May 28, 2008 -- To parents, it might sound like the best kind of health insurance -- a personal bank of stem cells, obtained from a baby tooth, that would be available for the taking should their child develop a life-threatening illness years down the road.
The catch: The therapies that would use these stem cells have not yet been developed. Stem cell experts say such advances are years or decades away -- if they ever come to pass.
And considering the cost of extracting and storing these stem cells -- an initial price tag of $590, plus an annual fee of $100 -- some experts say the slim chance that such stem cells would ever come in handy is not worth the expense.
Still, there are those that see potential. Grant Sadler is president of GMS Dental Centers in Houston, whose clinics began a collaboration last week with a Scottsdale, Ariz., company called StemSave that would offer parents the chance to bank the stem cells from their kids' extracted teeth.
Sadler said that in the first week of its launch, parents who have brought their children to his offices have expressed a great deal of interest in the banking of their children's baby teeth stem cells.
"They have responded very positively," he said. "I announced it to the staff, and there were some parents who were waiting in the corner of the lobby. After I was done, two of them came up and said, 'Boy, we really want to do this today. Can we use this?'"
He said the banking of these cells could be especially appealing to parents who did not have the option of having their children's umbilical cord stem cells banked when they were born.
But Dr. Curt Civin, professor of cancer research at the Johns Hopkins University School of Medicine in Baltimore, said the cells extracted from the pulp of baby teeth are quite different from those extracted from umbilical cords.
"The last time I saw this, the stem cells from baby teeth were mesenchymal," he said, adding that this layer forms such tissues as the cartilage, bone, fat and other "lining" cells.
This means that doctors would not be able to use these cells in the lifesaving procedures more commonly associated with therapeutic stem cell therapy today.
"Theoretically, if you wanted bone cells, maybe someday you could use these to produce them -- but you probably couldn't from what we know now," Civin said. "[Mesenchymal cells] haven't been used clinically yet, at least to my knowledge."
Pay Now, Cure Later?
In contrast to mesenchymal stem cells, hematopoietic stem cells -- the ones that come from umbilical cord blood -- have already seen therapeutic use. Today, such stem cells can be used to treat as many as 70 different diseases. Civin estimated that about 2,000 people every year are treated with such stem cells. Most commonly, the cells are used to regenerate the immune systems of patients who have received treatment for leukemia.
In light of this, many parents have taken the step of banking their children's umbilical cord stem cells when they are born -- an arrangement that has been known to cost $1,200 upfront and $100 each year for storage.
Today there are dozens of private companies that will store a baby's cord blood for a fee. Like a bank account, it will be available exclusively to the family of the donor -- though the chances that anyone will ever need to make a withdrawal from such an "account" may be slim.
A more reasonable approach, Civin said, is for parents to donate their child's umbilical cord to a public bank. Like a bone marrow registry, the bank keeps a database of the cells that are available and offers them to patients in need. Today, he said, most of the lifesaving procedures conducted with umbilical cord stem cells use cells that come from a public bank.
"These will be used by somebody who needs it, likely for cancer, or maybe a genetic disease," Civin said. "That I would recommend, if that's available at the hospital at which the baby is born. It's sort of an altruistic gift to society."
But Civin said since umbilical cord stem cells are seeing actual therapeutic use, "it's not as big a leap as baby teeth. ... The tooth cells may never be used."
Other stem cell experts agreed that baby teeth stem calls are not ready for widespread banking.
"The benefits are entirely speculative," said Jonathan Moreno, director of the Center for Biomedical Ethics at the University of Virginia in Charlottesville. "I would like to see an itemized bill that accounts for the ... charges. After the cells are harvested and treated, it's just a matter of holding them in a refrigerator, so the only real cost is the electricity."
"This is ridiculous, modern snake oil," agreed Sean Morrison, associate professor of cell and developmental biology at the University of Michigan Medical Center in Ann Arbor. "The difference relative to cord blood is that cells from baby teeth have never been used clinically to treat anything, and are unlikely to ever be used."
Still, studies on the potential of these cells are ongoing. The National Institutes of Health has, in past research, cited the potential of the cells to yield dentin and bone -- which means that future applications could include the repair of damaged teeth and bones.
Meanwhile, researchers at the University of Pittsburgh are also working to identify, characterize and come up with applications for the cells contained within human dental pulp.
When Marketing Comes Before the Science
Sadler said his clinics are planning to send information out to parents later this week about the banking option, and pamphlets outlining the procedure and its costs are available in the waiting areas of the offices.
"All of this is dependent upon the patient's or the patient's parent's choice," he said. "We're taking the role of exposing the patient to this, and if they choose to do this, they do it."
Still, Tim McCaffrey, vice chairman of biochemistry and molecular biology at the George Washington University Medical Center in Washington, D.C., said the marketing of this option is far too early.
"I'll be conservative and say that this is very highly speculative, because most people would look at this and call it snake oil," McCaffrey said in an e-mailed correspondence. "The part that annoys me is that it preys on parents' fear of something dreadful happening to their child, and I will guarantee you that the company will not produce data on the viability or potency of the 'stem cells' that they 'isolate' and store.
"There is no guarantee that this would work in 10 years when, heaven forbid, your child needs it. Do they give a money-back guarantee?"
Cathy Becker contributed to this report.