Fall 2018

The Acid Test

Can a tooth-mounted pH sensor curb an epidemic of tooth decay?

By Helene Ragovin

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An image of how a wireless-enabled U-CHU biosensor will fit around a molar and provide real-time data to patients and dentists.

Dentists have long understood that patients with acidic saliva are at increased risk for developing cavities. But dentists who want to monitor the environment of their patients’ mouths over time, in an effort to keep ahead of tooth decay, haven’t had an effective way to do so. A team of enterprising students from Tufts dental and engineering schools are betting they can help solve this problem with a tiny, wireless sensor worn on the side of a molar.

Caries is a “sad, silent epidemic” in the U.S., said Saam Bozorg, D19, one that cost patients and insurers an estimated $8.6 billion to treat in 2017. Studying the protocols of preventive care, Bozorg thought there had to be an evidence-based way for practitioners to better identify at-risk patients, and for patients to become more involved in preventing cavities. Bozorg eventually hit on the idea of a noninvasive salivary pH monitor. The biosensor would be mounted on a molar band and could wirelessly transmit real-time data to dentists and their patients.

To start a new business, Bozorg had some of the bases covered—he’d worked in finance before switching to dentistry—but partners with the right technical expertise were necessary, too. At an event from the Tufts School of Engineering’s Gordon Institute, he met Daniel Weinstein, E18, a biomedical engineering major who was researching oral biosensors to detect nutritional macromolecules. Noah Hill, E20, brought both biomedical engineering and computer science skills into the mix. And a chairside encounter with Jay Zebryk, an engineer who specializes in wireless technology, completed the team. Bozorg convinced them that salivary pH monitoring was a viable product to start with. “Dentistry is not sexy in terms of business,” he said. “I had to basically teach them the way we teach our patients in a preventive setting.”  In March of 2017, the four partners launched U-CHU Biosensors.

Since then, U-CHU has won a slew of grants and awards: the Gordon Institute’s Ricci Interdisciplinary Prize, Gordon’s Montle Prize for entrepreneurial achievement, a grant from the non-profit VentureWell, and the TAMID at Tufts startup competition. In July, they learned their start-up had been accepted into Tufts Launchpad|Biolabs, a new biotech incubator in Boston. If the team can hit its fundraising milestones, it hopes to have its device ready for FDA review by January and go on the market in the fall of 2020.

Among dental professionals, “it’s common knowledge that caries is a pH-mediated disease,” Bozorg said. Normal salivary pH is about 7.4, almost neutral. As it becomes more acidic and reaches the critical point of 5.5—a result of factors like food and drink choices, medications, gastric reflux, or even swimming in a chlorinated pool with unbalanced water—tooth enamel begins to demineralize, setting the stage for decay. At present, the standard method of measuring pH is using a paper test strip, but 96 percent of dentists surveyed are unsatisfied with that method. The test strip offers only a one-time snapshot of the oral environment, and, interpretation can be subjective.

A tooth-mounted biosensor, however, would provide continuous, real-time data, from inside the mouths of patients and wirelessly transmit that data. Patients “could be notified by phone, ‘you are at a critical level,’” Bozorg said. And that’s a change that could have enormous positive effects. “If we could detect the pH all day, over time, and have a profile of our patients, we could prevent this disease like never before.”

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