The summer 2010 issue of Global Health Nexus presented an excellent discussion of the theme, "The Rise of the New Dental Schools and the Future of the Profession." Each of the authors (Bertolami, Alfano, DePaola, Polverini, and Vogel) discussed the importance of research in advancing the dental profession, although from different vantage points. The immediate genesis of much of the discussion was a conference held in Ann Arbor, Michigan, in May 2010, organized by Dean Polverini, although certainly the discussion of the science-base of the profession has been ongoing since before the Gies Report of 1926.1 We would like to add to the discussion the perspective of the American Association for Dental Research (AADR)-the nation's preeminent dental and craniofacial research membership-based association.
In 1920, William J. Gies and others established the International Association for Dental Research (IADR), "in order to promote broadly the advancement of active research in all branches of dentistry."2 While founded at the Columbia University Club of New York City, prospective members from Chicago and Boston were also involved.
Initially, IADR's membership was based heavily in the United States, but as it grew internationally, different geographic divisions were formed and, in 1972, the American Association for Dental Research (AADR) was chartered-still the IADR's largest division. The mission of the AADR is to
- advance research and increase knowledge for the improvement of oral health,
- support and represent the oral health research community, and
- facilitate the communication and application of research findings.
While "dental schools" are not mentioned in our mission or even in the founding documents of the IADR, it goes without saying that if we are to be successful in our mission, we need to be working closely with dental academics and the dental profession. Indeed, many IADR/AADR members hold their primary academic appointments in dental institutions. The other members are in non-dental academic health centers, medical schools, other campuses of the university, or within the corporate sector.
From a purely scientific perspective, it shouldn't matter where the research is produced "to advance research and increase knowledge for the improvement of oral health." However, as we are also members of the dental profession, we very much desire dental institutions to be initiating research questions, seeking research funding, presenting and disseminating those research findings, and applying those research findings to products and services that improve oral health. There is also the argument that those closest to the clinical challenges will generate the most pertinent and relevant research questions, so naturally a robust body of dental and craniofacial research findings should be emanating from our dental institutions. We of course do not believe that dental institutions should have a monopoly on dental and craniofacial research and indeed some excellent science is coming from non-dental institutions. This is a natural development as our science is increasingly collaborative, cross-disciplinary, and multidisciplinary.
So What Has AADR Done to Promote Dental and Craniofacial Research and Support Dental Institutions?
Outside of our annual meeting and our publication, the Journal of Dental Research-which is jointly owned with the IADR-our biggest investment is research advocacy. We advocate with the US legislative branch of government, the executive branch, and with the profession directly.
Within legislative branch advocacy, AADR worked in partnership with other medical research advocacy groups, like Research!America, as well as dental organizations like ADEA and ADA, to ensure that medical research was included in the 2009 economic stimulus package. Thanks mainly to Senators Specter and Harkin, this resulted in an extra $10 billion to NIH, including $100 million to NIDCR.
Within the 2010 fiscal year appropriations process, AADR was able to educate key Senate staff about the same issues that were covered in the 2010 issue of Global Health Nexus and were the subject of the Ann Arbor meeting. Senate report language within the NIDCR appropriations stated:
Future of Dental Science: The Committee has learned that US dental schools now receive less than half of the NIDCR extramural budget. The Committee encourages NIDCR to work closely with schools of dentistry to foster a more intensive research component to dental education, with the goal of cultivating and retaining dental students who have an interest in research.
AADR also advocates across the NIH campus and the Senate report also included language regarding the difficulty dental schools have had in obtaining infrastructure funding from the NIH National Center for Research Resources (NCRR):
Infrastructure Projects: The Committee is concerned that schools of dentistry may not be receiving adequate infrastructure funding from the NCRR. The Committee encourages the NCRR to explore ways of ensuring an equitable distribution of infrastructure funding among various scientific programs.
AADR is following up with both Institutes regarding their response to this very specific Senate language.
AADR has raised the profile of dental and craniofacial research across other executive branch agencies such as the Agency for Health Research and Quality. AADR testified before both the US Federal Coordinating Council and the Institute of Medicine about the importance of oral health research within the comparative effectiveness research portfolio.
With the profession, the AADR submitted comments to the Council on Dental Accreditation (CODA) to strengthen the research program standard. Our comments, along with others, resulted in CODA adding an intent statement to the research standard. CODA Standard 6 now reads (to be implemented July 1, 2013):3
CODA STANDARD 6-RESEARCH PROGRAM
6-1 Research, the process of scientific inquiry involved in the development and dissemination of new knowledge, must be an integral component of the purpose/mission, goals and objectives of the dental school.
6-2 The dental school faculty, as appropriate to meet the school's purpose/mission, goals and objectives, must engage in research or other forms of scholarly activity.
6-3 Dental education programs must provide opportunities, encourage, and support student participation in research and other scholarly activities mentored by faculty.
The dental education program should provide students with opportunities to experience research including, but not limited to, biomedical, translational, educational, epidemiologic and clinical research. Such activities should align with the clearly defined research mission and goals of the institution. The dental education program should introduce students to the principles of research and provide elective opportunities beyond basic introduction, including how such research is conducted and evaluated, and where appropriate, conveyed to patients and other practitioners, and applied in clinical settings.
Finally, our best advocacy happens when we promote science from our community that demonstrates to policy makers and the public the value of our research. A striking recent example occurred when AADR hosted its Third Fall Focused Symposium. This year's topic was on "Salivary Diagnostics" and brought together key opinion leaders in diagnostic sciences, the dental profession, the payer community from CMS and Delta Dental, the regulators of FDA, the biotech industry, and, of course, NIH scientists. Over 20 speakers discussed the cutting edge of salivary diagnostics, including NYU's Daniel Malamud, who moderated a session on translational and clinical opportunities. The field of salivary diagnostics demonstrates the enormous possibilities of bringing together clinical scientists from dental institutions with engineers from other academic institutions and industry to further recent advances in our biologic understanding of disease in this post-genomic era.
While the AADR's mission is "to advance research and increase knowledge for the improvement of oral health" no matter where such research is conducted, the AADR has a special interest in assuring that dental institutions remain both consumers and producers of new knowledge. AADR will continue to advocate for research funding for dental institutions, provide the venue for sharing that new knowledge at our annual meeting and smaller symposia, disseminate research findings through our Journal of Dental Research, and partner with our professional colleagues at ADEA and the ADA to assure that we remain a science-based profession.
1. Gies WJ. Dental Education in the United States and Canada: A Report to the Carnegie Foundation for the Advancement of Teaching. The Carnegie Foundation, New York, 1926.
2. The First Fifty-Year History of the International Association for Dental Research. IADR, 1973.
3. http://www.ada.org/sections/educationAndCareers/pdfs/predoc.pdf. Accessed November 19, 2010.