciting ways to regenerate teeth. Meanwhile in the real world drilling & filling remains the cutting edge of dental treatment, as it has done for 7,000–9,000 years.

167 points by awb 6y ago

While this article fails to meet the promise of the title, there have been several promising studies using: Lasers: https://slate.com/business/2014/05/scientists-have-figured-out-how-to-regenerate-teeth-with-lasers.html https://slate.com/business/2014/05/scientists-have-figured-o... Sound: https://jtultrasound.biomedcentral.com/articles/10.1186/s40349-015-0028-5 https://jtultrasound.biomedcentral.com/articles/10.1186/s403... And others.

dkarras 6y ago

If I'm not missing something from the article, this is not for teeth you had and lost, but for teeth that didn't appear to begin with (so you naturally have fewer than normal) due to a genetic condition.

zadler 6y ago
It’s a bit confusing and wildly misleading if that’s the case. The article uses the word “regenerate” quite freely, but the scientific language is “agenesis” I.e. it wasn’t there in the first place. And of course the title “lost teeth” facepalm.
jorvi 6y ago
Tangentially related but I know of a surgery where a man lost his nose, they grew a secondary nose somewhere else on his face (so it already has blood vessels going towards it vs transplanting it from in vitro), and then they removed the damaged nose and replaced it with the new nose. If this moves beyond animal tests, the potential is there even for people who got all their teeth.
corobo 6y ago
So less regenerate more generate
- yreg 6y ago
  And less lost more lacking
hwillis 6y ago
Nope, that's the simplest use case but it can apparently be used to stimulate growth of completely new teeth. If you administer it locally it produces a specific tooth as well. First: the process, as far as I understand it. The hormones involved in growing teeth are hugely complex and have effects all over the body, so this group went after a protein that modulates the effect of those proteins to block tooth growth. They created an antibody that targets the protein, basically unlocking the production of additional sets of teeth. Obviously there is still a massive gap between this and human trials. First, using antibodies is never without risk because the immune system makes its own decisions and is... schizophrenic. Guillain-Barre occurs when the immune system starts attacking your nerves. If you tell the body that this protein is an enemy, god only knows what could happen- autoimmune disorders, uncontrolled tooth growth, all your teeth just falling out because of cytokines. You could make up potential rare side effects forever. Second, this required frequent re-administration and immunosupressants. You can't go giving people prednisone for a year just to fix a tooth. It's super dangerous and after only a week various glands are so suppressed they start to atrophy. This actually isn't the worst- as long as you can develop a chemical that binds to the protein like an antibody would without activating the immune system. But, and I'm just guessing here, that's probably really really hard. Third, teeth are different in humans and rodents. There may be (and probably are!) additional factors in humans- rodent teeth are meant to grow indefinitely, human teeth aren't. The teeth in ferrets weren't very well formed. That may be a deeper problem. Even if it's the simple problem -that dosage needs to be carefully regulated and stable so growth isn't interrupted- the solution to that isn't easy. And surely the dose is very important, as is the localization. You don't want to generate (malformed) teeth to the sides, or god help you multiple teeth in one socket (no clue if this is possible). Last, supernumary teeth are not usually problem-free. Permanent teeth are larger and there's not much/no room for teeth to develop behind them. If they do develop properly, they may be misaligned due to crowding. You aren't growing any more- I doubt supernumary teeth would come in cleanly even if you removed the old tooth. This isn't a child's mouth any more, and teeth are shaped so that they must come out in a certain order, otherwise you'll need braces. I've no idea if this treatment would cause the root of the old tooth to dissolve (or if permanent teeth can even do that!)- you may need to have it pulled and live like that until the new tooth can grow. That might have negative effects on the socket. Hell you might even be like me- my teeth are all around two inches long. I look like Venom in an x-ray; needle teeth going from just below my eye socket to just above the bottom of my jaw. I don't know how the hell I grew a second set (plus a few thirds) of teeth. I doubt I'd be a candidate even for a perfected procedure. > Last, to confirm that USAG-1–neutralizing activity affects BMP signaling to generate a whole tooth in a nonrodent model, we systemically administered antibody #37 to postnatal ferrets that had both deciduous and permanent teeth. We observed supernumerary tooth formation in maxillary incisor like the third dentition, although a five times higher concentration, three administrations of antibody #37, and immunosuppression were required (Fig. 6, A to D). The supernumerary tooth was likely to have a similar shape to the usual permanent incisor, located to the lingual side of permanent teeth, whereas a shorter root seemed to be growing (Fig. 6, E to G). Therefore, this supernumerary incisor might be categorized as the third dentition (32). https://advances.sciencemag.org/content/7/7/eabf1798 https://advances.sciencemag.org/content/7/7/eabf1798

the8472 6y ago

In mice.

bionhoward 6y ago

a nice candidate target for RNA interference, locally injected in the gums

runawaybottle 6y ago

Relevant Onion article: https://local.theonion.com/woman-s-subconscious-not-sure-how-much-more-clearly-it-1842215067 https://local.theonion.com/woman-s-subconscious-not-sure-how...

bredren 6y ago

I never had adult teeth grow in on my 25 and 24 lower incisors. That’s my smallest front middle teeth. This was a congenital condition as described in this article. I was fortunate enough to have access to implants, which I did not appreciate at the age of 13 and 14. The procedure was invasive. It required drilling out my baby teeth, (which did not fall out), and introducing a single peg which was fused into my lower jaw bone. There was a long time while my gum had to heal over this area which included stitches at first. I was given something called a flipper, which is like a retainer with two fake teeth on it. I wore this for what felt like an eternity. I recall one of the hardest parts about this was that I had become interested in girls and that I wanted to kiss my friend and this flipper was in the way of this. I was lucky that my friend Erin was accommodating and did not make me feel weird about both having to take out this dentures thing and that I was missing teeth while we made out. We are still friends so it must not have been too weird. Eventually, a mono tooth was made, (it’s probably not called this but that sounds fun) which screwed into the peg and had two “adult” sized teeth on the top. Over 25 year later, the teeth look real. The color was a good guess and unless you know to stare and look you do not notice them. I have yet to have a person identify them and I’ve had to tell partners, as they did not notice even after being close with me. I also do not notice them and have not had any real problems with them. That said, it would have been great to not have gone through all of that as an early teenager, though I came out just fine. Also, I can only imagine the fees that must have been associated with all of the work. I wonder if I could grow the teeth back now or if the fused peg has ruined the chances.

Waterluvian 6y ago
Are your cyborg teeth basically immune to tooth decay and other issues? Can you replace them longer term now that the foundation is in? Thanks for sharing your story.
- hwillis 6y ago
  No- care is basically the same, but the risks can be much larger. Your gums etc. are still at risk from bacterial buildup, and plaque etc live on your teeth more than they use it as a food source. Implants still develop plaque and calculus. If the gum starts receding from a tooth or an infection occurs, there are still barriers between it and the bone, and the body can repair some damage. Implants pass the point of no return far more quickly. If you get an infection around the implant, the bone around the implant will start breaking down and the implant will reject.

spicyramen 6y ago

When I was 12 I lost my front teeth before my first communion. My mum took me to the dentist that day and ask him if adult teeth can re-grow. Dentist seeing my mum desperation said that in very rare cases it could be possible. I got implants obviously as my adult teeth never re-grow. The implants look so real and nicer that the original ones. I wonder how this process would look like and how long the new teeth take to grow.

hwillis 6y ago
> I wonder how this process would look like and how long the new teeth take to grow. It's a long, long way off- I can't understate how much you would not want to try this on yourself yet. It's far more likely you'll see gene therapy cures for lactose intolerance and things like that first. Currently the procedure shares a lot of risks with an organ transplant. Autoimmune disorders, months or years of medication with dangerous complications, long-lasting or permanent changes to your endocrine system and hormones. The best case is you get a new tooth that is malformed, misaligned and highly vulnerable to decay. The worst case is that your jaw dissolves and you're on immunosupressants + prophylactics for the rest of your life and you die 20 years early from pneumonia. So... there are some bugs to work out. If they do work it out, it'll probably look like either a weekly/monthly injection or a tiny implant. You might need invisalign afterwards, and you might need to have the old tooth pulled first. Risks will probably be quite low, but the process is long and complex enough that it might only be for exceptional circumstances. It will probably be much better than total dental replacement, maybe better than a single implant, but probably not better than a crown. Personally I'm most excited for the possibility of a third set of teeth for later-life people who would otherwise need dentures or who just have to suffer from tooth pain.

bitwize 6y ago

In mice with tooth agenesis. I'll get excited when it shows similar results in, say, a human hockey player.

hwillis 6y ago
And in adult ferrets, generating totally a new (albeit undersized) tooth to replace a normal permanent tooth! That's a big deal since ferret teeth aren't particularly different from ours, while rodent teeth do all kinds of weird things like growing nonstop. It would have been awkward if we started human trials and found that instead of growing new teeth, the treatment just made our teeth get longer and longer. Like fingernails. Needing trimming. > Last, to confirm that USAG-1–neutralizing activity affects BMP signaling to generate a whole tooth in a nonrodent model, we systemically administered antibody #37 to postnatal ferrets that had both deciduous and permanent teeth. We observed supernumerary tooth formation in maxillary incisor like the third dentition, although a five times higher concentration, three administrations of antibody #37, and immunosuppression were required (Fig. 6, A to D). The supernumerary tooth was likely to have a similar shape to the usual permanent incisor, located to the lingual side of permanent teeth, whereas a shorter root seemed to be growing (Fig. 6, E to G). Therefore, this supernumerary incisor might be categorized as the third dentition (32). https://advances.sciencemag.org/content/7/7/eabf1798 https://advances.sciencemag.org/content/7/7/eabf1798

dehrmann 6y ago

Aside: if you want to see something disturbing, look up "human child skull." Seeing the adult teeth below the baby teeth is a little terrifying.

imalexsq 6y ago
Ah, i just found out this is not exactly true: https://www.reuters.com/article/uk-factcheck-xray-hyperdontia-toddler-te/fact-check-x-ray-shows-hyperdontia-not-generic-toddler-scan-idUSKBN2342W5 https://www.reuters.com/article/uk-factcheck-xray-hyperdonti...

ivolimmen 6y ago

I was born with this exact defect. I only have 8 adult teeth. Most people hate going to the dentist, I needed to go really often between 18 en 21. I have 4 wisdom teeth, 2 up and 2 down. 2 molars and 2 front teeth on the upper side. My front teeth became my fangs using braces for a few years. So somewhere around my 21st they finished the work by creating a bridge using gold and porcelain on the upper side residing on my molars and the 2 fangs. On the lower jar, since I only have 2 wisdom teeth there, I got titanium implants. The weird thing is that my teeth feel real. Since teeth do not have sensors you feel everything in your mouth with vibrations that go through your teeth to your jaws. I only understood that when I got my false teeth. I am really pleased with this news, as I hope that no one has to go through what I have been through. Getting this extensive dental surgery on the age I was leaves a deep mark. I never had any confidence due to my bad (small) teeth. I never smiled on photos. I think the first time I ever did was a few years back; I am almost 45 now.

INTPenis 6y ago

Layman here but wouldn't a growing tooth be extremely painful and hard to eat with? How exactly does it grow? Does the root grow and then the "tooth material" after, or does the tooth grow with the root protected inside of it? I'd rather see us just replace all the teeth with something artificial that won't break. Teeth seem like a problem area.

dang 6y ago

https://news.ycombinator.com/item?id=26641989 https://news.ycombinator.com/item?id=26641989

hyko 6y ago

You can make a decent living coming up with new and exciting ways to regenerate teeth. Meanwhile in the real world drilling & filling remains the cutting edge of dental treatment, as it has done for 7,000–9,000 years.