Oral Health Research Planning Workshop
“Towards a National Oral Health Research Agenda”
(June 2002)


Executive Summary

Oral health research makes a significant contribution to the health of Canadians by improving the prevention, detection and treatment of disorders of the mouth and face such as genetic abnormalities, traumatic injuries, infections and cancer. Today, however, oral researchers are making even greater strides, unraveling the reciprocal relationship between oral health and systemic conditions including respiratory diseases, diabetes, heart disease, fetal and maternal health.

To push the frontiers of oral health research even further, IMHA organized the first Oral Health Research Planning Workshop in Canada. Held on June 14 and 15, 2002, the workshop drew together a broad range of stakeholders from members of the research community, academic administrators, patient representatives and professional organizations to lay the groundwork for a national oral health research strategy that would include research priorities and training programs for oral health research.

Day 1

The two-day workshop kicked off with a presentation from Dr. Paul Allison, who summarized the available data on prevalence of the major oral diseases in Canada and attempted to link oral health status to demographic factors such as age, income and culture. He also emphasized the high incidence of dental caries and periodontal diseases in aboriginal populations.

Next, the research priorities of dentists were explored by Dr. Christophe Bedos from the Faculty of Dentistry, McGill University, who reported on a national survey carried out in collaboration with the Canadian Dental Association. This study revealed that the majority of dentists believe that research has a strong impact on health, but that research findings need to be translated into practice guidelines for their use. They also recommended that the highest priority be given to research that directly impacts treatments they most frequently provide.

In his address, focusing on ideas generated from the staff of Canadian faculties of dentistry, Dr. Richard Ellen from the University of Toronto and current President of the Canadian Association for Dental Research, pointed out that Canadian oral researchers are international leaders in a number of areas such as biomaterials, connective & mineralized tissue biology, oral microbiology & immunology, neurosciences & pain, and dental implants. He urged the workshop to address ways to sustain excellence in these fields and also to attract new investigators into these and emerging areas such as craniofacial development, health services and policy research, and clinical epidemiology.

The special oral health problems facing specific Canadian populations were addressed by Dr. Hal Leitch, Senior Dental Consultant, First Nations and Inuit Health Branch. Dr. Leitch discussed the unique oral health needs of the aboriginal community and shared a series of questions recently included in the Canadian Community Health Survey designed to more effectively assess the oral/dental needs of the whole country and specific populations.

An enlightening presentation from Anna Pileggi, Executive Director of About Face concluded the morning session with an overview of the special issues and needs faced by people with facial differences due to such causes as abnormal craniofacial development, traumatic injuries, and surgical resection of tissue to treat cancer.

With information gleaned from the morning presentations, breakout groups were formed and asked to define oral health research topics that might be developed around priority areas of IMHA and other institutes as follows:

Group I Injury, Immunity, Inflammation, Repair and Tissue Engineering;
Group II Pain, Disability and musculoskeletal (MSK) Rehabilitation, Mobility and Fitness;
Group III Biomaterials and Devices;
Group IV Aboriginal and Rural Health Research Priorities.

The group's collective efforts were discussed in plenary sessions and condensed by Dr Ellen into the following statement that falls within the general topic of Regenerative Medicine. This statement may form the basis for a Canadian Institute for Health Research (CIHR) Request for Application (RFA):

“Transdisciplinary team approaches to regenerative medicine (tools in biology, biomaterials, toxicology, immunology, biomedical engineering; applications in diagnosis, therapeutic efficacy, health policy/services, economics, ethics, quality of life issues) that address painful, disfiguring, and functionally disabling oral/craniofacial conditions: traumatic, congenital, surgical deficits; chronic pain and neurological disorders, consequences of caries, periodontal diseases and tooth loss.”

The workshop also recognized the acute need for CIHR to generate priority-driven RFA’s to address special needs in the oral health of aboriginal and rural communities and other unique patient populations. The choice of areas for priority-driven research and the initiation of responsive research programs should be developed in direct consultation with the target communities.

Day 2

In many ways, Canadian research has developed in synergy with research carried out in the United States. With this in mind, Dr. Lawrence Tabak, Director of the National Institute of Dental and Craniofacial Research (NIDCR) was invited to launch Day 2 of the workshop with an overview of planning that is taking place in the U.S.

Dr. Tabak reported that NICDR has an annual budget of approximately $306 million and assigns its resources to topics that are identified through a well-established process. The Institute ensures that its priorities are aligned with findings in national health surveys, with research themes developed through workshops and conferences, and with the goals of professional organizations and patient advocacy groups. Between 2004 and 2009, NICDR will focus on the following major topics including:

  • Genomics/proteomics of Oral, Dental and Craniofacial Diseases;

  • Repair and Regeneration of Oral, Dental and Craniofacial Tissues;

  • Clinical and Community Based Approaches to the Diagnosis, Prevention and Treatment of Oral, Dental and Craniofacial Disorders;

  • Training Programs.

Following Dr. Tabak’s address, breakout groups were once again formed to discuss how to build research capacity, establish partnerships and facilitate knowledge transfer. At the end of the day, the groups concurred that the following need to be addressed:

  • Universities should develop strategic plans for research that focus on recruiting and/or developing capacity. Retirement patterns, diminished pool of investigators, and low academic salaries were identified as major challenges. Strategies to improve the recruitment and training of future researchers and academics.
  • The reciprocal relationship between oral health and system disease.
  • The Canadian Association of Dental Research (CADR) should become the hub of a research planning and promotion network.
  • A model for research networks and advisory boards should be developed.
  • CIHR and partners should organize workshops and develop a database that will support partnerships, priorities development and specific programs.
  • CIHR and partners should develop communications strategies to promote oral health and health research.

 

Overview Of Workshop Recommendations


Development of an oral health research agenda within CIHR priority areas

Group 1: Injury, Immunity, Inflammation, Repair,
Tissue engineering
Group 2: Pain, Disability, & MSK Rehabilitation
1.Mechanisms underlying the inter-relationship of periodontal and systemic diseases. Does controlling periodontal disease promote general health?
2.Biological, bioengineering, and delivery systems to advance
Regenerative medicine for oral/facial deficits. Apply these tools to
study efficacy, health services, health economics, ethics, and quality of life issues. [cross-cutting issue with Group 2 #1 and Group 3 #2]
3. Mucosal immunity, inflammation and hypersensitivity to foods, volatile agents, and microorganisms in vulnerable populations; exploit new knowledge to develop preventive strategies and new vaccine and drug delivery routes. [partnership IMHA & III]
1. Transdisciplinary approaches to oral and craniofacial rehabilitation to address painful, disfiguring, and functionally disabling conditions:
- traumatic, congenital, surgical deficits
- chronic pain and neurological disorders
-consequences of caries, periodontal disease, and tooth loss
[cross-cutting issue with Group 1 #2]
2. Major thrust in clinical, health services and translational research.

Group 3: Biomaterials and Devices Group 4: Aboriginal and Rural Health Priorities
1. Inter-faculty / industrial, transdisciplinary partnerships
[centres / networks] to develop and translate knowledge of new biomaterials, pharmaceutical delivery devices, and diagnostic markers / devices
2. Health policy and services research linked to efficacy, life-expectancy, and toxicology of biomaterials
[cross-cutting issue with Group 1 #2]
Culture-respectful research teams [clients, care providers, academics, CIHR, government health agencies] to develop RFAs for new approaches to improve health through a client population - centred iterative process
- Burden / distribution of oral and craniofacial disorders
- Risk variables
- Models for assessment, prevention, treatment, education, health promotion

Building research capacity, partnerships and knowledge transfer


Group 1: Training, Recruitment, Mentorship, Entering the System, Responsibility of Faculties and Research Institutes in Career Development
Group 2: Emerging Areas, Collaborations, Trans-Disciplinary Research Programs
1. Develop database of investigator expertise and core facilities that are accessible
2. Partner with agencies that can develop population oral health status data
3. Workshops to identify collaboration priorities and develop RFAs for interdisciplinary solutions
4. Visitation programs to spread expertise
1. Develop database of investigator expertise and core facilities
2. Partner with agencies that can develop population oral health status data
3. Hold workshops to identify collaboration priorities and develop RFAs for interdisciplinary solutions
4. Develop visitation programs to spread expertise

Group 3: Building a National Perspective and Research Culture in Oral Health Research
Group 4: Partnerships with Consumers, Institutes, Networks of Excellence, Foundations, and Industry
1. Develop a coordinating strategy or process to serve oral health research
2. Establish Inclusive broad partnerships
3. Link priorities, pillars, and capacity
4. Develop a communications strategy
5. Raise profile and importance or oral health and oral health research
1. Develop a networking Model (includes all possible partners) with an Advisory Board
2. Establish a project development and implementation process to transfer priorities from advisory board to a project board
3. Establish a database of partners and of knowledge gaps
4. Hold workshops to effect culture changes that are required to advance partnerships
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