An interesting article titled “Iron oxide nanozymes stabilize stannous fluoride for targeted biofilm killing and synergistic oral disease prevention” written by Yue Huang and et. al. appears in Nature Communications, vol. 14, No. 6087, 2023. The article discusses a potent therapeutic synergism using approved agents while providing facile stannous fluoride stabilization, to help prevent oral disease and dental caries (cavities).
The authors describes a new method for using iron oxide nanozymes to stabilize stannous fluoride and improve the ability to kill biofilms. Biofilms are communities of bacteria that can form on teeth and other surfaces in the mouth. They are difficult to remove and can lead to tooth decay and other oral diseases. Stannous fluoride is an effective antimicrobial agent, but it is unstable and can be difficult to deliver to the site of infection. Ferumoxytol, an iron replacement, stabilizes stannous fluoride and shields against further demineralization. They found the combination didn’t disrupt the oral microbiota, had no side effects on surrounding tissues, and improve its ability to kill biofilms. Further, iron oxide nanozymes and stannous fluoride have a synergistic effect that work better together.
The authors say this approach can be used with high-risk individuals prone to cariogenic biofilm accumulation. The authors feel using iron oxide nanozymes to stabilize stannous fluoride has the potential to prevent oral diseases and cavities. This therapy can also be useful for children who have severe tooth decay as they may also have iron deficiencies.
More studies in the future can be conducted to determine the mechanisms of interaction between fluoride and ferumoxytol, the reactive oxygen species generation process, and the formation and efficacy of the protective enamel film. However the authors feel there findings can translate quickly to clinical applications. The authors state:
“In summary, we unexpectedly find a remarkable synergy between ferumoxytol (Fer) nanozymes and stannous fluoride (SnF2) in potentiating antibiofilm and anticaries efficacy, which is particularly relevant given that current treatments are insufficient for controlling biofilm and preventing demineralization simultaneously in high-risk populations prone to disease…This approach could be targeted for high-risk individuals prone to cariogenic biofilm accumulation without increasing the risk of fluoride overexposure.”
The authors propose that the synergy they found is due to three factors: (1) stabilization of stannous fluoride by ferumoxytol, (2) enhancement of ferumoxytol’ catalytic activity by stannous fluoride, and (3) formation of a Fe/Sn/F-rich film on the surface of tooth enamel. The authors believe that this combination therapy has the potential to advance current anticaries treatment and lead to the development of new modalities.