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Clearly there’s a lot more to this than what you’re claiming.
Unless you’d propose that all of my current problems are due to conditions while I was child or similar.
I skipped the dentist for 18 years, and during the earlier part of that span I had pretty sparse dental habits. I went in expecting the worst, but I had 1 cavity, and it was shallow enough to be drilled no novocaine. Nowadays I just brush once a day.
Thank you for letting me brag, because the other parts of my body, like heart and lungs, are total shit.
"Guarantees" are not strictly needed. What matters most is whether there is a substantial reduction of future caries, not whether it makes you totally immune to it.
Say, if Lumina/BCS3-L1 "only" reduces cavities by 50%, it is already half as good (arguably) as a drug which prevented 100%. This would already be large progress for such a massive global problem. The article author does not seem to recognize the potential of such a drug.
It's really confusing, and quite tiring.
Yet another example: In early 2020, for a few weeks many news sites claimed that face masks don't help against coronavirus transmission because there was "no evidence" that they did. Of course this wasn't true (the evidence was just limited, and the protection wasn't optimal), and they changed their tone quickly once multiple non-Asian countries started to introduce mask mandates for visiting public places.
There is an existing 'probiotic' that has been around for years and works the same way, and promises the same benefits, as the one described in the article, it is called Streptococcus salivarius M18, there are quite a few studies that indicate it does work to some extent [1]. You get them in the form of lozenges that you put in the mouth while sleeping and they dissolve by themselves, so not a very invasive treatment if one wanted to use it.
[1] https://www.google.com/search?q=Streptococcus+salivarius+M18
That's what the clinical trials and studies on the early adopters are for. There's lots of interesting commentary on the early research, such as Scott Alexander's write-up, that are much better than this article.
Yeah, emphasis on "plain". It's proposed as an addition, not an alternative, to conventonal tooth brushing.
Streptococcus salivarius M18 seems also interesting, but its results in preventing caries are much more limited, from what I can tell. It also has be taken continuously (once per day), instead being a one-time application like BCS3-L1.
Putting my conspiracy theory hat on, the dental hygiene industry in the US is for-profit, like the pharmaceutical, and would rather sell you a treatment than a cure.
I tried to have a dialog with my child's dentist about nano-hydroxyapatite. I was interested in their thoughts about it, not as a replacement for fluoride based therapies, but in addition to them. Rather than having a discussion about the merits of both treatments or discussing any concerns about compatibility, the dentist adopted an attitude that was belittling and made me feel like I was an anti-vaxer. The suggested we could just not do any fluoride therapies at all.
It was very odd and alarming.
That isn't a great sales pitch.
I think this company's latest news is the version of their toothpaste that has fluoride [2] is now FDA-approved for sensitive teeth, so they're going to be able to sell it in the United States specifically labeled to help with sensitive teeth. If you live in Canada or the UK [3], it looks like you can order this now.
Just noticed a blog post on the UK site: Why you shouldn’t over-prescribe fluoride to your patients - https://biomin.co.uk/news/article/why-you-shouldnt-over-pres...
[0] https://news.ycombinator.com/item?id=26669660
[1] https://drcollins.com/collections/toothpaste/products/biomin...
[2] https://biomintoothpaste.com/
[3] https://www.biomin-toothpaste.com/products/biomin-f-75-ml / https://biomin.co.uk/
Been doing this for years and have nearly perfect teeth due to it, flossing, and non alcohol based anti-gingivitis/anti-plaque mouth washing.
Also, people who think fluoride is bad for you or think it's not effective for teeth are exactly the kind of people I'm terrified of paying in the context of developing software. I really wish people would wear their love of homeopathy, and other psudo-scientific bullshit more clearly so they can be more easily avoided.
If I can do that for $250 I don't see why not. They're pretty clear it's not a replacement for brushing. I think of it as preventative care (assuming it is actually safe of course).
20-30 years later and humanity has had precisely zero benefit because of the FDA's simply absurd, technically impossible level of overcaution in this scenario.
It is incredible how much medical innovation is being held back because of these sort of politics. I hope the people that constantly cheer on more regulation or the FDA itself take a look at cases like this and hundreds of other similar cases where companies have simply given up on safe, promising approaches due to the regulatory red tape.
Enabling medical progress is far more important in the long term for our species (and to reduce suffering) than adding the umpteenth killswitch/safeguard for an ostensibly safe medicine.
But FDA regulators have no incentive in the positive direction, only in the negative direction. The more drugs they deny, the less likely they can be blamed if something goes wrong; the more requirements they add, the more secure their careers - humanity's medical progress be damned.
Go take it to some other country if the FDA is the problem.
Why didn't that happen here for many decades?
There was a slight, statistically significant decrease in cavities. That's meaningful at the population level, but at the individual level you're better off just using mouthwash or flouridated toothpaste.
Source? The article says something else.
It’s not even a question of whether it would spread, but whether it might spread. There’s a reasonable chance that this bacterium would, in fact, spread, and nobody has proven otherwise.
The FDA is doing its job here: it’s protecting the masses from people who believe they’re just consenting for themselves.
We should all be quarantined, all the time, by this criteria. Regulatory bodies have a great cognitive bias towards fictional 'purity' of systems that are in actual scientific fact, messy and routinely contaminated in various ways.
“So to start, they’ll be selling Lumina in Prospera, a libertarian charter city in Honduras. Prospera allows the sale of any biotech product under an informed consent rule: as long as the company is open about risks and the patient signs a waiver saying they were informed, people can do what they want.”
https://www.astralcodexten.com/p/defying-cavity-lantern-biow...
More generally, am highly skeptical of this whole genetic modification drive for replacement of undesirable creatures like mosquitos and screw worms and now bacteria. Sure, sounds like a great idea and may work for the advertised benefits, but look who's funding it and how keen they are on developing vectors to human blood and what other tampering may occur that would be undetectable to anyone without millions of dollars of sequencing equipment. It fits in with the biosynthetic technology drive towards transhumanism alongside nanotechnology, worth researching before jumping on the "Homo Deus" bandwagon that paints us as 'hackable animals' whose soul is due to be extinct (quoting the top transhuman posterchild N. Harari). Worth deeply investigating the other side of the story, most clearly outlined by Prof. Anita Baxas, but also see Dr. Edward Group, Dr Ana Mihalchea, Karen Kingston and Dr. David Nixon.
There’s a good chance all it’s doing is rinsing away or diluting existing acid.
I tracked down the chain of citations here. The directly cited article (https://www.nature.com/articles/sj.bdj.2018.81) says the following:
"These caries ecological concepts have been confirmed by recent DNA- and RNA-based molecular studies that have uncovered an extraordinarily diverse microbial ecosystem, where S. mutans accounts for a very small fraction (0.1%–1.6%) of the bacterial community implicated in the caries process.[20]"
Note the sudden conversion of "implicated in the caries process" to "cause caries".
The next step in the citation chain is https://www.cell.com/trends/microbiology/abstract/S0966-842X....
"In recent years, the use of second-generation sequencing and metagenomic techniques has uncovered an extraordinarily diverse ecosystem where S. mutans accounts only for 0.1% of the bacterial community in dental plaque and 0.7–1.6% in carious lesions[14,15]."
Now the claim is merely one of prevalence!
The next steps in the citation chain, https://karger.com/cre/article-abstract/47/6/591/85901/A-Tis... and https://journals.plos.org/plosone/article?id=10.1371/journal..., do seem to plausibly provide evidence that there are other mouth-colonizing bacteria which would perform the same function as S. Mutans when it comes to causing caries, such that fully eliminating S. Mutans probably wouldn't eliminate caries entirely.
But, importantly, the citation in the McGill article doesn't much support the original claim, and this citation chain could easily have bottomed out in a completely different set of results which didn't happen to lend some (weak) evidentiary support to the high-level claim.
Also importantly, this article is committing the sin of figuring out some reasons why a treatment might not be perfectly effective in all cases, and implicitly deciding that justifies ignoring any non-total benefits (i.e. cases where S. Mutans would have been counterfactually responsible for causing caries, that could be prevented). Questions that would have been appropriate, but were apparently uninteresting:
"Does this intervention also happen to chase out other acid-producing bacteria that fulfill a similar ecological niche as S. Mutans?"
"What percentage of caries cases would be prevented by chasing out just S. Mutans with this intervention, while leaving other acid-producing bacteria untouched?"
Likely this is because answers to those questions would not really have changed the bottom line. That bottom line was written by the "unanswered" safety concerns (reasonable in the abstract, less obviously reasonable in this specific case). All of the listed safety concerns have evidence pointing in various directions. Very little of that evidence is listed, probably because it's not in a format that's legible to scientific institutions. The article does note, earlier on, "The toxicity of this Mutacin-1140 compound had not been tested. What would be the consequences of millions of bacteria in the mouth releasing this compound? The answer wasn’t clear, even though the archetypal compound in the family Mutacin-1140 belonged to was known to be very safe." This is obviously relevant evidence about the safety of Mutacin-1140. _How much_ evidence? Unasked, unanswered. (I have no idea how predictive the safety of other compounds in the same family is of another unstudied compound in that family, I'm not a biologist. But this is not an _unanswerable_ question.)
(Marginal conflict of interest: I know the Lumina founder socially. I have no financial interest in that venture or any of his other ventures. I have not taken Lumina myself.)
Why not just let people experiment on their own with the original low acid bacteria if they want? It’s already there in the wild. You’re already “painting your teeth” with different bacteria when you kiss people, so why not at least let some people pick which naturally occurring bacteria they can expose themselves to instead of letting it happen by random chance?
A lot of the hype about Lumina seemed to be goofy, but the hand wringing over “painting your mouth with bacteria!” is just as bad if not worse.
I think you're confused about which changes to the bacteria were natural and which were engineered. A strain in the wild was discovered that produced a weak antibiotic that it had also developed a resistance to, but it still had the original metabolic pathway that produced lactic acid. Researches took that strain and genetically modified it to produce ethanol instead of lactic acid, and then relied on the natural antibiotic-related mutations to get this strain to replace common S. Mutans in the oral microbiomes of test subjects.
The useful non-acidic property of the strain is entirely artificially introduced. The natural mutation in the wild just allowed for outcompeting and replacing bacteria that lack it. There would be no benefit from personally experimenting with the natural non-engineered strains.
That was after they decided it needed to outcompete the existing bacterium and added a mutagen to kill it off.
Like sure that won't answer all questions, but it seems like it would shed some light on if other bacteria cause cavities or not, and if nothing else a basic starting point.
Also, the New York Times magazine had a piece on the Prospera island in Central America last weekend, was interesting as well. Supposed to have fewer regulations but the previous government is trying to reclaim it.
https://www.nytimes.com/2024/08/28/magazine/prospera-hondura...
And all my teeth aches are gone, one less problem to worry about.
This matches reports by others that K2 seems to pull calcium out of your saliva and into your gums/teeth where it should be and makes them stronger. Maybe. It does seem to keep teeth more "squeaky clean".
The word “cause” seemed to be doing a lot of lifting
how are you going to make any progress if you block research and experimentation consistently into areas that conveniently line the pockets of the state-protected dental guild?
