Could antimicrobial metals be the key to sustainable dentistry?

Antimicrobial metals and their powers

First of all, we need to address the fact that the antimicrobial properties of certain metals have long been known. Silver, for example, has been used in medicine for centuries for this very reason, and solutions made from this metal may even have the power to “zombify” bacteria so that they actively destroy living versions of themselves.[ii] Currently, silver is commonly used in treatments for burns and other topical instances where wounds need to be kept free from micro-organisms.[iii]

Other metals also have promising properties. A study that examined the antimicrobial powers of nine metals in their pure form found that cobalt, copper, nickel, zinc, zirconium, molybdenum and lead all had a positive impact on reducing levels of bacteria (the other two tested, titanium and tin, did not).[iv]

However, while these properties are encouraging, simply constructing tools and surfaces from these materials has limited potential. For instance, though copper has been officially named as an antimicrobial metal and has the power to kill 99.9% of bacteria through contact, this process still takes two hours or more.[v] This leaves ample opportunity for surface transmission of these microbes to occur, especially as they can transmit to hands with a single touch.

Creating a super material

So, the challenge is adapting these metals into surfaces and products that retain the antimicrobial properties, but which also act more effectively. In the research I mentioned at the beginning of the article, it looks at enhancing the natural antimicrobial effect of metals by creating surfaces that have other properties that are effective against pathogens. For instance, superhydrophobic surfaces have also been found to resist bacterial colonisation. Plus, because the way they resist bacteria is solely due to their structure, this means that bacteria and other pathogens will not be able to develop resistance to them over time.[vi]

Nanoprotrusions offer further exciting potential. Wings of insects such as dragonflies and cicadas naturally resist microbes due to nanoprotrusions – miniscule structural elements that damage microbial cells on impact, preventing colonisation.[vii]

In light of this, what if we could create a superhydrophobic, antimicrobial metal surface that has nanoprotrusions? This would effectively guarantee that the vast majority of pathogens would be unable to colonise on the surface at all, leading to a super material that would revolutionise healthcare and other industries.

Sustainable dentistry within grasp

Though development of this material is currently hypothetical, the sheer number of applications it could have in the modern world, let alone in the dental practice, would be astronomic. How versatile it could be would, of course, depend on its material properties, but if it were to retain the same malleability of metal then it could be feasibly used widely for things like surfaces in practice as well as instruments and even PPE (as face mask inserts).

One of the biggest sources of plastic and other waste in dentistry is the single-use items we use. While there are measures we can take to reduce plastics (buying products in recyclable packaging, and the one tip we get told time and time again – introducing reusable cups for things like water!) currently there is no easy solution for sustainability across the board. The steps we’re taking to create a super material could change this, with it ushering in a new generation of greener dentistry. But until this happens, we need to explore other avenues and keep ourselves open to more possible answers. The time for sustainability is now, but the materials and technology we use haven’t quite caught up, though this will change.

I, for one, am excited about where dentistry is headed, and the development of materials like this, as well as continuing innovation in areas such as AI, robotics and nanotechnology are all extremely positive steps forward. We may yet see a different kind of dentistry become the norm in the short-term, and this is something we should all be excited to witness.

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EndoCare, led by Dr Michael Sultan, is one of the UK’s most trusted Specialist Endodontist practices. Through the use of the latest technologies and techniques, the highly-trained team can offer exceptional standards of care – always putting the patient first. What’s more, EndoCare is a dependable referral centre, to which dentists from across the country send their patients for the best in specialist endodontic treatment.

[i] Birkett, M. et al. Recent Advances in Metal-Based Antimicrobial Coatings for High-Touch Surfaces. Int J Mol Sci. 2022 Feb; 23(3): 1162.

[ii] Science. Silver Turns Bacteria Into Deadly Zombies. Link: https://www.science.org/content/article/silver-turns-bacteria-deadly-zombies#:~:text=The%20use%20of%20silver%20in,and%20wreaking%20havoc%20once%20inside. [Last accessed February 23].

[iii] Clement, J. et al. Antibacterial Silver. Met Based Drugs. 1994; 1(5-6): 467–482.

[iv] Yasuyaki, m. et al. Antibacterial properties of nine pure metals: a laboratory study using Staphylococcus aureus and Escherichia coli. Biofouling. 2010 Oct;26(7):851-8. doi: 10.1080/08927014.2010.527000.

[v] Montero, D. et al. Antimicrobial properties of a novel copper-based composite coating with potential for use in healthcare facilities. Antimicrobial Resistance & Infection Control. 8, 3 (2019). https://doi.org/10.1186/s13756-018-0456-4.

[vi] Birkett, M. et al. Recent Advances in Metal-Based Antimicrobial Coatings for High-Touch Surfaces. Int J Mol Sci. 2022 Feb; 23(3): 1162.

[vii] Birkett, M. et al. Recent Advances in Metal-Based Antimicrobial Coatings for High-Touch Surfaces. Int J Mol Sci. 2022 Feb; 23(3): 1162.