Wisdom tooth extraction is a rite of passage for American teenagers. Family dentists often recommend it and most dental insurance pays for it. With 10 million wisdom teeth removed every year, it is a $3.5 billion industry in this country. And yet, there is disagreement among dental professionals on whether the pain and risk is necessary.
Dr. Leigh Colby, a dentist in Lebanon, Oregon may put an end to the controversy. Working with Dr. John Mata, an Associate professor at Western University of Health Sciences and Pharmacology instructor at CVM, Colby is developing a process for vaporizing wisdom teeth before they can form. His procedure uses microwaves to create thermal coagulation in the wisdom tooth bud, a pre-calcified mass of tissue that eventually develops into a tooth. “The goal is rather than wait for wisdom teeth to form and then be surgically extracted, we believe we can develop a technique that is micro-invasive,” says Colby. He envisions it as a routine, 60-second treatment that would typically be performed on children under age fourteen.
Currently in the research phase and a long way from FDA approval for human use, Colby and Mata are using the CT scanner at the OSU Veterinary Teaching Hospital to prove the procedure works on pigs.
A four-month old pig’s wisdom tooth bud is approximately equivalent to an eight-year old child’s. It is a good animal model for demonstrating the effictiveness and safety of Colby’s procedure. “We know it works,” he says. “We have to prove it to the FDA.”
Mata, a veteran researcher, is using his expertise to carefully design the study. “We have to do this on enough pigs to get statistical significance for proof of concept efficacy,” he says.
The procedure begins with a CT scan of the pig’s mouth that Colby uses to create an impression that will be used to create a custom surgical guide. The guide enables him to place the tiny tip of his microwave tool in exactly the right spot to dissolve the tooth bud without hurting surrounding tissue. The scan is a high-resolution, 3-D, cone beam CT rather than the more common axial tomography. “It is really impressive technology that wasn’t commercially available until about 2005,” says Colby. “This is all about high precision medicine. We want to position [the microwave tip] plus or minus a quarter of a millimeter in the tooth bud.”
Once the pig’s tooth bud is ablated, Mata documents the treatment’s effect on the pig. “We spend a lot of time detailing how the animal handles the procedure: Is it well-tolerated? Do they show any signs of discomfort?” says Mata. “We have good indication that it is very well tolerated. The pigs don’t seem to mind.”
Colby says the procedure will be much easier in humans. “In pigs, the tooth is way down in the bone. In the human tooth, you can reach in with your little finger and touch the tissue where the tooth bud is so it is readily available to be ablated.”
Colby has applied for patents on his procedure but the cost of bringing it to market is huge. Once the pig studies are done, he will need human clinical trials. Plus he still has to develop a small medical-grade generator built just for this procedure. “It’s a $10-15 million development,” says Colby. “Obviously you have to get investors. If we can show them that the FDA has approved the part that goes into the human [the microwave tip], then investors will step forward.”