Dentists Could Use Viruses to Treat Tooth Decay

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Your mouth contains a world's worth of bacteria. Roughly 7.7 billion humans dwell on Earth while some six billion bacteria inhabit the human oral cavity.

If you brush regularly and eat a balanced diet devoid of exorbitant amounts of sugar, your mouth's resident bacteria remain well-behaved and generally innocuous. But for those who slurp down soft drinks and ignore their oral hygiene, the story is much different.

With copious sugars to munch on and no toothpaste to police them, oral bacteria can run rampant. Streptococcus bacteria form dental plaques that cake your teeth and gradually eat away at them. Enterococcus faecalis can burrow to the root canals of your teeth and destroy the nerve, blood vessels, and connective tissue within. Porphyromonas, Tannerella, and Treponema might inflame and irritate your gums.

Dentists employ a variety of methods to treat these bacterial incursions, some of which you've likely experienced firsthand. Antibiotics constitute one of these tools – in 2016, dentists wrote 25.7 million prescriptions for them.

Now, many dentists are calling for a new tool to be added to their kits: viruses, specifically those that target bacteria. Called bacteriophages, these specialized viruses make their living infecting and hijacking bacteria in order to replicate. Some bacteriophages keep their single-celled hosts alive, while others kill them in the process. The latter variety could be of great value to dentists.

As scientists Liviu Steier, Silvia Dias de Oliveira, and José Antonio Poli de Figueiredo explained in an article published to Dentistry Journal, specialized bacteriophages could be unleashed upon dental bacterial infections.  Since the viruses target only certain species of bacteria, they could eradicate the offending microbes and then subside when the job is done, with little to no effect on the rest of the mouth. Moreover, bacteriophages are easy and inexpensive to produce and can be genetically engineered. Additionally, they could supplant antibiotics and thus lessen bacteria's growing resistance to the drugs.

Phage therapy has some limitations, however. "One of them is the need to customize the treatment for each patient according to bacterial status. However, this may also be a virtue, as it targets only the bacteria that causes the disease," the authors write. Another concern is that bacteriophages are capable of rapid evolution, and their use could result in unforeseen effects. The side effects of antibiotics are known and understood, but phages present novel unknowns.

Unraveling the mysterious is the duty of scientists, however, and many dental researchers, including an international team reporting in the journal Current Topics in Medicinal Chemistry, find the prospect of bacteriophage therapy too enticing not to dig deeper.

"Phage therapy offers new horizons to dentistry, both therapeutics and research."

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