Team:Shanghai United HS/Human Practices


Integrated Human Practice
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.”