Dental caries is more commonly known as tooth decay, caused by the breakdown of tooth enamel【1】. It is also the most prevalent condition in the 2015 Global Burden of Disease Study, ranking first for the decay of permanent teeth (2.3 billion people)【2】. More than 530 million children suffer from dental caries of primary teeth (milk teeth)【3】.
The tooth breakdown occurs due to a common chronic disease that has infected nearly half of the world's population. The later stage of dental caries may lead to symptoms such as pain, swelling, and inflammation. The infection at a higher stage affects the daily life routine, e.g., eating, speaking, and challenging to get proper rest and sleep. Severe dental caries causes pain in the mouth and has adverse effects on the digestion, chewing, and systemic system of the gastrointestinal tract.
Tooth decay seriously affects many aspects of daily life routine. Through investigation, we find that the following methods that are currently used to prevent caries【4】:
Due to the problems associated with the above-mentioned anti-caries methods, we have proposed a new approach to prevent dental caries through synthetic biology.
By consulting the relevant literature, we knew that Streptococcus mutans(S.mutans )was the main pathogenic bacteria of dental caries and was a facultative anaerobic gram-positive bacteria found in the oral cavity and in the dental biofilm. Thus, our team decided to choose S.mutans as our treatment target to prevent dental caries. Current approaches to inhibit S.mutans to form biofilms are using mouthwashes with broad-spectrum antibiotics , antimicrobial agents and natural products .However, the majority of these compounds do not exhibit high selectivity, affecting both pathogenic species and commensal beneficial species, and give rise to undesired side effects such as vomiting, diarrhea, addiction, or teeth discoloration.
Our PI Tang has been studying antimicrobial peptides(AMPs) for many years and suggested us to apply AMPs in preventing dental caries. After consulting the literature, we know that AMPs have the advantages of good antibacterial activity, low cytotoxicity, and resistance to tolerance and are promising candidates for development of novel alternative antibiotics .The testing results showed that antimicrobial peptides had an excellent antibacterial effect on the pathogenic bacteria of teeth S.mutans. Therefore, we determined to use antimicrobial peptides produced using synthetic biology to kill S.mutans to prevent dental caries.
On the other hand, most people rarely pay attention to dental care in daily life, leading to diseases like dental caries. People generally seek medical attention after the formation of a cavity or when the symptoms appear, e.g., pain or inflammation. At later stages, the infection developed into deep caries and pulpitis. We believe that early detection is also the first way to prevent the deterioration of dental caries.There are several detect method in hospital such as visual examination, temperature test and X-ray film.But these measures are insufficient and the cost is high【5】.
The regular checkup and timely diagnosis of dental caries help avoid severe infection that can lead to expensive treatment. As the above mentioned , S.mutans is the main pathogen of dental caries. For this reason, the dental caries can be diagnosed by detecting S.mutans in oral cavity. The current methods for detecting S.mutans mainly include traditional bacterial culture,PCR and ELISA.However,these methods require special equipment and only be used in hospital. In our plan ,we tried to find synthetic biology treatment's effectiveness for the timely diagnosis of dental caries at community hospitals, small clinics and home. After browsing the wiki of the CCU team in 2017 and the wiki of the MIT team in 2018, we found that dental caries can be detected through the quorum sensing signaling system of S.mutans. Based on the project of CCU and MIT , we designed an E.coli detector to detect the specific severity of dental caries using naked-eye inspection. The project aims to create a user-friendly system so that anyone can apply and use the detection kit for self-inspection.
Because of the current situation of dental caries and existing techniques, the given approach proposed a new mechanism for preventing and diagnosing dental caries. The system design includes the following three parts:
- Prevention
- Detection
- Safety mechanism
For details, see the link below ...
To implement our project in the real world. we developed a chewing gum that can prevent dental caries with expressed AMP or synthetic AMP probiotics. We also tried to implement the practical application of the E.coli detection system to prevent dental caries. Corresponding to the E.coli detection system we have developed a detection devices which can be used at community hospitals, small clinics, and even home for point-of-care testing (POCT).
For details, see the link below ...
Reference
- Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet. 2007 Jan 6;369(9555):51-9.
- WHO.Sugars and dental caries.9 November 2017.
- WHO.Oral health.25 March 2020.
- Philip N, Suneja B, Walsh LJ. Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth? Caries Res. 2018;52(1-2):153-165.
- Farkash Y.,Feldman M.,Ginsburg I.,et al.Polyphenols Inhibit Candida albicans and Streptococcus mutans Biofilm Formation.Dent J (Basel). 2019 Jun; 7(2): 42.
- Gomez J. Detection and diagnosis of the early caries lesion. BMC Oral Health. 2015;15 Suppl 1(Suppl 1):S3.