Tougher Teeth Coming

After gazing into many a U.S. mouth, the American Dental Association estimates that the country is afflicted with one billion unfilled cavities, five per head. It adds that 26 million Americans have lost all their teeth, while 80% of those over the age of 15 have some form of periodontal disease attacking the tissues that support the teeth. Worse, dental problems are proliferating faster than dentists can treat them.

Obviously, the American mouth is a disaster area. Dentists are quick to blame public indifference, and with some reason. If Americans used toothbrushes and gum stimulators properly, dental diseases could be sharply reduced. But as Tufts University's Dr. Irving Glickman told the Fourth Annual Workshop on Preventive Dentistry in Washington last week: "The public is apathetic, but our apathy makes the public's look small." Adds Harvard Orthodontist Herbert Wells: "Except for the introduction of high-speed drills, nothing much has happened to dental technology since the '30s."

Into the Labs. Last week's workshop demonstrated that professional apathy has begun to wane. In the universities and in the National Institute of Dental Research, most of the focus is on periodontal disease, which actually claims three times as many teeth as do cavities when people are past 35. To date, the main preventive treatment has been regular cleaning to remove the bacteria-containing film and tartar. Within two years, several commercial firms may be marketing new anti-periodontal-disease products in the form of toothpastes and mouthwashes.

Also on the way are new methods to prevent tooth decay. Rochester Dentists Eriberto Cueto and Michael Buonocore recently cut decay by 86% among 269 young patients by applying a thin plastic coating twice yearly to tooth surfaces. In upstate New York, an NIDR researcher cut decay by 80% among 500 children who wore mouthpieces treated with sodium fluoride for six min utes of each school day for two years. By contrast, mass fluoridation of water reduces decay by about 65%. Using a self-administered prophylactic paste, Annapolis midshipmen were able to cut their incidence of cavities by 93%. The NIDR is also supporting a study in a Colombian village where fluorides are being added to common table salt. All these methods could be used in areas where water fluoridation is impossible.

Barnacles & Baboons. Dental researchers have not ignored improvements in treatment. In another NIDR study, Dr. Nathan Cardarelli has been analyzing barnacle cementum with the idea that a similar synthetic substance might provide an almost indestructible tooth filling. Dr. Robert Hoffman of the Waldemar Medical Research Foundation has demonstrated for the first time that a metal can be welded firmly to dental enamel by ultrasonic vibrations. He hopes to use that method to replace missing teeth and damaged tissues. Working toward the possibility of a "tooth bank," the NIDR Dr. Paul Baer has already nurtured teeth in the yolks of incubating eggs. No one has found a way to transplant teeth from one person to another, but it soon may not be necessary. In 1965, a group of Brown University scientists were able to implant plastic teeth in baboons; the teeth are still firmly rooted, despite constant gnawing on cage bars.

To ease dentists' backaches and patients' distress, researchers are also overhauling the traditional dentist's office. Here and there, the standard straight-back chair is being replaced by a sculptured chaise longue that enables two people simultaneously to perform "fourhanded" dentistry in and around the mouth. To eliminate glare, Tufts dentists are also experimenting with pencil lights mounted on the ends of instruments. To illuminate the mouth, another light is attached to a flexible cable plugged into special eyeglasses that are worn by the patient. As Harvard's Dr. Wells sums up: "The technological revolution is finally coming to dentistry."

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