Whether through genetically manipulated probiotics or immune stimulation: the "vaccination" against oral diseases such as caries or periodontitis will remain a dream of the future in the coming years - but it is an interesting approach that is also being researched worldwide in periodontology and endodontics, writes the scientific information service "Zahnmedizin Report".



The US company Oragenics has announced a second clinical phase I study for "SMaRT Replacement Therapy". The treatment involves applying genetically modified, probiotic Streptococcus mutans strains to the teeth. These "weakened" bacteria are intended to displace the caries-causing bacterial strains living there and thus offer lifelong protection against caries. The clinical trial will begin in the next few months.[1] The first phase I trial, which began in April 2005 with 15 test subjects, was terminated prematurely. As a result, the US Food and Drug Administration (FDA) temporarily halted the study with a "clinical hold letter" and requested that the company submit a modified study protocol.



Other scientists have also been conducting research for a long time - Harvard professor Martin A. Taubman, for example, has been researching the principles and possibilities of "caries vaccination" for around 30 years [2]. Taubman is taking a different biological approach: in 2006, he announced an active immunization designed to stimulate the production of antibodies against the pathogens that cause tooth decay. To this end, the doctors are targeting glucosyltransferases - enzymes that help the bacteria to attach to the teeth and spread. It has long been known that tooth decay can be almost completely prevented if these enzymes are blocked. This activation of the immune system is said to be successful in animal experiments on rats[3].



Just how long clinical research takes is shown by the example of Australian researchers, who described back in 2002 how the protein groups of the periodontitis germ Porphyromonas gingivalis could be used for immunization [4]. Two years ago, they entered into a cooperation with the vaccine manufacturer Sanofi Pasteur, and the animal tests are now being followed by clinical trials. Here, too, it will take at least another five years before a marketable product is available at the end of this research.



[1] Oragenics, Inc. Announces a Second Phase 1 Clinical Trial of SMaRT™

Replacement Therapy. Announcement by Oragenics, January 31, 2011

[2] J L Ebersole et al: Effect of neonatal thymectomy on dental caries in rats. Infect

Immune (1982) 38: 1130-1136.

[3] M A Taubman et al: The scientific and public-health imperative for a vaccine

against dental caries. Nat Rev Immunol (2006) 6: 555-563

[4] P Sunethra Rajapakse et al: Immunization with the RgpA-Kgp Proteinase-

Adhesin Complexes of Porphyromonas gingivalis protects against Periodontal

Bone Loss in the Rat Periodontitis Model. Infection and Immunity (2002) 70: 2480-

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