Recent, exciting strides in permanently attaching false teeth to the jaw (dental implants), or using high-tech plastic bonding material to restore a tooth to its natural strength and beauty, can make it easy to forget that, not too long ago, millions of people in the United States had all their teeth out by the age of twenty-five or thirty in order to put an end to 'bothersome, rotting teeth'. In fact, throughout the 1950's, families that could afford a dowry would often provide for the purchase of a spouse's dentures. Even today, it seems that everyone over the age of fifty is anxious, to a degree, about the prospect of losing some or all of their teeth.  And at the dawn of the 21st century, one would be hard-pressed to find someone who actually looks forward to wearing dentures!

Is tooth loss inevitable? No!  In fact, when nanotechnology (the manipulation of matter at the atomic level, something we are just beginning to do) arrives within the next 10-15 years, it will put a halt to the genetics behind tooth loss, gum disease, and bone loss in the jaw due to aging. Nanotechnology will be able to reverse these aging processes once and for all. Let us consider how a visit to the dentist will be irrevocably altered when nano-technology goes from science fiction, to science fact.

Fast forward to... 2020 AD, not too far away.  Our dentally-challenged patient, John Garbage-Mouth, timidly enters the dental office of Dr. Harvey Smile-Makeover. His office is located, naturally enough, in Southern California, the trend-setting capital for cutting-edge dental care. Dr. Smile-Makeover peers into the dentally-challenged mouth of his new patient, whose teeth appear to have been in a state of chaos for years. 'Garbage-mouth' has steadfastly refused to use his robotic tooth-flosser before retiring to bed. His habit of eating starchy, concentrated sugars for breakfast, lunch, and dinner, while connected to the internet in a semi-vegetative stupor, has merely accelerated an already bad case of tooth rot and gum disease. And the stress of 'keeping up with the Joneses' latest holographic-tactile video games has increased an already bad case of gum disease and steadily loosening teeth. In fact, the odor from his mouth was the last straw that finally drove his girlfriend to leave him for greener virtual pastures.

This man is desperate for some decent, 2020 AD oral health care. The plunge is taken, the dye is cast as Mr. Garbage-Mouth timidly reclines in an air-cushioned dental chair that is immediately computerized to custom-fit the contours of his reclining body. As he hopefully nods at the holographic Gentle Dental Care sign hovering lazily overhead, the chair is beginning to make him drowsy. Its aromatherapy vapors are releasing endorphins, making for a totally relaxed patient. 

He barely notices the dentist adjusting a handheld, portable, positron-emission tomographic (PET) machine. The PET scan, coupled with billions of built-in molecular processing units (courtesy of the accelerated advances of boron nanotube technology of the 2010's) will show the precise 3D characteristics of the toothless regions of his mouth. It will also summarize, in digital-virtual format, the jaw-bone density, vascularity, bacterial flora, and the specific sites where further tooth loss is most likely to occur. 

The optimal jawbone sites and the precise amount of materials needed for the treatment begins. Tiny patches of the machine are attached to the patient's gums via nanotubes.  They send out customized, chemical-electrical signals that immediately deaden the jaw and tooth nerves of the patient. 'Mr. Robot', the tiny, computerized robotic arm, aka the best dental assistant imaginable,  begins drilling microscopic-sized cylindrical holes into the jawbone of the patients mouth, while the dentist monitors the sites that had been pre-selected by the PET scan. 5 minutes later, the holes are completed, and Mr. Robot grasps a syringe containing a few drops of 'seed' material.

This seed material is probably the most revolutionary process in the history of dentistry, as it contains uncountable, preprogrammed, artificially made molecules (nano-molecules). These molecules are precisely injected by the robotic arm into the drilled sites in the jaw. When an excimer laser or other form of controlled radiation is initiated, the dental impression tray, composed of millions of molecular circuits especially designed for the job at hand, are pre-programmed to attach and control the movements of the microscopic materials which will do the job, at a nano-level of precision, that the dentists of a generation earlier did painstakingly with their hands.

Soon, a reservoir of materials composed of trillions of specially-made teeth and bone cells, some natural, some artificial, but all controlled via man-made molecular signals to each other, are allowed to flow at precisely programmed trajectories and paths to begin the job of regrowth.  Of building.  They will reconstruct teeth, gum tissue, and eventually, even the jaw itself. 

Before you can say ‘dental floss’, a perfectly-shaped, young-looking tooth begins to take form. Pain-free, and in moments.   Forget about a long, tension-filled appointment with your dentist. ‘Nano-dentology’ will produce great-looking pearly whites within a relaxed morning's visit. Long enough for the patient to enjoy a video through the new 3D holographic glasses he is wearing while the nanobots are doing their thing in his mouth. What a far cry from dental implants of the early 21st century, when it took stressful surgery, and a wait of up to nine months for an implanted artificial tooth to achieve the same success as in a painless 30 minute dental appointment.

Bite an apple, anyone?

Nanotechnology will deliver the holy grail of dentistry: long-lasting, cavity-free teeth. But the story’s not done yet, for only a few years later, truly advanced nanotech will deliver another coup: arresting or neutralizing the genetics behind a degenerating, aging jawline. If we are able to fabricate perfect, ageless teeth, could not the same technique be used to augment and strengthen a thinning mandible? And what material would be the strongest and most durable to use for this procedure?

Diamond.

Why not? Nanotech will be able to produce the hardest, most durable compounds around. Diamond fits that bill. Advanced nanotechnology will allow diamond to become dirt-cheap, too. Our patient could even be a wizened, 80 year old, with little or no teeth and a pencil-thin jaw line, courtesy of father-time. Regardless, the treatment is essentially the same- uncountable nanobots from our dental nano-tray depositing a diamond-like substructure that fills in and augments the disease-deficient and thinning areas of the patient’s jaw. At the conclusion of another morning’s treatment, the patient could well end up with the youthful jaws of a 20 year old- or better. Forever freed from the ravages of a deteriorating jaw line (not to mention bone cancers, or other disorders), we could enjoy the jaws, teeth, and smiles of youth, perhaps for decades thereafter.  

Say goodbye to tooth decay, gum disease, jaw-bone loss, jaw cancer, root canals, fillings, in fact, dentistry as we know it today.  Don't worry, there will still be dentists around- after all, someone has to deliver the incredible oral health care of the year 2020.

A little further down the timeline, we could eventually see the replacement of the entire jaw and teeth with a diamond-like matrix (no, it would not look like diamond, but its durability, hardness and strength characteristics would be similar).

Why stop there? We can expand this approach to improve or replace the body’s entire skeletal structure. We’ve seen Batman, Superman, look out for Diamond Man. Only this amazing human will be each of an Everyman, finally freed from bad teeth, worn-out jaws, and other skeletal maladies. What an era the human race is fast approaching! A time when crutches, bone casts, and dentures will exist only in museums. And if you decided to never brush or floss again, the worst you might get is a case of ‘diamond breath’. To help you hold out for the nanotech miracles of your local dentist in a couple decades hence, floss and brush well. The world of dental care is entering an era of exciting improvements- all for a healthier you.

What a 'Nanobot' might look like  as it repairs blood cells in the body.

Dr. Edward Reifman is a Senior Associate member of the Foresight Institute, located in Palo Alto, California.  The Foresight Institute is in the forefront of nanotechnology research and its applications throughout the world.   Dr. Reifman has a private practice in Encino, California. When nanotech arrives, you can be sure that Dr. Reifman will be one of the first, if not the first, to apply the exciting strides in dental health care that a nanotechnology era will bring about.  Dr. Reifman's high-tech cosmetic dental office can be reached at: 818.990.6659, or via e-mail: reifmandds@yahoo.com