The American Academy of Pediatric Dentistry (AAPD) recognizes the emerging field of regenerative medicine and encourages dentists to follow future evidence-based literature in order to educate parents about the collection, storage, viability, and use of dental stem cells with respect to autologous regenerative therapies.To view the full AAPD policy, click here.
How do I start the conversation with my patient?Many of your patients are aware of the power of stem cells, having previously banked cord blood stem cells. However, not too many people know that there is a different type stem cell inside of their healthy teeth! In fact, the Mesenchymal stem cells found in teeth are the same sort that are found in cord tissue, which many of your patients did not have an opportunity to bank. Since many people are familiar with the process of cord blood and cord tissue banking, we've found that to be a nice starting point for the conversation. Perhaps it might unfold something like this: For a printable .pdf version of this graphic, click here.
Which teeth are the best candidates?
Deciduous (kids) TeethAll teeth contain dental pulp, and therefore are all a potential source of stem cells. However, research has shown that in deciduous teeth, the four lower incisors (laterals and central) are the best sources of stem cells. In the course of treatment under dentist supervision, any teeth in which the pulp chamber is exposed or teeth which are extracted would be acceptable, as long as there is healthy pulp present. The teeth that contain the highest quantity and quality of stem cells will be those that maintain a blood supply until they are harvested.
Wisdom TeethAnother excellent opportunity to harvest dental stem cells occurs when wisdom teeth are extracted from teenagers and young adults. Since these teeth are typically healthy upon extraction, they are also great candidates for harvesting dental stem cells. Impacted molars which necessitate extraction or removal of wisdom teeth due to crowding or to facilitate orthodontic treatment would be acceptable. Endodontic therapy whereby the vital, non-hyperemic pulp is exposed would also be acceptable. Based on the dental practitioner’s’ judgment, periodontal treatment does not necessarily eliminate teeth as a source of stem cells. While these two opportunities represent the best time to save dental stem cells, all healthy teeth have stem cells, and therefore are potentially good candidates for harvesting dental stem cells.
A suitable evaluation of each client’s oral health is essential. The oral examination conducted by the dental practitioner will provide insight to the general health conditions of the client storing or donating their teeth or dental pulp, with emphasis on mucosal pathologies, clinical signs of periodontal inflammation, and pathologic swellings in the tooth area (suggesting abscesses or bacterial infection). Poor oral hygiene or periodontal lesions should be avoided, as such conditions could negatively affect the future uses of the stem cells. If the donor is in good general health (disease free), no pre-treatment (dental hygiene) is required.
Teeth will not be accepted if:
- Severe caries are present in tooth
- Significant enamel demineralization is present
- Gross plaque
- Significant gingivitis
What preparations are needed?
Prior to extraction, it is strongly recommended that the crown(s) of each candidate tooth (teeth) be cleaned with an appropriate disinfectant rinse to decontaminate the candidate tooth (teeth) and to avoid any postoperative infections.