A recent article from vice.com pointed out that Tideglusib, a drug typically used to treat neurological issues including Alzheimer’s disease, has shown potential to enhance tooth repair and regrowth of cavities.
The groundbreaking study by King’s College showed that Tideglusib, applied topically to the injured tooth, was successful in regenerating cavities in mice teeth. The ability to regrow, or regenerate missing tooth structure is a breakthrough for dentistry, especially biomimetic dentistry. Biomimetic dentistry is a type of dentistry focused on improving dental restorations by making them more natural and conservative. The Biomimetic approach has a primary goal to make the dental restorations more “life-like”. In this regard, regeneration of tooth structure is the ultimate goal and this study unlocks an exciting new world of possibilities.
How does it work?
Normally, the tooth is able to only regrow a slight amount of dentin in response to an injury, but this is not nearly enough to prevent the need for dental restorations or fillings. Amazingly, this drug works by blocking an enzyme that is normally responsible for stopping dentin growth, glycogen synthase kinase (GSK-3). The King’s College researchers put the enzyme inhibitor on biodegradable collagen sponges, stuck them in subjects’ teeth where cavities had formed, and covered them with a protective outer coating. Over 4-6 weeks, they found the tooth had repaired with natural dentin and the pulp remained vital. As the collagen sponge is degraded over time, dentin replaces the degraded sponge leading to a complete, effective natural repair. This simple, rapid natural tooth repair process could thus potentially provide a new approach to clinical tooth restorations.
The future of dental fillings
Current dental practice for carious lesions (cavities) aims to remove decay and restore the missing tooth structure with various types of fillings or restorations. When large cavities are treated with this approach, the chance of root canals is significantly increased. In the biomimetic approach, maximum conservation of the remaining tooth structure (less drilling) is found to help preserve tooth vitality and avoid root canals. Keeping the tooth alive is one of the major goals of the biomimetic approach, and one of the most important factors to prevent further complications throughout the life of the tooth. Regeneration of tooth structure is the most biomimetic approach and until now, has not been significantly achievable. In the future, we have a very real possibility to treat teeth with the enhanced natural repair process described in this study as follows: first a dentist will be able to apply the drug and collagen plus and then seal the top of the tooth for 4-6 weeks or more to allow the regeneration process to occur. Then after the dentin has regenerated, some sort of surface restoration may still be necessary as the damaged enamel will also need to be replaced and there is currently no way to do so with regeneration. This is a tremendous paradigm shift for restorative dentistry and will really minimize the number of root canals patients will need.
When can I have it?
Further testing is needed, but it may not be so far away. The anticipated dosage needed for repair of human teeth is well below that which has been previously tested to treat Alzheimer’s disease and this may accelerate the approval process. Time will tell. In the meantime, don’t plan on skipping your dental visit quite yet. There is a long way to go before this treatment will be available to the public. Supporting studies and further clinical trials will be necessary to make a conclusion on whether or not this can replace traditional drilling and filling. Nonetheless, this is huge and exciting news for the industry!