Trials Begin For Lozenge That Rebuilds Tooth Enamel

For all the cool regenerative tricks the human body can do, it’s kind of weird that we only have one shot at tooth enamel with no way to get it back. That may be about to change, as researchers at the University of Washington have developed a lozenge that rebuilds this precious protective coating a few microns at a time and are taking it to the trial stage. Could it really work? It’s certainly something to chew on.

The lozenge uses a genetically-engineered peptide (a chain of amino acids) derived from a protein that’s involved in developing enamel in the first place, as well as with the formation of the root surface of teeth. Inside the lozenge, this peptide works alongside phosphorus and calcium ions, which are the building blocks of tooth enamel. It’s designed to bind to damaged enamel without harming the gums, tongue, or other soft tissues of the mouth.

The researchers have already verified the efficacy on teeth extracted from humans, pigs, and rats, so the trials will largely revolve around comparing it to other whitening methods and documenting their findings.

One added advantage is that the new enamel the lozenges produce is really white, because it’s brand new. These lozenges sound like an all-around great solution, especially compared with traditional whitening techniques that often make enamel weaker. The researchers are also developing an over-the-counter toothpaste and some kind of solution for hypersensitivity, which is right up our alley.

We are skeptical of course, because nothing in history thus far has been able to regenerate enamel. Then again, yours truly uses toothpaste with nano-hydroxyapatite, which is touted as a non-toxic version of the same mineral that makes up teeth and bones. Skepticism abounds with that stuff, too, although my grill looks better to me. But why settle for new enamel when you could regrow entire teeth?

Main image by Eric Moreau and thumbnail image by Kevin Bation via Unsplash

48 thoughts on “Trials Begin For Lozenge That Rebuilds Tooth Enamel

    1. The drill removes decayed dentin, that has a consistency like chalk and won’t stick to the filling material; otherwise it’s a bit like painting on rust. They stop cleaning a spot as soon as they see healthy tissue.

      1. For those who have been reading HaD from the beginning, we know, it has always been one of the charming quirks of this site. The readers are the beta testers and proofreaders. Personally I quite like it. I’ve often wondered if it’s intentional for recruitment or some sort of puzzle or long running code game nobody talks about.

  1. If this turns into a product, I wouldn’t be surprised if someone figures out a way to permanently dye the newly deposited enamel, maybe by having a colored candy in the mouth at the same time.

    1. That could be interesting.
      Also, who said the enamel must be within one’s mouth in order to be deposited. Or even tooth shaped. Maybe powdered teeth on a flat sheet. Perhaps it could be performed in a jar. Deposit, laser etch, dye, deposit. It could be interesting for an art project.

  2. Having a hard time believing that tooth enamel is a one-shot thing. They thought brain cells were similar and that wasn’t the case. Sorry but extremely paranoid about such claims ie. profitability-by-fear.

    1. Of course, it’s a conspiracy by Big Drill! It all makes sense!

      Or, one could take 5 seconds typing “why enamel doesn’t regenerate” into That Search Engine and be met by the very first excerpt:

      “It cannot regenerate itself, because it is formed by a layer of cells that are lost after the tooth eruption.”

      Or, ask someone who went to dentist school.

    2. I’m a dentist, working in a nonprofit clinic so I’m not part of any conspiracies or venture-capital-nationwide-chain-over-treat / loan sharking operations. Yes, enamel on the teeth is a once-only type of thing. Fluoride doesn’t regrow enamel (it’s also NOT a communist conspiracy to destroy the purity or our essence) but makes it harder and more impervious to decay.

      There’s no such thing as “soft teeth” and you didn’t inherit them from your parents who were in dentures when they turned 30. What does get passed from one generation to the next is ignorance. If your parents had dentures in their 30s, it’s because they didn’t take care of them, probably because no one taught them how, and they probably didn’t teach you how to do it. Even if there was such a thing as “soft teeth”, that would not be a reason for you to neglect your teeth. It would be a reason to be extra diligent about taking care of them. You know what? It’s not hard. Brush at least twice daily, preferably with an electric toothbrush (even a $5 spin brush is better than a manual brush), and floss at least once daily. Have your teeth professionally cleaned at least yearly. That will prevent 99% of dental problems for 99% of people.

      I have seen many people put off professional dental care citing “I didn’t have insurance” as a reason. You don’t need dental insurance. You need to take care of your teeth. ADA studies have found that people with dental insurance spend as much on the insurance as they would have on dental care without insurance. The damage to neglected teeth is not reversible. Tooth decay, like rust, never sleeps. If you don’t get things fixed as soon as they are a problem, they get worse. Like your car, maintenance is always cheaper (and less uncomfortable) than repair. Unlike your car, some dental problems can’t be repaired.

      The one thing I would like to be able tell my neglectful patients is “FFS, BRUSH YOUR DAMNED TEETH!” Coming to see me to fill cavities and extract teeth is not a substitute for self care.

      1. If you truly think that genetics has little to do with tooth decay, and that simply brushing your teeth will solve 99% of these problems, then please consider an immediate early retirement. The medical community will be better off without you.

        1. s/he didn’t say that genetics has little to do with tooth decay, s/he said that there is no such thing as “soft teeth”. There are people who have genetically “better” teeth than average, able to withstand more mistreatment before having problems, and there are people whose teeth are genetically less able to withstand mistreatment before decaying. What there are NOT is people whose teeth genetically just decay without some underlying cause.

        2. I didn’t say there’s no genetic contribution, but it is disproportionately used as an excuse for poor dental health, especially by people with poor self-care habits.

          There are inherited diseases, such as diabetes, that contribute to tooth decay. The mechanical positions of the teeth also contribute to certain problems (position problems in adult teeth are often – but not always- a result of inadequate care and premature loss of primary teeth) as well. Some people have physical disabilities that render them unable to adequately care for their teeth, too.

        3. I am 74 years old and have never had a cavity in my adult teeth. I have had cracked teeth (using them as pliers on metal nuts, etc.) and have about four caps from that, but never a cavity. My father died at 71 and he never had a cavity either. I believe I received a genetic gift from him. A few things helped. I don’t have much of a sweet tooth. I have never eaten meat and have been a vegan most of my life. But I am not a particularly good tooth brusher and have never been a flosser as my wisdom teeth are so far back I can hardly reach them. So I believe in genetics.

      2. >it’s also NOT a communist conspiracy to destroy the purity or our essence

        But adding fluoride to drinking water is just as likely to result in fluorosis for people who already have enough from their diet and otherwise, which ironically does make for “soft teeth” by making the enamel more porous and weaker. Almost a quarter of people have some level of fluorosis, which appears as small flecks or white patches on the teeth.

        1. You have it backwards- not softer, but harder and more resistant to decay. From the ADA:

          “Fluorosis isn’t a disease and doesn’t affect the health of your teeth. In most cases, the effect is so subtle that only a dentist would notice it during an examination. The type of fluorosis found in the United States has no effect on tooth function and may make the teeth more resistant to decay.”

          Fluoride was originally discovered to be useful for preventing decay when some groups of people who drank from wells that were naturally high in fluoride were found to have minimal tooth decay.

            “Dental fluorosis is a common[2] disorder, characterized by hypomineralization of tooth enamel”
            “Enamel hypocalcification is a defect of tooth enamel in which normal amounts of enamel are produced but are hypomineralized. In this defect the enamel is softer than normal.”

            The affected areas are more porous than normal, so the teeth stain more easily as well. In severe cases, the teeth become mottled, pitted and brown.

          1. Look – who’s profiting off of bleaching stained and blotched teeth on people suffering from fluorosis? Of course they’re going to say fluorosis is not a problem and please just keep adding fluoride to drinking water. The ADA is not a government organization, it’s not a public advocacy organization, it’s a professional association that furthers the business interests of dentists.

            And they’re both technically right – mild fluorosis can make teeth somewhat more resistant to decay by bacteria (also stated by wikipedia), it is technically not a disease (obviously), and in mild cases it’s just a cosmetic issue. At the same time the hypomineralization does make those parts of the enamel mechanically softer and more porous.


            >”Long-term ingestion of excess fluoride in infancy and childhood, when the teeth are being formed, can lead to dental fluorosis (…) A more recent analysis of NHANES data in 2001–2002 and 2011–2012 found that rates of dental fluorosis (from very mild to severe) increased during this 10-year period, from 29.7% to 61.3% [43].”

            More and more people are getting too much fluoride, beyond what is needed to help with dental caries, with over half of the average intake coming from drinking water.

      3. Well since you’re a dentist I have a question, if someone has a tiny cavity and they start taking this stuff and the enamel grows over it could bacteria trapped under the new enamel cause an infection? You know how a cat bite can heal over but the bacteria inside give you a bitch of an infection?

        1. An excellent question! The dentin under the enamel is much soften than the enamel, so once a small hole is made in the enamel, the decay spreads rapidly under it. If you close up the hole, you don’t stop the decay. The affected dentin has to be removed before you close up the enamel with a filling or new enamel from this treatment.

          I don’t see how this would reverse decay that has reached the dentin, so I would think you would want your teeth to be cavity free before using it. It may be that the new enamel only attaches to existing enamel, and may not bridge over a hole in the enamel, but we won’t know until it is thoroughly tested. I suspect this as more of a cosmetic treatment that might help prevent decay, but won’t stop existing decay. We’ll have to wait for the test results…

          1. Thanks for the answer, I worry that “micro” cavities (those that a dentist can’t see but are still more than large enough for bacteria) will be healed over causing internal infection. As you say though we’ll have to wait for the test results. And if worse comes to worst and cavities are a thing of the past you can get a job working a jackhammer. :)

      4. The moment you got LPR/GERD, you screwed up. Enamel wears off over the years, no matter how you brush your teeth or floss and rinse with soda water. You can forcefully stop the process of enamel destruction from bulimia, but LPR there is a chance that even surgery won’t help or will make things worse. I hope that future generations will receive help from regenerative dentistry, I don’t count on help for myself, considering how slow the progress in this direction and the lack of good funding.

      5. It’s not just brushing…
        I brush my teeth manually once a day and do not spend much time doing it, but I floss after eating anything. As a child I suffered from tooth decay because of bad dental care and too many sweets. I rarely eat sweets these days. I rarely suffer decay, but if I do it’s usually due to loose fillings. My dentist regularly tells me my teeth are exceptionally clean. I put this down to 2 things; I use a hard toothbrush to ensure I can get between the teeth well (most are soft these days) and the regular flossing.
        BTW, if I have not flossed properly, the next time I floss, I notice the smell of rotten food on the floss, when I get into some of the more difficult to get into tooth gaps.

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