(652d) Leveraging Surface Science of Biomaterials for Improving Oral Health Outcomes

Oral conditions are the most common conditions of humankind affecting 3.9 billion people around the world (Evidence-Based Dentistry (2013) 14, 35). It is estimated that that 90% of people have some form of chronic gingivitis (Periodontal disease. BMJ. 2000;321(7252):36-39). If left untreated gingivitis can cascade to periodontitis and eventually tooth loss. Tooth sensitivity is another common oral condition in which dentine tubules become exposed allowing nerve receptors to be activated in the tooth pulp. This is typically the result of gingival recession or acid erosion, affecting over 40 million Americans, reported by the Academy of General Dentistry. Many common solutions to combat oral disease focus on active compounds to control the microbial burden in the oral cavity such as chlorhexidine, cetylpyridinium chloride, triclosan, essential oils, etc. for gingivitis control or promotion of depolarization of the intradental nerves (e.g, potassium nitrate) for dentinal sensitivity relief. This research is focused on two alternate approaches utilizing surface modification biomaterials to demonstrate how improved oral health outcomes can be achieved by formulated medical devices. Ethyl lauryl arginate (LAE), is one such technology that we have shown to provide a protective hydrophobic shield over the enamel (validated with captive bubble contact angle) by interacting with pellicle proteins (validated by QCMD). The protective shield provided by LAE has resulted in the in vitro prevention of bacterial adhesion (approximately 1.5 log reduction in saliva-based bacterial biofilms from the water control following one 10 min treatment), mitigating biofilm formation and resulting in clinical efficacy for the treatment and prevention of plaque and gingivitis with twice daily 30-second exposures. We have taken a similar approach to combat tooth sensitivity by utilizing the surface modifying biomaterial, dipotassium oxalate (KO) in combination with labile -calcium in the oral cavity. It has demonstrated the ability to provide an acid-stable protective environment, reducing dentinal permeability and blocking 92% of exposed dentin tubules in just 6 treatments using an in vitro hydraulic conductance method and as a result, has been proven to treat dentin hypersensitivity in the clinic. In summary, the biomaterials, LAE and KO, provide clear evidence of the impact surface modification and surface coating approaches in formulated medical devices can have on improved oral health outcomes.