Clinical and Experimental Oral Sciences

This theme area in Birmingham has a long-standing track-record and focuses on:

• building the evidence-base to underpin policy developments on access to, provision of, and delivery of, oral healthcare at the primary care interface;
• assessment of the effectiveness of treatment modes within this setting; and
• broader public health implications of our epidemiological evidence-base.

In this research area, there is a strong focus on epidemiological oral health surveys of UK and international patient populations. This has helped identify disease trends and healthcare needs and thus strongly impacts upon healthcare policy and delivery. Importantly, our novel analyses have now identified significant relationships between oral and systemic diseases, including associations between periodontal diseases and cardiovascular disease and rheumatoid arthritis

Performance of new technologies and dental materials within the real-world environment of dental practices is assessed by way of two well-established Practice-Based Research Networks, which are pioneering in this increasingly recognised field. This approach facilitates translational research and helps identify needs for future development of targeted dental technologies. Interrogation of large datasets on dental restorations placed within the NHS has also characterised restoration longevity and survival as well as determining the factors influencing their performance and resulted in recommendations for optimal future treatment approaches

In the periodontal disease area, a major strand of research is focussed on unravelling the complex stress response pathways which occur during periodontal inflammation at the molecular, cellular and clinical levels.

Identifying the mechanisms underpinning disease pathogenesis and the inter-relationships between periodontal inflammation and other chronic inflammatory diseases (such as rheumatoid arthritis) and the ageing immune system are key goals. Translation is a priority through clinical trials to provide novel diagnostics and host-modulating therapies. Indeed we have completed the first ever randomised phase 3 controlled trial of a phytonutrient supplement, designed for periodontitis treatment and developed over the last 6 years in collaboration with Unilever.

Characterisation of the saliva and crevicular fluid proteome for the first time in health, gingivitis, mild and severe periodontitis, is being undertaken in a project designed at novel biomarker discovery for both human and canine veterinary fields with industry collaborators.

The development, implementation and outcomes of a novel online risk and disease assessment system through our spinout company “Oral Health Innovations”, that drives patient care pathways and capitation fee banding is now active in over 700 Denplan practices with over 40,000 assessments performed by summer 2015. Longitudinal patient monitoring will provide powerful data for public health service planning and profits from OHI Ltd have already funded 3 competitive grants in 2015 through donations to the UK’s Oral and Dental Research Trust.

We now lead a large European multicentre trial to test the clinical significance of these findings in an “un-treated” population. Characterisation of the saliva and crevicular fluid proteome for the first time in health, gingivitis, mild and severe periodontitis, is being undertaken in a project designed at novel biomarker discovery.

• Periodontal Research Group

In the area of developing dental technologies, our research on ultrasound has characterised its use in the cutting and cleaning of dental hard-tissues. Studies bridge both periodontal and endodontic research programmes and also underpin our biological studies into the use of US for stimulating tooth regeneration.

This work has evolved to include novel imaging of nanoflow under ultrasound and has recently attracted significant EPSRC funding. The dental cleaning aspect of ultrasound is further complemented by our research on the abrasive properties of dentifrices which has informed the development of novel toothpaste compositions in collaborative research funded by GSK for more than 25 years. These novel formulations minimise tooth wear whilst optimising cleaning and stain removal.

We are growing our research programme in Oral Cancer, which draws upon interdisciplinary research in cell biology, biomedical imaging and the computational modelling of patho-physiological processes. This programme aims to identify and develop novel evidence-based diagnostic tools, novel biomarkers and therapeutic targets for oral cancer. Recent recruitment of significant cancer epigenetics expertise means this area is anticipated to have significant sustainable growth and also complements our epigenetic studies in pulp biology.

• Oral Cancer Biology Research Group