Changing The Way We See Caries – Literally

by Lou Shuman, DMD, CAGS, CEO and Founder of Cellerant Consulting

GreenMark Biomedical uses non-invasive nanotechnology to rethink how dental professionals will diagnose and treat carious lesions

Typically the purview of science fiction writers and medical researchers, nanotechnology isn’t something dental professionals are asked to think about very often, let alone incorporate into their daily clinical practice. As more people learn about what GreenMark Biomedical makes possible, that will certainly change.

GreenMark is a healthcare startup specializing in targeted biopolymer particle technology. The company is aiming to transform the dental experience by enabling dentists to accurately assess when to treat carious lesions and make painless, natural repair possible. Caries remains the world’s most prevalent chronic disease and affects over 95% of Americans over their lifetime.

GreenMark is leveraging starch nanoparticles to identify and diagnose active pre-cavities at an early stage. Its diagnostic product – LumiCare™ Caries Detection Rinse, currently 510(k) pending – is intended for use in routine dental exams: The patient rinses first with the diagnostic solution and then with plain water. All that remains after the water rinse are the particles that have penetrated the tiny porosities in the enamel and attached themselves temporarily to the active subsurface lesions. The particles contain molecules that fluoresce or light up under exposure from a standard blue curing light. Within seconds, the dentist receives a direct visual diagnosis because the illuminated areas indicate areas of porosity. The starch particles are completely biocompatible and resorbable, making them ideal for use in the oral cavity. They break down in the presence of amylase which is a naturally occurring enzyme in human saliva. So, by the time the patient leaves the office the particles are completely degraded and there is no residue.

“We know visual and tactile exams using the explorer miss lesions or can cause cavitation. X-rays cannot catch lesions until they’re well advanced – by that time it’s too late for anything but drill and fill. But if you can detect caries in the incipient stage, you have the opportunity to treat noninvasively,” said Steven Bloembergen, PhD, GreenMark’s founder and CEO. “Active carious lesions are characterized by surface porosity, while inactive ones are non-porous and arrested. At present there are no diagnostic techniques or devices capable of differentiating between active and inactive lesions on the market. Dental professionals tell us that it’s a complete guess.”

Once the areas of early decay are detected, the dental team can use minimally invasive products and practices to treat the disease while preserving healthy tooth structure. This is an excellent way to build patient trust, avoid needles and drills where possible and for a practice to demonstrate it actively promotes modern dentistry. “This technology will allow dentists to better evaluate the effect of noninvasive treatments,” Steven continued, “So, we think this is truly a disruptive technology that has the potential of changing the way things are done in the field of caries management.”

Based on the same platform technology, GreenMark is actively developing CrystLCare™ Restorative Gel, which contains targeted mineral-loaded starch particles to non-invasively fill early sub-surface porosities.

“Calcium and phosphate, the key minerals that are depleted from teeth during the process of decay, can be bonded very effectively inside the small sub-micron starch particles. Since the targeted starch particles adhere to the internal surfaces of carious lesions, we have the potential to deliver the building blocks of enamel directly to the site of active disease. The minerals are released when the starch degrades, triggering recrystallization of the tooth subsurface by drawing on large amounts of naturally occurring calcium and phosphate from the saliva in a process known as “crystal nucleation,” shared Wendy Bloembergen, MD, MS, GreenMark’s Vice President of Clinical Affairs. “While this application is still in preliminary research, our team has been very excited by the initial test results.”

This is a company I’m excited to follow as I see its potential to bring the promises of early caries detection and minimally invasive treatment – goals our industry has talked about for years – to fruition. It is a new reality. It is a gamechanger that soon will be available to integrate into your practice. For more information, go to

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