201 points by gdudeman 10 days ago | 23 comments
SkyMarshal 10 days ago
A simpler alternative is xylitol. Not a drug, no FDA approval required. It's a plant-based sweetener that cavity-causing mouth bacteria love to ingest, but which provides no sustenance to them. It essentially fills them up and then causes them to starve them to death, helping maintain minimum mouth bacteria. No bacteria, no cavities. Get it in mints or gum like Zellies or PUR (the only two I've found that don't include Titanium Dioxide). Take one a day after brushing in the evening so it kills bacteria overnight.

https://zellies.com/

https://thepurcompany.com/

https://www.healthline.com/nutrition/xylitol-101

(Also if you have pets, make sure they don't get any, xylitol isn't good for them, especially dogs)

russdill 10 days ago
Just to be clear, it's not that it's not good for them, it's highly toxic
card_zero 10 days ago
I see it makes dogs release insulin and gives them fatal hypoglycemia, but doesn't do this to various other species. Quirky.
Ferret7446 7 days ago
Isn't that the definition of "toxic"?
nikolay 10 days ago
Not just xylitol but also mastic gum, which, in addition to cavities prevention, kills H. pylori and strengthens your jaw muscles as it's a bit harder than regular chewing gum.
sleepydog 10 days ago
I can attest to its effectiveness against H. pylori. I've suffered from canker sores most of my life. The two things that have helped were avoiding sodium lauryl sulfate in toothpaste, and chewing mastic gum at least once a week.
jkingsman 10 days ago
Anecdotal +1. I've switched to non-SLS toothpaste and seen a dramatic drop in my frequency and severity of apthous ulcers (and, unfortunately, I get them often enough and badly enough that I can state causality with some certainty).

I used to have a (powerful-to-the-point-of-personal-uneasiness) corticosteroid that I would put on them to dubious effect, but I haven't needed to resort to that at all since I switched away from SLS toothpastes.

FeloniousHam 10 days ago
BTW, the best treatment I've found for canker sores is Canker Cover. I switched baking soda toothpaste, but I'm not convinced it had a material effect.
novia 9 days ago
Kanka is better imo
zeteo 10 days ago
+1 for mastic, completely nontoxic and it's been used for thousands of years. My cavity problems have pretty much disappeared since discovering it several years ago.
nikolay 10 days ago
Yup! Here's one study [0]!

[0]: https://pubmed.ncbi.nlm.nih.gov/12747455/

SkyMarshal 10 days ago
Any brand you recommend?
zeteo 10 days ago
For someone trying it for the first time, I would recommend the Falim chewing gum, available on Amazon, or the mint-flavored toothpaste at mastic.gr. If you feel comfortable trying pure mastic, the best quality that I've found are the large tears from Chios Mastiha Growers Association.
SkyMarshal 10 days ago
Thanks!
vlovich123 10 days ago
Any specific brands you trust?
nikolay 10 days ago
I buy certified masic gum from Greece on Amazon [0] from one major importer of Greek products (Krinos).

[0]: https://www.amazon.com/gp/product/B000LQLIWM/

jbaber 10 days ago
I really like mastic, but it cuts my tongue up.
milesvp 10 days ago
Please be careful pushing xylitol, "sugar alcohols" are neither a sugar or an alcohol. This, of course, is exactly the thing that makes them desirable as a sweetener substitute, the body doesn't really know what to do with the stuff, and, presumably, neither do common mouth bacteria. Sugar alcohols are known for causing digestive troubles, for this very reason, with the most notorious example being the Haribo "sugar free" gummies that caused diarrhea.

Small quantities in gum may be fine but sugar alcohols are increasingly being added to foodstuffs, and I'm increasingly dubious about it.

dekhn 5 days ago
xylitol is a sugar and an alcohol- byt the classic organic chemistry definition. I'm not sure why you'd make that point.
devbent 9 days ago
Sugar alcohols are naturally occuring in many foods. There are also many different types, some of which cause some people stomach problems.

(Personally I can eat an entire bag of sugar free gummies w/o any ill effect, ymmv!)

benterix 10 days ago
Its twin brother is in serious trouble, too:

https://edition.cnn.com/2023/02/27/health/zero-calorie-sweet...

red-iron-pine 9 days ago
> the body doesn't really know what to do with the stuff

what does that mean? does it produce toxic chemicals? is it carcinogenic? or is this just fear mongering?

swishing a xylitol solution around your mouth is also different than pouring it in every drink you have.

9 days ago
FranOntanaya 10 days ago
Very much this. Specially if any relative has to watch their weight or sugar intake and a lot of "No sugar added" products are getting in the house, a very worrying amount of them are loaded with maltitol and its -ol friends. People don't understand why they are felling sick eating "health food" and go through a substantial amount of grief.
testfoobar 10 days ago
addaon 10 days ago
There are also Xylitol-containing toothpastes (e.g. Epic; be aware that they also make a flouride-free version that you likely want to avoid!), although I suspect the dosage of Xylitol is below the effective level.
nikolay 10 days ago
Also, recently there was a study that DIM also kills only the harmful bacteria in the mouth.
culi 10 days ago
3,3′-Diindolylmethane (DIM). Found in cruciferous vegetables (broccoli, cabbage, mustard, cress, nasturtium, arugala, radish, etc)

Also sold as bisindole which is a class of natural products derived from oxidative dimerization of tryptophan.

nikolay 10 days ago
clumsysmurf 10 days ago
Ehh, I tried it, like 15 years ago, but had to stop taking it for the reasons mentioned here:

https://medicalxpress.com/news/2024-04-qa-xylitol-teeth-swee...

What is the recommended daily dosage of xylitol for oral health?

"The recommended amount for cavity protection is 6 to 10 grams. And it's best to spread doses out throughout the day. So, if you want dental benefit from chewing xylitol-added gum, you should chew the gum for at least 20 minutes to extract the xylitol. That can be a lot of stress on the temporomandibular joints (in the jaw), so if you have problems with your TMJ, it's not a good idea to excessively chew gum."

That's a lot of Xylitol. It got expensive quickly, and I was heading towards TMJ dysfunction. Xylitol is also considered a high FODMAP, so if you are on a low FODMAP diet its best to avoid.

klyrs 10 days ago
Wow, I've never been so inspired to continue brushing my teeth daily.
SkyMarshal 10 days ago
Three a day seems like overkill. I think if you brush at least twice a day, then one xylitol gum at night after brushing is probably sufficient. Kills the bacteria that grew during the day and kills bacteria that try to grow in your mouth overnight.
onemoresoop 10 days ago
Xylitol upsets my digestive system. I try to avoid it as much as I can.
kleiba 10 days ago
Xylitol is known to be a laxative, so it is only recommended in small doses. You might be extra sensitive to it.
depsypher 9 days ago
I've been using a mouthwash with xylitol for around 5 years now and haven't had a cavity in that time. I hadn't heard about any concern with ingesting xylitol before reading this thread, but I imagine if it's a problem, a mouthwash would be a good way to avoid ingesting much.

The product I've been using is this: https://carifree.com/product/maintenance-rinse/

Also it's alkaline in ph, unlike many mouthwashes on the market. Caries need an acidic environment to do their thing, so you want your mouth to be inhospitable to them. Acidic mouthwashes may kill off the bacteria, but they make it a nice environment for any that remain to attach your teeth.

gautamcgoel 10 days ago
But don't you need "good" bacteria in your mouth?
SkyMarshal 10 days ago
It seems that it reduces bad bacteria but has no effect on good bacteria, though I'm not sure if there are enough studies on that to be conclusive.
mock-possum 10 days ago
I think the deal is that the bacteria that eats sugar produce the byproducts that mess with your teeth. If they ate something else, their waste would be differently comprised, and wouldn’t present that same threat to your teeth.
hintymad 10 days ago
Will bacterias evolve themselves to become xylitol-resistant? That's the same reason I'm hesitant to use xylitol or the like to treat stuffy nose.
echelon 10 days ago
I worry this would impact your gut microflora too. Imagine the downstream systemic effects and diseases this might trigger.
hgomersall 10 days ago
It does impact the gut biome, but current research suggests it's positive, insofar as we can gauge what a positive change would be.

Edit: One can easily find various papers like this: https://microbiomejournal.biomedcentral.com/articles/10.1186...

HeatrayEnjoyer 10 days ago
No swallowing maybe
xeromal 10 days ago
A xyletol based mouthwash?
mock-possum 10 days ago
You can put it in toothpaste too.
EasyMark 9 days ago
i haven't found in xylitol gum that doesn't taste like ass. My nanohydroxyapatite toothpaste does use some in its formula tho, so I guess there's that.
renewiltord 10 days ago
Gives some of us rocket powered shits though. I’ve been known to hit escape velocity at the border mall in Basel. Well contained within the inverted engine bell and served well by powerful flush mechanism.
SkyMarshal 10 days ago
Lol, true it can. Were you just eating one a day and still suffered that?
renewiltord 10 days ago
Haha, no, what happened was I ate about a third of a xylitol-based chocolate bar. So far higher dose than what you described, but it's given me a deathly fear of the substance, lest I transform myself into the fastest self-propelled man.

Perhaps I'll give it a crack some time.

meew0 10 days ago
There is a huge difference in dose between “bacteria in your mouth producing an antibiotic” and “taking an antibiotic for an infection”. Bacteria, even the normal bacteria currently present in your mouth even without taking BCS3L-1, constantly produce antibiotics to kill competing bacteria. But they only produce tiny amounts, enough to affect the competitors in their immediate vicinity, but not nearly enough to cause any kind of systemic effect. If they did, you would already be experiencing these effects right now from all the other antibiotics produced by other bacteria in your mouth. In contrast, antibiotics for medical use are usually given in doses measured in the hundreds of milligrams or even grams, far more than mouth bacteria could ever possibly produce.
maxbond 10 days ago
Whenever this topic comes up on HN it strikes me as bizarre that anyone thinks they can genetically modify a bacteria, release it into the wild - and that it'll stay genetically modified? Like the author mentions, bacteria are constantly swapping genes via horizontal gene transfer. Surely the bacteria in our mouths have found the optimal metabolism for their environment? Why wouldn't we expect our genetically modified bacteria to adopt the same strategy?

I imagine that you could, at least on paper, create a Rube Goldberg machine in their genes that, say, killed them if they produced lactic acid, and made it very difficult to delete these genes without destroying their ability to reproduce. But you'll probably also handicap them in the process and make it difficult for them to adapt to competitive adaptations from other bacteria.

swatcoder 10 days ago
There are obviously numerous locally-optimal strategies for bacterial colonies in one's mouth (and gut, etc) as the population of bacteria varies widely across individual people.

That's not to suggest that knocking out one or two specific functions is going to accomplish recolonization, or that we should even trust the effort to be wise in the medium-/long-term in light of gene transfer or migration into the gut and elsewhere, but the broad idea of pursuing recolonization by less destructive bacteria isn't without merit in itself.

teeray 10 days ago
> I imagine that you could, at least on paper, create a Rube Goldberg machine in their genes that, say, killed them if they produced lactic acid

It’s like Jurassic Park’s “Lysine Contingency”, but in your mouth

brookst 10 days ago
I do not think "Jurassic Park, but in your mouth" is a winning marketing angle.
red-iron-pine 9 days ago
disagree, i think that's a hilarious line and will get eyeballs / thoughts
Terr_ 10 days ago
In this case it sounds more like the dinosaurs would have a fatal allergy to human flesh.
polishdude20 10 days ago
On that note, I wonder how kissing affects our mouth bacteria. Like, does making out with someone transfer enough bacteria between the two people to make a difference?
0x457 10 days ago
Not sure about just kissing, but here is about couples living together: https://journals.asm.org/doi/10.1128/msystems.00043-17

I have a friend who started having a lot of teeth issues after moving in together. She swears nothing else has changed (i.e. food or stuff)

evmar 10 days ago
Babies are born without the mouth bacteria that cause cavities, and generally acquire them from their parents (e.g. kissing or sharing utensils).
Tagbert 10 days ago
Or transmitting prechewed food. That's the old school way.
aspectmin 10 days ago
>Whenever this topic comes up on HN it strikes me as bizarre that anyone thinks they can genetically modify a bacteria, release it into the wild - and that it'll stay genetically modified?

Hubris?

I'm all for progress and innovation. We need to couch such progress through the lens of thinking through the potential impacts of such progress though.

somenameforme 10 days ago
$$$ is a much easier explanation. People selling things that they know won't work in the way they claim is as old as time. Never attribute to incompetence that which can be attributed to malice, when it involves earning a ton of money.
pragma_x 10 days ago
> and that it'll stay genetically modified?

I honestly think the play here is to have customers continually inoculate with the same, or even improved, versions of their modified bacteria. Possibly with a very strong antibiotic course in between if a clean slate is needed. That would provide ample room to stay on top of mutations and gene swapping in-situ. Otherwise, you don't have a continuous revenue model or a successful product.

SamBam 10 days ago
But how do your re-inoculations colonize the teeth that have been fully colonized by your now-mutated old strains? Is the plan to require a full antibiotic mouthwash every few days, and then fresh inoculation? Ugh.
callalex 5 days ago
“Plan” is a strong word for what’s going on here. They don’t even have successful clinical trials.
twic 10 days ago
Or just brush your teeth twice a day.
SamPatt 10 days ago
Seriously - this is interesting tech but it seems like a mostly solved problem. Brush your teeth when you wake up, then floss and brush them again before you sleep.

Once it's routine (hopefully established in youth) it seems extremely easy to maintain.

ToValueFunfetti 10 days ago
It's evidently not a solved problem- 80% of Americans have had a cavity by their mid thirties. I very much doubt even 5% of them were never told to brush their teeth.
hhjinks 10 days ago
Then on the other hand, a dingle cavity isn't a big deal, and might be enough to scare people into better oral hygiene. It did for me, at least.
sitzkrieg 9 days ago
dismissive advice like this completely ignores the fact you can brush several times a day and have way more dental issues than someone else due to different mouth flora.

but ya bro shoulda brushed! what is their problem!

ravenstine 10 days ago
It's as if most of us don't have a background in biology or genetics.
maxbond 10 days ago
Fair enough but I do feel like our everyday experience with biology informs this. If you cultivate a certain color of rose and release it into the wild, you wouldn't expect that color to persist, right? Maybe I'm out of touch but I feel like that's intuitive. Maybe the technology is sexy and dazzling and that makes it more difficult to engage critically.
ceejayoz 10 days ago
Depends on the plant. I've got two GMO plants in my house right now; glow-in-the-dark petunias (https://light.bio/) and purple tomatoes (https://www.norfolkhealthyproduce.com/). The tomatoes breed true (i.e. the seeds have the gene); the petunias do not and must be cloned via propagation.

Roses, fruit trees, etc. are the latter.

somenameforme 10 days ago
How's the glow on those petunias in pitch black? Those look absolutely amazing and the ad is hilarious enough to make me want to pick some up.
callalex 5 days ago
I live in the hills of the Bay Area and the light pollution is too great outside for them to be obviously bright unless it’s been a really nice weather day (the parts that are growing are the parts that glow which is fascinating!). Outside, you can tell they look different than other plants if you are told they are different and you really take the time to look. Inside with all the lights off, they definitely make you say WOW!. They’re similar to the old “Indiglo” watch faces of the 90’s. You will not be able to see them glowing even in dim room lighting, the lights must be off.

All that being said, I am still quite happy with them! They take effort to be observed, but that effort is rewarding since it is such a unique experience. It’s really neat to see a stem glowing one night, which indicates that the next night there will be a new bright flower bud. Also I get a huge kick out of doing everything I can to propagate them, since it is stupidly illegal to do so.

Edit: for something comparable that you are familiar with, I would say it would take 6-8 plants at the size they arrive at to make the equivalent amount of light as a single small tea candle.

ceejayoz 10 days ago
In pitch black they're very visible unless you're going immediately from bright sunlight. With 5-10 mins of adjusting it's really something.

The photos on the site are definitely long exposure, but I'm pretty pleasantly surprised in person.

maxbond 10 days ago
But those aren't really in the wild, right? They're in your garden? If they were left to their own devices and started to breed with wild type tomatoes, and/or were subject to selective pressures for an extended period, they probably would either abandon the gene or discover a niche it was adaptive for?

Glow in the dark petunias sound really cool, I want those.

ceejayoz 10 days ago
The point is the gene may or may not be passed down at all.

It's possible my glowing petunia has some sort of advantage - the energy use going into the light might be balanced by attracting bugs at night, perhaps - but its seeds won't ever have the adaptation.

The purple tomato, on the other hand, if more attractive to birds who might eat and spread its seeds, might have more likelihood to spread.

SamBam 10 days ago
The tomatoes will only breed true so long as they are hand-bred or kept in an environment where no other types of tomatoes are around. And even then mutations will eventually creep in.

Same goes with the bacteria, except you may be talking about days or weeks instead of years.

ceejayoz 10 days ago
Tomatoes are largely self-polinating.

Yes, mutations will creep in, but the gene will persist more based on a) can it be passed down to seeds and b) does it infer an advantage in natural selection?

SamBam 10 days ago
The vast majority of changes made by humans to food plants, mostly through selective breeding, but also through gene editing, do not infer a selective advantage (except toward more human breeding). Big red fat juicy tomatoes are a disadvantage in the wild, where hundreds of thousands of years of natural selection pre-humans produced small, hardy, efficient, easy to maintain fruits.

Just like with pure-bred dogs, if humans suddenly disappeared it would probably only take a few decades for many species to return to muttier wildtypes.

Sure, some gene-editing is to make the plants hardier. Some of those genes would likely remain.

We're getting rather off-topic, though, which is about whether the bacteria in your mouth would be likely to mutate and/or swap genes with other bacteria in your mouth.

bbarnett 10 days ago
One could just eat other fruits, is there some reason the tomato, other than marketing "antioxidants", need be the purple fruit one eats?

Maybe it's a different question. Does the flavour seem mostly the same? A drop in for recipes?

drewm1980 10 days ago
Grapes are for luddites! Seriously though, my grapes are so reliable at cropping compared to tomato plants I think it would be more interesting to engineer grapes to be tomato-like.
ceejayoz 10 days ago
The reason I bought it was simply "that's neat". I'm not doing it for health reasons.

Mine aren't mature yet, but the flavor is apparently just a pretty typical cherry tomato.

bbarnett 9 days ago
Interesting, thanks.
blacksmith_tb 10 days ago
Ooh, did you grow your purple tomatoes from seed? I haven't seen any starts in my area yet.
ceejayoz 10 days ago
Yeah, I ordered a seed packet.

The petunias came grown in a pot.

blacksmith_tb 10 days ago
It's possible (in a sense the species we see were all the winners of the same process). And it's being proposed to try and push desired traits throughout populations, like disease-spreading mosquitos[1]

1: https://en.wikipedia.org/wiki/Gene_drive

worik 10 days ago
> ...create a Rube Goldberg machine in their genes that, say, killed them..

Bacteria are not machines, DNA is node code. Life is very different from mechanics

maxbond 10 days ago
You can, however, build machines using genes. Eg I met someone who was working on research to come up with sets of genes that implemented low level programming primitives, like "if". When some chemical concentration reaches a certain level, a gene is turned on or off. This is fundamental to how cells work, they're just trying to repurpose the machinery that's already there (if you'll forgive the metaphor).

The research I've heard of that I was thinking about here was about splicing genes in such a way that in order to remove it, you will also need to remove genes necessary for reproduction.

I'm not a geneticist and it's been a long time since I've read about this type of thing, so if I'm mistaken or if you know more, I'm all ears.

pas 10 days ago
dmbche 10 days ago
You remind me - wasn't Crispr going to cure Malaria by modifying mosquitoes and releasing them in the wild? Wonder how thats going.
ceejayoz 10 days ago
That's a technique used since the 1950s with great success against the parasitic screw-worm; it's now gone from North and Central America. Every year we release millions to keep them in South America.

https://en.wikipedia.org/wiki/Sterile_insect_technique

https://www.fao.org/4/u4220t/u4220T0g.htm

> In February 1991, after 15 years of production and the sterilization of 220 billion insects, Mexico was declared screwworm free. The screwworm rearing plant in Mexico, the only one of its kind, continues producing flies on a large scale for the eradication efforts under way in Central America and now provides FAO's Screwworm Emergency Centre for North Africa (SECNA) with sterile flies to combat the recent outbreak in North Africa.

dmbche 10 days ago
Incredible! Thanks for the link.
grahamplace 10 days ago
Gene driving is the specific technique you’re referring to:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10795774/

koeng 10 days ago
I got a tube of this probiotic. They asked me not to sequence it, but I'm a little suspicious of putting it in myself, so trust-but-verify (probably Nanoporing). I literally cannot see why sequencing it is a "dick move", so I think I'll be doing it anyway.

I do not buy that it is dangerous. However, I haven't seen any statistics showing the frequency of mutacin-1140 or its efficiency. Back in 2015 when I was a teen I did an experiment using colicin V (an E.coli one - I was planning on engineering E.coli Nissile to replace my current gut E.coli with something more fun. Got kicked out of the science fair for that one - https://keonigandall.com/posts/colicins.html ). Turns out, you need a sizable portion of the population to get takeover. I haven't seen ANY data on the population percentage necessary for takeover with this strain. Nor have I seen statistics of its natural occurrence percentage.

I wanted to modify the strain to have GFP expression, so I can have my own little engineered biome for myself that is showable at parties and such, but it looks like they removed comE :( will have to start from an original strain instead, I guess.

seventyone 10 days ago
I guess I am going to die from making my own kombucha, kefir, and yogurt because the FDA isn't regulating it.

WHAT IF... the mass increase in colon cancers in young people is due to gut bacteria colonies being taken over by a strain of bacteria in mouths that also survives stomach acids? What if that is causing the huge increase in IBS? What if the high carb diets and alternative sugars being consumed at mind boggling rates is a root cause? That the oral bacteria has been overtaken by a strain optimized for these carbs but is actively harmful to our bodies?

And what if fixing it is a treatment like this?

I'm willing to gamble.

Signed,

older millenial who has suffered with IBS for years

edit: If I could get a fecal transplant procedure in the USA to replace my gut colony I totally would.

edit2: fun fact -- did you know Sucralose accumulates in the environment because almost nothing breaks it down? it's pretty close to being a forever chemical. We can tell how much treated sewage injected into the water table is leaking into the ocean by measuring the amount of Sucralose in the ocean waters near the shoreline. That and nitrogen. But glug glug drink up those sugar free sodas and energy drinks!

green-in-gold 9 days ago
You may know this, but DIY fecal transplants are supposedly very doable
seventyone 9 days ago
canucker2016 10 days ago
One could try gum with xylitol instead, https://en.wikipedia.org/wiki/Xylitol

from https://www.aapd.org/globalassets/media/publications/archive...

"In addition, xylitol has a number of other effects on S mutans that may account for some of its clinical effects in caries reduction. Short-term consumption of xylitol is associated with decreased S mutans levels in both saliva and plaque.15 Long-term habitual consumption of xylitol appears to have a selective effect on S mutans strains. This results in selection for populations that are less virulent and less capable of adhering to tooth surfaces and, thus, are shed more easily from plaque into saliva."

buildsjets 10 days ago
Relating to fluoride's effect on bacterial biofilm - There are several different kinds of fluoride available in toothpaste, and they do not all have the same efficacy against bacterial plaque. Stannous fluoride is considerably more effective than sodium fluoride or sodium monofluorophosphate, but you may need to pay a small amount more for it and actually read the packaging to find it.

It's hard to find a website discussing it that is not paid for by a toothpaste company, but here's something. https://pubmed.ncbi.nlm.nih.gov/24660268/

ivan_ah 10 days ago
Very interesting.

From that paper, the brand they used as example of stannous fluoride was "oral-B pro expert all-around protection" Do you know of any other brands?

I wonder if we can conclude it was the stannous fluoride that made the difference and one of the other ingredients.

buildsjets 10 days ago
I use Crest Pro-Health, from the grocery store. It also happens to be what my dentist hands out in their goody bag, but she did not know about the difference between different forms of Fluoride when I brought it up at a check-up. Probably picks the goody bag contents based on who gives the best kickbacks/perks.

I'm sure that there are other studies out that that compare the active ingredients in isolation rather than as a part of a commercial preparation, that's just the first one I came across that looked to be from a reasonably independent source, rather than a disguised advertisement.

ivan_ah 4 days ago
Update: I went to the drug store and is seems "stannous fluoride" is quite common in Crest brand toothpastes. All the "high-end" toothpastes had it, so it's not a rare thing at all, just have to read the medical ingredients as you said.
PaulHoule 10 days ago
It drives me nuts that many toothpastes make big claims about what they do but don't clearly link that to the ingredients they contain. One of very few new ideas was the incorporation of Triclosan into Colgate Total which certainly takes a bite out of biofilms

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9220381/

but who knows if it is good for the rest of you.

neilv 10 days ago
> I think this is a terrible idea, as well as probably illegal. Unlike most people in the Bay Area, I think formalized safety and efficacy trials are a must for health products. In fact, I told Aaron Silverbook this when he asked me for my advice about his product last fall.

No one is going to want to consult you, if you might blog about it, attacking them by name, so... if it was serious enough to burn professional bridges, why not go to the FDA, an Attorney General, a public health authority, an academic-professional society or journal, a Congressperson, or some other channel more official and credible than Substack?

slibhb 10 days ago
> Taking unapproved drugs is a bad idea

What about off-label medication?

I don't think taking Lumina is smart, more or less for the reasons the author ennumerates. I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

Aurornis 10 days ago
> What about off-label medication?

Off-label means prescribed for a different purpose than originally indicated, at the prescriber's discretion. The medication must still have past safety testing and have shown efficacy for something.

> I also think it's unlikely enough to hurt people that FDA approval shouldn't be required. There's a lot of stuff in that category!

You can sell a lot of products as-is without FDA approval. However, making substantial claims about that product's medicinal properties is regulated in a different manner.

These people are trying to have the best of both worlds: Making extraordinary claims about preventing a medical condition, while also avoiding any participation in the FDA process or even funding standard trials.

I think the most obvious counter argument is that this could easily be a massively successful drug if it works as well as they claim. The TAM is everyone with teeth who wants to keep them, which is basically everyone. Yet instead they've chosen this weird path of embracing the rationalist community and supplement nuts, which is a much smaller market.

cool_dude85 10 days ago
>I also think it's unlikely enough to hurt people that FDA approval shouldn't be required.

The author has provided some solid arguments that this is not the case. Why do you think so?

bigstrat2003 10 days ago
I actually don't think the author provided very good arguments. It was my only real beef with the article: "this might do bad things" gets rounded off to "this is dangerous", even though his sources don't say the bad things will happen. They simply might happen.
tptacek 10 days ago
The Precautionary Principle is problematic applied to public policy generally, but it's the accepted practice in medicine. You can argue it shouldn't be, but you shouldn't pretend you'd be in the mainstream with that argument.
cool_dude85 10 days ago
Nobody can predict the future. Bad things only ever "can" happen until they do - they never "will" happen. The author explains why and how those things are possible.
axblount 10 days ago
Off-label drugs are still approved by the FDA for their original purpose.
ToValueFunfetti 10 days ago
Yeah, God forbid anyone take ginger or mint for an upset stomach, chamomile tea to relax, or melatonin to help them fall asleep. Or, more on topic, a toothpaste with FDA approved fluoride and FDA approved biomin which, when combined, lacks FDA approval. I never make any decisions that have not been approved officially by the US government
ryangs 10 days ago
Interesting read. Does not seem to be working with the same set of facts as the ACX post[1], especially around FDA approval.

[1]: https://www.astralcodexten.com/p/defying-cavity-lantern-biow....

llsf 10 days ago
Okay, so what happens if I (french) kiss a person that is taking this bacteria producing continuously mutacin-1140 and ethanol ? Could it take over my mouth, and I would ended up mutacin tolerant, and accelerating my cirrhosis ?
MostlyStable 10 days ago
In theory yes, in practice no. Application is unlikely to be succesful without an extremely thorough cleaning of your mouth (think post-dentist). In the absence of dental-visit quality cleaning, the recommendation is to brush your teeth multiple times, using fresh brush heads, which results in an acceptable, but still not 100% success rate.

Infants being kissed by their mothers might get it though, as they lack an already existing micro-biome in their mouths against which the new bacteria would need to compete.

Additionally, if you were in a relationship with someone and were consistently kissing that person over time, it might eventually establish a foothold. But a single kiss, no matter how wet and sloppy, is almost certainly not enough.

ted_dunning 10 days ago
Gee... that could plausibly be a risk.

Surely that is analyzed in the FDA application file.

Oh wait, it's not.

Oh wait, there is no file.

Oh wait, they didn't do any significant testing at all.

To quote Dirty Harry, are you feeling lucky today?

jeffbee 10 days ago
Easiest way to determine whether some health fad is dangerous snake oil: search for it on Twitter and determine the overrepresentation of blue checks. Every character at the end of a screen name that comes from a Unicode "symbol" block counts as ten blue checks. The presence of "/dd" counts as 100 blue checks. Simple, effective metric.
astura 10 days ago
>The presence of "/dd" counts as 100 blue checks.

Sorry, I don't understand Twitter lingo and Google doesn't return anything - What does /dd mean?

jeffbee 10 days ago
It is associated with Bryan Johnson's book "Don't Die". The author advocates daily electrocution of your penis, among other moronic ideas. He has a bazillion followers among the petty VC crowd.
adamsb6 10 days ago
This was so shocking that I went to look it up, and discovered that there's a bit of a telephone game here. It's "shockwave therapy" that isn't eletric. It uses acoustics to cause microscopic damage, and which Johnson rates as a 9/10 on the pain scale, "at the tip."
jeffbee 10 days ago
My mistake for assuming there was only one way for a quack to "shock" a body part.
10 days ago
Beijinger 8 days ago
indigo0086 9 days ago
>Pictured: Jeffrey Hillman’s origin story. Any resemblance to Tim Burton’s 2005 remake of Willy Wonka is purely coincidental. Ignore the Warner Bros. copyright in the corner.

Blogger trying to convince us he's presenting a good faith article challenge: impossible

10 days ago
dur-randir 9 days ago
I've never heard about this product, but the tone & narrative of this article made me highly wonder about author's intentions.
refulgentis 10 days ago
The Reddit CEO posted a long thread praising it, with distanced language like "How did I get that info? If you ask Lumina, they seemed happy to share"

He's an investor!

JohnFen 10 days ago
That it's marketed as a "cosmetic" and also includes the word "probiotic" is plenty enough reason for me to steer very clear of this.
julianeon 10 days ago
As soon as I understood "it kills the bacteria in your mouth... by making it a permanently alcoholic environment" I was out.
zepton 10 days ago
The negligible alcohol production is just a side effect, the alcohol itself does not kill the bacteria.
julianeon 10 days ago
Sorry, I didn't know that - I thought it was the mechanism. I appreciate the correction.

I don't like having alcohol there 24/7 but I concede that, this being true, it's not the issue I may have thought it was. I would want the FDA to sign off on it being okay, however.

infotropy 10 days ago
Came here to be “that guy”. Never had a single cavity in over 50years of being alive and have really bad dental care habits. I brush once a day for about 30 seconds, don’t really floss and have gone up to 6 years between cleanings.

I don’t eat a lot of processed foods or foods high in sugar, but I don’t completely abstain from them either.

Nothing to do with Lumina directly, but I’ve always been curious about my dental microbiome and how something about it is different from others.

I often worry about new products like Lumina upsetting whatever balance I’ve got going on.

beaugunderson 9 days ago
my guess is that you don't graze enough to put your Stephan curve negative for long periods of time... https://jamiethedentist.com/dental-caries-decay/stephan-curv...
jrd259 10 days ago
I'm disappointed by the somewhat ad-hominem attack on Silverbook for being a porn producer: "Aaron, based on his previous work as guy at a rationalist nonprofit, videogame producer, and porn producer, decided to recreate Hillman’s work." Previous work experience is irrelevant, and besides, don't at least some of aspire to being polymaths?
everyoneinmusic 10 days ago
Funny joke, but many people consider pornography and its creators to be fundamentally immoral, anti-social and destructive towards civil society in general. So I think it's plenty relevant. Same reason Scott promoting the work of "sex researchers" who promote the same sort of thing is reason for many to be skeptical of his integrity.
pseudalopex 10 days ago
> Previous work experience is irrelevant

Track record on similar projects was a question on the Manifund application. Those were Silverbook's answers. Were the footnote explaining this and the link to the application added after you read the article?

Aurornis 10 days ago
> I’ve also been disappointed for some months to see how many people I respect (and some I don’t respect) have been using it/promoting it. Taking unapproved drugs is a bad idea, no matter what rationalist bloggers with MDs, porn star/escort/sex researchers, Twitter guys, or conservative firebrands who get sick immediately after taking the unapproved drug tell you.

The "rationalist community" has always been quirky and edgy, but iterations in recent years have felt increasingly reactionary and contrarian at all costs. Being anti-FDA has been a meme in the rationalist community for several years, especially since Scott Alexander (Slate Star Codex / Astral Codex Ten) started writing anti-FDA pieces. (Side note: The conservative firebrand they're talking about is a person who was caught using a pseudonym to post extremely biased, racist material, who has somehow remained prominent in the community despite the revelations).

This appears to have primed the community for "FDA bad" takes, which has triggered their contrarian tendencies to assume that anything that goes against the FDA must therefore be good.

A supplement maker publicly defying the FDA and pushing out a miracle treatment without the normal rigor of human trials and safety reviews is the type of behavior that would have triggered skepticism from the rationalist community. Yet because the community has been primed with "FDA bad, anti-FDA good" memes for years and the person pitching this supplement is vaguely connected to the rationalist community, this product has triggered a lot of adoration and praise from the community.

The product also exists in a space that is difficult to disprove: The effects of any anti-cavity product can only really be shown over very long periods of time in controlled settings. Anyone who gets a cavity while using this product will surely be dismissed as having a pre-existing cavity growing, or poor oral hygiene, or being a statistical anomaly, or any other number of excuses. At the same time, I'm sure we're about to hear endless anecdotes from people who have been taking the supplement and haven't had any cavities (while ignoring the fact that most people also don't get cavities in a given year, even without this magic probiotic).

It feels like the perfect storm for a grift, and this company is taking the lead and running with it. It's weird that a blog post advising some caution and skepticism for a supplement pusher making extraordinary claims who has refused to participate in the normally expected clinical trials. It's equally weird to see the self-described rationalist community throwing scientific rigor to the wind and embracing marketer's claims.

I don't entirely understand what's going on here, but I think it's strange that an article advising a modicum of skepticism for supplement pushers is now considered a contrarian take in the rationalist community.

jseliger 10 days ago
Being anti-FDA has been a meme in the rationalist community for several years

The FDA is bad: https://jakeseliger.com/2023/07/22/i-am-dying-of-squamous-ce... and I'm dying largely because of their torpor and intransigence. It's not just "a meme." It's my life.

ultrasaurus 10 days ago
I'm sure it's been posted to HN before but Scott Alexander's writing on the FDA is pretty nuanced. "Beyond "Abolish The FDA"[0] is pro-FDA but contains the section "What policy proposal closest to abolish-the-FDA would I feel comfortable supporting in the real world?"

He's been pretty explicit on Lumina too:

"My real opinion, as precisely as I can express it, is:

* Advance of approximately the same magnitude as fluoride: 5%

* Good on balance, comparable to other beneficial dental treatments: 35%

* Doesn’t work in its current form, but could easily be modified into something that does: 10%

* Doesn’t work at all and never will: 50%

* Causes minor side effects for some people, same scale as Tylenol: 30%

* Causes medium side effects, same scale as tricyclics: 5%

* Causes disastrous side effects, same scale as thalidomide: <1%"

[0] https://www.astralcodexten.com/p/beyond-abolish-the-fda [1] https://www.astralcodexten.com/p/updates-on-lumina-probiotic

exmadscientist 10 days ago
To be fair to the anti-FDA people, the number-one source of FDA hate is actually having to interact with the FDA. They are not a pleasant agency to work with.

But I'd still rather have the current state of affairs than no FDA! I don't even have to think about that one!

generalizations 10 days ago
> person who was caught using a pseudonym

You mean doxxed. Since when do we condone doxxing?

tptacek 10 days ago
I don't think we have to have this subthread, but opinion on what happened here is anything but unified --- if you're talking about Alexander. If you're talking about Hanania, calling what happened to him a "doxing" would be closer to a fringe opinion.
dannyobrien 10 days ago
Note that Scott Alexander says it's 50/50 whether it works at all: https://www.astralcodexten.com/p/updates-on-lumina-probiotic...
comp_throw7 10 days ago
> who has somehow remained prominent in the community despite the revelations

Hanania is just some dude on twitter. He's not prominent in the rationalist community in any meaningful sense.

bee_rider 10 days ago
I think the idea that an organization like the FDA could have thought hard about ideas like “thinking about risk and probability” before contrarian bloggers arrived to save us from ourselves is offensive to rationalists.
NoImmatureAdHom 10 days ago
[flagged]
mrguyorama 10 days ago
>I'm pretty sure using "biased" to denigrate other people is over, Gretchen.

Your username is literally "NoImmatureAdHom"

NoImmatureAdHom 9 days ago
[flagged]
mrguyorama 9 days ago
I was referring to calling them "gretchen"
deelowe 10 days ago
I was hoping for a more thorough explanation for why this particular regimen is dangerous. Instead this is a rather lengthy essay which ultimately relies on the appeal to authority fallacy. Not to say I think people should just put random things into their bodies - It is indeed probably not the best idea.

That said, I'm not sure I learned anything new after reading this.

samrmay 10 days ago
The article does specifically mention that the strain used produces an antibody which survives in the gut and may demolish your gut microbiome. Also one of the footnotes mentions that producing alcohol instead of lactic acid as a byproduct may not be as harmless at it seems.

I'm also not sure that taking issue with a company bypassing systemic protections against dangerous drugs is an appeal to authority.

atuladhar 10 days ago
What a strange take! Not an expert (or even a beginner) in this area by any means, but I definitely learned a lot, and I thought the author pretty clearly laid out why they think this probiotic may not be good for your body. Did we read the same blog post?
nrdgrrrl 10 days ago
[dead]
1939416836 10 days ago
The article lists several reasons why the regimen is dangerous: if you get the bacteria that you're supposed to be getting, that bacteria will be continuously producing an antibiotic. Having bacteria constantly dosing you with antibiotics can lead to all the sorts of issues that long-term antibiotics present. Secondly, the article claims, probiotic manufacturing is very susceptible to contamination. Luckily, there are steps a manufacturer can take to avoid contamination, but it doesn't appear that this manufacturer is taking these steps.

All of this is stated in the article, if you missed this on your first read, you might consider re-reading it :)

comp_throw7 10 days ago
Many bacteria produce antibiotics to outcompete other bacteria, though, so this isn't new or alarming information. Especially given that, as the author admits, the mutation that causes it to produce that particular antibiotic is naturally occurring in S. mutans!

It'd be a more interesting claim if it was argued that mutacin-1140 was particularly dangerous in the relevant doses (and this somehow never came up in the wild-type S. mutans that produce it).

SamBam 10 days ago
Did you stop reading halfway through?
ted_dunning 10 days ago
Citing published articles is not generally considered appeal to authority.
eynsham 10 days ago
How does the section titled ‘Category 2: the known health risks of BCS3L-1’ problematically appeal to authority? It seems to about as much as appealing to known results that swallowing vast quantities of lead is a bad idea would. (The other sections certainly appeal to authority, although not obviously fallaciously to me, but that would be to go over quite tired ground about medical regulation.)