Search for the Elusive Caries Vaccine

Just before I graduated dental school in 1971, one of our instructors delivered bad news. He said recent articles had been published concerning the development of a vaccination that would eliminate dental caries. This, of course, was devastating to the members of our class, because at that time the vast majority of dentists made their living either repairing the ravages of dental decay or removing and replacing teeth as a result of the disease process. The last time I checked, we still do not have a caries vaccine. Why? Well, as you may have read in previous Editor’s Note columns, it’s possible that the bacteria supposedly associated with dental caries were misidentified for a number of years. If this proves to be fact, we have been chasing ghosts.

This somewhat disturbing/somewhat comical memory was brought to mind when I read an article in the New York Times about studies that examined a small group of individuals who seem virtually immune to heart disease. According to researchers, this group apparently has a genetic anomaly that reduces triglycerides and/or cholesterol to incredibly low levels and keeps them stable for a lifetime. As a result, the authors hypothesized that if medications could be developed that mimicked these genetic anomalies, the risk for heart disease among patients without these anomalies could be reduced exponentially.

IT’S POSSIBLE THAT THE BACTERIA SUPPOSEDLY ASSOCIATED WITH DENTAL CARIES WERE MISIDENTIFIED FOR A NUMBER OF YEARS

This raises the broader topic of investigations into new approaches to therapy, including techniques and medications. In many cases, these studies receive financial backing from private industry. As such, the supporting companies have a vested interest in the economic consequences of the outcomes. In many cases, this has led to glowing reports of positive study findings (but not those that had negative results). As a result, some oral health professionals have called for registration of oral research projects, so studies could be evaluated through a database — regardless of whether the results were positive or negative. Another unfortunate trend is that, in some cases, research is published with the goal of stimulating public and corporate interest, and thus help secure funding for further studies. One has to wonder if this could lead to intentional or unintentional bias in terms of the study’s conclusions.

In the case of the population subset who seem immune to heart disease, I truly hope that an interventional therapy will be discovered that reduces the risk of cardiovascular disease. But a careful reading of these studies also indicates these are very early findings, and it will take years to prove whether or not of this genetic anomaly can be developed into a standalone cure for cardiovascular disease — or whether there are other, as yet unknown, factors in play.

In the meantime, on the oral health care front, researchers across the globe continue the search for the elusive caries vaccine.

Thomas G. Wilson Jr., DDS
Editor in Chief
twilson@belmontpublications.com

From Decisions in Dentistry. August 2017;3(8):8.