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Oral diseases and dental health

Support innovative and high impact research that advances the understanding of tobacco impacts on dental health and developing approaches to detect and prevent 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 tobacco and non-tobacco 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 tools that are accessible to these 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 and improve oral disease outcomes is an additional focus.

Sub-Focus areas

  • Molecular and cellular aspects of tobacco-related oral disease.
  • Tools and diagnostic methods of early detection of tobacco-related oral diseases.
  • Oral epithelial dysplasia as a risk for oral cancer; biology and early detection.
  • Oral microbial biofilms and disease progression as they are impacted by combustible and new and emerging tobacco product use.
  • Basic and applied research in periodontitis, chronic and opportunistic infections of the mouth.
  • Tobacco-related oral disease prevention and early diagnosis through community-clinic partnerships.

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Examples of relevant research topics

  • Manifestation and systemic inflammations of oral mucosa or periodontal disease.
  • Pathophysiology and biomarkers of oral squamous cell carcinoma (OSCC).
  • Periodontitis and tooth loss as a result of use of tobacco products.
  • Pathobiology of human periodontitis and related immune system signaling pathways.
  • Role of oral microbial entities in oral cancers, inflammatory and degenerative aspects of progression.
  • Potential causal pathways from combustible and new and emerging tobacco product use to oral diseases and conditions.
  • Research into interventions to reduce oral cancer incidence and mortality among priority groups.

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