Laureate Professor Eric Reynolds invented a key weapon in the fight against tooth decay while building Melbourne Dental School into a world-class institution. Now he’s taking on periodontitis with a new vaccine that’s about to go into human trials. By Shane Conroy
Winner of the Prime Minister’s Prize for Innovation and the CEO of the Oral Health CRC, Melbourne’s Laureate Professor Eric Reynolds is developing a vaccine that could signal the end of periodontitis. He says the hope is that the vaccine will substantially reduce tissue destruction in patients harbouring P. gingivalis. And the most exciting news—for both dentists and their patients—is that the periodontitis therapeutic vaccine clinical trials may start later this year.
As every dentist knows, periodontitis is widespread and destructive. Professor Reynolds told the NPJ Vaccines journal, “We hold high hopes for this vaccine to improve quality of life for millions of people. It’s a huge global market.”
In Australia, the average percentage of people with periodontitis is around 22 per cent, according to an Australian Institute of Health and Welfare report. In addition, people over 65 have rates approaching 53 per cent. And University of Adelaide’s Indigenous Oral Health Unit revealed that Indigenous people have significantly more periodontal problems than average.
While Professor Reynolds’ vaccine release is now on the horizon, he has always had a curious mind. As a young boy, he would stare up at the stars pondering the nature of the universe and was fascinated with science shows on television.
“I was always interested in science—where we came from, how the earth was formed, and how the solar system works,” he says.
Melbourne-born Professor Reynolds grew up in a working-class suburb and attended a public primary school. He was a keen sportsman during his childhood, but his obvious talent for academia landed him a scholarship to secondary school where he developed his love of science. “I liked physics and chemistry, and have always loved problem-solving,” he says. “I would go to the library and read books about it, and in my final year I could recite the periodic table.”
Professor Reynolds was the only student from his high school to gain admission to the University of Melbourne. He began his first year at university studying medicine, but later moved to dentistry in 1970. “Starting uni did take a bit of adjustment because I didn’t know anybody, but I soon met people and formed lifelong friendships. I discovered learning at uni. I found learning about the body fascinating. As I look back now, it was no surprise I went into scientific research.”
An important discovery
It didn’t take long for Professor Reynolds to make a splash as a young researcher. He was studying tooth decay and periodontal disease in the late 1980s and early 1990s, and approached the National Health and Medical Research Council (NHMRC) for funding.
“When I went in for my interview, the people in the waiting room with me were working on cancer and heart disease. So when I said that I wanted to work on tooth decay, my research had to be really, really good to be funded,” he says.
“I was going out getting the money for the infrastructure we needed. People donated money and companies gave us equipment either at list price or for nothing. The state-of-the-art clinics and research labs we were able to build have enabled us to get the research funding which has enabled other inventions.”—Professor Eric Reynolds
Thankfully, he was onto something really, really good—and the NHMRC agreed. With the funding he needed, Professor Reynolds threw into himself into his research. “There was some anecdotal and epidemiological evidence that people who were high milk drinkers tended to have low levels of tooth decay,” he says.
“My curiosity was that if dairy products are associated with low risk of tooth decay due to calcium, there must be something about the specific form of calcium in dairy products.
“Calcium in milk is stabilised by a particular protein called casein. I wanted to know what is happening to protect the teeth, so embarked on a long journey of purifying the protein, purifying the part of the protein that stabilises calcium, and then working out the molecular structure of it.”
Rather than experiencing one almighty ‘eureka’ moment, Professor Reynolds explains that it was much more a process of small wins leading to an important discovery. “Once we characterised the molecular structure of casein, another time we X-rayed incubated teeth to measure mineral changes in the tooth enamel and we saw that it significantly increased in mineral content. That was exciting.”
Professor Reynolds and his team used these findings to develop a sugar-free chewing gum, Recaldent, and the results have been impressive. In a 2005 clinical trial, Recaldent or a control sugar-free gum was given to 2700 Melbourne school children. “We saw a 50 per cent greater remineralisation in children using the Recaldent gum versus the control gum.”
Recaldent in sugar-free gum and oral care products has gone on to generate sales of more than $2 billion around the world, and Professor Reynolds was recently awarded the 2017 Prime Minister’s Prize for Innovation. He has even starred in a Japanese TV advertisement. “Recaldent became the number-one sugar-free chewing gum in Japan,” he says. “Some marketer came up with the idea of having the original inventor stand there in a white coat and explain how this technology works. I had to stand there holding a glass of milk. It was really outside my comfort zone, and they cut my bit down to a few seconds so I’m not sure how successful it was!”
Show me the money
Despite the enormous success of Recaldent, it’s only one episode in Professor Reynold’s long, distinguished career. He was also the head of the Melbourne Dental School for 16 years and was a driving force behind its impressive evolution into a world-class institution. “It was a challenge because we were going through significant transition then. I started in 1998 and the old dental hospital building was way past its use-by date. So we needed to get funds for a new dental hospital and a new dental school.”
The state government kicked in about $30 million, but that left Professor Reynolds to generate the additional $20 million that was required to build the new facility.
“I had to engage with the dental industry and with philanthropists,” he says. “I was going out getting the money for the infrastructure we needed. People donated money and companies gave us equipment either at list price or for nothing. I spent a lot of time engaging with people and really enjoyed it. The state-of-the-art clinics and research labs we were able to build have enabled us to get the research funding which has enabled other inventions.”
Taking on periodontitis
To achieve that, Professor Reynolds modelled himself on US deans that he got to know throughout his tenure. “Deans of dental schools in the US operate differently to the historical role of heads of dental schools here,” he says. “They spend quite a lot of time with their alumni and with industry, and they have major targets in terms of philanthropy and funding so their role is to get money for their school.
“By controlling the periodontitis we can help increase metabolic control for the diabetes. We also think it will lower the risk for the development of heart attack and stroke because they are also linked to chronic inflammation.”—Professor Eric Reynolds
“Australia is now following suit because universities are underfunded and dentistry, I maintain, is the most expensive university course because dental students are the only students who do invasive procedures.”
Today, however, Professor Reynolds is back in the research lab as chief executive officer of Oral Health CRC. He and his team are making significant strides towards developing a vaccine for chronic periodontitis. “It is a severe form of gum disease where the jaw bone gets resorbed and teeth become loose. It has been linked with heart attacks and stroke,” he says.
Unlike other gum diseases that are caused from plaque build-up due to lack of brushing, Professor Reynolds and his research team have shown that a particular species of bacteria is at play in chronic periodontitis.
“If you are unlucky enough to have these bacteria, they get down deep underneath your gums and they are impossible to clean,” he says. “They cause the body’s immune system to effectively resorb the jaw bone in order to get rid of the tooth because these bacteria are on the tooth’s root.”
Vaccine’s positive impact
The good news is that Professor Reynolds has developed a therapeutic vaccine that has shown success in treating the disease in animal trials.
“The bacteria trick the immune system in to establishing chronic inflammation which feeds the bacteria on the tooth root,” he explains. “The vaccine switches that off. It switches off the destructive immune system and makes it protective, which then targets and kills the offending bacteria without resorbing the jaw bone.”
Professor Reynolds believes the vaccine may also have a positive impact on other serious diseases linked to periodontitis. “In diabetes, for instance, we find people with severe periodontitis have far greater issues with trying to control their diabetes because the periodontal inflammation makes the diabetes worse,” he says.
“By controlling the periodontitis we can help increase metabolic control for the diabetes. We also think it will lower the risk for the development of heart attack and stroke because they are also linked to chronic inflammation.”
Professor Reynolds and his team are scaling up to start clinical trials in humans this year, but we’ll be waiting a while for its market release.
“These things are slow,” he says. “We are pretty confident we will see very positive results with it in the human trials, then we have to get regulatory approval for commercial release of the vaccine. We are hoping it will be very big news in about five years’ time.”