The World Health Organization estimates that 20% of people worldwide (over a billion people) are affected by dental trauma at some point in their lives. Sustaining trauma to the mouth often results in tooth loss, affecting approximately 150 million adults currently, with more than 10 million new cases expected during this decade.
Tooth loss can affect a person’s ability to eat, smile, and speak with comfort and confidence. People experiencing damaged or missing teeth often feel a profound loss of dignity and fear of social situations, affecting their overall physical and mental wellbeing.
Unlike many animals and fish, adult humans typically can’t regenerate teeth if they lose them.
Scientists are changing that.
But first, it helps to understand how we treat tooth loss today.
Treating Tooth Loss Today
The current state-of-the-art process for treating tooth loss involves using titanium dental implants, which was first discovered in 1965 by Swedish physician Dr. Per-Ingvar Brånemark to be a viable solution for replacing lost teeth.
The discovery of dental implantology was a fantastic biomedical breakthrough in its own right, providing millions of people with the chance to replace a missing tooth with an artificial one, even to this day.
The metal implant process involves drilling a hole into the patient’s jawbone and screwing a metal implant in the socket. The patient then waits several months to a year for the titanium screw to integrate with the jawbone, a process called osseointegration.
Metal dental implants have many well-deserved, perceived benefits and downsides. They are, in most cases, the most appropriate option for replacing lost teeth.
But every technology has its risks and downsides.
If osseointegration succeeds, the dentist places a prosthetic crown on top of the implant. But if it fails, then the patient has to go through the whole process again.
Even if it succeeds, the metal implant can fail for several reasons later on in the patient’s life. One main reason is that metal implants, made entirely from non-biological materials, don’t seem to preserve the biological tissues that support and maintain a natural tooth.
Like any other natural tissue or organ, teeth depend on a complex vascular network that supplies nutrients, keeping them alive and healthy. Metal implants do not need nutrients, therefore blood vessels, so the body takes it all back. As a result, critical supporting tissues like the bone tend to degrade over time, causing the metal implant to fall out.
But what if it doesn’t have to be this way?
The current metal implant treatment for tooth loss can be costly, lengthy, and often require additional procedures throughout the patient’s life. This process can be financially and emotionally draining for the patient, adding to the already traumatic experience of losing teeth.
Tooth replacement technology itself has remained essentially the same for over half a century. Relatively recent advancements in bioengineering and developmental biology research have changed all of that.
A Whole New Way to Treat Tooth Loss
Scientists have made great strides in regrowing teeth biologically over the past few decades.
Biotooth, as is referenced in the scientific literature, describes the laboratory process developed and tested in animals that produce living, functional teeth using stem cells, along with the power and understanding of developmental biology and bioengineering.
The ultimate aim of Biotooth research is to create a widespread clinical treatment for people experiencing tooth loss based purely on biology.
Imagine going to your dentist and having the option to regrow a natural, living tooth in the lab to replace the one lost to disease, injury, or plain bad luck.
That’s the scenario that Biotooth research is aiming to achieve.
How Does Biotooth Work?
One of the leading Biotooth methods involves using the basic principles and understanding of how teeth develop naturally in the body.
First, let’s understand how teeth develop naturally.
Teeth develop following a complex process involving two cell types: epithelial and mesenchymal cells.
The epithelium is tissue made up of cells (epithelial cells) packed tightly together. It is responsible for covering or lining various bodily surfaces and cavities.
The mesenchyme is tissue made up of loose cells embedded in a collection of proteins and fluid called the extracellular matrix. The mesenchyme is directly involved in forming most of the body’s connective tissues, such as bones and cartilage.
The interactions between mesenchyme and the epithelium are responsible for forming nearly every organ in the body, including teeth.
Their interactions include exchanging various cellular signals back and forth, directing each cell to develop into a specific organ.
In this case, these two cell types mutually induce each other to follow the process of tooth development and become teeth instead of some other organ. This mutual crosstalk continues throughout tooth development, resulting in a fully formed tooth.
The interaction of these two cell types (epithelial and mesenchymal) is essential for proper tooth development.
Ok, now with that basic understanding of how teeth develop in the natural setting, let’s explore how these principles apply to the Biotooth process.
Scientists start with two cell populations, following the natural process. The difference is that these cells are taken from the animal host’s body and isolated in the lab.
One cell population has tooth-inducing instructions, which involve initiating and sustaining the process of growing a tooth. The tooth-inducting cell population can be either mesenchymal or epithelial. What matters is that it contains tooth-inducting properties.
The other cell population receives the tooth-growing signals and responds by developing into a complete tooth.
Scientists combine the two cell populations in the lab. The cellular signals fire back and forth nonstop to produce a tooth primordium, the earliest stage of a developing tooth.
Scientists then take this tooth primordium from the lab and transplant it into the jawbone of an adult animal by placing it in a small pocket in the gums made via a surgical incision.
Now, here’s the incredible part: the tooth primordium continues to grow into a fully functional tooth in the jawbone, just like in the natural tooth development process.
According to Further Health’s interview with Dr. Paul Sharpe, a pioneer in Biotooth research and the head of the Department of Craniofacial Development and Stem Cell Biology at King’s College London,
A significant advantage of the Biotooth process is that an implanted Biotooth primordium develops into a whole tooth that includes new bone and ligament tissue. This new bone tissue is essential for tooth root development and periodontal ligament formation, crucial to the health of natural teeth.
“Once [the cells] start making this tooth in the mouth, they don’t stop. They just carry on, and they do the whole process,” Dr. Sharpe explains, “The teeth erupt; they make new bone. Bone that attaches the tooth and they make a ligament. So they do exactly what they would normally do within a different context, essentially.”
As a result, we can use Biotooth in clinical situations of extreme bone loss where current metal dental implants and bone grafts are not possible. The Biotooth alternative would be a 100% natural tooth organ replacement that maintains the connections with bone via a periodontal ligament and will not be prone to the same failures as traditional metal implants.
The supporting dental tissues like the blood vessels, nerves, periodontal ligament, and bone would also regenerate and live on, unlike metal implants.
All animal experiments, so far, show that Biotooth is an effective solution to replacing lost teeth.
Biotooth Going Forward
The oral healthcare world needs better and more effective therapies and is long due for significant technological advancement.
Biotooth research has made tremendous progress in the past several decades, making it possible to regrow teeth biologically using stem cells.
Significant scientific and funding challenges need to be solved first to make Biotooth more scalable and applicable to humans if the goal is to turn it into a clinical treatment within our lifetime.
However, despite the remaining challenges, we are now closer to translating Biotooth to humans than we were just over a decade ago. Propelling Biotooth research forward could be the catalyst in reaching a new standard in oral healthcare.
Biotooth will significantly reshape oral healthcare and push the field towards a more regenerative biological approach, offering the hundreds of millions of people currently experiencing tooth loss a whole new way to restore smiles.