National Institute Of Dental Research Research Articles

Dental Fluorosis Trends in US Oral Health Surveys: 1986 to 2012.

Dental fluorosis has been assessed only 3 times in nationally representative oral health surveys in the United States. The first survey was conducted by the National Institute of Dental Research from 1986 to 1987. Subsequently, the National Health and Nutrition Examination Survey (NHANES) conducted fluorosis assessments from 1999 to 2004 and more recently from 2011 to 2012. A large increase in prevalence and severity of fluorosis occurred between the 1986-1987 and 1999-2004 surveys. To determine whether the trend of increasing fluorosis continued in the 2011-2012 survey. We analyzed publicly available data from the 2011-2012 NHANES, calculating fluorosis prevalence and severity using 3 measures: person-level Dean's Index score, total prevalence of those with Dean's Index of very mild degree and greater, and Dean's Community Fluorosis Index. We examined these fluorosis measures by several sociodemographic factors and compared results with the 2 previous surveys. Analyses accounted for the complex design of the surveys to provide nationally representative estimates. Large increases in severity and prevalence were found in the 2011-2012 NHANES as compared with the previous surveys, for all sociodemographic categories. For ages 12 to 15 y-an age range displaying fluorosis most clearly-total prevalence increased from 22% to 41% to 65% in the 1986-1987, 1999-2004, and 2011-2012 surveys, respectively. The rate of combined moderate and severe degrees increased the most, from 1.2% to 3.7% to 30.4%. The Community Fluorosis Index increased from 0.44 to 0.67 to 1.47. No clear differences were found in fluorosis rates among categories for most of the sociodemographic variables in the 2011-2012 survey. Large increases in fluorosis prevalence and severity occurred. We considered several possible spurious explanations for these increases but largely ruled them out based on counterevidence. We suggest several possible real explanations for the increases. The results of this study greatly increase the evidence base indicating that objectionable dental fluorosis has increased in the United States. Dental fluorosis is an undesirable side effect of too much fluoride ingestion during the early years of life. Policy makers and professionals can use the presented evidence to weigh the risks and benefits of water fluoridation and early exposure to fluoridated toothpaste.

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There is increasing interest in investigating the association between dental caries and childhood obesity, particularly among preschoolers where the evidence is limited. We aimed to measure the prevalence of obesity/overweight among preschool children aged 3 to 6 years, and to determine the relationship between obesity and dental caries in the primary dentition. A cross-sectional study was carried out in eight public and private preschools using a multi-stage stratified sample of 820 children. Waist circumference (WC) and body mass index (BMI) measurements were obtained. Caries was assessed using the National Institute of Dental Research’s decayed, missed or filled score (dmft). Based on BMI, 15% of children were obese and 10% were overweight. Based on WC, 13% of children were obese. The prevalence of obesity/overweight based on BMI was significantly higher among girls (p-value=0.014) and private preschools (p-value<0.001). Based on BMI, obese and overweight children had lower dmft scores than underweight and normal children (p-value<0.001). Based on WC, obese children had lower dmft scores than non-obese children (p-value<0.001).  Obesity prevalence was high, particularly among girls and private preschool children. Caries activity was lower in overweight and obese children. Longitudinal studies are essential to investigate the association between caries and obesity in preschool children. Key words: Children, obesity, overweight, dental caries, body mass index (BMI).

A Timeline of Biological Assessments: Our Nonspatial Continuum

Much of our dental history is recognized through oral tradition, which has led to myths and misconceptions regarding the efficacy of early restorative agents. Dental biomaterial history has tended to report only certain aspects research in a few textbooks that are expensive and not readily available to the larger dental audience. Our purpose is to provide a detailed peer-reviewed document, which provides a chronological account of our in vitro and in vitro biological continuum. This document follows a published historical chronological timeline of biomaterial testing literature beginning with its little known inception in 1779. Many of the early dental restorative agents evolved due to their anodyne capacity to alleviate tooth pain and provide a modest bacteriostatic capacity. Those that were successful were modified as temporary cavity filling agents and evolved to more permanent fillings. Unfortunately, many of the early agents e.g. antimony, arsenic, asbestos, canthrides, formalin, mercury, mustard, phenol to name a few were toxic to the tooth and supporting periodontal tissues as well as failing to support lost tooth structure. The National Institute of Dental Research required biomaterial testing in the late 1940’s. Even today, the agency permits many pre-1950 agents via the grandfather clause for commercial inclusion and clinical use, while requiring all new post-1958 agents to pass both in-vitro and in vivo testing hurdles. We routinely place restorative agents that infiltrate in graded interphases to interdiffuse into vital enamel, dentine and even cementum by forming a unique biomimetic substrate that mimics the color and opacity of the human tooth. Our biological continuum is still evolving with technologies that will continue to change our clinical future. Our profession has been the global benefactor of dynamic change. Unfortunately, our biomaterials testing status quo is not acceptable as many toxic agents e.g. formalin still remain in our clinics.

Industry influence and tooth decay

History of Science The most common chronic disease among children and adolescents in the United States is tooth decay. Without concerted efforts by the sugar industry, we might be a lot closer to eradication. Industry papers from 1959–1971 reveal a pattern of diverting the National Institute of Dental Research (NIDR) toward strategies to make sugar less harmful and away from reducing sweets. Kearne et al. , who analyzed these papers, also found that 78% of an industry-established statement by the International Sugar Research Foundation was directly incorporated into the text of the NIDR request for research proposals for the National Caries Program in 1971. PLOS Med. 10.1371/journal.pmed.1001798 (2015).

Sugar industry influence on the scientific agenda of the National Institute of Dental Research's 1971 National Caries Program: a historical analysis of internal documents.

BackgroundIn 1966, the National Institute of Dental Research (NIDR) began planning a targeted research program to identify interventions for widespread application to eradicate dental caries (tooth decay) within a decade. In 1971, the NIDR launched the National Caries Program (NCP). The objective of this paper is to explore the sugar industry’s interaction with the NIDR to alter the research priorities of the NIDR NCP.Methods and FindingsWe used internal cane and beet sugar industry documents from 1959 to 1971 to analyze industry actions related to setting research priorities for the NCP. The sugar industry could not deny the role of sucrose in dental caries given the scientific evidence. They therefore adopted a strategy to deflect attention to public health interventions that would reduce the harms of sugar consumption rather than restricting intake. Industry tactics included the following: funding research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay with questionable potential for widespread application, cultivation of relationships with the NIDR leadership, consulting of members on an NIDR expert panel, and submission of a report to the NIDR that became the foundation of the first request for proposals issued for the NCP. Seventy-eight percent of the sugar industry submission was incorporated into the NIDR’s call for research applications. Research that could have been harmful to sugar industry interests was omitted from priorities identified at the launch of the NCP. Limitations are that this analysis relies on one source of sugar industry documents and that we could not interview key actors.ConclusionsThe NCP was a missed opportunity to develop a scientific understanding of how to restrict sugar consumption to prevent tooth decay. A key factor was the alignment of research agendas between the NIDR and the sugar industry. This historical example illustrates how industry protects itself from potentially damaging research, which can inform policy makers today. Industry opposition to current policy proposals—including a World Health Organization guideline on sugars proposed in 2014 and changes to the nutrition facts panel on packaged food in the US proposed in 2014 by the US Food and Drug Administration—should be carefully scrutinized to ensure that industry interests do not supersede public health goals.

Alberto Abbruzzese (1952–2011) Scientist who studied from amino acids to nanoparticles in anti-cancer therapy

Alberto Abbruzzese (1952–2011) Scientist who studied from amino acids to nanoparticles in anti-cancer therapy

Evidence of oxidative stress in temporomandibular disorders: a pilot study

Oxidative stress is involved in the pathogenesis of many conditions and is caused by free radicals in concentrations that overwhelm the natural scavenging mechanisms and cause pain and inflammation. This investigation sought to determine whether pain from temporomandibular disorders was associated with increased oxidative stress as measured by biomarkers in saliva and serum. Both salivary and serum levels of the oxidative stress biomarkers including 8-hydroxydeoxyguanosine, malondialdehyde and total antioxidant status were compared in patients with mild and severe TMJD pain and with healthy controls. These biomarkers were determined spectrophotometrically in saliva and serum from 10 high TMJD pain patients, 10 low TMJD pain patients, and 10 healthy control subjects from National Institute of Dental Research's TMJ Implant Registry and Repository. Linear and logistic regression analyses were used to evaluate the association between each biomarker and TMJD pain. The mean levels of log 8-hydroxydeoxyguanosine (saliva P < 0·0001, serum P = 0·0008), malondialdehyde (saliva P = 0·002, serum P = 0·004) and total antioxidant status (saliva P = 0·005; serum P = 0·001) achieved statistically significant differences between groups. In linear regression analysis, both salivary and serum levels of each biomarker were associated with TMJD pain. In a multivariable analysis, again, both salivary levels and serum levels were also different between groups. Salivary levels of oxidative stress ratios of 8-hydroxydeoxyguanosine, malondialdehyde and total antioxidant status were significantly different between patients with TMJD pain and controls and was comparable to that in serum. These biomarkers hold promise as a potential diagnostic and therapeutic strategy.

The Evolution of America's Scientific Advancements in Dentistry in the Past 150 Years

During the last 150 years, dentistry in the United States faced many challenges as it developed its scientific foundation. In the latter part of the 19th century, clinical practice was driven by empirical evidence, and the first few decades of the 20th century set the stage for America's scientific evolution of dentistry. Seminal developments in America's contribution to science in dentistry and oral health included the 1926 Carnegie Foundation for the Advancement of Teaching report and the vision of William J. Gies; the development of scientific dental journals; the role of immigrant dental scientists from Europe and oral biology as a discipline; and the establishment of the National Institute of Dental Research in 1948. Due in large part to America's contribution to dental science and practice, we are at the brink of a transformation that may expand the role of the dental profession dramatically and improve the oral health of people throughout the world.

Radiographic and periodontal requirements of the American Board of Orthodontics: A modification in the case display requirements for adult and periodontally involved adolescent and preadolescent patients

The increased number of adults undergoing orthodontic treatment is one of the most dramatic changes in our specialty, at least partially due to the population's elevated awareness of dental esthetics. 1 Proffit W. Special considerations in comprehensive treatment for adults. in: Proffit W. Fields H.W. Contemporary orthodontics. 3rd ed. Mosby, St Louis2000: 644-674 Google Scholar Studies have shown an 800% increase in the number of adult orthodontic patients starting treatment between 1970 and 1990. 2 Vanarsdall R.L. Musich D.R. Adult interdisciplinary therapy: diagnosis and treatmen. in: Graber T.M. Vanarsdall R.L. Vig K.W.L. Orthodontics: current principles and techniques. 4th ed. Elsevier-Mosby, St Louis2005: 937-992 Google Scholar In conjunction with the rise in the adult patient pool, orthodontic treatment complexity has likewise increased. Periodontal involvement in adults as young as 18 years has been documented in over 50% of subjects and in most adult patients over 45 years of age. 3 Miller A.J. Brunelle J.A. Carlos J.P. Brown L.J. Loe H. Oral health of United States adults NIH publication 97-2868. National Institute of Dental Research, Bethesda, Md1987 Google Scholar Documentation of advanced periodontal disease has been shown to affect approximately 8% to 30% of the adult population, and many of these patients are unaware of it. 4 Papapanou P.N. Wennström J.L. Gröndahl K. A 10-year retrospective study of periodontal disease progression. J Clin Periodontol. 1989; 16: 403-411 Crossref PubMed Scopus (170) Google Scholar , 5 Löe H. Anerud A. Boysen H. Morrison E. Natural history of periodontal disease in man Rapid, moderate and no loss of attachment in Sri Lankan laborers 14 to 46 years of age. J Clin Periodontol. 1986; 13: 431-445 Crossref PubMed Scopus (574) Google Scholar It is logical that some patients who are prone to periodontal involvement will proceed with orthodontic therapy.

Facing the Future: the NIDCR Celebrates its 60th Anniversary

Facing the Future: the NIDCR Celebrates its 60th Anniversary

The Relationship Between Occlusion and TMD: An Evidence-Based Discussion

The form, function, and pathofunction of the dynamic masticatory system comprises one of the most fascinating, basic, and important areas of study in dentistry. Today’s health care professional is faced with the stark reality that the most common reason patients seek medical or dental care in the United States is due to pain or dysfunction. Pain in the orofacial region is a frequent occurrence in the general population. Lipton et al’s 1 study of 45,711 households revealed that 22% of the US population experienced orofacial pain on more than one occasion in a 6-month period. Certainly it comes as no surprise that the most commonly experienced orofacial pain is odontogenic in nature. However, non-odontogenic orofacial pain such as temporomandibular disorder (TMD) is also common. TMD has been defined as BA collective term referring to a number of clinical problems involving the masticatory musculature, the temporomandibular joint(s), and associated structures or both[ (p. 116). 2 Recent studies indicate the prevalence of TMD-related pain to be 12%. 3 It has been reported that 10 million Americans suffer from TMD-related complaints each year. 4,5 Cardinal signs and symptoms of TMD are pain in the temporomandibular region, limitation or disturbance in mandibular movement and/or masticatory functional ability, and temporomandibular joint sounds. 6 Our current understanding of the complexity of innervation in the head and neck region reveals the dynamic interaction between a number of cranial andcervicalnervestoincludethetrigeminalsystem,whichmay complicate the evaluation of the orofacial pain patient. This shared neurologic circuitry may make the etiology of pain difficult to diagnose. 7 Confusion with regard to diagnostic and clinical decision making is compounded by the fact that signs associated with TMD occur quite commonly in the general population.Seventy-fivepercentofthoseevaluatedinonestudy exhibited at least 1 sign such as joint noise or palpation tenderness and 33% of this nonpatient population exhibited at least 1 symptom 8 that would potentially prompt that individual to seek evaluation and care. Signs and symptoms in the general population have been found to occur in females only slightly more frequently than males, at a ratio of approximately 2:1 as contrasted to patient populations that are significantly biased toward the female population. 9-13 Personal communication with the administrative staff of the National Institute of Dental Research (NIDR) revealed that in 1993 approximately one-third of its total funding for the study of pain was allocated to TMD research. Since that time substantial monetary resources have been expended in an effort to better understand TMD. Yet little consensus exists with regard to a universally accepted diagnostic classification schema because most formats are based on signs and symptoms rather than cause (etiology) and epidemiologic information. 4,5 A suggested classification of myogenous and arthrogenous TMD may be found in Figure 1.

Endostatin binds biglycan and LDL and interferes with LDL retention to the subendothelial matrix during atherosclerosis

Retention of lipoproteins to proteoglycans in the subendothelial matrix (SEM) is an early event in atherosclerosis. We recently reported that collagen XVIII and its proteolytically released fragment endostatin (ES) are differentially depleted in blood vessels affected by atherosclerosis. Loss of collagen XVIII/ES in atherosclerosis-prone mice enhanced plaque neovascularization and increased the vascular permeability to lipids by distinct mechanisms. Impaired endothelial barrier function increased the influx of lipoproteins across the endothelium; however, we hypothesized that enhanced retention might be a second mechanism leading to the increased lipid content in atheromas lacking collagen XVIII. We now demonstrate a novel property of ES that binds both the matrix proteoglycan biglycan and LDL and interferes with LDL retention to biglycan and to SEM. A peptide encompassing the alpha coil in the ES crystal structure mediates the major blocking effect of ES on LDL retention. ES inhibits the macrophage uptake of biglycan-associated LDL indirectly by interfering with LDL retention to biglycan, but it has no direct effect on the macrophage uptake of native or modified lipoproteins. Thus, loss of ES in advanced atheromas enhances lipoprotein retention in SEM. Our data reveal a third protective role of this vascular basement membrane component during atherosclerosis.

BITING INTO MATERIALS RESEARCH

AT A GOVERNMENT LABORATORY facility in Gaithersburg, Md., there is a unique public-private research center where scientists work in areas of chemistry and materials science, pursuing development of new medical materials. It's not a name that trips readily off the tongue, but the work of researchers at the Paffenbarger Research Center (PRC) touches nearly everyone—at least anyone who has ever seen a dentist. PRC—named for George C. Paffenbarger, the unit's first director from 1929 to 1974—is and has been an engine for advancement in dental materials research. It is a $4 million-per-year cooperative research activity that today involves scientists from the National Institute of Standards & Technology (NIST), the American Dental Association Health Foundation (ADAHF), the National Institute of Dental Research, the dental materials industry, and guest scientists from the Navy Dental Corps and from domestic and foreign universities in the dental field. Recent and ongoing work showcases PRC's contributions to he...

Prevalence and trends in enamel fluorosis in the United States from the 1930s to the 1980s

The National Survey of Dental Caries in U.S. School Children: 1986-1987 conducted by the National Institute of Dental Research, or NIDR, remains the only source of national data about the prevalence of enamel fluorosis. The authors analyze these data and describe changes in the prevalence of enamel fluorosis since the 1930s, as reported by H. Trendley Dean. A sample of children comparable to those described in the 1930s was selected from the NIDR data set among children living in households served by public water systems during the child's first eight years of life. The type of water system (that is, natural, optimal and suboptimal) for each household had been recorded in the NIDR data set using data from the 1985 U.S. Fluoridation Census. The NIDR data set included information about the children's history of fluoride exposure obtained from parents. In the 1986-1987 period, the prevalence of enamel fluorosis (ranging from very mild to severe) was 37.8 percent among children living in residences with natural fluoride (0.7 to 4.0 parts per million fluoride ions, or F-), 25.8 percent in the optimal fluoride group (0.7 to 1.2 ppm F- and 15.5 percent in the suboptimal fluoride group (< 0.7 ppm F-). The largest increase in fluorosis prevalence from the 1930s to the 1980s was in the suboptimal fluoride group (6.5 to 15.5 percent). Exposure to multiple sources of fluoride may explain the increase in enamel fluorosis from the 1930s to the 1980s. The exposure to fluoride from sources such as dietary supplements has decreased since the 1980s because of reductions in the recommended dosage, but these changes occurred too late to have an effect on the study cohort. Evidence of simultaneous use of systemic fluorides indicates the need to reinforce guidelines for the appropriate use of fluorides and promote research on measuring total fluoride exposure.

Performing a death-defying act

Performing a death-defying act

Pain Research at the National Institutes of Health

The National Institute of Dental Research [NIDR] (subsequently redesignated the National Institute of Dental and Craniofacial Research [NIDCR] of the National Institutes of Health [NIH]) has created a historical report on the development of pain research at the NIH over the past half century. This report documents that history and explains how much of what is now known about the pathophysiology and management of pain evolved from work of that Institute. Beginning with an exploration of dental pain, the work resulted in creation of animal models and clinical research that has proved understanding of mechanisms and treatments. The pioneering work of Dr. Ronald Dubner and many of his colleagues at the NIDR, the development of the Neurobiology and Anesthesiology Branch, the interdisciplinary approach developed within the Institute, the drug testing program and the ongoing work of the Institute are described.

Incidence of operative procedures on cleft lip and palate patients.

The incidence of operative procedures in a group of 374 cleft lip and palate patients was determined by a chart review. These patients were part of a long term study funded by the National Institute of Dental Research at the Lancaster Cleft Palate Clinic. The chart review provided a breakdown of the primary and secondary procedures performed on the patients. Although the secondary procedures carried out were underestimated in this study, it is clear that these operations comprise a major component of the successful treatment of these patients. The results of the study and the implications in today's managed care environment are discussed.

Fifty Years of Dental, Oral and Craniofacial Research: The National Institute of Dental Research’s Division of Intramural Research

Fifty Years of Dental, Oral and Craniofacial Research: The National Institute of Dental Research’s Division of Intramural Research

Special Recognition of the National Institute of Dental Research on the Occasion of its 50th Anniversary

Journal of Public Health DentistryVolume 58, Issue 2 p. 148-148 Special Recognition of the National Institute of Dental Research on the Occasion of its 50th Anniversary Robert (Skip) J. Collins, Robert (Skip) J. Collins PresidentSearch for more papers by this author Robert (Skip) J. Collins, Robert (Skip) J. Collins PresidentSearch for more papers by this author First published: 27 April 2007 https://doi.org/10.1111/j.1752-7325.1998.tb02501.xAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume58, Issue2March 1998Pages 148-148 RelatedInformation

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Neurobiology and Anesthesiology Branch, National Institute of Dental Research, National Institutes of Health, 9000 Rockville Pike, Bethesda, Maryland 20892 (Sang, Gracely, Max); Department of Neurology, Allegheny University of the Health Sciences, Mail Stop 423, Broad and Vine Streets, Philadelphia, Pennsylvania 19102 (Bennett).In Reply:-Dr. Vandam correctly points out that the medium in which capsaicin is dissolved may itself cause pain, perhaps by destroying peripheral nerve fibers as has been shown to occur with 5–10% benzyl alcohol. He mentions that Zostrix, an OTC preparation of capsaicin, contains benzyl alcohol and acetyl alcohol. We did not use this preparation but prepared our injectate from purified capsaicin powder (Fluka, Ronkonkoma, NY) and dissolved it in 15% Tween-80 in water at a concentration of 10 mg/ml. We are unaware of reports that examine the direct effects of Tween-80 on the peripheral nerve fibers. In previous studies (Simone et al., 1989)[1] injection of this vehicle alone does not cause secondary hyperalgesia. However, even if the vehicle had caused peripheral nerve injury or sensitization, our findings would still support the conclusion that in normal human volunteers, mechanical allodynia and hyperalgesia caused by a focal noxious stimulus spread beyond the distribution of the nerve supplying the injection site. This indicates that strong peripheral nociceptor input can produce mechanical allodynia and hyperalgesia by sensitizing central nervous system neurons.Christine N. Sang, M.D., M.P.H.Richard H. Gracely, Ph.D.Mitchell B. Max, M.D.Neurobiology and Anesthesiology Branch; National Institute of Dental Research; National Institutes of Health; 9000 Rockville Pike; Bethesda, Maryland 20892Gary J. Bennett, Ph.D.Department of Neurology; Allegheny University of the Health Sciences; Mail Stop 423; Broad and Vine Streets; Philadelphia, Pennsylvania 19102(Accepted for publication April 10, 1997.)