In 2015, Thailand imported over 4.4 billion baht of dental material and equipment. Figures from a study in Chiang Mai also revealed that up to 95% of dental material used in dental clinics nationwide came from foreign lands.
"There is only some dental equipment that Thailand can produce. They are patient face drapes, dental cotton roll and gauze," said Prof Dr Pasutha Thunyakitpisal from the Department of Anatomy, Chulalongkorn University's Faculty of Dentistry.
"This has put us in an inferior position to countries like the United States, Japan and European nations who are major manufacturers of dental materials and tools. And the fact that we cannot produce our own dental material leads to Thailand falling short on negotiation power."
One day during a lunch meeting with his peer lecturers and academics from Chulalongkorn University's Faculty of Science, Faculty of Pharmacy and Faculty of Veterinary Science, Dr Pasutha and his team came up with an idea to produce two important dental materials -- dental sealant and cavity liner -- so that Thai dentists have local choices.
The research and manufacturing process took 12 years. In December 2017, the two products were officially launched. They have been certified by Thailand's Food and Drug Administration (FDA).
The team's dental sealant, also known as All-Zeal, is basically a medical-grade resin coating, which is applied on the tooth biting surface that is usually full of pits and fissures. These pits and fissures make teeth vulnerable to decay because food particles can easily get stuck in them, leading to bacteria accumulation. So when these pits and fissures are covered with resin, it leaves less room to be a playground for bacteria.
"The best way to tackle tooth decay is not a filling, but prevention," explained Dr Pasutha. "Dental filling means expenses and anxiety from the patients' side. So if we cover these pits with sealant, the tooth surface will be smoother. There is no need to worry that food will get stuck and it [the coated tooth] will be easier to clean."
Dentists usually suggest sealants be used on the molars to help protect them from decay. And the procedure is totally non-invasive. The selected tooth will be cleaned and blow-dried before being coated with resin. "It takes pretty much two minutes per tooth to get the job done," said the dentist.
Dental sealant is actually applied in almost every dental clinic and hospital with prices ranging from 600 to 800 baht per tooth (of course using imported sealants). But with this locally-made material, the price can go down to around 400 to 500 baht per tooth.
Apart from the coating, the team also made a resin modified glass ionomer (RMGI) dental cavity liner called Embaze that is basically designed to provide extra protection for cases of dental restoration work.
"To treat tooth decay, dentists perform tooth grinding before filling the cavity with materials like composite resins, porcelain or dental amalgam," explained Dr Pasutha. "These materials are made to be very strong and they are placed next to the tooth that might become very thin after grinding. So after filling, if you chew on something hard, chances are high that it will break your tooth."
"So this dental cavity liner comes in at this point to be placed between your tooth and the filling material. It will help absorb the pressure caused by biting or chewing and your restored tooth will be saved," said Dr Pasutha, adding that the dental liner also helps with hypersensitive teeth. The material also releases fluoride which helps strengthen the teeth and kills bacteria.
Currently All-Zeal and Embaze are being used at Chulalongkorn University's Faculty of Dentistry and several other dental clinics.
Speaking on behalf of his team members who invented these locally-made dental materials, Dr Pasutha hopes for all Thai consumers to be aware of their choices, which will not just help save costs but will also enable the work of Thai researchers to become more recognised not just in Thailand but in other countries.
"There are many more dental materials that we would like to produce by ourselves such as white filling [composite resin]. So we wish to use the profits from our sales to fund more future research. We also hope for an opportunity to expand to Cambodia, Myanmar, Laos and Vietnam markets."
For Dr Pasutha, these inventions do not just mean monetary gain. Rather, he treats them as a stepping stone to the country's "dental security".
"There is this ancient Chinese proverb saying, 'It is the first step that is difficult'. Although this is only our small step, I think it sets an important milestone for Thailand's dentistry."
