DENTAL SCHOOL AWARDED MAJOR GRANTS

The Delta Dental Plan of New Jersey Foundation, Inc. awarded grants totaling more than $1 million to support three innovative research projects at UMDNJ-New Jersey Dental School under the direction of Daniel Fine, DMD, professor and director of research, Jeffrey Linfante, DMD, associate professor, and Maxine Strickland, DMD, MS, clinical assistant professor.

The first project will focus on determining the incidence of "occlusal caries," a condition in which decay in the pit of the biting surface of the tooth is often missed by a dentist, and does not show up on an X-ray until the damage is so advanced that it undermines the tooth and root canal is required. The dental school team will employ a laser fluorescence device able to uncover demineralization of affected teeth. The researchers will try to enroll 1,000 to 2,000 12- to15-year-olds over a two year period to answer the question: How prevalent is this condition among Newark's children? Participants will be rechecked one year after their initial screening.

The investigators will then compare their data to the incidence in areas with fluoridated water to determine if fluoride inhibits formation of these caries. "It is thought that 80 percent of this disease resides in 20 percent of the population," states Linfante. Although funding for treatment is not provided, the team will recommend care when needed.

The second project will look at the incidence of periodontal disease in the same children. According to Fine, a specialist in this field, there has been only one similar study done in this country, and it indicates that the incidence of periodontitis is 25 percent higher in African American children than in other children in the U.S. "In general, kids don't get periodontal disease, but these kids do and it leads to tooth loss," says Fine. He says the goals of this part of the study are to compare the Newark data with the national figures, and to try to determine if the organism that causes this severe, early form of periodontal disease is prevalent in the Newark population.

He explains: "There are variations of this organism, Actinobacillus actinomycetemcomitans, called clones. One of four clones identified is particularly virulent and destructive. The virulent clone is found almost exclusively in African Americans. No Caucasians have it." In his research to date, Fine says that 30 percent of those with early onset periodontitis have the virulent clone, and 70 percent do not.

He expects that 50 out of every 1,000 kids examined as part of this grant will have this disease, but he does not know how many will have this particularly damaging clone. And if some participants are found to have the clone, but no evidence of periodontitis, will they develop the disease later? Do they have a factor protecting them? The team will collect saliva and buccal shavings to be cultivated and frozen in the lab for future study. Fine is pursuing an NIH grant to study host factors that may either protect or incite the disease process.

The dental researcher, who has been studying this disease for 20 years, says there is most likely a genetic component, since it seems to run in families. The overall goal is to find factors that would allow it to be diagnosed before actual symptoms develop.

The team will provide treatment for those identified with the disease. Healthy kids with the "suspect" organism will be followed every three months to see if, in fact, they begin to show symptoms. They will then be treated.

Fine says this early onset periodontitis, which generally begins between 12 and 20, frequently goes completely undetected in the dental community. He advises dentists and parents to look for the warning sign – if a child's front teeth start to spread, he or she may need the care of a specialist.

The investigators and their "screeners" will hit the road in September in a minivan with two exam rooms equipped by the Colgate-Palmolive Company, and will park and set up shop next to various schools in the community, where parents have given consent for their children's participation.

The third grant will allow researcher Maxine Strickland, DMD, to see if using special power toothbrushes will provide physically challenged individuals with cleaner teeth and better dental health. To conduct this study, 25 students at Matheny School and their caregivers will be educated about using the special toothbrush and will be studied for a six-month period.

It is hoped that these three studies will serve as springboards for increased federal funding to improve dental health for minority populations nationwide.