[dflock]

> detect the earliest signs of cavities and gum disease - then provide evidence-based recommendations and treatments to help prevent them.

What preventative treatment is this? If it isn't just "brush & floss", then what is it? If it's so great, why not just tell everyone about it now - why do you need a microbiome test?

[carabiner]

There's Cavibloc, which is supposed to reduce cavity-inducing bacteria. It was developed at UCLA. There's also CloSYS, which is basically a highly diluted bleach that clears your mouth of bacteria. It is ADA approved. There's also Xylitol, which is also supposed to help reduce bad bacteria. I've been using all of these for the past year, and my most recent dental cleaning had almost no tartar buildup, which is really unusual for me. I have poor flossing habits. You can look into the book "Kiss your dentist goodbye" by Dr. Ellie Phillips for more info. FYI she's not a quack, but some of her claims have been controversial among other dentists.

[jedberg]

> but some of her claims have been controversial among other dentists.

I have a lot of dentist family and friends. Anything that isn't "drill and fill" is controversial to them. :)

Dental school these days seems to really stress that everything must be treated with intervention by a dentist that happens to bring money to their practice.

They are also super frightened of new technology. There was a technology that was like a new kind of mouthpiece with microbrushes that could brush your entire mouth in a few seconds. The dentists I know would barely even look at the picture before dismissing it.

I don't know why this is, but I'm pretty sure it has to do with the way their schooling works.

[TheTaytay]

We became exposed to this mentality and reluctance to adapt when exploring solutions to our son’s cavities. There is an amazingly effective treatment called SDF that arrests cavities with no need for drilling by painting it on in a procedure that takes about 1 minute. It’s proven to work, is non invasive, and much easier to use to treat a squirming small child. It’s been used for decades in Japan. Only recently did it become allowed in the US. Yet a couple of years ago it was still shockingly difficult to find dentists who knew about or approved of its use. I was also surprised to find very little literature linking particular bacteria to tooth decay. I think Bristle is on to something here, and I am glad that they are pushing this research forward. Tooth decay seems to have many of the hallmarks of an infection, yet its primary treatment is still to remove damaged portions of teeth with a drill. It feels remarkably primitive.

[phnofive]

Since Silver Diamine Fluoride is a little newer, it helps to look at Silver Nitrate, which has the same mechanism save for the, you know, fluoride (which is a boon).

Medical management of caries is anathema to assuming seven figures in debt to hang up a license and turn on the lights, and I’m not implying ill will. The first world countries with national healthcare sans dental could use this without coming close to the dental standard of care - a cavity arrested with silver nitrate is actually better to drill and fill since the infection is halted.

[SamBam]

Did you see any of the permanent staining that is mentioned in a sister comment's aappublications link (https://www.aappublications.org/news/2016/08/05/SilverDiamin...)?

[EMM_386]

If anyone is looking for more information on SDF (silver diamine fluoride), there is some information here:

https://www.aappublications.org/news/2016/08/05/SilverDiamin...

[david_l_lin]

Well said! Incumbents in the space have a lot to gain from the status quo of "drill, fill, and bill". This has limited the adoption of new diagnostic technology and advances in preventive health. We hope to eventually replace observational screenings that detect the onset of irreversible symptoms with early detection and interventions that prevent disease altogether.

[carabiner]

Are you guys familiar with Dr. Ellie Phillips? I'm definitely not a dental health expert, but she seems to be objective about how tooth decay occurs, see: https://drellie.com/2020/10/19/what-happens-to-teeth-when-yo...

I wonder if she'd have useful input on your product. Of course, she's trying to promote her own stuff (she sells Xylitol mints) but she also advocates for OTS treatments like Listerine.

[bmau5]

I'm not familiar with her, but I agree she does seem objective and could have some useful input. We'll reach out.

Thanks for sending!

[psychiatrist24]

But should you simply kill all bacteria in your mouth? Perhaps some are actually useful?

[sfjailbird]

There are many that are not only useful, but essential to oral health.

You can supplement with probiotics, which have been proven in quality studies to improve mouth/nose/throat health, and, to a lesser extent, even prevent caries. The bacteria cultures are known by their shorthand K12 and M18, respectively. In New Zealand this is part of official health guidelines.

On phone so can't look for references but look it up, it is well supported.

[cromka]

I think I read here recently that mouthwash can cause cancer – even the non-alcoholic one, presumably because of the altered microbiome.

[thotsBgone]

Just kiss someone with better bacteria and you'll be fine.

[hellbannedguy]

I’ll get hammered for my statement because it’s beyond antidotal. I’m also a bit superstitious, and feel I should just dummy up right now.

I’ve noticed some people just have good teeth, and others are not so lucky.

I’ve been down on my luck for years now. Close to being homeless. I haven’t been to a dentist in over two decades. I still have my all my teeth, except wisdom which I had pulled proactively when I had insurance.

Why do I still have my teeth, and my gums don’t bleed, or are recessed?

1. I feel it’s because I developed a neurotic compulsion to pick my teeth with those disgusting disposable tooth picks, with the floss. (I say disgusting because I see them discarded everywhere, and I worked for the inventor of the product. (Actually his wealthy father invented them, and fully funded his sailboating brat of a son a son to peddle them. He is now a 1 percenter, and yes—I’m jealous.

2. I’ve tried to use an ultrasonic toothbrush once a day.

3. I don’t eat much sugar, but I eat a lot of carbs?

4. Buy a few dental cleaning picks/tools, and learn how to scale your teeth yourself. If you’re gentile, and use common sense, you can get most of the gunk off. Below the gum line is another story though?

Take what I said with a grain of salt. A dentist told me 20 years ago, “you have great teeth, but let’s wait for the X-ray, and look at the bone. He said I got lucky.

I hope my next exam goes the same way?

[habosa]

There's definitely luck with teeth! My dad and grandpa are both dentists so my family had access to every kind of tooth care on a regular basis.

I don't know anyone who gets more cavities than me and my mom. Seriously every time we go to the dentist we're either getting a new filling or replacing an old one.

I even spent 3 years (for non-dental reasons) eating no sweets and not much changed. We just have "weak teeth". I could maybe take better care of mine but my mom is an obsessive brusher/flosser and it hasn't helped her much.

[m_ke]

Can definitely confirm this. My brother and I grew up on the same diet, followed the same routine of brushing twice daily, flossing, using mouth wash and going to the dentist at the same time but for some reason he has only had like 2 fillings in the last 25 years while I've had to get some work done on almost every tooth and have had like 6 root canals done.

[david_l_lin]

Each microbiome is unique, and preventive measures against bacteria that cause gum disease may not be effective against bacteria that contribute to cavities and vice versa. The solutions (such as prescription-strength fluoridated toothpastes, antimicrobial mouthwashes, or personalized probiotics) that we plan to recommend may require a prescription that we anticipate we will be able to fulfill only after a diagnostic evaluation. This provider-mediated solution is critical to avoiding unnecessary and potentially harmful prescriptions, while also preventing disease.

We're working on building a knowledge base, as there are several pseudoscience wellness recommendations that have no clinical validity, and will share these on our blog that you can find on our website. A Bristle mission is to also develop more effective personalized therapeutics and oral care products that effectively treat microbiome dysbiosis to prevent disease prior to the onset of symptoms and irreversible disease.

[droningparrot]

Since you mention prescriptions and providers, does this mean you intend to distribute the product through dentists?

[david_l_lin]

Forgoing the details, from the user perspective, the product is almost entirely direct to consumer, and the Bristle platform provides users the opportunity to both request a test and further consult with a dentist. Prescriptions and interventions will be physician-mediated upon interpretation of test results.