Considering the Past and the Future of Dental Fillings

Could robots be cleaning your teeth in the future? Can fillings be made out of glass? Find out with this entertaining guide to the future of dental technology.


The future of fillings

Image from Eric Schmutternaer on Flickr.

Over the last decade, an awful lot of technological and scientific progress has been made within the field of dentistry. The majority seems to have been focused on one area – the humble dental filling. Now, this should come as no surprise, because fillings are the most common (and one of the most reviled) forms of dental treatment.

They may be routine, but they usually require a small amount of dental drilling and this is enough to get most patients dreading their next trip to the dentist. The good news is that our endless battle with cavities and decay has become something that dental scientists are very interested in. They are keen to discover new ways of filling decayed teeth, so that the drill can be laid aside for good.

While the main benefit of this would certainly be for patients – many people go without treatment, because they are afraid of drilling – the general belief is also that the industry should have found a more precise method of removing decayed enamel by now. The drill might get the job done, but it is noisy, inefficient, and it puts patients on edge.

Fortunately, dental science has come up with not one potential solution, but a whole plethora of technologies and inventions. There is the EAER machine that can kick the natural healing properties of teeth into overdrive, by passing tiny electric currents through them. There are the researchers in the US, who have discovered a way to grow organic enamel using stem cells. The future is bright and it is here already for dentistry – let’s take a look at the next big step.

The Unusual Combination of Teeth and Crushed Glass

The latest dental science development to get the world talking is the ‘crushed glass’ filling. Yes, that’s right, glass fillings. But it is more promising than it sounds. According to scientists, compounds such as silicon oxide, calcium oxide, and phosphorous oxide are extremely tough and durable. Not only that, but they are ‘active’ compounds, which means that the body can actually respond to them being in the mouth.

This is very valuable, because one of the downsides to using fillings to treat cavities has always been a lack of cohesion. A dentist can place a filling in the mouth. They can make sure that it stays in place for a long time (usually around 7-12 years). What they cannot do is make the mouth notice that it is there, so they are just filling in a hole. This is not ideal, because teeth are living things, even if we are not used to thinking of them as such.

If a tooth cannot recognise a filling as a substitute for lost tooth enamel, there is always the chance that bacteria will simply continue to move around it. This is called secondary tooth decay and it is very common, though dentists usually have a trick or two up their sleeves to delay it for a while. Eventually though, everybody who has a filling does have to return to the dentist to get it replaced. And they have to do this every 7-12 years, for the rest of their life.

With a ‘bioactive’ (so called, because it reacts to the mouth) glass filling, the repaired tooth would have a much longer lifespan. The dentist would have a lot more control over the progression of tooth decay and fillings could, therefore, be replaced much less frequently. If this weren’t enough, bioactive glass fillings may also significantly reduce the amount of bacteria present in the mouth and around the original cavity.

Exploring the Antimicrobial Properties of Glass Fillings

The antimicrobial properties of bioactive glass can probably be explained by the fact that the material produces ions. These are toxic for the nasty bacteria that live in the mouth and they can neutralize destructive acids. According to biomaterials researchers, bioactive glass has been used in bone repair treatments for many years, precisely because of its ability to fight the signs of infection.

Ultimately, the bacteria in our mouths are not very fond of bioactive glass and they avoid it where possible. This means that they are less likely to grow around fillings which contain it. For patients, the discovery is very important, because it means that dental scientists may now be able to develop a commercial filling that is not vulnerable to secondary tooth decay. So, it seems like the only obstacle left for glass fillings is the response of patients themselves.

How many people would be happy to have a glass filling in their mouths? Would the thought of using glass put people off heading to clinics for cavity treatments or is to more likely to encourage them? This is something that the dental industry will have to think carefully about if these bioactive glass fillings ever do make it onto the market. Luckily, they are not the only possible alternative to the dreaded dental drill.

The Next Big Thing for the Treatment of Cavities

The next section will take a closer look at some of the dental developments promising to transform the industry over the next decade.

Electrically Accelerated Enhanced Remineralization

As already mentioned, EAER uses very mild electric currents to stimulate the natural healing properties of the teeth. Now, you might not know it, but human teeth can repair themselves. They ‘remineralize’ by regenerating and reproducing lost enamel. The problem is that they do this at a much slower rate than is needed to fight decay and cavities.

So, EAER relies on electrical stimulation to kick the damaged teeth into overdrive. They then accelerate the healing process and can, potentially, build over a cavity in just a few hours. If this technology is all that it promises to be, it really will revolutionise the industry, because it eliminates the need for drilling and for artificial ‘filling’ materials.

If you do not need mercury or glass or any other kind of filling, you can deliver affordable dental treatment anywhere in the world. The possibilities for underdeveloped regions are huge. Like bioactive glass fillings, remineralized repairs also last for much longer than standard ones; maybe even for life, if patients take good care of their teeth.

Antibacterial Fillings and Nanocomposites

The bioactive glass fillings could be called a type of ‘nanocomposite.’ These compounds are less likely to continue decaying than things like mercury, which has traditionally been used to repair teeth. So far, silver, calcium, and phosphate nanoparticles have been found to exhibit antimicrobial properties.  

The difference between active and inert materials is that the active ones encourage the mouth to respond to their presence. This increases the likelihood of a healthy bond and a long lasting repair. We have a tendency to think of our teeth as being inactive things, as passive and unresponsive objects without live impulses, but this is inaccurate.

Our teeth contain nerves and living pulp tissue. They are living things. And, as such, dental scientists are realising that, while amalgam metals may be tough, they are also brittle and they are unnatural. The mouth never really accepts them and this is why problems like secondary tooth decay and repeat root infections are still so common.

Laser Aided Fillings

If it is not secondary decay that dentists are struggling with, it is accuracy and precision. Yes, modern dental tools are fairly sophisticated. If a dentist approaches your mouth with a drill, it might sound scary but you can trust that they know exactly what they are doing. Nevertheless, drilling must still involve jarring contact with teeth.

This can lead to pressure, stress, and trauma in and around already fragile enamel. With laser guided dentistry, precision tools are used to vapourise decaying material and prepare teeth for fillings. This is a very ‘hands off’ approach (dentist do not really have to touch the mouth at all), so the likelihood of more bacteria making it into the cavity is further reduced.

With lasers, smaller cavities can be filled which may otherwise have been left to degenerate into larger holes. This might sound like a strange thing for a dentist to do, but if a cavity is detectable but far too small to fill in the traditional manner, there really is no other option. The patient may simply have to wait and see if the hole gets any bigger. However, laser aided dentistry could change all of that.

Dental ‘Nano Bots’

Now, we move into the realms of science fiction (kind of). While laser guided dentistry, remineralizing enamel, and antibacterial nanoparticles are all here and likely to hit the market soon, nano bots are still only a possibility. However, scientists really do believe that, in the future, we will be using tiny robots to clean and repair our teeth.

These nano bots are likely to be programmed and controlled via acoustic signals. They could be introduced into the mouth in something fairly run of the mill like mouthwash. And, they could potentially help dentists to build up visual maps of patient mouths. It may be some time yet before we see any of this, but it does not stop it from sounding very exciting indeed.

Light Regeneration and Stem Cell Growth

This is another possible dental technology that makes use of lasers. In this case, low powered concentrated light is used to stimulate the stem cells in our teeth. Essentially, this is what a group of scientists in the US have already discovered, but they are starting the process outside the body and then implanting the regenerating stem cells into a mouth.

If the technology does develop, it is likely that the regenerating will be triggered in dentals stem cells already in the mouth, rather than isolated samples. The problem is that this is a tricky thing to achieve, so it may be some time before scientists get to the bottom of it. On top of the challenge of moving the process from outside to inside of the mouth, they will have to deal with the many regulatory headaches that stem cell work throws up.

Finding a Way to Make Dental Discoveries Commercial

This is an important point to make too, because many dental innovations and inventions do run into regulatory troubles. In the US, especially, the FDA places very strict parameters on the development of medical technologies. If researchers, like the ones who created EAER treatments, want to introduce their discovery to the US market, they need to fulfil some very rigid criteria and jump through a lot of hoops.

The best way to do this is to work closely with the regulators themselves and, fortunately, the inventors of EAER are in the midst of negotiations right now. But there is no telling when the FDA will approve the technology, or if it ever will. And, if it does, there is no guarantee that dentists will accept and embrace it. On average, it takes around twenty five years for a new technology to be entirely integrated into the dental industry.

This is a very long time and it is primarily down to the fact that dental clinics and surgeries operate within fairly narrow profit margins. They treat a lot of customers, but procedures are fussy and time consuming. Even things root canals, which are now routine, take several hours to complete. They may also require materials that are expensive to produce and costly for surgeries to purchase.

All the while, dentists have a responsibility to offer affordable rates that do not fluctuate too much or cut out any large segments of the population. This is, of course, difficult when it comes to low income patients. In places like America, the divide between premium and subsided dental care is often very sharp indeed. There are huge sections of the elderly, homeless, low income, unemployed, and veteran communities who are not seeking routine dental care.

Hints and Tips for Picking a Great Dentist

If you have not visited the dentist for a routine check-up or appointment in the last year or more, you need to do it as soon as possible – even if you are sure that there are no problems with your teeth. You do not have to have cavities or decay to visit the dentist. You should be attending for a routine exam at least once a year, preferably twice.

During these visits, the dentist is able to check for signs of trouble. This is the perfect example of prevention being cheaper than the cure. Attend regular appointments, let your dentist keep an eye on your mouth and teeth, and any signs of infection or decay will be dealt with immediately. And you will save time and money that is better spent elsewhere anyway.

Once you have located a surgery that seems suitable for you, head in to talk to a dentist or an advisor. They will take your details, get you to fill out some patient registration forms, and you will be good to go. You may be asked to undergo a routine exam on the same day or you may have to schedule another appointment for this; it depends how busy the surgery is at the time.

This examination is not invasive. The dentist will simply check your mouth, probe at the gums for signs of infection, and have a quick chat with you about your oral health. If all is well, this will be the end of your contact with the dentist for a while (about six months). If there are indications of infection or gum disease, your specialist will talk you through the best courses of action and explain what can be done to halt degeneration in the meantime.

Following Orders and Taking Recommendations

It is absolutely imperative that you follow the advice given by your dentist. Whether this means brushing after every single meal, gargling with salt water, or making preparations for a root canal – this is your specialist and the only person who knows your teeth better than you do. Don’t be afraid to ask any questions that you might have or raise any relevant concerns.

Dental phobias are extremely common these days, so if you are anxious about a treatment, talk about it. Your dentist will not think badly of you, would never ridicule or downplay your fears, and has a responsibility to make sure that you are comfortable enough to proceed with treatment. If a patient is extremely agitated or distressed, it makes procedures harder for everybody, so dentists have a vested interest in helping them stay calm and relaxed.

Just remember that you can trust your dental health professional. Long gone are the days when dentists wielded frightening instruments and handled mouths roughly. The stereotype of the scornful dentist with the dastardly drill is one that only really exists in storybooks these days. This is a caring profession, so swallow your fear and prove to yourself that a trip to the dentist really is nothing to fear after all.


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