As part of the budget planning process for Fiscal Year 2019, NIDCR is identifying topical themes for development into research initiatives. During this process, we welcome input from our scientific advisory boards, the extramural community, interested organizations, and the public at large.
What are Initiatives?
Initiatives are a vehicle used by the Institutes and Centers to communicate future research goals to NIH, the Department of Health and Human Services, and Congress. NIDCR begins the initiative development process each year by identifying broad research topic areas, or themes. We then develop a specific initiative proposal for each theme, taking into consideration the input received. Themes identified for FY 2019 are listed below.
Please remember that initiatives are not a complete picture of the Institute’s planned research portfolio for the year indicated, nor do they signal that themes highlighted the previous year have been abandoned. Several initiatives from last year have become formal funding opportunities and are posted on NIDCR’s website. Others are still under development. Proposed FY 2019 Initiatives will be integrated into this larger landscape as they are considered for funding.
How can you provide input?
Please send your comments and suggestions related to these specific theme areas directly to us at FY2019Comments@mail.nih.gov. If you want to suggest additional topic areas, or comment on the process for developing research initiatives, please send those suggestions to the same email address. Please submit all comments no later than Tuesday, September 5, 2017.
Thank you for your interest and input. I look forward to hearing from you.
Martha J. Somerman, D.D.S., Ph.D.
National Institute of Dental and Craniofacial Research
Proposed NIDCR FY 2019 Research Themes (alphabetical by title)
Advancing our Understanding of Enamel Development
The enamel that forms the protective outer layer of our teeth is critical for oral health. Environmental exposures and inherited conditions can weaken or damage the enamel, leading to caries and, if left unchecked, tooth loss and decreased quality of life. While the structure and protein components of enamel have been well characterized, we need to better understand the process by which enamel forms (called amelogenesis). The goal of this initiative is to use multi-disciplinary approaches to develop models of amelogenesis for research that more closely mimic human physiology. Potential research areas include establishing new cell lines and 3-dimensional cultures that promote enamel formation and improving methods for reproducibly growing enamel-producing cells. This initiative will advance our understanding of the complexities of enamel formation and lead to the development of additional tools and approaches for enamel repair and regeneration.
Basic and Translational Research on HIV and AIDS-Related Pathogens in the Oral Cavity
Globally, 40 million people are living with HIV/AIDS, and an estimated two million new cases arise every year. Although treatment advances have dramatically improved the lives of those with HIV/AIDS, oral complications of the disease are not adequately controlled by current therapies. Additionally, mother-to-infant HIV transmission is still a risk due to viral transfer across oral tissues during breastfeeding. Scientists need to better understand the biological mechanisms of HIV transmission through oral tissues, as well as how AIDS-related pathogens cause oral complications once an individual is already infected with HIV. These complications include viral and fungal infections of the oral cavity and salivary glands, HIV-related imbalances in oral bacterial species that lead to caries and periodontitis, and inflammatory responses that damage the salivary glands and cause dry mouth. Therefore, this initiative encourages basic and translational research on mechanisms of HIV and AIDS-related oral infections, as well as the immune system’s role in defending against these invaders. This research will also develop new research tools such as assays and cell and tissue models, as well as foster potential new therapies. Ultimately, such knowledge could lead to more effective interventions for HIV and AIDS-related oral infections.
Bioinformatics/Data Science Jumpstart for Dental, Oral, and Craniofacial Diseases
Biomedical research is in the midst of a big data revolution. To make the best use of this information explosion, researchers need better tools to integrate and analyze increasingly large and complex datasets. This initiative will encourage bioinformatics and data science research to develop innovative strategies, tools, and technologies to utilize big data to advance dental, oral, and craniofacial research. To maximize NIDCR’s investments, this effort will encourage the leveraging of existing data sources. This initiative will encourage research in diverse scientific areas, including electronic health records, as well as approaches that examine an entire class of biological molecules, such as DNA (genomics) or proteins (proteomics). The creation of these tools is essential to harness data and ultimately enable development of effective prevention, diagnostic, and treatment approaches for dental, oral, and craniofacial health.
Biological Factors Underlying Dental, Oral, and Craniofacial Health Disparities
Although the nation’s oral health is improving, certain groups of Americans experience a disproportionate burden of dental, oral, and craniofacial diseases and conditions. For example, early childhood caries and periodontal disease are more prevalent in a number of minority populations. African-American men with oral and oropharyngeal cancers have consistently higher death rates than white males, a disparity not observed across all cancer types. Some of these health disparities are related to socioeconomic factors, such as access to and use of health care. However, biological factors may play a significant role in whether a disease occurs, how it progresses, and whether treatments work. This initiative will encourage studies to identify biological factors that contribute to disparities in dental, oral, and craniofacial disease onset, progression, persistence, and response to treatment. A better understanding of these processes could lead to targeted therapies and treatment strategies for those in greatest need.
Biology of Aging in Dental, Oral, and Craniofacial Tissues
Over the next four decades, the population of Americans 65 and older is projected to more than double. As people age, their cells undergo natural changes that increase their vulnerability to diseases and disabilities, including declining oral health. To develop better ways to prevent and treat age-related dental, oral, and craniofacial (DOC) conditions, scientists need to understand the physiological processes of aging common among multiple organ systems as well as those unique to DOC tissues. The goal of this initiative is to accelerate basic and clinical research on the oral health of older adults. This effort will include studies on age-related epigenetic changes, inflammation, tissue regeneration, and wound healing. The initiative will also support clinical research, including longitudinal cohort studies, to develop best clinical care and prevention guidelines for older adults. Collaborations among researchers from the aging and dental, oral, and craniofacial scientific communities are strongly encouraged.
Dental Practice-Based Research Networks
NIDCR supports efforts to engage dental practitioners in research to facilitate the translation of evidence-based findings into clinical practice. A dental practice-based research network is a unique research venue, providing practitioners with an opportunity to propose or participate in research studies that address day-to-day issues in oral healthcare. The studies, conducted in participating dental offices with consenting patients, help to expand the profession’s evidence base and further refine care.
In 2005, the Institute launched regional dental practice-based networks and revised this strategy in 2012 to fund one national network. The National Dental Practice-Based Research Network (National Dental PBRN) has been tremendously successful in providing a clinical research infrastructure to address questions of everyday relevance to dental practitioners and their patients. This initiative will support the third phase of the National Dental PBRN by building on the knowledge gained from the previous two phases. It will utilize a single Institutional Review Board (IRB), further explore the use of electronic data collection, and increase the number of public-private partnerships while maintaining a geographically diverse network capable of reaching all interested participants.
FaceBase 3 – Bioinformatics and Data Management Hub
The FaceBase Consortium generates and compiles data on craniofacial development and the diseases and disorders that lead to birth defects and facial malformations. The Consortium advances craniofacial research by creating, integrating, and disseminating a variety of large datasets via the FaceBase Hub web site, a resource that is free and openly accessible to the scientific community. The goal of this initiative is to continue to improve the FaceBase data repository and website so that it better serves the craniofacial research community. These efforts include further development of tools for data visualization, integration, and standardization, as well as outreach to the researchers whose projects could benefit from these data. This initiative would also support supplements to existing NIDCR grants to allow the integration of their datasets into FaceBase.
Precision Imaging of Oral Lesions
Healthcare providers need better ways to detect and diagnose oral lesions in order to identify and treat diseases earlier and more effectively. To characterize oral lesions currently, clinicians may need to perform invasive surgical biopsies and laboratory testing that is time consuming and potentially inaccurate. A new approach called precision imaging combines novel visualization technology with detection of disease-specific molecular markers. The goal of this initiative is to develop high throughput, real-time methods for imaging and measurement of oral lesions. Research areas may include the development of new tools for detecting frequently misdiagnosed oral diseases; identifying lesions that should be biopsied; assessing disease progression and treatment; and detecting lesion tissue margins in real time to improve surgical outcomes.
Understanding Gene-Environment Interactions in Dental, Oral, and Craniofacial Diseases
Complex interactions between our genes and the environment influence human health and disease. Understanding these interactions will inform the development of targeted interventions and therapies to minimize or overcome negative impacts of the environment on health. This initiative will support research on the biological mechanisms of gene-environment interactions related to dental, oral, and craniofacial health. This effort will promote research using models to study how exposures women experience during pregnancy may affect prenatal development and infant health. The initiative will also encourage studies to explore interactions of the oral microbiome with genes of interest in dental caries or periodontal disease. Finally, the initiative seeks to spur development of novel animal or organoid models to advance research on the mechanisms of gene-environment interactions.
Please note, when identifying themes for potential funding initiatives, NIDCR takes many factors into account. These factors include: scientific opportunity, alignment with the mission and goals of the Institute’s strategic plans, robustness of the existing portfolio in a particular theme area, both currently and in the year under consideration, and current budgetary climate.