Grow New Teeth?

Picture from Amazon

Last week I wrote about how consuming too much energy drinks can cause erosion in our teeth. I grind my teeth a lot when I sleep and have been using a night splint for the last 20 years. Also, I used to drink a lot more Coca Cola, sports drinks and consume energy gels back when I was competing. So I am worried about the erosion in my teeth.

If we fall and our bones break, the bones have the ability to heal and grow back. However with our teeth, the same cannot be said. Once you lose a tooth, that's it, unless you put in a dental implant to hold an artificial tooth on top.*

What if I told you now that growing back teeth may be a possibility in less than 5 years. Japanese researchers are now experimenting with an experimental drug that may regrow human teeth.

This is after years of study around Uterine sensitization-associated gene-1 (USAG-1), an antibody shown to inhibit the growth of teeth in ferrets and mice. However, back in 2021, the researchers found a monoclonal antibody (usually used in fighting cancer) that disrupted the interaction between USAG-1 and molecules known as bone morphogenetic protein or BMP. 

Suppressing USAG-1 benefits tooth growth. And believe it or not, ferrets have a similar dental characteristics to humans. Both develop 2 sets of teeth in a lifetime, a temporary set or "baby" teeth followed by a permanent adult set.

The researchers have started trials on humans. It will last 11 months and focus on 30 males between the ages of 30 and 64 with each missing at least one tooth. The drug will be administered intravenously to assess it's effectiveness and safety. Previous animal studies did not show any adverse side effects.

The researchers are hoping that if the trial goes well, they can administer this treatment to patients between the ages of 2 to 7 who are missing at least 4 teeth. The end goal will be to have tooth regrowing medicine by 2030. 

Although the current treatment will be focused on young patients with congenital tooth deficiency, the treatment will eventually be available to anyone who is missing a tooth. Human trials began last September 2024. Let's wait and see.

Reference

Murashima-Suginami A, Kiso H, Tokita Y et al (2021). Anti- USAG-1 Therapy For Tooth Regeneration Through BMP. Sci Advances. 7(7): eabf1798. DOI: 10.1126/sciadv.abf1798

* Thanks to Dr Winston Tan and Dr Dr Frank Liew who have been looking after my implants and teeth all these years.

Too Much Energy Drinks Causes Tooth Erosion

Guess what I'm drinking in my 2 water bottles in 2001?

My patient who is a dentist tells me he is seeing a lot of younger patients having erosion in their teeth.  The features of their particular erosion is non-bacterial acid induced loss of dental hard tissue. A notable contribution is due to increased consumption of acidic drinks, especially energy drinks. 

Fortunately, I never had any Red Bull or Monster in my water bottles when I was still training seriously or racing.

Like I wrote previously, energy drinks are thought to be beneficial for performance. My platoon mates in the army when we were doing national service, would frequently load up with energy drinks such as Red Bull. There was no Monster drink then. They would consume it especially in the morning before physical training and Standard Obstacle Course (SOC) training sessions. Those who were less fit tended to count on those energy drinks. One of them commented that without Red Bull he would definitely fail his fitness tests.

Some of them would also mix Red Bull with alcohol when they book out on Fridays so they can party the night away.

This was similar when I was in university. Some of my classmates did the same when cramming for an exam or writing a paper.

Energy drinks from the study

A paper published last year (Martinez et al, 2024) was investigating the pH of energy (pictured above) and pre workout/ sports drinks (below) and the consumption frequency and habits among amateur athletes. Their study analyzed the pH of 67 commercially available energy drinks and pre workout/ sports drinks. There were 43 energy drinks and 24 pre workout/ sports drinks.

Pre workout/ sports drinks

The authors also did a survey among 113 amateur athletes who completed an anonymous questionnaire to find out about the use of different beverages during various sports activities. The participants participated in strength training, endurance sports and some of them participated in both. They reported consuming energy and/ or pre workout/ sports drinks before, during or after workout.

Ready for the results? The average pH for the beverages studied was 3.3. The pH level at which enamel erosion begins is approximately 5.5, which is known as the critical pH. When the pH in our mouths drop below this level, the enamel starts to dissolve, leading to tooth decay.

51 percent of the participants surveyed said, they consumed at least one of the beverages studied. Most participants aged ≤ 29 consumed them 3-5 times each week while the older participants consumed them 1-2 times per week.

Shocked? The study showed that ALL the  energy drinks and the majority of pre workout beverages evaluated have erosive pH levels that can damage tooth enamel. Please remember this when using energy drinks or pre workout/ sports drinks. 

I always carry water with me during my bike rides instead of energy or sports drinks. Drinking plain water after your sports drinks is a good way to mitigate the erosive nature of the energy drinks. You may also want to brush your teeth when you get home.

Reference

Marthiez Lm, Lietz, LL, Tarin CC et al (2024). Analysis Of The pH Levels In Energy And Pre-Workout Beverages And Frequency Of Consumption: A Cross-Sectional Study. BMC Oral Health. 24,1082. DOI: 10.1186/s12903-024-04843-0.

Take your pick

Nose Strips Help You Race Faster?

Picture by Tim de Waele, Getty images

A patient just asked me about nasal (or nose) strips. She had seen lots of runners using them recently and wonder if they can help her run faster. 

I remember getting a couple of Breathe Right nasal strip samples in my goodie bag in a triathlon race that I took part way back in 1999. I had never used them before and I thought there's no harm in trying them in the race. 

Paula Ratcliffe in her heyday- M Hewitt, Getty images

I actually won that race but felt that the nasal strip did not help much except giving me a funny tan on my nose as race day was blistering hot. I remember seeing Jan Ullrich and Paula Radcliffe wear them when they were racing as well. 

Picture by O Docelin, Getty images

I noticed them again during the Tour De France this year (pictured above). Many cyclists were seen using them, some even using custom decorated ones. 

Bastille Day -Tim de Waele, Getty Images

So are these nose strips worth wearing? Do they help improve your sporting performance? Yes they do help with the "negative pressure" that builds up and blocks your nostrils during heavy breathing. They do improve airflow by enlarging your breathing passageway. 

However, what really matters is the amount of oxygen that gets into your bloodstream and not the amount of air you breathe in. For most people, the normal air you breathe in will mostly saturate your blood's oxygen carrying capacity.

A recent systematic review concluded that nasal strips do not help with VO2 max, rates of perceived exertion or heart rate response (the body's response to exercise).

If you're eating an energy bar on the bike or run, the nasal strip can help increase the ease of eating and trying to breathe at the same time. They can increase the comfort of breathing, especially if you have a deviated septum, some nose congestion or allergies, but they do not offer a performance advantage.

There is no real 'downside' and at best a placebo effect for those using them. I personally think it is more of a fashion statement if you look at the pictures from the 2025 TDF.

Should you try the nose strips? Yes, if you suffer from specific nose structure issues or want to use them as a fashion statement. They are not expensive and a good placebo effect is a legal performance enhancer.

References

Dinardi RR, Ferreira CHS, Silverira GS et al (2021). Does The External Nasal Dilator Strip Help In Sports Activity? A Systematic Review And Meta-Analysis. Eur Arch Otorhino. 278(5): 1307-1320. DOI: 1007/s00405-020-06202-5.

Illidi CR, Romer LM, Johnson MA et al (2023). Distinguishing Science From Pseudoscience In Commercial Respiratory Interventions: An Evidence-based Guide For Health And Exercise Professionals. Eur J Appl Physiol. 123(8): 1599-1625. DOI: 10.1007/s00421-023-05166-8