Recently, researchers from Harvard University and the University of Nottingham have developed a material that can be used for “stem cell fillings.” These fillings are designed to regenerate both the dentin, a hard substance directly beneath the tooth’s enamel, and the pulp, which is the innermost part of the tooth and contains tiny nerves and blood vessels. This new scientific advancement may sound too good to be true, and only time will tell if stem cell fillings will be as groundbreaking as advertised.
I have some concerns about the study and statements attributed to head researcher Adam Celiz, PhD, of the University of Nottingham. My first concern was that I could not readily find the actual research paper that Celiz and the rest of the research team wrote, just press releases and news reports. As a dentist, there are several questions that I want answered:
- How much of the pulp can and/or should be removed for the regenerative filling to work?
- How durable is the filling, and will it require replacement at some point
- How successful is the procedure long term?
- Has it been used on live patients, or just in the laboratory?
- If it fails and the tooth requires root canal, will it be more difficult to do a successful root canal with the dentin and pulp altered?
- How expensive are the stem cell fillings and are they likely to be covered by dental or medical insurance?
I also have serious questions about a statement that was widely quoted by researcher Celiz.
“Existing dental fillings are toxic to cells and are therefore incompatible with pulp tissue inside the tooth…”
This statement is factually incorrect. Dental fillings are not toxic. If that were true, all or most teeth that have fillings would become infected and require a root canal or need to be extracted. In fact, most teeth that are filled with composite (tooth-colored material), porcelain, amalgam, or gold last many years. Even for teeth that decay has reached the pulp, dental materials like Dycal or MTA can regenerate dentin to protect the pulp and often prevent root canal. So in a way, healing fillings have been around for many years. The only difference is that the stem cell filling can regenerate both pulp and dentin, whereas existing materials can regenerate dentin only.
A tooth that is infected and requires root canal is an involved process. A root canal takes one or two trips to the dentist, and then additional visits will be required for a post and a crown to rebuild the tooth. The success rate of a root canal is about 90 percent, and the cost of a root canal, post, and crown can be substantial. A filling that can regenerate both dentin and pulp could reduce the need for root canals, but many questions still remain.
Dr. Jerry Gordon can be reached at (215) 639-0571.
Comments, questions, and second opinions are available at The Dental Comfort Zone, 2734 Street Rd. Bensalem, PA 19020 (across from the Giant supermarket).