Weird but cavity-free
Over at Astral Codex Ten, the other Scott A. blogs in detail about a genetically engineered mouth bacterium that metabolizes sugar into alcohol rather than acid, thereby (assuming it works as intended) ending dental cavities forever. Despite good results in trials with hundreds of people, this bacterium has spent decades in FDA approval hell. It’s in the news because Lantern Bioworks, a startup founded by rationalists, is now trying again to legalize it.
Just another weird idea that will never see the light of day, I’d think … if I didn’t have these bacteria in my mouth right now.
Here’s how it happened: I’d read earlier about these bacteria, and was venting to a rationalist of my acquaintance about the blankfaces who keep that and a thousand other medical advances from ever reaching the public, and who sleep soundly at night, congratulating themselves for their rigor in enforcing nonsensical rules.
“Are you serious?” the rationalist asked me. “I know the people in Berkeley who can get you into the clinical trial for this.”
This was my moment of decision. If I agreed to put unapproved bacteria into my mouth on my next trip to Berkeley, I could live my beliefs and possibly never get cavities again … but on the other hand, friends and colleagues would think I was weird when I told them.
Then again, I mused, four years ago most people would think you were weird if you said that a pneumonia spreading at a seafood market in Wuhan was about to ignite a global pandemic, and also that chatbots were about to go from ELIZA-like jokes to the technological powerhouses transforming civilization.
And so it was that I found myself brushing a salty, milky-white substance onto my teeth. That was last month. I … haven’t had any cavities since, for what it’s worth? Nor have I felt drunk, despite the ever-so-slightly elaevated ethanol in my system. Then again, I’m not even 100% sure that the bacteria took, given that (I confess) the germy substance strongly triggered my gag reflex.
Anyway, read other Scott’s post, and then ask yourself: will you try this, once you can? If not, is it just because it seems too weird?
Update: See a Hacker News thread where the merits of this new treatment are debated.
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Comment #1 December 8th, 2023 at 2:51 pm
Here’s a comment from the Other Scott’s blog that made me a bit skeptical: https://www.astralcodexten.com/p/defying-cavity-lantern-bioworks-faq/comment/45004350
—-
Yehuda Isseroff
15 hrs ago
All of the above. No one cares enough about dentistry to invest the millions (or tens of millions) of dollars to construct and run a propely-designed trial to evaluate this question. And yes, cavity formation is not linear with pathogenic strep mutans presence. There are many, many cariogenic pathogens in the oral flora – strep mutans is just the biggest one. This is not a debatable point; it’s accepted science. The fact that nowhere on the website is that noted is a huge red flag in my opinion. What do the 5-10 year outcomes look like in a group of patients who think they are “immune” to caries but actually are not, and who potentially change their diets and habits under the impression that they are? Might they have an even greater incidence of new decay than a control group who never took the vaccine?
It also has no mention of the clinical challenges of evaluating and treating dental caries in the “real world.” How do you classify previous restorations where the bonding breaks down and starts leaking? Technically, those are “cavities…” This is part of the larger issue of overdiagnosis and overtreatment in dentistry. I could speak for hours on the topic.
It sounds to me like they really haven’t consulted with any clinical dentist on this. I just read through their whole website and their “literature,” and it’s even worse than I thought. One animal study on germ-free rats. No humans studies that I can find. That’s embarrassing!
—-
ChatGPT claims that cavities can also be caused by Streptococcus sobrinus, Lactobacilli and Actinomyces. So I do wonder if the “cavity free for life!” claims are actually true. I can see this being helpful on the margins for sure but I’m a bit more skeptical than I was before.
Comment #2 December 8th, 2023 at 2:53 pm
I’m personally skeptical of this being a good idea. Not for the usual reasons! Doing self-guided research or seeking out people doing research but working around usual channels like drug trials doesn’t bother me at all; there are lots of reasons to think the bureaucracies around medical research are a lot more burdensome than they have reason to be; I’m on board with “if you have informed consent and the potential downsides aren’t very bad, go nuts, do whatever you want”.
But what bugs me is that you have no real way of finding out what strong cases *against* this particular treatment might be. Like… sure, ACX’s article is kinda convincing, and the blurbs you get from the company doing the research are compelling, but maybe there are really compelling counter-takes out there also. How would you find them? There’s no way to find the detractors easily unless they happen to show up in the comments on the advocates’ articles somehow. Maybe it turns out that you describe this to a researcher in the field at some university and their response is just “oh, we thought of that but it obviously doesn’t work because X”. Or maybe, even worse: “we thought of that but it’s obviously dangerous because of Y”. How would you know?
I just don’t think it’s reasonable to do something based only on a strong supporting take without also getting to read the strongest dissenting take and being sure that you’re okay ignoring it.
What would be really great is if there was some sort of repository of this on all the popular experimental idea, which just collects all the strongest arguments for and against each one, just for the purpose of disseminating information.
(Scott Alexander’s post was on HN yesterday: https://news.ycombinator.com/item?id=38562939 and the top comment is a dissenting take that says “this obviously won’t work”, for instance. Maybe they’re wrong! Nevertheless, you would want to have found that take before trying the treatment, I think.)
Comment #3 December 8th, 2023 at 3:01 pm
I’m not about to debate the merits of this particular bacteria. Good luck to you with it. It seems plausible that it will help you.
And it distresses me that you would use the form of address that you do on other people doing their best to keep the population of the US safe when faced with so many tech and medical situations that are untested and even outright scams. It might make sense to you, but then, so did Theranos. It made sense to lots of people, it just wasn’t true. Also, you’ve heard of thalidomide, right?
I’m not saying this is a scam. What I’m saying is that the people advancing it believe in it, which is necessary, but that belief makes them not so great at evaluating risks. At the very least, not the authority on the risks.
Frankly, I think it’s probably a regulator’s duty to remain mostly anonymous and “blank faced”. The job isn’t about them, after all. They should not be calling attention to themselves.
Comment #4 December 8th, 2023 at 3:13 pm
To clarify: I’m continuing to brush my teeth, and floss, and use mouthwash twice every day! Because of this, and because hundreds of others have tried this with no obvious harm, I judged the downside risk to be extremely low. The worst plausible case seemed to be that this would do nothing, and I’d get exactly what I paid for ($0).
Also, FWIW: I think the FDA should absolutely have the authority to attach a giant warning label to any medicine saying “we think taking this would be a terrible idea, and here’s why, but if you want to try it anyway then knock yourself out.” The trouble with the actual authority they have is that, empirically, it’s created an opening for unbounded blankfacedness—for shutting down entire fields of (100% voluntary) medical innovation and experimentation in ways that it’s completely obvious will lead to more death and suffering over the long run.
Comment #5 December 9th, 2023 at 4:15 am
Even though they say the amount of ethanol produced isn’t significant enough to get someone drunk, I can’t help but wonder if the Inebriati are behind this. https://www.youtube.com/watch?v=-Zj50DmBFp0
Comment #6 December 9th, 2023 at 7:12 am
“mouthwash twice every day”
Most mouthwash kill bacteria.
I had a lot of cavities as a child but haven’t had one for decades, probably from fluoride water and toothpaste.
I chew an OTC dental probiotic and use a mouthwash that promotes good bacteria.
Comment #7 December 9th, 2023 at 10:04 am
The cost was not just the $, but also the time, energy, risk…
Also, the unknown unknowns!!
That is why I’d not do it.
Comment #8 December 9th, 2023 at 12:13 pm
RD #7: What in life doesn’t have unknown unknowns?
But there are also known knowns like cavities, which I’ve had more than enough of in life. I’m down for anything with a decent chance of keeping me away from the dentist’s drill forevermore if the downside risk looks reasonably small.
Comment #9 December 9th, 2023 at 1:42 pm
It is funny how science fiction gets most things right up to one detail. Logic is, apparently, the advantage that *humans* have over machines. The viral outbreak created mindless zombies, but only from the internet discourse surrounding the cure. Biohackers are drunk, but not on power over creation, just microscopic amounts of alcohol.
Comment #10 December 9th, 2023 at 4:06 pm
Re:I think the FDA should absolutely have the authority to attach a giant warning label to any medicine saying “we think taking this would be a terrible idea, and here’s why, but if you want to try it anyway then knock yourself out.”
Isn’t that the de facto case already, unless a drug is known to produce harm? (Or even if, in some cases.) You can still buy and smoke cigarettes, and go to chiropractors and buy witches potions. They just can’t be labeled as “FDA Approved”. I think companies decide for themselves whether or not to try to sell products which aren’t harmful but aren’t FDA approved. If they are harmful, such as thalidomide, then they should be banned, not just so-labeled, in my opinion. I think the FDA has probably been under-funded in favor of tax cuts and has too much to do already without having to devise labels for everything sold.
I analogize the FDA with police: society needs something like them, but they don’t always do their jobs well or make the best decisions. I didn’t always do so in my job either. (We had a saying in GE Turbine Engineering: everyone who works here long enough will make their million-dollar mistake.)
(Just joking? Never mind.)
Comment #11 December 9th, 2023 at 4:28 pm
JimV #10: No, it’s not the case now. Cigarettes and a few other things are “grandfathered in” despite how dangerous they are, and anything that can be labeled a “dietary supplement” has had different, laxer rules since 1994. Other than that, anyone who wants to market a new medicine can basically either go through the $1B FDA approval process or go to prison.
Comment #12 December 9th, 2023 at 11:50 pm
I was informed by ChapGPT, who is familiar with the matter, on condition of anonymity, that what these bacteria are actually trained to do is to eavesdrop on your thoughts and report to the Masters of the Matrix accordingly.
Comment #13 December 10th, 2023 at 4:52 am
FDA is blank faced in lieu of big money and then too often happy faced. I posted this here before but a good example of the Realpolitik at the FDA.
Excerpt-
“Richard Sackler worked tirelessly to make OxyContin a blockbuster, telling colleagues how devoted he was to the drug’s success. The F.D.A. approved OxyContin in 1995, for use in treating moderate to severe pain. Purdue had conducted no clinical studies on how addictive or prone to abuse the drug might be. But the F.D.A., in an unusual step, approved a package insert for OxyContin which announced that the drug was safer than rival painkillers, because the patented delayed-absorption mechanism “is believed to reduce the abuse liability.” David Kessler, who ran the F.D.A. at the time, told me that he was “not involved in the approval.” The F.D.A. examiner who oversaw the process, Dr. Curtis Wright, left the agency shortly afterward. Within two years, he had taken a job at Purdue.”
The “patented delayed absorption mechanism” was simply a crude mechanical barrier that could simply be destroyed by crushing/chewing the tablets.
Full article and good read if you have the time concerning the rise of OxyContin including FDA approval. I am not trying to demonize the Sackler family. Some family members understood how the drug approval system really works and worked the system.
I agree with Dr Aaronson that ultimate responsibility rests with the end consumer of pharmaceuticals and belief in the FDA as simply an objective and pure determiner of what drugs are rightly available is naive.
https://www.newyorker.com/magazine/2017/10/30/the-family-that-built-an-empire-of-pain
Comment #14 December 10th, 2023 at 5:43 am
Would I try this? NO. And not all at “because it seems too weird”. During the height of the pandemic, I would mask using an industrial construction respirator, and I didn’t care at all that it looked weird, because it worked (highly recommended, by the way). I still use it at times. But this is strewn with red flags. “Too good to be true?” – be cavity-free for life, for our one-time low, low, price = red flag. No subject-matter experts = red flag. Promoted by the same general crowd which was promoting and then doing apologetics for Sam Bankman-Fried = red flag. Crank-style tribal narrative – “This cure has been suppressed by the Establishment, *THE* *BLANKFACES*” = big red flag. Deliberately taking place where there’s no oversight to basically prevent faking data = BIG RED FLAG (and see previous Sam B-F gullibility).
No, no, no. I’m individualistic enough that I’ll shrug my shoulders at people deciding to do this on themselves. However, for myself, hard pass. They can be the pioneers (and get the arrows in their backs). It’s probably not too bad all things considered. But it’s that same flaw in probability calculation, estimating big positive outcome times low percentage, and then puffing the positive outcome while brushing off the small but real risk of large negatives.
I also want to concur with Jay L Gischer#3. This particular “supplement” seems mostly harmless, but it’s not hard to see how others could go very bad very fast. Or at least, it shouldn’t be hard. It’s very revealing to see which types of people are considered essentially well-intentioned but make an occasional error, and which others are considered ill-intentioned by default even if they do the occasional good thing.
Comment #15 December 10th, 2023 at 7:05 am
Seth #14: I started formulating a counterargument to you … only to realize I didn’t have one! I’m totally cool with your decision not to try this based on your Bayesian priors, so long as you’re cool with my decision to try it for what turned out to be the low price of $0.
Comment #16 December 10th, 2023 at 8:55 am
I’m glad projects like this are moving forward. Having said that, I try not to be the first to update my laptop OS, and I don’t think I’ll be among the first to try this. As other commenters have said, there are lots of unknowns to be worked out. I’m happy to wait for that, especially for something that’s not life threatening.
In other news, it seems there is now a CRISPR-based gene therapy for sickle cell anemia! I think that’s a much better example of important healthcare innovation.
Comment #17 December 10th, 2023 at 3:06 pm
Scott#15 – as I said, I’m individualistic about this, for the believers. I’ve known people to who do megadosing of Vitamin C, or “colon cleanse”, or exotic herbs. None of that is for me, but I don’t crusade against them for doing it (though I had to bite my tongue about the colon cleanse). There’s a lot of real harmful medical quackery out there, so I see no need to chase after the small stuff. On a personal level, I ordinarily wouldn’t say much about it.
However, when something like this is presented as a factual argument against FDA current practices, I find it rather anti-convincing. The lack of any skeptical critical thinking, versus all the ideological anti-FDA narrative, is very troublesome.
Comment #18 December 10th, 2023 at 4:21 pm
Seth Finkelstein #17: I was radicalized by the pandemic, when it became painfully obvious that “what was safe was unsafe, and what was unsafe was safe” — that by insisting on the whole Phase I/II/III process rather than letting any interested person take a vaccine in Spring 2020 after a single human challenge trial with willing volunteers, the world’s regulatory agencies had needlessly consigned millions of people to their deaths. The idea was destroyed that there’s some guiding intelligence behind the scenes with my best interests at heart. So now, if something seems like a good bet to me — “offered to me legally and free of charge, simple one-time brushing procedure, hundreds of people have tried it with no obvious ill effect, plausible mechanistic story of how it will solve my cavity problem forever” — I just take the bet. “But the FDA!” is no longer a counterargument with any particular purchase on me.
(Note: For a different example of a “safe” answer turning out to be “unsafe” for the person who gave that answer, and for the “unsafe” answer being the “safer” choice, you could ask the now ex-president of Penn! 🙂 )
Comment #19 December 10th, 2023 at 6:28 pm
First I wanna say something useful and important: I think all medicines approved in civilized countries should be approved in other civilized countries, well at least here. If its good enough for Canadians, its good enough for me. This would save manpower, money, time and health. To me its just a low-hanging-no-brainer fruit that I can’t imagine any sane argument against it, other than some regulatory mafia-like turf issues.
As for this stuff in OP: interesting, but I don’t have enough research to say one way or another (if it works). All I can say though is brush your teeth kids, my dental bills can attest to that.
Then I wanna give two FDA examples. First one would be MDMA, which was known since 1970s (actually 1912), and is now being approved as a very effective treatment, I think 3/4 reported full remission of PTSD symptoms (and these were people like combat vets with real PTSD). That’s 50 years later, and it costed I think $200-500 millions to get it done. My numbers might be wrong though, so check MAPS/FDA if you wanna be sure. In any case, I can’t imagine this is the best we can do? It’d take probably about $50k, a year and some volunteers to prove its not more harmful than alcohol. After that people can use it for therapy, whether it works or not and we wouldn’t have to wait 50 years. And that’s just for PTSD, my guess it will take a decade for less severe forms of mental health issues, and more to drip to other countries.
Second example would be COVID. When COVID was found, it was sequenced a month later and vaccine developed *in a weekend*. Now it took 11 months for FDA to approve it for emergency use. Obviously testing takes time and that’s quite impressive, but that’s not the real problem. The problem was that instead of people choosing *themselves* whether to take the risk with vaccine or virus, FDA made this decision for them. This can only come from logic that FDA owns people’s bodies. And 5000 people dying from COVID every week in US alone. Multiple that by a few months and its just mind-blowing. I actually kinda knew a CERN physicist who passed away at age of 38 (later Spring 2020 iirc.) due to COVID btw. Imagine if COVID had ebola-like fatality rate.
Of course in hindsight its easy to say that we would have saved N lives, because we know its safe, but I honestly I think we should put the drug into human challenge trials. Like in case of vaccines, my guess in a few weeks we’d know if it was more harmful then the virus in short-term. After that people can choose. That doesn’t mean its safe, but if rate is lower (which it was eventually very significantly), it would still be better. And my guess the real PDF of long-term problems would be extremely low, while as the real short-term death rate (of the virus) is a very real reality.
And of course FDA drug regulation hits the poor first. Because it costs $1B or whatever, of course companies need to recover that cost, which means higher prices. Vis-a-vis magic of supply and demand, poor will have less of it.
I believe the simple moral argument is that I think people own their bodies, and should use medicine if they want to. FDA should stamp them and test them but people should still have right to choose. But beyond that argument, I seriously doubt most drug approvals would survive real statistical simulation or full-house risk-adjusted CBA. I believe we’re just integrating the risk aversion at wrong spot. Just like people pay for their life $100 when flying but $5 when driving.
The ultimate problem with FDA is that it’s a monopoly, which isn’t really directly accountable unlike markets. Then there’s famous Knowledge Problem, value theory issues, etc. For the record, I’m not saying we should skip drug verification. I think there’s always going to be some sort of testing, whether its private or public. The question is about the right to try, and risk aversion.
Seth Finkelstein #17
>> The lack of any skeptical critical thinking, versus all the ideological anti-FDA narrative, is very troublesome.
I agree that I don’t think some experimental thing like the OP is a very good example, but I think there are serious arguments against FDA’s policies. Some of them are in my comment but there are many more. I’m happy to discuss them, although I’m very far from an expert in the field. First step would be to make people more accountable. There are market solutions which don’t automagically change policy but make people accountable, and all bullshit flies out of the window. Cost of banning a working drug for T amount of time has real humanitarian cost which could easily be in hundred of millions using standard CBA. Surprisingly the people at FDA do not pay this cost, its the patients. Likewise benefit of banning of a bad drug has also benefit that is at least some fraction of that. Additionally the people who make these decisions are probably not eg. in the high-risk group for COVID. You could also use subsidized prediction markets to assess eg. the probability of long-term health risks of some drug when needed.
The numerous arguments against FDA (not its existence mind you) are not ideological all but are based on simple common sense and logic. That doesn’t mean there are not ideological people who hate all government without any critical thinking.
p.s. I wrote the comment on Friday but didn’t finish it until now, so I ended up repeating Scott a bit.
Comment #20 December 10th, 2023 at 7:03 pm
Seth #14
For once I am going to post something positive… should I change my name for that? 🙂
> But this is strewn with red flags. “Too good to be true?” – be cavity-free for life, for our one-time low, low, price = red flag (1). No subject-matter experts = red flag (2). Promoted by the same general crowd which was promoting and then doing apologetics for Sam Bankman-Fried = red flag (3). Crank-style tribal narrative – “This cure has been suppressed by the Establishment, *THE* *BLANKFACES*” = big red flag (4). Deliberately taking place where there’s no oversight to basically prevent faking data = BIG RED FLAG (and see previous Sam B-F gullibility) (5).
(1) Too-good-to-be-true is an efficient market argument, which doesn’t apply to new inventions.
(2) They’re licensing the technology from a biotech company.
(3,4) The advertising industry has even less of a reputation for turning away fraudsters and keeping out hyperbolic language than the world of bloggers – and yet nearly every product we buy is advertised conventionally. Does it make sense to hold word-of-mouth advertising to a higher standard than the nonexistent standard we hold commercial advertising to, when deciding when not to buy a product through suspicion-by-association? (Slightly off topic: people taking the failure to spot SBF as a single trump card against any argument raised by anyone associated with him need to take a serious look at the people they buy gasoline, food products, or home loans from!)
(5) Fraud is not legal, even outside of the FDA-regulated medical system. In fact, the FDA relies on the same laws against fraud as would apply to this company: for example in this story [1], the convicted abusers of the clinical trial system are charged with “one count of conspiracy to commit wire fraud and one count of wire fraud.” There was nothing FDA- or even government-specific about that.
[1] https://www.fda.gov/inspections-compliance-enforcement-and-criminal-investigations/press-releases/miami-medical-clinic-owner-and-pharmacist-convicted-clinical-trial-fraud-scheme
Comment #21 December 11th, 2023 at 4:04 am
Although this is irrelevant to the post, can you comment on the Quanta Magazine article “Why Mathematical Proof Is a Social Compact” Number theorist Andrew Granville discusses what mathematics really is and why objectivity is never quite within reach. (Link: https://www.quantamagazine.org/why-mathematical-proof-is-a-social-compact-20230831/). I used to think that Quanta is different from Scientific American. How do you see this?
Comment #22 December 11th, 2023 at 11:59 am
I think you should raging about politics and world events, and rather focus on what you know and understand and are able to actually positively contribute on. Whether that’s AI or QC. But IMO QC is where you provide your most interesting takes.
Comment #23 December 11th, 2023 at 12:43 pm
Were there any independent studies? “What the FDA said was too hard so instead we are doing no independent studies” seems like an overreaction. What if there was a sign error in their math and you get super-cavities for $0 instead?
In general, I notice that a lot of bad beliefs are of the form “bad/wrong people believe X so I’m immediately inclined to believe the exact opposite of X”.
Comment #24 December 11th, 2023 at 1:53 pm
Christopher #23: My understanding is that Hillman, the professor in Florida who discovered these mutations, did a bunch of studies involving hundreds of people over decades, which in any case lets us upper-bound the probability of a terrible outcome (eg if the participants got super-cavities it would’ve been noticed by now).
Comment #25 December 11th, 2023 at 2:27 pm
Scott #24
But I mean like, did you personally ask any of them, or just a third-party without COI, if this is actually the case? If half the participants got super-cavities, how would you, Scott, have heard about it?
Comment #26 December 11th, 2023 at 2:42 pm
Christopher #25: No, I didn’t personally ask them. And if I start getting super-cavities, I’ll report it, and you can come back and tell me I’m an idiot.
Comment #27 December 11th, 2023 at 4:25 pm
For what it’s worth (I’m not saying those are issues in this case, but maybe should be considered), ethanol is a carcinogen, and oral bacteria sometimes migrate deeper in the GI system, where the bacteria has a huge effect on metabolism and health.
Mouth bacteria is also known to be tied to cardiovascular health (because it can also move easily into the blood stream).
https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2019/march/gum-disease-and-heart-disease
The human body is a very complex system, tuned over millions of years of evolution, so there’s rarely an easy win without some downsides when it comes to health.
Comment #28 December 11th, 2023 at 4:31 pm
It’s just a matter of identifying and permanently suppressing the human genes that would rid us of teeth permanently!
Comment #29 December 11th, 2023 at 4:41 pm
Another thought.
There are conditions called Oral Thrush, where fungus can overgrow in the mouth and spread to the rest of the GI system.
It would be surprising that changing the mouth environment from acidic to alcohol wouldn’t affect this one way or another.
https://www.mayoclinic.org/diseases-conditions/oral-thrush/diagnosis-treatment/drc-20353539
Comment #30 December 11th, 2023 at 4:53 pm
Fair enough I’m probably just being overly paranoid, lol.
Comment #31 December 11th, 2023 at 5:07 pm
fred #27: In this case, the fact that the amount of sugar we eat today is so far outside our evolutionary parameters, and also that having full rows of white teeth into old age isn’t something we even really tried for until very recently, made it more plausible to me that maybe there really are relatively easy wins to be had here.
Comment #32 December 11th, 2023 at 5:18 pm
Scott #27
Yeah, but I’m really not clear when it comes to sugar vs fructose, because hunters/gatherers have also been feeding on fruits for quite a while.
Also, I know plenty of people who hate sweets and end up with lots of cavities… but, they’re boozing and lots of alcohol drinks like beers and wines (and most fermented drinks) do contain fair amounts of sugars (hence I guess they had that problem in the antiquity too)
https://www.premierdentalohio.com/blog/alcohol-and-its-effects-on-your-teeth
I think the easiest/safest win for humanity has been tooth brushing (with Fluoride?) and then flossing!
Comment #33 December 11th, 2023 at 7:14 pm
Read about these bacteria decades ago, always wondered why they never reached the market.
Here’s to hoping it takes, and manages to finally clear the FDA hurdles!
Comment #34 December 11th, 2023 at 11:07 pm
Murray Gell-Mann’s comments on Feynman’s views on oral health are quite entertaining. As I remember Feynman found the positive evidence for flossing and brushing (?) lacking and so didn’t. Gell-Mann complained of halitosis but I don’t believe Feynman suffered from a substantially increased rate of dental caries.
I am optimistic about the potential for engineered bacteria to improve human health. I give my daughters, and take myself, prebiotics containing bacteria associated with oral health. Bacterial populations vary from person to person. There are suggestions that elite athletes and long lived individuals have uncharacteristic intestinal bacterial populations.
I wouldn’t hesitate to undergo this treatment. In the very unlikely event there were undesirable effects, then as is the case with toxic bacterial infections in otherwise healthy individuals, a treatment protocol with antibiotics and probiotics would reset bacterial populations.
Comment #35 December 11th, 2023 at 11:44 pm
Sorry
“prebiotic” should be “probiotic” and “uncharacteristic” better as “atypical”
Comment #36 December 12th, 2023 at 12:24 am
One of my daughters fought the dentist when she was say 4-6 years old. The dentist recommended that she be anesthetized in office and all of her teeth capped. I got the name of the service that performed the in-office anesthesia and got the details of the anesthesia protocol and found that a technician performed the service. I looked through the literature regarding the anesthesia agents in their cocktail for pediatric use and concluded that there was no way I would agree with anesthesia for my daughter unless a life or death emergency. We switched dentists and the new dentist was able to talk her down and have never had a problem since.
My problem with dentists is an abnormally strong gag reflex from any contact in the back of my mouth. It is a reflex and I can’t control it. Anything that reduces the probability of dental work requiring contact in the back of my mouth is a God-send.
Comment #37 December 12th, 2023 at 2:32 am
… sure, I’d give it a try. Anything for fewer dentist appointments.
Comment #38 December 12th, 2023 at 3:45 am
OhMyGoodness #36: Oh my goodness! But I’m still missing something in your story. Namely: was the first dentist right that your daughter needed all of her teeth capped? If so, why? If not, why did he say it?
Comment #39 December 12th, 2023 at 5:38 am
Scott, would you consider devoting at least a short post (or a section of a longer post) to the abuse suffered by Palestinians now at the hands of Israeli soldiers? I mean stories like this: https://www.aljazeera.com/features/2023/12/12/like-we-were-lesser-humans-gaza-boys-men-recall-israeli-arrests-torture and numerous similar stories. You may question the veracity of any single story like this, but there are so many of them it’s hard to imagine all of them are fake. Writing about Palestinians every once in a while might be good for mental hygiene, especially for people who are pro-Isreli.
Comment #40 December 12th, 2023 at 5:55 am
Scott #38
No she didn’t need all her teeth capped. His reasoning was that it was impossible to work on her teeth when she was conscious, and likely to have cavities in the future, and so best to anesthetize her once and cap her baby teeth so no further work required until her permanent teeth came in. He was a pediatric dentist at a reputable practice but wrong on all counts. She has a normal rate of cavities up until now (11 years old).
Comment #41 December 12th, 2023 at 8:56 am
I’m essentially with Seth Finkelstein #14, too many red flags.
Also, as with mRNA “vaccines”, again we see advertised good effects and no comment on negative ones (whether not seen at that time or suppressed, or maybe – here, certainly not with mRNA – non existent). Fiddling around with our bacteria (with outnumber, by far, our “own” cells) seems to be a linear (here: multiply by 0) impact on part of a very non-linear system, w/o ANY understanding of what else might happen due to this, in the mouth or even “further down”.
And NO, I do not think that the uninformed public (that would include all of us here, I guess, incl. Scott himself) should be invited to participate “on their own risk”. If the FDA is/was part of the pharmaceutic lobby or the WHO is(!) bought by Gates etc.etc. that should be a point for policy change, but not for circumventing the protocol altogether.
#36: Strong gag reflex 😉 Me too. Have a RED boldface 1-liner in my patient record on this. My dentist knows to avoid that area, others do not. Switch dentist, until satisfied. It is possible.
Comment #42 December 12th, 2023 at 9:25 am
MJV #41: For me and most of my readers, I really don’t think comparing this probiotic to the mRNA vaccines that successfully ended the pandemic is the knock-down argument against it that you think it is. 😀 Unfortunately, I will not allow further comments about vaccines.
Comment #43 December 12th, 2023 at 9:55 am
MJV #41
Even dental trays for impressions are a huge problem for me. Specially constructed trays and quick set material does not help. They still have to feverishly dig it out almost immediately from my red gagging face. This leads to differences between individuals including their bacterial populations. The FDA as a political organization is now to regulate what bacteria I have in my body? That is absurd.
Comment #44 December 12th, 2023 at 2:42 pm
My advice about oral care:
– always get a second opinion when your dentist claims that you really need to get something serious (i.e. expensive) done.
– the most important thing is daily careful and vigorous flossing. Never miss a day.
Comment #45 December 12th, 2023 at 11:50 pm
“I was radicalized by the pandemic, when it became painfully obvious that…by insisting on the whole Phase I/II/III process rather than letting any interested person take a vaccine in Spring 2020 after a single human challenge trial with willing volunteers, the world’s regulatory agencies had needlessly consigned millions of people to their deaths.”
Oh dear, Scott. We’ve all been witness to the damage – the millions of deaths – that anti-vaccine hysteria has created during this pandemic, and will continue to create for babies who fall victim to measles, pertussis, etc., and for the thousands upon thousands still dying unnecessarily from COVID. (This is particularly scary to me due to immunosuppressive medication I’m taking.) And you think it would have been a great idea to have potentially played right into that narrative by putting out vaccines before those with expertise were comfortable they’d been fully tested?
Comment #46 December 13th, 2023 at 5:13 am
“the mRNA vaccines that successfully ended the pandemic”
Is that a common claim nowadays? I thought on the contrary it was now widely acknowledged that the vaccines didn’t significantly slow transmission, just made it easier for some parts of the population to deal with the infection. Also, note that the pandemic “ended” everywhere, including in countries in which the mRNA vaccines were either rare or absent. What this means in practice is that everyone by now has had covid, probably multiple times, so people are psychologically used to it and usually don’t bother testing for it anymore. I myself had two doses of adenovirus vaccine, and after that, at least one wild infection, and probably one or two more wild infections in the following years.
Comment #47 December 13th, 2023 at 5:43 am
Jud #45: There were millions of people who wanted the vaccine as soon as it existed, but were blocked from getting it by the state—some of whom died while waiting. There were millions of others who didn’t want the vaccine, because they thought it contained tiny brain-control microchips or whatever, and who had to be pushed into getting it with various carrots and sticks or who never got it. There are few words to describe how much more I’m concerned about the first group. Indeed, my concern about the second group was mostly about the likelihood of their spreading COVID to the first group (the vaccine being only ~95% rather than 100% effective in stopping death), and also about the children of those in the second group who didn’t deserve to die for the stupidities of their parents.
[NOTE: There were people who had reasons for declining the vaccine that didn’t involve idiotic conspiracy theories, and I apologize if the above appeared to lump them in with the conspiracy theorists, which was not my intention.]
Comment #48 December 13th, 2023 at 11:51 am
If this start up wants investors by the score they should develop intestinal bacteria that reliably produce polypeptides associated with excellent health like MOTS-c and Humanin and compounds like Urolithin A.
Comment #49 December 13th, 2023 at 2:22 pm
Scott #47:
Vaccines were scarce and expensive during the testing phases. IIRC several $1000 per shot. The millions ready to test might not want to spend that kind of money for a treatment, that was neither proven to be effective nor to cause no side effects. There was no FDA approval before for any mRNA vaccines. And I don’t think either Pfizer or Moderna would have invested in mass production of billions of doses before they were sure the vaccines work as intended. Most of the delay was caused by the time needed to scale up production of a vaccine of a type, that was never mass produced before.
Comment #50 December 13th, 2023 at 4:29 pm
Scott #47:
“Indeed, my concern about the second group was mostly about the likelihood of their spreading COVID to the first group (the vaccine being only ~95% rather than 100% effective in stopping death), and also about the children of those in the second group who didn’t deserve to die for the stupidities of their parents.”
Of course I agree, since I have the experience of being immunosuppressed and talking to people who say they don’t want to mask or get vaccinated because of whatever slight bother or inconvenience it might cause them, without any thought for vulnerable populations.
I think this article provides a nice contemporary view at the time of the factors affecting the FDA’s far speedier than usual approval process for the vaccines.:
https://www.theatlantic.com/science/archive/2021/08/fda-pfizer-vaccine-full-approval/619870/?utm_source=copy-link&utm_medium=social&utm_campaign=share
Comment #51 December 13th, 2023 at 11:47 pm
Uspring #49
At the very best best debatable if the vaccines worked as intended. The most important consideration for pharm companies was that they had the backing of the government and so the vaccines would be covered under public and private insurance plans and they would enjoy release of liability under the PREP Act.
At the time of vaccine release already clear that mutants were in circulation that were resistant to the vaccine. As is often the case with this type of virus it mutates quickly.
Comment #52 December 14th, 2023 at 4:28 am
Single stranded RNA viruses, like the Covid associated virus, are sloppy replicators and so have high genetic diversity and are therefore often difficult to control through vaccination. Examples include HIV, Hepatitis C, Influenza, various Rhinoviruses, Coronaviruses, and now specifically SARS-Cov 2. With frequent genetic copy errors, and population wide replications of say quadrillions every day, they are a cloud of genetic diversity and vaccines often act just as a filter allowing resistant strains to flourish and supplant the strains sensitive to the vaccine.
Comment #53 December 14th, 2023 at 12:21 pm
OhMyGoodness #52:
Efficacy wrt infection dropped significantly with mutations, efficacy wrt severe outcomes not very much.
A much overlooked fact is, that reproduction factors of e.g. around 1.1 already lead to a surge in infection numbers due to the short generation time of around 3 days. This reproduction factor can be decreased to a value below 1 with a vaccine preventing only 20% of the infections. A rather small effect can go a long way here.
Comment #54 December 14th, 2023 at 2:08 pm
Uspring #52
I looked at the population wide fatality rates from the NHS for England and Wales (last time maybe six months ago) . The vaccination status was included and my numbers indicated very similar population fatality rates for vaccinated vs unvaccinated. Say the vaccination population rate was 96% and the proportion of vaccinated vs unvaccinated fatalities was close to 96% (very slightly lower). I don’t believe any of the other single strand targeted vaccines have shown any reduction in fatalities for new variants that evaded the evoked vaccine response. If they had it would have been a huge victory for viruses with a relatively high fatality rate.
Comment #55 December 14th, 2023 at 2:28 pm
I realize that data presented from the US contradicts my statements above concerning the NHS data and I am unable to explain the discrepancy. I do know that the NHS has uniform regulated reporting standards country wide but otherwise do not know why a material difference.
Comment #56 December 14th, 2023 at 3:08 pm
I looked through a recent study from Israel and it is true that almost all studies indicate lower fatality rate with bivalent booster.
Comment #57 December 17th, 2023 at 6:32 pm
Even further off topic than the Oppenheimer movie: quantum computing has apparently reached outdoor culture, with Civivi introducing a line of pocket knives called Qubit:
https://www.bladehq.com/cat–CIVIVI-Qubit-Knives–4944
If anyone cares, they are Chinese-made knives of recognized high quality, provoking various reactions from knife people who like good gear but tend to be nativists. I’m not trying to encourage or discourage anyone about buying them, but if you do think you might want one for novelty purposes or whatever else, it is safe to say that they are a good value as midrange folding knives go.
Comment #58 February 25th, 2024 at 12:51 am
Do you have any updates on this? How has your experience been like?