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Skipping the Drillings and Fillings

A visiting professor and international researcher involves UNLV dental students in studies that address new methods for treating cavities among children.

Research  |  Aug 24, 2018  |  By Kevin Dunegan

As a practicing dental specialist in the United Kingdom, professor Edward Lynch has never been fond of giving injections, especially to younger children. Since injections are so often part of cavity treatment, Lynch wondered, could he hold back the needle and drill by finding a new way to repair those pesky little holes in kids’ teeth?

The answer is yes, and his solution changed dental practice in many countries—and saved parents a bit of money to boot.

His method uses pharmaceutical agents like ozone to both kill cavity-causing microorganisms in children’s mouths and encourage teeth to heal themselves. Although this treatment is not yet available in the United States, UNLV dental students have been reviewing relevant literature and, under Lynch’s mentorship, evaluating the related research. Here, he explains his research further.

How did you come to focus on children’s cavities for this research?

The American Academy of Pediatrics considers early childhood cavities the No. 1 chronic disease affecting young children. Cavities are a chronic condition five times more common than asthma and seven times more common than hay fever among children. And cavities are a major oral health problem in most industrialised countries, affecting 60 to 90 percent of schoolchildren.

What other risks are associated with cavities?

Treating cavities is expensive, invasive, and time-consuming. The cost of restoring children’s teeth when they’ve been afflicted with early childhood cavities can exceed $1,000 per child. And young children often require general anaesthesia, sedation, and restraint prior to procedures and multiple extractions because they’re afraid, which not only increases the stress for the child, parents, and dentist, but also increases the treatment cost to around $6,000 per child.

Early childhood cavities also result in higher rates of hospitalization and emergency room visits. Nearly 20 percent of all dental emergency visits are attributed to early childhood cavities.

Untreated cavities can affect a child’s ability to eat. Studies have shown that children with early childhood cavities are at risk of weighing less than 80 percent of their ideal weight, fitting into the “failure to thrive” criteria. Cavities in baby teeth have been cited as a major risk factor for future dental cavities in permanent teeth as well. And in today’s world, the prevalence of cavities within baby teeth is on the rise.

What upsets me most is having to treat tiny children with abscesses, many of whom require general anaesthesia in hospitals to extract their teeth. When baby teeth are lost too early, the surrounding teeth may drift into the empty space. This movement can cause teeth to be crooked or crowded, which leads to a need for an expensive orthodontic treatment down the line.

And left untreated, cavity-related lesions can lead to expensive treatments, disruption of growth and development, pain, and life-threatening infections.

All this, when cavities are 100 percent avoidable.

Can you tell us a bit more about the solutions you’ve found through your research abroad?

In the U.K., I’ve focused on finding simpler, pharmaceutical-based methods aimed at eliminating the cause of dental diseases in the first place. I’ve tested fluoride at high levels as well as silver diamine fluoride, chlorine dioxide, hydrogen peroxide, carbamide peroxide, peroxoborate, and ozone.

My research in the U.K. found that ozone, an energy-rich and highly unstable form of oxygen, is most effective at eliminating causes of dental diseases. This is because healthy mammalian cells have antioxidant enzymes in their cell membranes that protect them from being oxidized, or destroyed by ozone. In contrast, pathogens like bacteria, viruses, and yeasts have little or no antioxidant enzymes in their cell membranes. This makes them vulnerable to oxidants like ozone, which damage the microbial cell walls and membranes of pathogens but leave no toxic byproducts as some other antimicrobials do.

How is this research making its way to the international dental care market?

I’ve secured multiple patents for my pharmaceutical-based treatment methods. One invention, for example, has been used to create the healOzone machine, which converts oxygen into ozone gas for disinfection and treatment purposes. The hardness of open, shallow, single-surface cavities improved following ozone treatment through healOzone, reflecting a remineralization process, or healing, of the tooth. The device is used around the world except in the United States; offers a highly-effective, pain-free treatment of cavities; and improves patients’ quality of life.

I recently published five studies about using advanced oxidative processes—wherein other chemicals or elements combine with oxygen—involving combining ozone and hydrogen peroxide. Our most recent clinical trial findings found that the hydrogen peroxide and ozone combination did not result in tooth sensitivity, while hydrogen peroxide used alone did increase sensitivity.

How are UNLV dental students involved in this research?

UNLV dental students have assisted me in analyzing publicly available data from double-blind clinical trials about ozone and related agents that could become part of care in the United States for treating cavities. They have also conducted critical systematic literature reviews and evaluated the objections to using ozone for treatment purposes.

While students and faculty can review published literature about a plethora of topics, having access to a study’s primary investigator is rare. These experiences could further shape the students’ approach to scholarly work and inspire them to pursue research opportunities as professionals.

One of our UNLV dental school students, Larry Hon, is completing a systematic review of the best ways to monitor and measure success when using our methods to manage cavities, which we plan to publish later this year. UNLV dental student Alice Trieu is completing her systematic review on the roles of silver diamine fluoride and fluoride varnishes to manage and prevent cavities in underserved children and older adults. We aim to publish the review this year as well.

What’s on the horizon for you and your students?

Our next steps include securing funding for clinical trials focused on managing and preventing holes in teeth among underserved children and older adults using simple, inexpensive pharmaceutical approaches. Our team will also continue a nuclear magnetic resonance spectroscopic analysis of tissue from human dental cavities, plaque, and saliva, which can provide an objective quantitative method through which we can measure, without any potential for bias, the outcomes of our pharmaceutical methods for managing cavities.