Which sounds better when your gums need checking? A painful poke with what’s really just a fancy stick or a miniaturised ultrasound device?
It’s a little more technical than that, but Professor Warwick Duncan, director of the Sir John Walsh Research Institute at the University of Otago, says it amounts to the same thing.
“We’re developing a new tool to diagnose gum disease around teeth and dental implants to avoid painful probing of tissue. Our diagnostic technique hasn’t changed for a century, so it’s high time for an improvement,” says Duncan.
Severe periodontitis is the sixth most prevalent condition in the world, and one in three New Zealand adults have evidence of periodontal pockets. There is a strong link between periodontal infection and other diseases with high mortality and morbidity, including cardiovascular disease, stroke, diabetes, and adverse pregnancy outcomes.
“It began when Callaghan Innovation engineer Paul Harris first asked how I diagnose gum disease and I told him I poked it with a stick. It’s actually called a periodontal probe, but it’s much the same thing. We’re aiming to do better than that,” says Duncan.”
Together with Harris and a world-leading team with capabilities in dental research, ultrasonics, electronics and materials science, Duncan is trying to develop a miniaturised ultrasound device to help diagnose gum conditions like gingivitis.
“We’re aiming to provide an early diagnosis of periodontal disease using ultrasonics and elastrography which measures tissue stiffness. We are examining changes in the elasticity of the gum tissue (gingiva) and ligaments that connect the tooth to the surrounding tissues.”
Duncan says their vision is a smarter, safer, more efficient method for assessing gum disease, reducing time, and accelerating detection and accuracy of diagnosis.
He and Harris received a $1.2million grant from the Ministry of Business, Innovation and Employment, along with support from the University of Otago, venture financing and support from the former medtech centre of research excellence.
In 2022 , they formed Periomedic – a New Zealand venture-backed group developing and commercialising transformative products in the dental and periodontal technology sectors. They also brought on board a founding CEO, Tom Snyder, who has commercialized similar medical devices on a global scale. Research and development is led by Dr Tanmoy Bhattacharjee.
Duncan is at pains to point out that this journey began in 2014. “Ten years later, we’re starting to get somewhere in what is a difficult development pathway.”
Human tissue is essential to their research and they’ve been working with donated samples, but the old 1960s model of introducing inflammation is proving a challenge. “The 1960s model is to stop brushing your teeth for 21days at which point the gums are inflamed and bleeding. Then you start brushing again. The problem is that dental students these days are a dreadfully healthy bunch with healthy teeth.”
Now, in 2024, the Periomedic team has conducted their first trial on gingivitis detection with what Duncan calls “some encouraging bits but also the need for additional device modifications. This is our third prototype. We’re focusing on correlation of measures and shrinking the device down from toothbrush size.”
Up next is a trial in 2025, looking at patients with established disease and not just gingivitis. “We’re also looking at expanding the prototype to diagnose oral cancers in lips, tongue and cheeks which has the potential to remove the need for a biopsy.”
Duncan says we “tend to biopsy everything but our approach is to triage at a earlier stage which is better for the patient and for our resources. New Zealand has just one oral pathology resource – based at the University of Otago – which Duncan says struggles for funding.
This sort of research is right up Duncan’s street, as it were. “I like the discovery stuff.. If an idea is successful and I can put it out into the world, that’s great.”
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