Applications will be accepted until December 31, 2013 for NIDCR’s Residency Program in Dental Public Health. The 12-month full-time or 12-month equivalent part-time Residency Program provides a formal training opportunity for dentists planning careers in dental public health, with an emphasis on oral and craniofacial, health-related epidemiologic research. The Residency Program is accredited by the Commission on Dental Accreditation of the American Dental Association. Program graduates receive a certificate of completion and are qualified educationally to apply for examination by the American Board of Dental Public Health for specialty certification. 



While emphasizing research training and oral disease prevention and health promotion, the residency also provides experience in other areas of dental public health, ie, public health administration and management, the organization and financing of dental care programs, and the development of resources. Residents develop an individualized initial training plan, which describes activities to be undertaken during the residency and conduct at least one research project under the guidance of NIDCR staff and other qualified mentors. The training program in research will be tailored to meet the particular interests and previous experience of each individual selected. However, a typical resident's effort will require that time be spent in each of the following areas: Research Methods in Dental Public Health; Health Policy, Program Management, and Administration; Oral Disease Prevention and Oral Health Promotion; and Oral Health Services and Delivery Systems.

Applicants must have a DDS or DMD degree or its equivalent and a graduate degree in public health. Additional information about the program and the application are found at: https://go.usa.gov/Wdb5.

November 25, 2013 -- Updated guidelines from Virginia A. Moyer, MD, MPH, on behalf of the US Preventive Services Task Force (USPSTF) say the evidence is insufficient to assess the balance of benefits and harms of screening by primary care providers for oral cancer in asymptomatic adults, Medscape reports. The guidelines will be published online November 26 in the Annals of Internal Medicine.

The USPSTF noted in its recommendation that its study focused on oral cavity screenings performed by primary care providers, not dental providers or otolaryngologists. It reiterates the group's 2004 recommendation, which also found insufficient evidence to recommend for or against screening.

To read more, click here.

November 22, 2013 – Chicago – A report recently released by the Centers for Disease Control and Prevention (CDC) includes, for the first time, a discussion of health disparities and inequalities within periodontal disease prevalence in the United States. The report, “CDC Health Disparities and Inequalities Report — United States, 2013,” is the second in a series to highlight discrepancies across a variety of diseases by sex, race, ethnicity, income, education, disability status and other social characteristics.

The report finds that while nearly half of US adults aged 30 or older have periodontal disease, the prevalence is significantly higher in non-Hispanic Blacks and Mexican Americans compared to non-Hispanic Whites. In addition, periodontitis is higher in men than in women; in people with less than a high school education; in people of lower income levels; and in current and former smokers. The report is based on an analysis of the 2009-2010 National Health and Nutrition Examination Survey (NHANES).

The American Academy of Periodontology (AAP) has been working closely with the CDC since 2003 to determine the extent, severity and prevalence of periodontal disease in the US. According to Dr. Stuart J. Froum, DDS, President of the AAP, clinical professor and Director of Clinical Research in the Department of Periodontics and Implant Dentistry at New York University Dental Center, the inclusion of periodontal disease in this report indicates a significant public health concern.

“Almost 65 million US adults have some form of periodontal disease, and certain populations are more vulnerable than others,” says Dr. Froum. “I commend the CDC for drawing attention to the disparities that exist within periodontal disease prevalence. These findings support a need for both local and national public health programs to improve the periodontal health of all adults, regardless of age, race or education.”

The AAP recommends that all patients receive a comprehensive periodontal evaluation on an annual basis as a way to effectively assess for disease. “The insidious and sometimes asymptomatic nature of periodontal disease means that many patients may have periodontal disease, but do not know it. As dental professionals, it is crucial we ensure that our patients are being screened annually via a comprehensive periodontal evaluation to determine their disease status and treat accordingly.”

For more information, visit perio.org.

November 13, 2013 -- INTELIHEALTH -- Interviews with frail older people show that some common barriers to dental care may be more complicated than they seem.

Researchers from the Netherlands interviewed 51 older people between 2009 and 2012. All were in assisted-living facilities. Some lived there full-time. Others went there during the day only.

The researchers found that most older people see oral self-care as something that helps to maintain their sense of self-worth. Taking care of their teeth and gums helps them feel normal and independent.

But they didn't look at visiting the dentist in the same way. Of the people interviewed, only two felt that visiting the dentist contributed to their sense of self-worth and dignity. Those who were more frail and less independent were much more likely to abandon regular dental visits. But they did continue their oral hygiene routines.

Many of the people with full or partial dentures did not visit a dentist anymore. However, about half of the people who had stopped going to the dentist also complained about oral problems. These included poorly fitting dentures, loose teeth or painful spots in their mouths.

There were three main themes behind why people no longer visited the dentist:

- They didn't believe that going to the dentist would do anything. Those with dentures tended to assume that dentures were supposed to be uncomfortable. They didn't think visiting the dentist would help.

- They thought their oral health was less important now, because they were old and frail and possibly near death. In the face of other health problems, oral health seemed less crucial. 

- They had a limited amount of energy, and were choosing not to use some of it for a dental visit.

Some people also mentioned other barriers to visiting the dentist or continuing their oral hygiene routine. These included: frailty, problems with holding a toothbrush or using floss, problems with walking, confusion, lack of social support.

Cost is a commonly recognized barrier to dental care. However, the people in this study said they would not visit a free dental clinic, even though most had some form of dental discomfort. To them, the benefits did not exceed the effort needed to visit the dentist: It simply wasn't worth it.

The authors suggest focusing on interactions between nursing-home staff and elderly people. Compassionate listening, paying attention to what's important to each resident, and more careful observation could help staff understand the priorities of each person and support oral care.

The study appears in the November issue of the journal BMC Oral Health.

-- Nancy Volkers, InteliHealth News Service

November 20, 2013 -- INTELIHEALTH -- People with inflammatory bowel disease may be more likely to have gum disease as well, according to a new study.

The study was done in Switzerland. Researchers compared 113 people with inflammatory bowel disease (IBD) and 113 people without it. Each person's mouth was examined for signs of gum (periodontal) disease. Researchers looked for gums that bled and gums that had become detached from the teeth.

People with IBD were more likely to have signs of periodontal disease than people who did not have IBD. This was true for people with both types of IBD: Crohn's disease and ulcerative colitis. Researchers also saw mouth lesions, or sores, in about 10% of people with IBD.

Earlier, small studies have suggested that people with IBD may be more likely to have periodontal disease or tooth decay.

But a large U.S. study, which used national survey data, came to a different conclusion. The study was presented at a conference in October 2013. It found that people with IBD were slightly less likely to have periodontal disease than the rest of the population. The study included more than 2 million people with IBD. It did find that people with IBD were more likely to need urgent dental care, however.

The Swiss study appears in the Nov 7 issue of the journal Inflammatory Bowel Disease.

-- Nancy Volkers, InteliHealth News Service

ST. LOUIS – Extract taken from an Asian vegetable may have therapeutic qualities to treat head and neck cancer, a Saint Louis University researcher has found.

Preliminary findings of the research were published in the Public Library of Science One Journal by Ratna Ray, PhD, associate professor of pathology at Saint Louis University. Ray found that bitter melon extract, a vegetable commonly used in Indian and Chinese diets, reduces the head and neck cancer cell growth in the animal model.

"We wanted to see the effect of the bitter melon extract treatment on different types of cancer using different model systems," said Ray, who first tested the extract in breast and prostate cancer cells. "In this study, the bitter melon extract treatment suppressed the head and neck cancer cell growth in the mouse model, reducing the growth of the tumor."

In a controlled lab setting, Ray found that bitter melon extract regulated several pathways that helped reduce the head and neck cancer cell growth in the animal model. After a period of four weeks, Ray found that the growth and volume of the tumor had reduced.

Bitter melon is a tropical vegetable that is commonly used in Indian and Chinese cooking. Ray, who is originally from India, often uses bitter melon in her meals. People in Asia use this vegetable in stir fries, salads, and also drink its juice as part of a healthy diet.

Although more research is needed, Ray believes the bitter melon extract may enhance the current treatment option.

"It's difficult to measure the exact impact of bitter melon extract treatment on the cell growth, but a combination of things – existing drug therapy along with bitter melon – may help the efficacy of the overall cancer treatment," Ray said.

Head and neck cancers, which account for 6% of all cancer cases, start in the mouth, nose, sinuses, voicebox and throat. They frequently are aggressive, and often spread from one part of the head or neck to another.

Before moving to phase I clinical trial with head and neck cancer patients, Ray said she and her team would need to validate their results with other preclinical models.

Ray's initial research found that treatment with this natural substance halted the breast and prostate cancer cell growth, eventually stopping them from spreading.

A drug currently used to treat intestinal worms could protect people from periodontitis, which untreated can erode the structures—including bone—that hold the teeth in the jaw. The research was published ahead of print in Antimicrobial Agents and Chemotherapy.

Current treatment for periodontitis involves scraping dental plaque, which is a polymicrobial biofilm, off of the root of the tooth. Despite this unpleasant and costly ordeal, the biofilm frequently grows back. But the investigators showed in an animal model of periodontitis that the drug Oxantel inhibits this growth by interfering with an enzyme that bacteria require for biofilm formation, says corresponding author Eric Reynolds, of the University of Melbourne, Australia. It does so in a dose-dependent manner, indicating efficacy.

The researchers began their search for a therapy for periodontitis by studying the symbioses of the periodontal pathogens, using genomics, proteomics, and metabolomics, in animal models of periodontitis. They soon found that the periodontal biofilm depended for growth on the availability of iron and heme (an iron-containing molecule related to hemoglobin), and that restricting these reduced levels of the enzyme, fumarate reductase. Since Oxantel was known to inhibit fumarate reductase in some bacteria, they then successfully tested its ability to inhibit fumarate reductase activity in Porphyromonas gingivalis, one of the major bacterial components of periodontitis biofilms. Fumarate reductase is absent from humans, making it an ideal drug target.

They also showed that Oxantel disrupted the growth of polymicrobial biofilms containing P. gingivalis, Tannerella forsythia, and Treponema denticola, a typical composition of periodontal biofilms, despite the fact that the latter alone is unaffected by Oxantel.

The researchers found that treatment with Oxantel downregulated six P. gingivalis gene products, and upregulated 22 gene products, all of which are part of a regulon (a genetic unit) that controls availability of heme.

Periodontitis affects an estimated 30-47 percent of the adult population with severe forms affecting 5-10 percent. It also increases the risks of diabetes, heart disease, stroke, arthritis, and dementia, says Reynolds. These risks arise due to the pathogenic bacteria that enter the blood stream from periodontitis, as well as from the chronic inflammationcaused by this disease, he says. Additionally, periodontitis correlates with increased risk of cancersof the head and neck, the esophagus, the tongue, and the pancreas, the investigators report.

Source: Medical News Today

Researchers identified thousands of genetic sequences that may help shape each person’s unique face, according to the National Institutes of Health (NIH). The findings may explain how facial differences develop and lead to a new understanding of how facial birth defects arise.

Inherited genes are known to play a role in shaping a person’s face. Yet even family members have many subtle differences between them. Scientists have previously identified genes involved in birth defects such as cleft lips and palates. However, the factors responsible for normal, subtle facial differences are still largely unknown.

Genetic enhancers are short DNA sequences that control the activity levels of genes. These sequences are essentially docking sites for proteins that “enhance” the expression of their target genes through various mechanisms. Multiple enhancers can regulate the same gene from different locations on the genome. Variations in any of a gene’s enhancers can affect the gene’s activity level.

In previous work, Dr. Axel Visel of the Lawrence Berkeley National Laboratory and colleagues identified hundreds of enhancers that orchestrate gene expression during heart and brain development in embryos. In this study, Visel led a team to explore whether similar enhancers play a role in the development of facial features. Their work was funded in part by NIH's National Institute of Dental and Craniofacial Research (NIDCR), National Human Genome Research Institute (NHGRI), and National Institute of General Medical Sciences (NIGMS). The results were published in Science on October 25, 2013.

First, the researchers searched for gene enhancers active in the facial tissue of mouse embryos at the time of face development. They identified candidate enhancers by finding regions of facial tissue DNA that were bound by enhancer-binding proteins. The team found more than 4,000 candidate enhancer sequences across the mouse genome.

The scientists selected 200 enhancers for further characterization. For each, they engineered mouse embryos to show a distinct color in facial areas where the enhancer was active. Images of the developing faces showed that different enhancers affected different facial regions. For example, one enhancer was active in the areas on either side of the nose, whereas another was active near the upper lip and nose. Most of these characterized sequences are also found in the human genome.

The researchers directly tested whether 3 of the enhancers affected the shape of the facial regions where they were active. They deleted the enhancers and then compared precise skull measurements of the mice to those of normal mice. None of the deletions caused obvious deformities. Two of the deletions were associated with subtle but significant changes in the facial regions where the enhancer was previously shown to be active.

“Knowing about the existence of these enhancers, which are inherited from parents to their children just like genes, knowing their exact location in the human genome, and knowing their general activity pattern in craniofacial development should facilitate a better understanding of the connection between genetics and human craniofacial morphology,” Visel says.

The team is now working with human geneticists to explore whether mutations of human enhancer sequences similar to those found in the mouse genome are linked to facial birth defects in people.

— by Katherine Wendelsdorf, PhD

Source: NIH

CHICAGO, Nov. 15, 2013 /PRNewswire-USNewswire/ -- The American College of Prosthodontists confirmed Carl F. Driscoll, DMD, FACP as its Vice President on Oct. 11 at the ACP Annual Awards & President's Dinner during the College's 43rd Annual Session in Las Vegas. Next year at the 44th Annual Session, Dr. Driscoll will be inducted as the President-Elect of the American College of Prosthodontists. (Photo: https://photos.prnewswire.com/prnh/20131115/DC16710)

Also, Julie A. Holloway, DDS, MS, FACP was confirmed as ACP Treasurer.

Dr. Driscoll received his DMD from Tufts University. He completed a General Practice Residency at Ft. Meade, Maryland and received his prosthodontic training at Letterman Army Medical Center in San Francisco. In 1990, he completed a Fellowship in Maxillofacial Prosthetics at the National Naval Dental School in Bethesda, Maryland.

Dr. Driscoll currently serves as a Professor at the University of Maryland Dental School and as Director of the Prosthodontic Residency. He previously held the same position with the United States Army at Walter Reed Army Medical Center in Washington, D.C. from 1994-1997. Dr. Driscoll retired from the U.S. Army in 1997 with the rank of Colonel. He is originally from Somerville, Mass.

Currently, Dr. Driscoll is a Diplomate of the American Board of Prosthodontics and a Fellow of the American College of Prosthodontists. Dr. Driscoll has served as President of the American Academy of Fixed Prosthodontics, President of the American Board of Prosthodontics and is a respected board examiner.  He has given more than 300 presentations worldwide and authored more than 60 publications.

"Like medicine, dentistry has taken incredible leaps forward in the past decade," said Dr. Driscoll.  "Prosthodontists are at the forefront of this innovation by applying their advanced training and commitment to life-long learning of new materials, using state of the art digital dentistry tools to help patients save time, visits and expenses and applying advanced training in cosmetic dentistry procedures to help improve patient outcomes. Patients are opting to go to a prosthodontist."

Portland, Ore. November 12, 2013 -- Oregon Health & Science University School of Dentistry researchers are preparing to conduct the first clinical investigation in the new National Dental Practice-based Research Network, thanks to a six-year, $1.5 million National Institutes of Health (NIH) grant.

OHSU principal investigator Thomas Hilton, D.M.D., M.S., alumni centennial professor of operative dentistry, and co-investigator Jack Ferracane, Ph.D., OHSU chair and professor of restorative dentistry, will lead a four-year study of cracked teeth in 3,000 patients from approximately 150 to 300 private practices within the National Dental Practice-based Research Network.

Cracked teeth are fractures that involve the whole tooth, from the chewing surface down to the nerve. If a tooth becomes damaged or diseased because of a crack, root canal treatment or even extraction may be necessary to treat the tooth.

“The prevalence of cracked teeth is quite high, with more than 70 percent of adults having at least one cracked posterior tooth,” said Hilton. “Cracked teeth are problematic not just for patients, but for dentists. In confronting cracked teeth, dentists have to decide whether the cracked tooth will get worse, when the tooth needs to be treated, and the best treatment for the patient. It is our hope that this study will help dentists answer these questions.”

The National Dental Practice-based Research Network was initiated in April 2012, a sequel to the three separate NIDCR-funded regional networks. One of those three networks was NW PRECEDENT, a joint effort between OHSU School of Dentistry and University of Washington that began in 2005.

OHSU School of Dentistry has also coordinated its own Practice-based Research in Oral Health (PROH) network since 2003. PROH currently has about 180 practitioners in Oregon and southwest Washington, many of them OHSU dental alumni who participate in clinical studies within their private practices.

“We not only have long-term expertise in practice-based oral health research, but have conducted practice-based research studies previously in cracked teeth,” said Hilton. “As we expect PROH practitioners who are part of the national network will be involved in this study, we anticipate a number of Oregon patients in the new study, as well.”

The National Dental Practice-based Research Network, based out of the University of Alabama at Birmingham College of Dentistry, is funded by the NIH’s National Institute of Dental and Craniofacial Research (1U19DE22516).