ARRA Investments in Dental/Oral Diseases
Dental caries (tooth decay) and periodontal disease (gum disease) are among the most prevalent infectious diseases of humankind. The Centers for Disease Control and Prevention estimate that 90 percent of all Americans over the age of 40 have experienced tooth decay. It is estimated that over 164 million work hours and 51 million school hours are lost each year due to oral health issues. This problem disproportionately affects the most vulnerable members of our society, low-income children, many of whom are from racial or ethnic minorities.
One grant is developing the foundation for a culturally-appropriate educational intervention to reduce dental disease among Latino children. The intervention – aimed at the parents of young Hispanic children – w ill be delivered by community-based Latina lay health workers, called promotoras. The intervention seeks to reduce oral health disparities in early childhood caries, a particularly devastating form of dental caries highly prevalent among low income, preschool aged, Hispanic/Latino children.
Although very low birth weight (VLBW) infants represent only 1.4% of total live births, they often have poor health outcomes and account for significant increased health care costs. This project will investigate the relationship between birth weight and early childhood caries (ECC) by comparing VLBW and normal birth weight infants followed for up to two years. This study could lead to improved approaches in taking care of very low birth weight children.
Among U.S. adults ages 18-65, 50% have gingivitis, or inflammation of the gums, and 5-15% have a moderate or severe form of periodontitis; in seniors over the age of 65, the prevalence of periodontitis rises to 15-30%. Advanced stages of gum disease lead to loss of bone and diminished tooth attachment. Chronic periodontitis has been linked to systemic diseases, including diabetes and cardiovascular diseases.
Standard periodontal treatment consists of physical removal of plaque deposits around the teeth where the bacteria accumulate; local antibiotic treatment in addition has clinically proven benefits. It is important to discover which antibiotics have the most benefits. One project will synthesize compounds using click chemistry, a process that generates substances quickly and reliably by joining small units together. The goal is to develop new antibiotics with stronger and more selective effects against the major bacterial species associated with chronic gum diseases. This will help advance the treatment options and outcomes for periodontal diseases.
Another study will identify functional metagenomic signatures of the microbes that live in the mouth, including genes, DNA regulatory motifs, pathogenic elements, and functional pathways or interactions, and compare these signatures in both periodontal health and disease states. This information will provide a foundation for understanding the molecular mechanisms of chronic periodontitis and allow the development of innovative clinical approaches to diagnosing, preventing and managing the disease.
Understanding the physical changes that occur with age that are associated with periodontal disease will facilitate the development of new and better treatment. In another project, saliva and blood samples taken from postmenopausal women will be studied for their biological characteristics related to tissue inflammation. Researchers may be able to predict both the incidence of new and the progression of existing periodontal disease. If successful, this project will provide a novel and non-invasive method, that is, the use of saliva samples, for assessing systemic inflammation in older women, which could have many clinical applications.
The healthy mouth contains a vast ecosystem, the oral microbiota, of over 700 different types of bacteria and fungi, some of which are recognized pathogens capable of causing several oral diseases. Because microbes colonize sites throughout the body, the lessons learned in the readily accessible oral cavity are applicable not only to oral diseases but to many other chronic conditions throughout the body. However, a major roadblock in this important research area is that several oral bacteria are “uncultivable,” and are known only by their genetic signatures because they cannot be grown in the laboratory.
One project is conducting a detailed examination of the uncultivable bacteria, which is essential for determining whether and how this unique subpopulation contributes to oral health and disease. Once identified, researchers will develop approaches to grow, or “domesticate” these organisms in the laboratory, allowing thorough examination of their physiology and disease potential.
Another project is searching for changes in the oral microbiota between states of health and disease. This will clarify the role of pathogens in disease and the role of the other bacteria, including the uncultivable members, in maintaining a healthy mouth or possibly contributing to disease progression.
-- Contra Caries: Preventing ECC Using a Promotora Model for Rural Latino Families -- Barker, Judith C. -- (CA)
-- Longitudinal Study of Dental Caries in VLBW Infants -- Nelson, Suchitra S -- (OH)
-- Click chemistry for novel antimicrobials against periodontal pathogens -- Eckmann, Lars -- (CA)
-- Molecular signatures of the periodontitis metagenome -- Haake, Susan Kinder -- (CA)
-- Saliva and Serum Inflammatory Biomarkers in Periodontitis: A Study in Older Women -- Wactawski-wende, Jean -- (NY)
-- Cultivation and domestication of previously uncultivated species from human oral -- Epstein, Slava Simon -- (MA)
-- Molecular signatures of the periodontitis metagenome -- Haake, Susan Kinder (CA)
Page Last Updated on June 30, 2018
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