This story emanates from a research award given to researchers at the University of Nottingham by the UK-based Royal Society of Chemistry to study the use of native stem cells to repair dental tissue. It says stem cells could allow patients to regrow decayed material inside their teeth: “Instead of the current dental materials used on fillings, which are toxic to cells, the new approach harnesses stem cells instead.”
The story makes clear that this idea is far from being tested on humans but strays into the realm of stem cell hype by asserting that it might someday offer “significant benefits” to millions of patients and even “put an end to root canals.” This material, according to the researchers, has been studied in cell culture and is about to be studied in rodents.
Suggesting at this point that it might offer any benefits is a stretch at best and suggesting that its use in repair of dental caries could “put an end to root canals” is absurd. The story inflates the benefits, ignores the risks and provides no counterbalance by experts in the field.
Root canals are commonly performed when an existing dental filing fails. The notion of doing away with root canals makes a tantalizing headline. More than 15 million root canals are performed every year, according to the American Association of Endodontists. A material that could reduce the risk of failure by helping the tooth to repair decayed material, could be an important advance. But headlines should be saved for research that involves humans, and not cell clusters.
The story does not address the potential cost of this procedure and how it might compare to a root canal, but this is important to consider since root canals are very expensive, and presumably a procedure involving stem cell regeneration would be, too. According to one consumer information website, a root canal costs between $585 to $1,400 depending on the location of the dentist’s office and the type of tooth. Those estimates do not include restorative procedures such as crowns, posts and cores, and fillings, which can cost hundreds or thousands of dollars more.
Benefits are not quantified, which is not surprising since it’s essentially cell culture research and hasn’t even been tested in animals. When there are no direct clinical benefits to quantify about a possible new medical intervention, it’s a sign the research may be too preliminary for a wide audience.
And despite the attempts at including provisos into the story, there are more positives presented suggesting benefit than we think are appropriate at this juncture in the research. Here are the statements that we think are a bit optimistic:
“What we found is a material that can potentially regenerate components of a patients’ tooth,” Celiz told CBS News.
“We’re trying to provide an alternative material, an alternative therapy,” he said, because the current method involves the dentist removing all of the infected pulp tissue, “scraping it out, and it can be very painful.”
“CBS News chief medical correspondent Dr. Jon LaPook put it in simple terms: “The cells in the area of a root canal, in the pulp, those are normally asleep. It’s like this material goes over and just taps it on the shoulder and says, ‘Wake up, wake up,’ and then it starts to repair itself.”
And finally, “If successful, a treatment like this could someday offer significant benefits for millions of dental patients each year.”
While that last statement may be true, it’s more likely that this research will never pan out clinically, and the story never addresses that likelihood or the long road that this approach faces before it might be widely used.
The story does not mention the potential for risks when using stem cells to grow dental tissue. As with many reports on new research, this story suffers from its optimism. The new material has been tested in cell cultures and has yet to even make it to an animal model, so predicting harms is difficult but it is easy to come up with some concerns: Will this material be as durable as existing fillers? Has the material been tested for long-term safety? If the material fails, how will that impact a subsequent root canal? Clearly these questions cannot be answered but we think that any good story should point out the unknowns and not just the potential positives.
The story quotes a researcher saying that the idea has been “tested it in cell cultures and we’re moving it along into rodents.” This is extremely preliminary research, to such a degree we’d argue it’s not newsworthy. But at the very least, the story should have dialed back many of its positive statements that overreach on this not-yet-existent treatment and make it sound like the evidence is more conclusive than it is. And the click-baity headline is clearly out of bounds given the state of the evidence.
Although the story does not meet the criteria for disease mongering we are a bit troubled by the suggestion that existing fillers are “toxic to cells.” The American Dental Association disagrees, “Dental amalgam is considered a safe, affordable and durable material that has been used to restore the teeth of more than 100 million Americans.”
The story lacks viewpoints from independent experts, such as someone from the American Association of Endodontists.
The story mentions that root canals are the current standard of therapy.
The story explains that the research is “still in its early stages, and has not yet been tested in people.” It also quotes a researcher saying, “It’s hard to put timeline on it, but we’re talking years before we test it in humans.”
Still, the story could have been more skeptical in its approach, pointing out that the therapy may never pan out.
The story suggests that this research is indeed new. This is indeed not the case, stem cells have been studied for dental applications for years. A group in Japan has been developing a stem cell based therapy for dental caries that has progressed in 2013 to animal studies.
The story used some statements from the news release without attribution, although they were slightly altered.
Example, from the story:
When dental pulp disease and injury happen, a root canal is typically performed to remove the infected tissues, explained Dr. Adam Celiz, Marie Curie Research Fellow at the University of Nottingham. Instead of the current dental materials used on fillings, which are toxic to cells, the new approach harnesses stem cells instead.
And how it appeared in the news release:
“Existing dental fillings are toxic to cells and are therefore incompatible with pulp tissue inside the tooth. In cases of dental pulp disease and injury a root canal is typically performed to remove the infected tissues.”
Systematic, Criteria-Driven
Monday at #ADA2021, an infectious disease epidemiologist, a journalist, and a researcher shared perspectives on communication of risk in the era of COVID-19: http://ow.ly/ROfR30rMeE7 @AstleyCM @garyschwitzer @berthahidalgo @ADA_DiabetesPro
Shoutouts to @susan_bewley @drkevinknopf @MichaelBaum11 in this call for more than fawning coverage from press releases for these kinds of stories.
Also, linked history inside goes back 5 years just on Grail apparently trying to become Holy Grail. https://twitter.com/garyschwitzer/status/1408849696416841731
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