Severe early childhood caries can destroy most of a child's teeth by age three, and disproportionately affects underserved populations, including American Indians and Alaskan natives. Although the link between Lactobacilli bacteria (Lb) and severe early childhood caries has been known for almost a century, progress in delineating which of 140 Lb species are responsible for the disease has remained elusive.
The recent development of whole genome sequencing has made it much easier to identify destructive bacteria. Now, an NYU dental research team has received a four-year, $2.2 million grant from the National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institutes of Health (NIH), to use whole genome sequencing to identify those strains of Lb that contribute to the development of severe early childhood caries.
The study's principal investigators, Dr. Page W. Caufield, professor of cariology and comprehensive care, and Dr. Yihong Li, professor of basic science and craniofacial biology, will analyze several hundred bacteria samples from children with severe early childhood caries and their parents, and from caries-free children and their parents. Sampling and collection will take place at Bellevue Hospital Center in New York.
Sequencing will be conducted by co-investigators at University College in Ireland and at the Wellcome Trust Sanger Institute in the United Kingdom. Drs. Caufield and Li will collaborate with experts on bacterial genome evolution at the American Museum of Natural History to identify sequences common to children with severe early childhood caries and to their parents.
Earlier research led by Drs. Caufield and Li identified virulent strains of Streptococcus mutans, another group of bacteria commonly associated with severe early childhood caries. Dr. Caufield, a microbiologist and infectious disease specialist, and Dr. Li, a molecular epidemiologist, demonstrated that these bacteria are transmitted from mother to infant during intimate contact.
"The findings from our new study, as well as the earlier research on Streptococcus mutans, will help propel the development of a diagnostic test that dentists can administer chairside to identify those at risk," said Dr. Caufield.
"Severe early childhood caries is one of the most prevalent chronic diseases in underprivileged populations," added Dr. Li. "Much still needs to be learned about how the disease develops, and how it can be prevented. Our study will help to fill those gaps."
Co-investigators on the Lb study include Dr. Silvia Argimon, research scientist in cariology and comprehensive care; Dr. Charles Larsen, clinical assistant professor of pediatric dentistry, Dr. Untray T. Brown, clinical associate professor of pediatric dentistry; Dr. Robert Norman, research associate professor of epidemiology and health promotion; and Dr. Peter Catapano, Jr., clinical associate professor of pediatric dentistry, all of the NYU College of Dentistry. Dr. Catapano is also a clinical associate professor of pediatrics at the NYU School of Medicine and director of the pediatric dental clinic at Bellevue Hospital Center.
Additional co-investigators include Dr. Paul O'Toole, senior scientist at University College, Ireland; Dr. Julian Parkhill, senior scientist at the Wellcome Trust Sanger Institute; Dr. Rob DeSalle, curator of the Sackler Institute for Comparative Genomics of the American Museum of Natural History; and Dr. Paul J. Planet, a research associate at the American Museum of Natural History and a fellow in the pediatric infectious disease division of the Columbia College of Physicians and Surgeons Children's Hospital of New York.
Drs. Caufield and Li are also focusing on how severe early childhood caries affects children living on American Indian reservations. They are participating in a series of outreaches to Indian reservations, under the auspices of the American Dental Association, and will incorporate their observations into the NIH study.