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Oral diseases and dental health

Support innovative and high impact research that advances the understanding of the effects of combustible and new and emerging tobacco products on dental health and develops approaches to detect, prevent, and treat tobacco-related oral disease.

Cigarette smoking and use of other tobacco products cause oral and dental diseases, including gum diseases, bone loss and cancers of the mouth and throat. Oral cancer risk for smokers and smokeless tobacco users is substantially higher compared to non-smokers.

This priority area will support research on early detection, prevention and treatment of tobacco-related oral diseases. Oral diseases in commercial tobacco product users are preventable in many cases, but advances in early-stage basic research are still lacking to inform treatment. 

The 2014 Surgeon General’s Report “The Health Consequences of Smoking – 50 Years of Progress” listed the evidence as suggestive but not sufficient to infer a causal relationship between dental caries (cavities) and active cigarette smoking.  In addition, the pathways from tobacco use (combusted or vaporized) to oral disease initiation, progression and prognosis are less clear.

The National Academies of Sciences, Engineering and Medicine recently published a consensus study report reviewing the available evidence of the health effects related to the use of e-cigarettes and identifying gaps and opportunities for future research.  This report states that “there is limited evidence suggesting that nicotine- and non-nicotine–containing e-cigarette aerosol can adversely affect cell viability and cause cell damage of oral tissue in non-smokers.” Thus, California-based researchers are invited to explore innovative fronts in research on combustible and new and emerging tobacco product-induced oral disease.

According to the 2017 report “Status of Oral Health in California,” significant health disparities exist for oral diseases.  African American men are more likely to die from oral cancer than non-Hispanic white males, partly because their cancers are diagnosed at a later stage.  In addition, rural areas of California generally have higher incidence and mortality rates for oral cancer.  Research into diagnostic screening tools that are accessible to priority groups is urgently needed.

Building the health workforce to address oral diseases and dental health is also a priority for TRDRP. Research that addresses health disparities, fosters partnerships to conduct effective prevention and treatment interventions for oral diseases in California’s diverse communities is also highly encouraged. Translational science to speed discovery from the bench to the community clinic to prevent oral disease and improve outcomes is an additional focus.

Sub-focus areas and examples of relevant research topics

Sub-Focus areas and examples of relevent research topics

Tools and cost-effective diagnostic methods of early detection of tobacco-related oral diseases

  • New approaches to make early detection of oral disease more cost effective and accessible.
  • Research into interventions to reduce oral cancer incidence and mortality among priority groups

The impact of nicotine and flavored e-liquids on oral health

  • Investigation of causal pathways from new and emerging tobacco product use to oral diseases and conditions
  • The effect of nicotine on the oral microbiome, dental caries, periodontitis or tooth loss
  • The effect of flavorings on the oral microbiome, dental caries, periodontitis or tooth loss
  • Investigations of carcinogenic properties of nicotine and flavorings in oral cancer

 Evaluation of cessation strategies practiced by dental professionals

  • Motivational interviewing in the detail clinic to encourage commercial tobacco product cessation
  • Evaluation of ethnically and culturally sensitive cessation strategies in priority populations.

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Examples of relevant research topics

  • Pathophysiology and biomarkers of oral squamous cell carcinoma (OSCC)
  • How new and emerging tobacco products affect dental caries, periodontitis or tooth loss
  • Role of oral microbial entities in oral cancers, inflammatory and degenerative aspects of disease progression
  • Potential causal pathways from new and emerging tobacco product use to oral diseases and conditions

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