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Instead of settling for the bling of gold, a more practical person seeking a false tooth might eventually be able to get one that can deliver drugs.
Researchers in Europe and Israel, funded by the European Union, are working on a tiny drug-dispensing system called IntelliDrug that goes into a person's mouth - with the ultimate goal of getting the parts small enough to fit into a replacement tooth placed in the back like a molar.
The device can release a specific amount of medicine at certain intervals, ensuring that the patient gets the proper dosage at the right time.
Patients, on average, follow instructions on taking drugs only half the time, even for people who need them to survive, said Dr. Andy Wolff, an Israeli dentist who initially came up with the concept.
Patients often forget or find it too inconvenient to take medicine, especially in the middle of the night. He believes the device will rectify the problem by automating the process.
Wolff's company, Saliwell Ltd., and German microelectronics institute HSG-IMIT are two of 15 organizations involved with the development of the device. The project is funded by a program that promotes cooperation between EU nations and Israel. The organizations include universities, companies, research institutes and hospitals. One notable name is Spanish telephone company Telefonica SA, which is helping with the communications technology side of the development.
By placing the device in the mouth, the drug can be delivered directly into the bloodstream through the lining of the cheek and around the mouth, a surface that is porous enough to absorb the medicine. Saliva, meanwhile, mixes with the drug and carries it to the lining more consistently than just swallowing a pill every few hours.
"Why in the mouth? It's very accessible, it's very permeable, not like your skin," Wolff said.
The treatment of diabetes is one area where delivering drugs can be advantageous. People with diabetes must take regular injections of insulin to maintain low blood-glucose levels. Instead of pricking their skin, patients can wear the IntelliDrug device for a little while.
The device consists of a stainless steel housing, a pump and custom valves to regulate the drug flow, a microprocessor, batteries and a reservoir for the drug pill. It is currently a block the size of two teeth and strapped to the side of teeth so it hugs the inside of the cheek. Developers hope to ultimately turn it into a replacement tooth.
The unit can be removed from the mouth, where a technician can refill the drug reservoir, clean the system and replace the battery if needed.
IntelliDrug also has a communication port that allows the user to control the device via remote control with hopes of eventually linking it with a cellular phone or to a nearby hospital or care center.
"This approach combines dentistry with software, communication and technology," Wolff said.
Ongoing clinical trials on pigs have been successful. Dr. Axel Schumacher, who is helping design the pumps, said he hopes to have a prototype ready for human testing by the end of the year. Schumacher works for the research institute HSG-IMIT, which is based in southern Germany.
So far, the prototypes can only be worn for a limited period. There are hopes that when the components become small enough, they can become a permanent fixture.
The concept of IntelliDrug could solve the problem of compliance, said Dr. Charles Smith, professor of pharmacy at the Medical University of South Carolina. While he isn't familiar with the device, he said, "Having an automated delivery system might be interesting."