Research Highlights Possibility of Halting Dental Cavities Epidemic

Dental caries is an infectious disease that occurs when microorganisms accumulate on the teeth, especially in the presence of sucrose (sugar), says Taubman, head of the Department of Immunology at Forsyth. “Oral health is a critical component of general health and well-being,” said Dr. Taubman. “Unfortunately, dental caries remains a chronic problem that is not only widespread in the industrialized world, but is also increasing in prevalence in developing nations. We have a real opportunity to address this public health crisis, and to improve quality of life, while preventing long-term health problems.”

A full report of the scientific and public health imperative for a vaccine against dental caries will be published in the July 2006 issue of Nature Reviews Immunology. (Available online at http://www.nature.com/nri/index.html on May 25.)

“Many people are fortunate enough to never experience the devastating effects of severe dental caries,” said Phil Stashenko, Vice President of Research for The Forsyth Institute. “However, even here in the U.S. dental caries is the most common childhood disease.”

Why A Vaccine is Needed

Worldwide, 5 billion people suffer from tooth decay. The World Oral Health Report 2003, published by the WHO, indicates that dental caries is a major health problem in most industrialized countries, affecting 60-90% of school children and most adults. In the United States, dental caries remains the most common childhood disease ¯ five times more common than asthma. At the same time, there are considerable disparities in oral health status, with a sharp increase in cavities among the nation’s poorest children. These children suffer from chronic pain that is caused by abscessed teeth, as well as from the psychological stigma of unsightly decayed teeth.

Dental disease also significantly impacts the national health budget. In the United States, more than $70 billion is spent on dental treatment, a figure that is expected to grow by nearly 10% per year. Thus, over 5% of total US health care budget is committed to treating oral disease. The impact is also felt in other ways. Over 20% of reservists in the US Armed Forces were unable be deployed to Iraq in the recent Middle Eastern conflict.

Forsyth's strategy is aimed at stimulating the production of antibodies that inhibit the enzyme that allows bacteria to accumulate on teeth. The researchers believe that the best way to protect against caries over the long term is to vaccinate children at about the age of one, after teeth have begun to emerge, but before mutans streptococci bacteria have begun to colonize the tooth surfaces. At this stage, Taubman explains, children’s immune systems are developed enough to produce antibodies to prevent accumulation of mutans bacteria and the tooth-decaying acid the bacteria manufacture. Once the bacteria already accumulated, antibodies form, but are not effective in halting decay.

The Forsyth researchers are focusing on "mucosal" vaccines that can be sprayed into the nose for several reasons. Primarily these vaccines are better-targeted to stimulate nasal-associated lymphoid tissues, which can result in antibodies in saliva or other mucosal areas and, they are easier to administer to young children.

The Forsyth Institute is the world’s leading independent nonprofit research organization focused on oral, craniofacial and related biomedical science. Established in 1910, Forsyth’s mission is to lead the discovery, communication and application of breakthroughs in oral health and disease prevention that will significantly improve the health and well-being of the nation and the world.