Our teeth can’t repair themselves…but what if they could? The future of dentistry lies in the captivating field of regenerative medicine, where stem cell research is diving deep into the potential to repair damaged teeth with “living fillings.” But how far are we from ditching fillings for specialized tooth restoration? While the research is science fact, getting a “living filling” from your dentist is still science fiction…for now.

Featured Experts

• Victoria Veytsman, DDS is a cosmetic dentist based in New York
• Salvator La Mastra, DDS is a cosmetic dentist based in Dallas, TX

Stem Cells for ‘Living Fillings’

“I find this field really fascinating,” says New York cosmetic dentist Victoria Veytsman, DDS. “The field of tissue engineering and regenerative medicine in dentistry is really at the forefront of where healthcare is going.”

Stem cells are those super useful specialized cells (found in adult body tissues and in embryos) that can be guided towards becoming many different cell types and can self-replicate. That makes them immensely useful in regenerative medicine, where the goal is to get the body’s repair processes engaged to handle damaged, diseased or otherwise unwell tissues. According to the California Institute for Regenerative Medicine, the most commonly used stem cell-based therapy is for bone marrow transplants.

“When it comes to filling a cavity with them, stem cells alone aren’t enough to complete the process of tooth restoration,” explains Dallas, TX cosmetic dentist Salvator La Mastra, DDS. “They would need a framework of some kind in order to form in the correct manner.”

Dr. Veytsman explains that current research is focused on creating that framework, creating a kind of “living filling.”

“We don’t want enamel to grow in a petri dish; we want it to grow on your tooth,” Dr. Veytsman says. “So the process requires a scaffold or matrix to support that growth.”

Cavity Repair Now

When a tooth develops a cavity, the first step is to remove the decay and stop the process of damage. “Cavities are caused by bacteria,” Dr. La Mastra explains. “That acid producing bacteria is what causes the cavitation of the tooth, which is the cavity itself and the decay. It’s basically necrotic tissue that we have to drill out.”

Then, you have to fill in what’s lost. “We do things like crowns and fillings to replace the chief structure that was lost or decayed,” Dr. Veytsman explains. “It’s called restorative dentistry because we’re trying to restore what’s been lost.”

Those fillings are made of amalgam (a mixture of metals) or composite resin filling materials (made from polymers and glass particles), and we know they’re safe, functional and that they won’t decay in the future. That’s something we can’t say about these “living fillings.”

“One thing about our current implants and fillings is that we know they won’t develop cavities down the line,” La Mastra says. “There are complications that could arise from the regenerative method that could cause more than just aesthetic consequences; your bite can also be impacted.”

The Future of Dentistry

“I think we’re just at the beginning of this technology,” Dr. Veytsman says. “But it definitely has the potential to change the way we approach cavities in the years to come.”

Stem cells could also be utilized outside of “living fillings” to benefit oral health. Aside from repairing enamel, stem cells could be used to encourage the growth of dentin, restore pulp, even regenerate lost gum tissues.

“You’re seeing the rise of stem cell banking now for these purposes,” Dr. Veytsman explains. “Harvesting and banking stem cells for future applications and to use as a preventative measure are growing in popularity.”

‘Living Fillings’ are Science Fiction for Now

“I think we’re multiple decades away from a changeover to regenerative medicine in dentistry,” La Mastra says. “I already have patients who ask me if they can just regrow their tooth, and we are nowhere near being able to do that.”

While “living fillings” aren’t going to enter your dentist’s office in the immediate future, there’s still reason to be excited.

“The advent of AI technologies is really accelerating this research,” Dr. Veytsman says. “And it’s letting us ask a ton of questions about possible applications. Can regenerative medicine deal with prevention? Can it help stop decay in the very early stages? We’re still so early in this process, but AI and regenerative medicine are really at the forefront of healthcare right now.”