6 ms·

This is very interesting and has a lot of potential, especially for people who struggle to brush their teeth, but I think there's another future where brushing

by bmau5 4y ago

This is very interesting and has a lot of potential, especially for people who struggle to brush their teeth, but I think there's another future where brushing and flossing largely become obsolete. If we could develop a more effective mouthwash tailored to restoring each persons oral microbiome we could likely reduce the need for brushing and flossing and instead replace it with a daily mouth rinse that clears out food debris and selectively targets pathogenic bacteria while promoting healthy species. I'm a bit biased, though, because this is something we're working towards building at my company down the road.

Victerius 4y ago
Like a dishwasher but for teeth?
- coryrc 4y ago
  Some people rarely brush their teeth and never get cavities. Some people brush thrice daily and floss and still get cavities and need root canals. The working theory is we could all be in the first group with the right bacteria in our mouth.
  - newscracker 4y ago
    Could it also be about the level of salivation in general, since saliva also helps kill some bacteria and keep the mouth cleaner (relatively)?
    - bmau5 4y ago
      Definitely! Saliva is our best natural defense against cavities (and harmful bacteria), so we always recommend people who have struggled with cavities or dry mouth to consider options for increasing their saliva production, like chewing sugar-free or xylitol gum.
  - bmau5 4y ago
    That's it exactly. Some beneficial species play an active role in suppressing the pathogenic species (those that release acid or cause gum disease) and have other benefits including helping us break down dietary nitrate into nitric oxide, which is critical for heart/brain health. My company tests/researches the oral microbiome and we're starting to discover the signatures of what puts people in one group vs. the other, with hopes of helping develop more personalized approaches down the road, but for now helping people understand what will work best for them. Here's my company for anyone who is interested in learning more: https://www.bristlehealth.com/ https://www.bristlehealth.com/
    - comeondude 4y ago
      This is very cool. What’s your take on xytiol gums? Think they’re effective in changing our oral microdiome for the better?
      - bmau5 4y ago
        The initial data on xylitol looks promising for reducing cavities! Particularly for stimulating saliva production (dry mouth is a large contributor to cavities risk) and as a sugar substitute that cavity-causing species can't digest into acid. I'm excited to see more research come out and compare it with our data.
      - jrootabega 4y ago
        I'm also curious about this, but unfortunately I think that's where it will end for me in practice. Even if xylitol is effective, it seems the xylitol you'll get in any products (at least in the US) is going to be industrial byproduct from sketchy unregulated sources, just with greenwashed packaging. If there is a gum or rinse out there that is transparent and credible about their source of xylitol, and it's a source you can trust with your health, I'd love to try it out. (I admit that you can probably say the same thing about any toothpaste you can buy in the US. But those have at least some additional benefits from regulation.)
    - rkagerer 4y ago
      What's preventing you from shipping to Canada, and any plans to expand outside the US in the future?
  - throwaway4837 4y ago
    Those two groups are likely differentiated on diet. For starters, diet can overload your mouth with complex and simple sugars, but diet can also determine the bacterial makeup of your mouth.
    - 13of40 4y ago
      No idea where it eventually led, but I read about work done back in the 80s to vaccinate against the bacteria that cause tooth decay. That suggests that some people might have natural immunity to them.
  - maxerickson 4y ago
    It's also pretty likely that there is variation in enamel formation and hardness (driven by genetic differences).
- bmau5 4y ago
  I was referring to something more along the lines of what the above comment mentions (rebalancing with beneficial bacteria), but there are companies working on something like a dishwasher for teeth, one example is below: https://freshhealth.com/ https://freshhealth.com/
legalcorrection 4y ago
This doesn't sound possible. A big component of oral hygiene is removing the relatively large chunks of food that are hiding invisibly between your teeth. If you leave them there, they will rot and smell bad and cause other issues like infections. You need a physical object like the bristles of a tooth brush and/or floss to physically dislodge the bits of food. That's why every culture developed some way to clean their teeth.
- cheschire 4y ago
  GP did say "replace" but they also said "reduce" so I'm thinking they meant replace the majority of brushing, but probably not all of it. If they had an effective way of removing lettuce from teeth chemically, I'd be afraid of side effects.
  - bmau5 4y ago
    Yes, thank you for catching this. As the comment above pointed out there will still be a need for removing larger food particles and hard to reach areas, but ideally with the addition of the mouthwash/intervention I'm mentioning we could drastically reduce the incidence of oral disease.
- uoaei 4y ago
  It doesn't seem far-fetched to imagine a chewing-gum-like substance which achieves this.
throwaway4837 4y ago
Wouldn't the mouthwash need abrasive particles as well? Part of why Listerine doesn't replace brushing and flossing is because it has a much smaller mechanical component in the washing process. The physical rubbing of bristles and wire through and around the teeth creates the physical abrasion that is necessary to remove large films of plaque. I imagine without any sort of abrasive, the liquid would need to be dangerously strong to remove tougher plaque.
- Retric 4y ago
  Preventing plaque formation avoids the need to remove it. Actually accomplishing that seems unlikely, but not impossible.
  - klipt 4y ago
    A keto diet without sugar or starch should prevent most plaque formation, shouldn't it?
    - Retric 4y ago
      No, a balanced keto diet might be moderately better than a normal diet in terms of plaque, but even wild cats living on a nearly 100% meat diet still get dental plaque.
      - trhway 4y ago
        reminded - our cat was flossing his teeth using the corn broom that we had. He would press the broom with his paw and would byte a fiber close to the broom root and would move his head away so that the fiber would be flossing the teeth, and he would repeat it multiple times flossing different teeth. Still had perfect teeth at 13 when the cancer took him.
  - rhinoceraptor 4y ago
    There has been work done is creating GM S. mutans that don't produce biofilms, and that would replace your native S. mutans. It could be done by just brushing your teeth with a toothbrush treated with the bacteria so it would cost pennies per treatment.
rhinoceraptor 4y ago
Why not just continue the work that's already been done in developing GM strains of S. mutans that don't produce biofilms?
- bmau5 4y ago
  We think this work is fascinating, but S. mutans isn’t the only species in the oral cavity capable of developing biofilms (nor is it the only cavity-causing species). I think this could be a great first step, but we’re currently more focused on how to cultivate our healthy species than bioengineer alternatives (a question of competencies and priorities)
  - canadiantim 4y ago
    What is your company? And have you identified anything you could recommend to help “cultivate our healthy species”?
    - bmau5 4y ago
      My company is Bristle (bristlehealth.com), and we've found several things that look to cultivate healthy species so far. Hygiene plays a huge role (of course), but outside of that diet plays a large role. Cheese/dairy has been found to reduce cavity incidence, high fiber vegetables stimulate saliva production and neutralize acid, and a nitrate rich diet has been shown to increase levels of beneficial bacteria (called nitrate reducing species) that help us produce nitric oxide [2]. There's some exciting research on probiotics [3] as potential interventions as well, particularly if used with a proper hygiene regimen. [1]https://www.bristlehealth.com/post/how-our-diets-can-affect-our-oral-health https://www.bristlehealth.com/post/how-our-diets-can-affect-... [2]https://pubmed.ncbi.nlm.nih.gov/33742692/ https://pubmed.ncbi.nlm.nih.gov/33742692/ [3]https://www.bristlehealth.com/post/a-guide-to-oral-probiotics-and-dental-probiotics https://www.bristlehealth.com/post/a-guide-to-oral-probiotic...
carabiner 4y ago
Do you have much hope that dentists would cooperate in studying this, possibly disrupting the drill-fill-bill model that supplies their income?
simonebrunozzi 4y ago
Interesting. Could you share a bit more, without revealing stuff that you don't want to share in public?

by bmau5 4y ago

Victerius 4y ago

Like a dishwasher but for teeth?

coryrc 4y ago
Some people rarely brush their teeth and never get cavities. Some people brush thrice daily and floss and still get cavities and need root canals. The working theory is we could all be in the first group with the right bacteria in our mouth.
- newscracker 4y ago
  Could it also be about the level of salivation in general, since saliva also helps kill some bacteria and keep the mouth cleaner (relatively)?
  - bmau5 4y ago
    Definitely! Saliva is our best natural defense against cavities (and harmful bacteria), so we always recommend people who have struggled with cavities or dry mouth to consider options for increasing their saliva production, like chewing sugar-free or xylitol gum.
- bmau5 4y ago
  That's it exactly. Some beneficial species play an active role in suppressing the pathogenic species (those that release acid or cause gum disease) and have other benefits including helping us break down dietary nitrate into nitric oxide, which is critical for heart/brain health. My company tests/researches the oral microbiome and we're starting to discover the signatures of what puts people in one group vs. the other, with hopes of helping develop more personalized approaches down the road, but for now helping people understand what will work best for them. Here's my company for anyone who is interested in learning more: https://www.bristlehealth.com/ https://www.bristlehealth.com/
  - comeondude 4y ago
    This is very cool. What’s your take on xytiol gums? Think they’re effective in changing our oral microdiome for the better?
    - bmau5 4y ago
      The initial data on xylitol looks promising for reducing cavities! Particularly for stimulating saliva production (dry mouth is a large contributor to cavities risk) and as a sugar substitute that cavity-causing species can't digest into acid. I'm excited to see more research come out and compare it with our data.
    - jrootabega 4y ago
      I'm also curious about this, but unfortunately I think that's where it will end for me in practice. Even if xylitol is effective, it seems the xylitol you'll get in any products (at least in the US) is going to be industrial byproduct from sketchy unregulated sources, just with greenwashed packaging. If there is a gum or rinse out there that is transparent and credible about their source of xylitol, and it's a source you can trust with your health, I'd love to try it out. (I admit that you can probably say the same thing about any toothpaste you can buy in the US. But those have at least some additional benefits from regulation.)
  - rkagerer 4y ago
    What's preventing you from shipping to Canada, and any plans to expand outside the US in the future?
- throwaway4837 4y ago
  Those two groups are likely differentiated on diet. For starters, diet can overload your mouth with complex and simple sugars, but diet can also determine the bacterial makeup of your mouth.
  - 13of40 4y ago
    No idea where it eventually led, but I read about work done back in the 80s to vaccinate against the bacteria that cause tooth decay. That suggests that some people might have natural immunity to them.
- maxerickson 4y ago
  It's also pretty likely that there is variation in enamel formation and hardness (driven by genetic differences).
bmau5 4y ago
I was referring to something more along the lines of what the above comment mentions (rebalancing with beneficial bacteria), but there are companies working on something like a dishwasher for teeth, one example is below: https://freshhealth.com/ https://freshhealth.com/

legalcorrection 4y ago

This doesn't sound possible. A big component of oral hygiene is removing the relatively large chunks of food that are hiding invisibly between your teeth. If you leave them there, they will rot and smell bad and cause other issues like infections. You need a physical object like the bristles of a tooth brush and/or floss to physically dislodge the bits of food. That's why every culture developed some way to clean their teeth.

cheschire 4y ago
GP did say "replace" but they also said "reduce" so I'm thinking they meant replace the majority of brushing, but probably not all of it. If they had an effective way of removing lettuce from teeth chemically, I'd be afraid of side effects.
- bmau5 4y ago
  Yes, thank you for catching this. As the comment above pointed out there will still be a need for removing larger food particles and hard to reach areas, but ideally with the addition of the mouthwash/intervention I'm mentioning we could drastically reduce the incidence of oral disease.
uoaei 4y ago
It doesn't seem far-fetched to imagine a chewing-gum-like substance which achieves this.

throwaway4837 4y ago

Wouldn't the mouthwash need abrasive particles as well? Part of why Listerine doesn't replace brushing and flossing is because it has a much smaller mechanical component in the washing process. The physical rubbing of bristles and wire through and around the teeth creates the physical abrasion that is necessary to remove large films of plaque. I imagine without any sort of abrasive, the liquid would need to be dangerously strong to remove tougher plaque.

Retric 4y ago
Preventing plaque formation avoids the need to remove it. Actually accomplishing that seems unlikely, but not impossible.
- klipt 4y ago
  A keto diet without sugar or starch should prevent most plaque formation, shouldn't it?
  - Retric 4y ago
    No, a balanced keto diet might be moderately better than a normal diet in terms of plaque, but even wild cats living on a nearly 100% meat diet still get dental plaque.
    - trhway 4y ago
      reminded - our cat was flossing his teeth using the corn broom that we had. He would press the broom with his paw and would byte a fiber close to the broom root and would move his head away so that the fiber would be flossing the teeth, and he would repeat it multiple times flossing different teeth. Still had perfect teeth at 13 when the cancer took him.
- rhinoceraptor 4y ago
  There has been work done is creating GM S. mutans that don't produce biofilms, and that would replace your native S. mutans. It could be done by just brushing your teeth with a toothbrush treated with the bacteria so it would cost pennies per treatment.

rhinoceraptor 4y ago

Why not just continue the work that's already been done in developing GM strains of S. mutans that don't produce biofilms?

bmau5 4y ago
We think this work is fascinating, but S. mutans isn’t the only species in the oral cavity capable of developing biofilms (nor is it the only cavity-causing species). I think this could be a great first step, but we’re currently more focused on how to cultivate our healthy species than bioengineer alternatives (a question of competencies and priorities)
- canadiantim 4y ago
  What is your company? And have you identified anything you could recommend to help “cultivate our healthy species”?
  - bmau5 4y ago
    My company is Bristle (bristlehealth.com), and we've found several things that look to cultivate healthy species so far. Hygiene plays a huge role (of course), but outside of that diet plays a large role. Cheese/dairy has been found to reduce cavity incidence, high fiber vegetables stimulate saliva production and neutralize acid, and a nitrate rich diet has been shown to increase levels of beneficial bacteria (called nitrate reducing species) that help us produce nitric oxide [2]. There's some exciting research on probiotics [3] as potential interventions as well, particularly if used with a proper hygiene regimen. [1]https://www.bristlehealth.com/post/how-our-diets-can-affect-our-oral-health https://www.bristlehealth.com/post/how-our-diets-can-affect-... [2]https://pubmed.ncbi.nlm.nih.gov/33742692/ https://pubmed.ncbi.nlm.nih.gov/33742692/ [3]https://www.bristlehealth.com/post/a-guide-to-oral-probiotics-and-dental-probiotics https://www.bristlehealth.com/post/a-guide-to-oral-probiotic...

carabiner 4y ago

Do you have much hope that dentists would cooperate in studying this, possibly disrupting the drill-fill-bill model that supplies their income?

simonebrunozzi 4y ago

Interesting. Could you share a bit more, without revealing stuff that you don't want to share in public?