The University Record, October 8, 2001

Dentistry aims to fill gaps in oral health

By Jerry Mastey
School of Denistry

The School of Dentistry has received funding from the National Institute of Dental and Craniofacial Research (NIDCR) to develop a research program to investigate the social, economic, environmental and biological causes of disparities in oral health.

The main theme of the U-M research project is centered on finding answers to the question: Why do some low-income African American children and their caregivers have better oral health than others who live in the same neighborhood?

To try to answer that question, NIDCR, a division of the National Institutes of Health, approved approximately $6.5 million to fund the Detroit Center for Research on Oral Health Disparities. The Center’s efforts to answer that question will represent the first and largest evaluation of oral health among low-income African Americans.

The Detroit Center is a collaborative venture that involves the School of Dentistry, other U-M schools and colleges, the Voices of Detroit Initiative (VODI), and the Detroit Department of Health. The Detroit Center’s research builds upon one of the major themes of last year’s report on oral health by the U.S. Surgeon General that cited “profound and consequential oral health disparities within the U.S. population.” It also said “reducing disparities requires wide-ranging approaches that target populations at highest risk for specific oral diseases and involves improving access to existing care.”

Here in Michigan, the Detroit Center will attempt to promote oral health and reduce disparities of low-income Black children, birth–5 years, and their main caregivers, 14–54 years, who live in Detroit. The Center also will be the site of a training program of clinical research and research training on reducing disparities.

Research will focus on 1,529 low-income Black caregivers and 1,676 children who reside in about 40 census tracts in Detroit that have incomes below 200 percent of federal guidelines (i.e. a family of four earning less than $17,050 annually or a family of two earning less than $11,250 annually).

During the recruiting phase of the research projects, family members will be questioned about their oral health care practices. Trained interviewers will visit households in the 40 census tracts to gather the information on social, behavioral and dietary habits, as well as access to health care. Participating families will be examined at a neighborhood center or clinic.

The examination will include a detailed oral health assessment, screening for lead and screenings for diabetes, lipids, plaque bacteria and markers associated with periodontal diseases. Senior investigators in dentistry, medicine, social sciences, epidemiology, genetics and public health will examine closely the data to determine the reasons for intra-group disparities in oral health.

Approximately three dozen researchers will focus on two core projects:

Daphna Oyserman, social psychologist and prevention researcher, will lead a project on the social characteristics of parents, families and neighborhoods that are associated with disparities in the oral health of children and adults.

Brian Burt, epidemiologist at the School of Public Health, will lead a project on the causes of dental caries (tooth decay) in children and adults. The project will investigate the association between tooth decay and lead levels in children’s saliva, and saliva and the blood of the main caregivers. This project will also note the dietary habits of Black families participating in the study.

Once information from these projects has been gathered, investigators will develop a customized, long-term oral health education program. The program, led by Unto Pallonen with the Cancer Care Research Center, will seek to promote and maintain good oral health and prevent oral diseases among low-income children and their caregivers.

Simultaneously, the Detroit Center will monitor how dental care in Michigan is used and how oral health care providers are compensated to determine if funding needs to be improved. Stephen Eklund, associate professor of epidemiology at the School of Public Health and adjunct professor at the School of Dentistry, will lead this study.