Team:Shanghai United HS/Human Practices
Integrated Human Practice
Overview
The goal of our project is to find a better way to treat dental caries problems,
which is using lyases of a phage: ClyR. In order to make phage-lyase treatment possible, the target, which
is the research topic, is to learn how to induce ClyR from arabinose extracted from probiotics. To study
this research topic, our team members have conducted various experiments to understand and prepare for the
engineering process for our product in the laboratory. In the meantime, our team members also have consulted
biological experts for help in laboratory safety, answering conceptual questions, and the procedures of
experiments.
Nowadays, the problem of dental caries is a severe issue. According to CDC, the
prevalence of total dental caries (untreated and treated) in primary or permanent teeth among youth aged
2–19 years was 45.8%. Prevalence increased with age, going from 21.4% among child aged 2–5 to 50.5% among
6–11 to 53.8% among those aged 12–19 [1]. Therefore, people could have lots of problems in eating food when
they have dental caries. However, although today’s treatment is effective using surgical filing treatment,
it has lots of side effects and will bring lots of potential trouble: it causes pain to the patient, and
patients could not eat spicy food after surgery, not chewing hard food, risks of infection, etc. Therefore,
our project aims are effectiveness and comfort in curing dental caries and low side effects. Our product
could kill the bacteria that cause dental caries in a short amount of time without any sense of pain.
Furthermore, users won’t have to worry about what food they should not eat.
What do we learn from survey?
We select the opinions of 323 people. The survey shows that people aged 5-28 do not
pay attention to the problem of tooth decay and lack the awareness of tooth protection.
Middle-aged people have more serious tooth decay problems but have a stronger sense
of tooth protection and are more willing to spend time and money. People with fewer cavities will have a
stronger sense of tooth protection.
Most people of all ages tend to brush their teeth for 1-2 minutes, some people
choose 3-4 minutes, and a few people choose less than 1 minute or more than 4 minutes. However, the correct
time for brushing teeth recommended by doctors is more than 3 minutes, this indicates that the correct
brushing time needs to be popularized. The number of tooth decay is directly proportional to the number of
tooth brushing. There is still a large part of the masses in society who do not have a strong sense of tooth
protection.
People without tooth decay are generally willing to seek medical attention
immediately after tooth decay is discovered, up to 64.5% (71 people). However, the proportion of people with
tooth decay who choose to seek immediate medical attention only fluctuates around 35%. On the contrary, more
people will choose to seek medical treatment when they are free or not, accounting for more than 60%.
Among the 300 people, 292 are willing to invest a certain amount of money and time
to protect their teeth, accounting for 90.4%. Therefore, most people are willing to buy dental products.
Only 41 people chose to use products containing phage lyase. Accounted for 12.7%. 262 people (81.1%) did not
know that products containing phage lyase can protect teeth. Among 323, 256 (79.3%) people most hope that
the type of tooth care product is toothpaste, and mouthwash is ranked second.
What did we learn from interviews with four experts in different regions?
The first expert we interviewed is Dr.Qingzhuo Wang, Ph.D.,Chinese Academy of
Sciences, postdoctoral researcher at Nanjing Noarmal University, expert of synthetic biology. First, the main customer group is people of all ages because people
of every age have their own unique reasons that cause their tooth decay. Second, the interviewee mentioned
that phage lyase is currently mainly used in experiments, not products, and more likely to appear in the
form of drugs. The main difficulty is that a large number of clinical trials are needed to verify the
absolute safety and functionality of the phage lyase. The cycle is very long and can even reach 20 years.
Third, the rationality of the product. Products need to be guaranteed long-term effectiveness. The current
technology is not perfect enough to achieve this goal. However, the interviewee still proposed several
conjecture methods. The first is to use substances, such as nanometers, to wrap the phage lyase to ensure
its activity. Such as the form of capsules. The second is to make phage lyase into powder to extend its
shelf life. Fourth, we mentioned whether phage lyase will cause damage to the intestines and stomach along
with probiotics. Experts pointed out that in theory, the enzyme will not be inactivated after entering the
intestines and stomach. Fifth, are their alternatives to E. coli. Experts point out that Escherichia coli is
easy to edit, prove it. But experts also mentioned that microorganisms can be extracted from the oral cavity
for modification, which may have a better effect on the oral cavity. Sixth, we asked about the feasibility
of cooperating with the dental office. We intend to put the phage lyase into the dental filling materials.
Glue for braces. Experts believe that it is theoretically feasible and effective. However, most organisms in
the oral cavity have biofilms, making it difficult for other organisms to approach them. In addition, the
effect of filling materials and braces cannot be maintained for a long time, and it will be invalid in a
short time. In conclusion, experts believe that we need more experiments to prove the rationality of the
above conjecture.
Our second expert is Atlas Zheng (Consultant at Oriental Securities). First, expert believes that we should attract potential
customers in a short period, introduce our advantages, including principles, such as using stories to
unfold. Second, expert suggests that we make products our focus but also use concise language. Third, expert
believes that we should pay attention to the shortcomings of the industry rather than our company itself.
The ambitious goal cannot attract the interest of others. Fourth, when we introduce our products, we should
emphasize our product advantages-strong effects and satisfy market vacancies. Fifth, expert also suggests
that we pay attention to the pain points of users. For example, the existing anti-cavity toothpaste is not
effective, and the substances in the existing products are harmful to the body and slow to play. Sixth,
expert believes that we should move the product introduction part forward so that users can intuitively use
product features to attract users by simply entering the web page. Seventh, expert believes that we can
think about more business plans, such as selling our products to leading compan ies and becoming one of the
suppliers of raw materials. Eighth, expert suggests that we should plan for the future, for example, we will
join global trade.
Our third expert is Ji Guoping, MD of Shanghai Jiao Tong University, Loma, Master of
Oral Implantology of Linda University. First, he mentions the sources of cavities, sugary foods such as
starches, bacteria, minerals that produce acids that dissolve teeth, and the host's ability to resist
cavities. Toothpaste containing FU can strengthen resistance. Second, phage lyase is a virus that infects
other bacteria, Streptococcus mutans. Third, do not use products that can kill all bacteria, because this
will also eliminate many benign bacteria, leading to the ecological imbalance of bacteria. Fourthly, we
propose the conjecture whether it can be combined with bacteriophage lyase and fluoride toothpastes. Experts
explain that brushing teeth attaches lyase enzymes to the surface of teeth. Bacteria form a thin film on the
surface of teeth called plaque, which is difficult to penetrate. Bacteriophages, on the other hand, are
effective at removing harmful bacteria from the membrane. Fifth, expert says we should consider time of
action. The normal brushing time is three minutes, so the lyase needs to function in three minutes.
According to laboratory data, the play time of lyase is 3-5min, so it is feasible to combine lyase with
toothpaste containing . Sixth, he explains the advantages and disadvantages of pit and groove surgery and
fluoride toothpaste. The fossa and fissure sealing surgery is mainly for host and food factors. The depth
and shape of the lines on the surface of the teeth are easy to hide dirt, and the grooves and grooves
surgery can smooth the lines so that dirt can not remain on the surface of the teeth. Fluoride toothpaste
and groove surgery can not be completed by people themselves, they need to go to the hospital. Plus,
technical requirements are not high, trauma is not large, the effect is obvious, and the price is not high,
but it is not convenient. With fluoride toothpaste, the requirements are high and effective brushing action
is needed. Otherwise, no matter how effective the toothpaste is, correct brushing actions are the most
essential. And these three methods do not overlap, they can be carried out at the same time. Seventh, he
suggests that we should put lyase into existing everyday products rather than develop an innovative product.
It can be putted it in gum, cleavage sealant, braces glue. But the main problem is how to maintain long-term
activity, which needs more experiments. Eighth, what are the benefits to consumers of phage use? Easy to
use, price is cheaper than filling teeth. Ninth, what are the negative effects of lyase? Currently, this is
unclear. He points out that a large number of experiments, from basic to animal and then to clinical trials,
will be needed to confirm this. However, it is difficult to simulate the real oral environment and consider
all factors, so applying it to reality is difficult.
The fourth expert is Li Qiang, vice president of Shanghai Stomatological Hospital.
First, the expert points out that the data of each city is different, and it is related to the local
economic development conditions because the popularization rate of relevant information in places with good
economic development is higher than that in places with low economic development. Second, the way people
brush their teeth is very important. The correct method of brushing teeth, the habit that is brushing teeth
in the morning and evening and gargling after meals, the appropriate way of using dental floss and regular
examinations are recommended to prevent tooth decay. Moreover, experts believe that prevention is the most
effective way to solve tooth decay. Third, fluoride products and surgical risk is not big, but need regular
technical personnel to operate. It is hard to tell which one is more beneficial. The effect of pit and
fissure sealing on big teeth is significant. Fluoride products have protective effect on teeth, and have no
absolute advantage, because the focusing point is different. Thus methods are decided based on actual
situation. Fourth, experts emphasized the safety and universality of the product, which needs to meet the
national conditions and a large number of clinical trials to effectively publicize lyase technology. Of
course, people's habits are also very important.
Impacts to our project
Based on our data and experts' advice, we made the following changes:
1. The product idea should be altered from
self-developed products to providing lyase to oral care products for suppliers because there is already a
relatively complete oral product system in the market. There is no better innovation that can effectively
compete with existing care products or treatments.
2. The product that can be used daily, such as
gumshoes, should be selected as the carrier because the phage lyase has a significant effect and plays a
role in a short time.
3. We should popularize lyase because most of the
people who know lyase are professionals. The ordinary people are our main customer consumer groups, but they
do not have enough understanding.
4. We should have a plan for the future to expand the
demand market, such as joining international trade.
[1] Eleanor Fleming, Ph.D., D.D.S., M.P.H., and Joseph Afful, M.S.. July 25, 2018.
“Prevalence of Total and Untreated Dental Caries Among Youth: United States, 2015–2016.”
https://www.cdc.gov/nchs/products/databriefs/db307.htm.