Could a genetically-engineered bacteria cure tooth decay forever?

Came across this fascinating news in Scott Alexander’s Astral Codex Ten newsletter: a company called Lantern Bioworks has developed a genetically-engineered bacteria similar to the one that causes tooth decay, which is known as streptococcus mutans. It converts sugar into lactic acid, which dissolves the enamel coating on your teeth, leading to cavities. The bio-engineered version doesn’t cause decay because it turns sugar into something else (alcohol, as it turns out, although not enough to get drunk on), and it also has a mild antibiotic property, so it eventually kills off all of the other bacteria in your mouth.

One of the interesting aspects of this invention is that the man who came up with it has been working on it since the mid-1980s. In 1985, Professor Jeffrey Hillman of the University of Florida surveyed the microorganisms on his graduate students’ teeth and found that one had an unusual strain of S. mutans that contained the natural antibiotic, and he spent the next few decades refining it and adding the other features. But when he tried to get FDA approval, they made it almost impossible — they wanted him to do a study with 100 subjects, all of whom had to be age 18-30, with removable dentures.

Eventually, the founder of Lantern Bioworks came across it and licensed it from Hillman. To get around the need for a study of teenagers with dentures, Lantern is going to market the engineered bacteria as a “probiotic,” for which the FDA has lower standards than it does for drugs. Technically, any bacterium which you take in order to change your natural microbiome is a probiotic, and there are already a few genetically-modified probiotics out there that have been approved. Some are almost as creative as Lumina: Zbiotics is a genetically-engineered species of Bacillus that sits in your stomach and supposedly prevents the user from getting a hangover by metabolizing alcohol byproducts.

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