Dean, faculty contribute to landmark national report on oral health in America7 min read

Ann Arbor, Mich., Jan. 7, 2022 – A new landmark report on the state of oral health in America contains significant contributions from 17 faculty members at the School of Dentistry.

“Oral Health in America: Advances and Challenges” was prepared under the direction of the National Institute of Dental and Craniofacial Research (NIDCR) at the National Institutes of Health (NIH), with collaboration from the U.S. Surgeon General and the U.S. Department of Health and Human Services. The report is an update of a groundbreaking Surgeon General study in 2000 that emphasized how oral health is directly related to overall health and well-being, while identifying significant gaps in access to oral healthcare for many Americans.

The new report utilized the expertise of more than 350 scientists, academics, researchers and dental practitioners to document how research, policy changes and technological advances have improved both oral and general health in the U.S. over the last two decades. But there are still widespread systemic inequities that limit universal access to education, prevention and treatment related to oral health.

In their introduction to the report, NIDCR Director Rena D’Souza, NIH Director Francis Collins and U.S. Surgeon General Vivek Murthy note that the report “sheds new light on how people in the United States experience oral health differently, based on their age, economic status, and a number of other social and commercial determinants. And, while good oral health is vitally important to the health and well-being of everyone, the report shows that oral healthcare has not been, and is not, equitably available across America.”

The 790-page report, released Dec. 21, 2021, is organized into six sections that are described in its executive summary as “an exhaustive review of scientific knowledge accumulated over the last 20 years.” Each section includes “Calls to Action” and specific recommendations on how to improve oral health across the country. They include:

• Policy changes must be enacted to reduce or eliminate social, economic and other systemic inequities that affect oral health behaviors and access to care.

• Dental and other health care professionals must work together to provide integrated oral, medical and behavioral health care in schools, community health centers, nursing homes, medical care settings and dental clinics.

• The composition of the nation’s oral health professionals, should be diversified, the costs of educating and training the next generation should be addressed, and a strong research enterprise dedicated to improving oral health should be ensured.

School of Dentistry Dean Laurie McCauley, the William K. and Mary Anne Najjar Professor in Periodontics, was one of the six Section Editors for the report. She coordinated content for Section 6 on “Emerging Science and Promising Technologies to Transform Oral Health.” It looks at advances in foundational basic sciences, such as research related to the oral microbiome, genetics and single-cell technologies, while also documenting how the technology of clinical dental practices has changed dramatically since the first report 20 years ago.

“In 2000, few dental practices utilized electronic health records, telehealth was conceptual, and digital platforms were developmental,” McCauley notes. “This section brings us up to date on the science and technology of dentistry and sets the stage for opportunities in the future.  It emphasizes that technology needs to be more widely deployed to provide better access to care for the underserved. It also highlights the critical need for increased training for a future workforce that is diverse and dedicated to research and discovery.”

The section’s “Call to Action” notes the importance of linking scientific research to clinical practice: “Training, support and mentorship of more oral health scientists and academics are needed to ensure a robust workforce who can extend and effectively use the advances in science that are so critical for delivering care in the changing landscape of oral health.”

William Giannobile, a former faculty member at the U-M School of Dentistry and now Dean of the Harvard School of Dental Medicine, also contributed to Section 6, as an Associate Editor, while he was still at U-M.

School of Dentistry faculty member Margherita Fontana was also an Associate Editor for a section – “Oral Health Across the Lifespan: Children and Adolescents.” The section documents improvements over the last 20 years in understanding how to prevent cavities in children and its importance on overall health as the children grow into adults. It reports that about half of U.S. children do not receive regular dental care because of social, economic and geographic obstacles. Fontana is the Clifford T. Nelson Endowed Professor of Dentistry in the Department of Cariology, Restorative Sciences and Endodontics. She is recognized internationally as a leading scientist in the field of cariology and has an extensive clinical research background in childhood caries management. She is currently leading two long-term studies of childhood caries funded with major grants from the NIH.

Other School of Dentistry faculty members who were contributing authors to the report and their dental school appointments are:

Lucia Cevidanes, the Drs. Thomas M. and Doris Graber Endowed Professor of Dentistry and an Associate Professor in the Department of Orthodontics and Pediatric Dentistry; Alexandre DaSilva, Associate Professor in the Department of Biologic and Materials Sciences & Prosthodontics (BMSP); Nisha D’Silva, the Donald A. Kerr Endowed Collegiate Professor of Oral Pathology in the Department of Periodontics and Oral Medicine (POM); Carlos González-Cabezas, Associate Dean for Academic Affairs, the Richard Christiansen Collegiate Professor of Oral and Craniofacial Global Initiatives, and Professor of Dentistry in the Department of Cariology, Restorative Sciences and Endodontics (CRSE); Elisa Ghezzi, Adjunct Clinical Professor in CRSE; Jan Hu, the Samuel D. Harris Collegiate Professor of Dentistry and chair of BMSP; Marita Inglehart, Professor in POM and University Diversity and Social Transformation Professor; Lynn Johnson, Associate Dean for Faculty Affairs and Institutional Effectiveness and Professor of Dentistry in POM; Darnell Kaigler, Associate Professor in POM; Yu Leo Lei, Associate Professor of Dentistry in POM; Peter Ma, the Richard Kingery Endowed Collegiate Professor of Dentistry in BMSP; Romesh Nalliah, Associate Dean for Patient Services and Clinical Professor of Dentistry in CRSE; Jacques Nör, chair of CRSE and the Donald A. Kerr Collegiate Professor of Dentistry; and Danielle Rulli, Clinical Associate Professor and Director of the Graduate Dental Hygiene Program.

Among the scientific reviewers credited in the report is Peter Polverini, the Jonathan Taft Distinguished University Professor in POM.

Organizers of the report asked Dean McCauley to join the project in 2018, which was the start of a three-year schedule of meetings, both in person and virtually, as topics were identified, the structure of the report was determined, and experts were enlisted to write and edit the material. McCauley and other editors dealt with multiple timelines, deadlines and drafts that required many revisions, a process made more difficult and delayed when the Covid-19 pandemic hit in early 2020.

“What I am most impressed with,” McCauley said, “is the breadth of individuals involved in assembling this vital report. In the end, it is a highly detailed reflection of the state of oral health in our world and the directions we need to pursue for continued improvement. It sets the stage of what we know, what challenges persist, and the many exciting opportunities we have to extend the benefits of excellent oral health to everyone across this country.”

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The report – “Oral Health in America: Advances and Challenges” – can be found here on the NIDCR website.

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The University of Michigan School of Dentistry is one of the nation’s leading dental schools engaged in oral health care education, research, patient care and community service.  General dental care clinics and specialty clinics providing advanced treatment enable the school to offer dental services and programs to patients throughout Michigan.  Classroom and clinic instruction prepare future dentists, dental specialists and dental hygienists for practice in private offices, hospitals, academia and public agencies.  Research seeks to discover and apply new knowledge that can help patients worldwide.  For more information about the School of Dentistry, visit us on the Web at: www.dent.umich.edu.  Contact: Lynn Monson, associate director of communications, at [email protected], or (734) 615-1971.

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