Date: June 10, 2005
Place: Building 31C, Conference Room 6C10
National Institutes of Health
Bethesda, Maryland
DEPARTMENT OF HEALTH AND HUMAN SERVICES
NATIONAL INSTITUTES OF HEALTH
NATIONAL INSTITUTE OF DENTAL AND CRANIOFACIAL RESEARCH
The 179th meeting of the National Advisory Dental and Craniofacial Research Council NADCRC) was convened on June 10, 2005, at 8:35 a.m., in Building 31C, Conference Room 6C10, National Institutes of Health (NIH), Bethesda, Maryland. The meeting was open to the public from 8:35 a.m. to 12:20 p.m., followed by a poster session and lunch break and the closed session for Council business and consideration of grant applications from 2:00 p.m. until adjournment at 4:00 p.m. Dr. Lawrence A. Tabak presided as Chair.
Members Present:
Dr. Eli I. Capilouto
Dr. Nereyda P. Clark
Dr. Matthew J. Doyle
Dr. Augusto R. Elias-Boneta
Dr. Linda G. Griffith
Dr. Mark C. Herzberg
Dr. Josephine Lai
Dr. Jon D. Levine
Dr. Anne S. Lindblad
Dr. Francis L. Macrina
Dr. Harold Morris
Dr. Tracy A. Scott
Dr. George W. Taylor, Jr.
Members of the Public Present:
Mr. Jack Bresch, Associate Executive Director, American Dental Education Association (ADEA), Washington, DC
Dr. Clifton Carey, Federal Agency Relations, American Dental Association (ADA), Washington, DC
Dr. Aida A. Chohayeb, Women Network Collective Research, Washington, DC
Dr. Frank A. Kyle, Jr., Manager, Legislative and Regulatory Policy, ADA, Washington, DC
Ms. Gina Luke, Director, State Government Relations and Advocacy Outreach, ADEA, Washington, DC
Ms. Monette McKinnon, Director, Grassroots Advocacy and State Issues, ADEA, Washington, DC
Dr. Daryl Pritchard, Director of Legislation, American Association for Dental Research, Alexandria, VA
Mr. Peter Reinecke, Health Policy Advisor, The TMJ Association, Ltd., Milwaukee, WI
Dr. Alec Stone, Executive Director, Friends of the NIDCR, Washington, DC
Ms. Joan Wilentz, Contractor/Science Writer, Bethesda, MD
Federal Employees Present:
National Institute of Dental and Craniofacial Research:
Dr. Lawrence A. Tabak, Director, NIDCR
Dr. Robert C. Angerer, Scientific Director, Division of Intramural Research (DIR)
Dr. Albert Avila, Director, Office of Education, DIR
Ms. Carolyn Baum, Committee Management Specialist and Council Secretary, Office of the Director (OD)
Dr. Sangeeta Bhargava, Health Scientist Administrator and Program Director, Immunology and Immunotherapy Program, Division of Basic and Translational Sciences (DBTS)
Dr. Henning Birkedal-Hansen, Acting Deputy Director, NIDCR
Dr. Norman S. Braveman, Executive Secretary, NADCRC, and NIDCR Board of Scientific Counselors, and Assistant to the Director, OD
Dr. Patricia A. Bryant, Health Scientist Administrator and Program Director, Behavioral and Social Science Research Program, Clinical Research Branch (CRB), Division of Clinical Research and Health Promotion (DCRHP)
Dr. María Teresa Canto, Health Scientist Administrator and Program Director, Epidemiology Research Program, CRB, DCRHP
Mr. Hong T. Cao, Grants Management Specialist, Grants Management Branch (GMB), Division of Extramural Activities (DEA)
Dr. Lois K. Cohen, Associate Director for International Health, NIDCR, and Director, Office of International Health (OIH)
Mr. George J. Coy, Chief, Financial Management Branch (FMB), Office of Administrative Management (OAM)
Mr. Kevin L. Crist, Grants Management Specialist, GMB, DEA
Ms. Mary Daley, Chief Grants Management Officer, GMB, DEA
Ms. Yvonne H. du Buy, Associate Director for Management, and Chief, OAM
Dr. Isabel Garcia, Acting Director, Office of Science Policy and Analysis (OSPA), andCo-Director, Residency Program in Dental Public Health at NIDCR, DCRHP
Dr. Kevin Hardwick, International Health Officer, OIH, and Special Assistant for Research Infrastructure and Curriculum Development, OD
Dr. Thomas Hart, Clinical Director, DIR
Dr. H. George Hausch, Acting Director, DEA
Dr. Alice M. Horowitz, Health Promotion Specialist, Population Research and Health Promotion Branch, DCRHP
Dr. Rosemarie Hunziker, Director, Technology Development and Industrial Relations Program, Center for Biotechnology and Innovation (CBI)
Ms. Lorrayne Jackson, Extramural Research Analyst and Outreach Specialist, OD
Dr. Lynn M. King, Scientific Review Administrator, Scientific Review Branch (SRB), DEA
Dr. Dushanka V. Kleinman, Chief Dental Officer, U.S. Public Health Service, and Deputy Director, NIDCR
Dr. Eleni Kousvelari, Acting Director, CBI
Dr. John W. Kusiak, Health Scientist Administrator and Program Director, Molecular and Cellular Neurobiology Program, DBTS
Dr. James Lipton, Senior Advisor to the Chief Dental Officer, U.S. Public Health Service
Dr. Yujing Liu, Scientific Review Administrator, SRB, DEA
Dr. Dennis F. Mangan, Acting Deputy Director, DBTS, and Chief, Infectious Diseases and Immunity Branch, DBTS
Ms. Dorothy Maxwell, Program Analyst, OSPA
Ms. Amy McGuire, Grants Management Specialist, GMB, DEA
Ms. Gladys Melendez-Bohler, Management Analyst, OAM
Dr. Richard L. Mowery, Chief, CRB, DCRHP
Dr. Mostafa Notka, Health Scientist Administrator and Program Director, AIDS and Oral Manifestations of Immunosuppression Program, DBTS
Dr. Ruth Nowjack-Raymer, Health Scientist Administrator and Program Director, Health Disparities Research Program, DCRHP
Ms. Helen Pham, Grants Management Specialist, GMB, DEA
Dr. Bruce L. Pihlstrom, Acting Director, DCRHP
Ms. Rebecca Roper, Scientific Review Administrator, SRB, DEA
Ms. Diana Rutberg, Grants Management Specialist, GMB, DEA
Dr. Ann L. Sandberg, Acting Director, DBTS
Dr. Robert H. Selwitz, Chief, Population Research and Health Promotion Branch, and Co-Director, Residency Program in Dental Public Health at NIDCR, DCRHP
Dr. Yasaman Shirazi, Health Scientist Administrator and Program Director, Epithelial Cell Regulation and Transformation Program, DBTS
Dr. Lillian Shum, Health Scientist Administrator and Program Director, Physiology, Pharmacogenetics, and Injury Program, DBTS
Dr. Rochelle Small, Health Scientist Administrator and Program Director, Developmental Biology and Mammalian Genetics Program, DBTS
Ms. Traci Walker, Committee Management Assistant, OD
Other Federal Employees:
Dr. William Maas, Director, Division of Oral Health, Centers for Disease Control and Prevention, Chamblee, GA
OPEN PORTION OF THE MEETING
I. CALL TO ORDER
Dr. Lawrence A. Tabak, Director, NIDCR, called the meeting to order and welcomed everyone. He invited the Council members and guests to introduce themselves. Dr. Tabak welcomed Dr. Tracy A. Scott, a new ex officio Council member, and he congratulated three Council members on their new appointments. Dr. Eli Capilouto is now Provost of the University of Alabama at Birmingham; Dr. Matthew Doyle is Director, Health Care Research & Product Development – Worldwide, The Procter & Gamble Company; and Dr. Francis Macrina is Vice President for Research, School of Dentistry, Virginia Commonwealth University, Richmond.
Dr. Tabak noted that the agenda for the meeting focused on research training and the NIDCR Implementation Plan. He encouraged Council members to talk with 12 intramural research fellows who, during the lunch break, presented posters of their research.
Dr. Norman S. Braveman, Executive Secretary, NADCRC, referred the Council to a new NIDCR publication, entitled “Have You Considered a Career in Oral Health Research?” The booklet profiles, in an interview format, Dr. Tabak and two minority oral health researchers.
II. APPROVAL OF MINUTES
The minutes of the Council’s meeting on January 28, 2005, were considered and unanimously approved.
III. FUTURE COUNCIL MEETING DATES
The following dates for future Council meetings were confirmed:
September 23, 2005
January 23, 2006
May 22, 2006
September 18, 2006
January 22, 2007
May 18, 2007
September 24, 2007
IV. REPORT OF THE DIRECTOR
Dr. Tabak presented highlights of NIDCR staff and budget activities and NIH initiatives since the previous Council meeting. Additional details and items are presented in the written Director’s Report (see Attachment III). Dr. Bruce Pihlstrom, Acting Director, Division of Clinical Research and Health Promotion (DCRHP), reported on a recent personnel change.
Staff Activities
NIDCR Director. Dr. Tabak noted that he and Dr. Pihlstrom co-authored “Research for the Practicing Dentist,” the cover article for the June 2005 issue of the Journal of the American Dental Association. In this article, they discuss the new NIDCR initiative in practice-based research (see below) and they highlight NIDCR-supported research initiatives of interest to practicing dentists.
Chief Dental Officer, U.S. Public Health Service (PHS). In February and May, Dr. Dushanka V. Kleinman hosted Professor Raman Bedi, Chief Dental Officer of England, and his immediate staff. They discussed PHS programs of relevance to England’s Public Health Service.
Budget Activities
Fiscal Year (FY) 2005. The NIDCR appropriation is $391.8 million. Dr. Tabak stated that research project grant funds, which total $235.1 million, will support an estimated 679 awards. NIDCR will maintain the research centers program at 7 awards, support an estimated 87 Research Career Development Awards (RCDAs), and fund 346 full-time training positions.
FY 2006. Dr. Tabak reported that the President’s budget request for NIDCR is $393.3 million—a 0.4 percent increase over the FY 2005 budget. The President’s budget request for NIH, which is $28.7 billion, represents a 0.5 percent increase.
NIH Reauthorization. Dr. Tabak said that the issue of reauthorization was raised by the Congress during a March 17 meeting on NIH portfolio management. The Congress has not yet set a date for introducing specific legislation on NIH reauthorization.
New Practice-Based Initiative. Dr. Tabak noted that NIDCR has awarded three grants to establish regional practice-based research networks to investigate “everyday” issues in the delivery of oral health care. The three awardees of these 7-year grants are New York University, which will oversee an East Coast research network; University of Alabama at Birmingham, which will coordinate studies in the South with the University of Florida, Gainesville; and University of Washington, Seattle, which, together with Oregon Health and Science University, Portland, will operate a network in the West. NIDCR is allocating an initial $75 million to this important investment.
The regional networks will each conduct approximately 15 to 20 short-term clinical studies to compare the benefits of different dental procedures, dental materials, and prevention strategies in different patient and clinical conditions. The researchers also will perform anonymous chart reviews, as allowed by the Health Insurance Portability and Accountability Act, to generate much-needed data on oral disease, trends in treatment, and prevalence of less common oral conditions.
NIH Initiatives
Public Access to Research Publications. Dr. Tabak noted that, effective May 2, the National Library of Medicine’s PubMed Central began hosting an electronic, searchable database of peer-reviewed journal articles reporting on research funded by NIH. NIH-funded investigators are being asked, but are not required, to post their manuscripts to PubMed Central.
NIH Roadmap. Dr. Tabak reported that NIH has cancelled its Planning Grants for Regional Translational Research Centers, which were first announced in October 2004. NIH will build on the concept, however, to re-engineer a larger and bolder initiative that will create greater opportunity to catalyze the development of clinical and translational sciences in the United States. The aim is to partner with academic health centers to foster clinical research as a separate discipline and to offer integrated packages of resources to clinical researchers. The National Center for Research Resources is leading this NIH effort.
NIDCR Personnel
Dr. Pihlstrom reported that Dr. Robert H. Selwitz, Chief, Population Research and Health Promotion Branch, and Co-Director, Residency Program in Dental Public Health at NIDCR, DCRHP, is retiring from Federal service. He has accepted positions as Clinical Professor, College of Dentistry, University of Florida, Gainesville, and Director of Public Health Dentistry, Duval County, Florida. The Council applauded Dr. Selwitz for his many years of service to NIDCR.
V. TRAINING CONFERENCE REPORT
On June 9, NIDCR convened the NIDCR Meeting on Research Training. This meeting was one component of the effort to develop an Implementation Plan for the NIDCR Strategic Plan. All Council members were invited to attend the meeting. Dr. Braveman asked four members who participated to report on the meeting: Drs. Matthew Doyle, Linda Griffith, Mark Herzberg, and Frank Macrina. A summary list of talking points from the discussions at the meeting was distributed to the Council.
Dr. Griffith spoke on behalf of the four Council members. She presented a recommendation that these members had developed after the meeting to address issues raised at the meeting and to help focus NIDCR efforts at critical stages where NIDCR could have immediate impact. Dr. Griffith summarized the essence of the meeting and encouraged the full Council to engage in a general discussion of the proposed recommendation.
Dr. Griffith noted that the challenge confronting dental research is to create a quantum increase in academic dental medicine research and to change the culture of dental education to value research in dental school admissions and training. Pertinent observations noted during the June 9 meeting included the following: (a) admissions committees in many dental schools select against students who have or desire a research experience; (b) some dental students are eager to do research; (c) students who are eager to do research are worn down by highly restrictive and constrained curricular demands; and (d) dental schools that are rated as being in the top two quintiles (i.e., the top 20 schools) have research funding levels that could support a cadre of research-oriented students in each entering class.
As a first step toward meeting the challenge presented, the four Council members proposed that NIDCR create an NIDCR Oral Health Scholars Program that would provide support for a research experience during the last 2 years of dental school, which would be extended to 3 years. The student would receive a master’s degree in a chosen field of research that is relevant to oral health (e.g., oral biology, tissue engineering, economics, clinical research, science journalism). Dental schools would be required to have flexible curricula and plans for enhancing the participation of diverse students in dental research. Initially, the program would be available to the top quintile of dental schools (approximately 10 schools) that already have substantial research funding, which they would be designated as “five-star” schools, and would support a critical mass of 7 to 10 students per class (for a total of 50 to 60 students each year). The NIDCR could partner with industry members of the American Dental Association (ADA) to fund the program.
Dr. Griffith noted two potential outcomes of the program: (i) it would create competition among dental schools to increase the research base, and (ii) the increased research base and increased funding levels would provide a foundation for creating a D.D.S.-Ph.D. program analogous to the highly successful Medical Science Training Program (MSTP) supported by NIH. The overall result would be to increase awareness about oral health research and to “catapult” dental research into a more robust enterprise.
Dr. Tabak thanked Dr. Griffith and her colleagues for their efforts and proposed recommendation. He suggested that their action was a positive model for Council’s participation in other NIDCR endeavors.
VII. DISCUSSION
The full Council discussed the proposed NIDCR Oral Health Scholars Program. The Council congratulated the four members for envisioning a “consumable” program that embraces major issues facing dental research, education, and practice. The Council noted that micro programs such as that proposed can have macro effects within a university environment. The program would be an important lever for stimulating oral health research, have synergistic effects with other research training programs, promote collaborations, and enlarge the exposure of dentistry to other fields.
The Council commented that the program should interface with the NIDCR research program, should be evaluated rigorously, and should encourage clinical research, strong mentor–mentee relationships, increased participation of underrepresented minorities, and partnerships between research-intensive dental schools and non-research-intensive dental schools.
The four Council members who proposed the program responded to questions. They noted that the program could have synergistic effects by creating “waves” of students who are trained in stronger research-oriented environments and could apply for existing training mechanisms. They also noted that the proposed program would include specific expectations of trainees and mentors and would be evaluated for its success and efficiency (e.g., in enhancing minority representation in oral health research). The Council suggested that evaluators utilize and compare measurements of success used in other research training programs and include specific measures of expertise in basic and/or clinical research methods.
The four Council members envisaged a program that would not be proscriptive regarding the type of research experience supported. The primary aim would be to leverage scholarly activity in dental schools whose faculty have substantial investigator-initiated research grant (R01) support. The overall program would have broad and versatile “horizons,” and the nature of each institution’s program would depend on the interests and creativity of the students and the resources of the institution. Institutions would be required to propose plans to support positive mentoring and to increase the participation of underrepresented minorities.
The program would encourage all dental schools to incorporate research into their curricula. Initially, the program would focus on dental schools in the top quintile—to give them recognition and honor—and subsequently would be expanded to include dental schools that have increased their capacity for research and have a critical mass of interested students. The four members suggested that, to generate success, a dental school must have an “organic” commitment to the concept of the program and an institutional system and capacity for research. Thus, the initial investment would be in a few schools that have a high probability of success. Smaller or less-research-intensive dental schools could partner with larger or more-research-intensive schools to participate in the program.
Again, the overall aim of the program is to change the culture across dental schools to celebrate research and scholarship. The members anticipated that students who participate in the program would become leaders in dental research, education, or practice. Although some may become dental school faculty, the program is not intended to focus on the replacement of retiring faculty.
The Council noted that the catalysts which foster individuals’ interest in science and research are still unknown and need to be identified and understood. The Council commented that, to improve the pipeline of dental researchers, programs are needed at earlier levels of education—at the undergraduate, pre-dental level and in elementary and middle schools.
Dr. Birkedal-Hansen thanked the four Council members for their inspired response to the June 9 meeting, and he thanked the full Council for its spirited discussion. Dr. Tabak thanked the Council for taking a proactive role in developing and discussing the proposed program.
VII. TENURE TRACK FACULTY MEETING REPORT
Dr. Kevin Hardwick, Special Assistant for Research Infrastructure and Curriculum Development, Office of the Director, NIDCR, reported on the NIDCR grants workshop for tenure-track or recently tenured dental school faculty. Held at the NIH on April 18–19, 2005, the workshop was co-funded by the American Association for Dental Research and the American Dental Education Association. It attracted more than 120 participants from 46 U.S. dental schools. Dr. Hardwick commented that most of the participants had limited knowledge of NIH and were on the NIH campus for the first time. He noted that most of the participants had a D.D.S. degree and some specialty training or experience in research and that more than 20 participants had both D.D.S. and Ph.D. degrees. NIDCR intramural research fellows were invited and attended.
The agenda of the workshop was distributed to the Council. The first day included an overview of NIDCR priorities and strategic directions by Dr. Tabak, a review of grant application and review procedures, lunch with NIDCR extramural program directors, a videotaped “mock” review of three grant applications (which was prepared by the NIH Center for Scientific Review), and presentations on the NIH Roadmap and NIH shared resources. On the second day, the attendees participated in a grants writing workshop.
Dr. Hardwick said that the workshop was a success and that the participants urged NIDCR to hold another similar workshop. They rated the overall workshop at 4.5 (5 is highest), and they gave the highest rating (4.9) to the grants writing component.
Discussion
In response to Council’s questions, Dr. Hardwick said that one way that NIDCR might evaluate the workshop would be to track workshop participants in terms of future NIDCR research grant applications. NIDCR would consider “packaging” the information presented at the workshop in a different format(s) (e.g., print, Webcast, slides/videotape) for wider distribution. With regard to the issue of wider attendance, Dr. Hardwick noted that all 56 U.S. dental schools had been invited to participate. The Council suggested that information on NIDCR activities and funding mechanisms should be included in the packet of materials provided by dental schools for new faculty members.
VIII. REPORT AND DISCUSSION: IMPLEMENTATION PLAN WORKING GROUPS
Dr. Birkedal-Hansen reported on the process and status of developing an Implementation Plan for the NIDCR Strategic Plan. He noted that the convening of the NIDCR Research Training Meeting on June 9 completed the preparatory work for drafting the Implementation Plan. In addition to this meeting, NIDCR has convened 10 working groups over the past year and an international meeting on mucosal immunity. Dr. Birkedal-Hansen said that NIDCR staff will utilize the recommendations from the working groups and meetings to draft the Implementation Plan and that NIDCR will present this draft plan to the Council at its September 2005 meeting.
The Implementation Plan is for the revised NIDCR Strategic Plan, which was adopted by the Council in June 2003. Dr. Birkedal-Hansen noted that the NIDCR strategy for developing the Implementation Plan involved (a) internal staff review of every program area in the NIDCR portfolio, to analyze research gaps and opportunities and to identify major scientific and programmatic areas for the future; (b) formation of working groups for the 10 areas identified by staff; and (c) convening of the working groups for free-ranging discussions of scientific opportunities, research gaps, and future priorities. The working groups comprised members of the Council and Board of Scientific Counselors, external experts, and NIDCR staff.
The first working group, Microbiology/Immunology, met in August 2004. Subsequent working groups focused on Head and Neck Cancer; Craniofacial Developmental Biology and Mineralized Tissue Research; Salivary Research and Sjögren’s Syndrome; Biomaterials, Tissue Engineering, Nanotechnology, and Industrial Relations; Pharmacogenetics; AIDS Research; Pain and Neuroscience Research; Behavioral and Social Sciences Research; and Health Disparities Research. The Executive Summary of each working group was provided to the Council in electronic form and was available in hard copy as well.
Dr. Birkedal-Hansen listed sample recommendations from each working group. He noted that similar themes emerged from the working groups and that recommendations from one group may overlap those of other groups. For all areas, advances in basic science and technology, development and use of appropriate animal models, and collaboration in research are providing the foundation for more sophisticated basic and clinical research and for focused translational research to improve understanding, diagnosis, detection, and treatment of oral diseases and conditions. A major theme for the future is systems research, which NIDCR already emphasizes in all program areas. In this regard, dental practitioners may be viewed as the “gateway” to diagnosis and treatment of systemic conditions that exhibit oral manifestations.
Dr. Birkedal-Hansen noted that all the working groups encouraged NIDCR to “do what is doable and approachable,” rather than to try to fund everything. Examples of the research priorities recommended by the working groups include the mapping of oral biofilms in health and disease; the prevention and early detection of premalignant, dysplastic, and malignant oral lesions; and the definition of normal and abnormal embryonic and postnatal craniofacial development, including the use of stem cells from exfoliated teeth and salivary glands to repair and regenerate tissues. Research to better understand the systems of salivary gland secretions is essential and will complement NIDCR’s co-funding of an international registry for Sjögren’s syndrome. Newer priorities include research on pharmacogenetics (e.g., to understand the genetic aspects of adverse drug effects in patients with chronic pain, mucositis, or xerostomia) and on inhibitors that block entry of human immunodeficiency virus into cells (in response to concerns about the potential development of multidrug resistance to highly active antiretroviral therapy).
Areas in which dental scientists have unique roles and lead research efforts include pain and neuroscience and behavioral and social sciences. Many of the research priorities in these two areas overlap. Priorities include full participation of NIDCR in NIH-wide pain-related initiatives (e.g., the Pain Consortium) and understanding of the genetic, physiological, and behavioral aspects of chronic orofacial pain, including that associated with temporomandibular disease (TMD). NIDCR co-funding of an international registry for TMD will foster development and validation of objective diagnostic criteria and outcome measures.
Because of the great disparities in oral health within the United States, dental researchers also must have a significant role in addressing health disparities. NIDCR-funded, community-based National Centers for Oral Health Disparities are making progress. Priorities include collaborating in interdisciplinary research to better understand the factors underlying oral health disparities among the wide variety of heterogeneous population groups; defining more accurate and adequate racial/ethnic categories for research; and training underrepresented minority researchers.
Discussion
The Council applauded NIDCR for organizing an Implementation Plan process that involved substantial contribution from the extramural community. The Council noted that the process was extremely worthwhile and the members encouraged NIDCR to engage the extramural community in similar ways in the future. Dr. Birkedal-Hansen thanked all the working group members for their valuable expertise and insights.
The Council unanimously approved acceptance of the recommendations from the working groups for the NIDCR Implementation Plan.
IX. CONCEPT CLEARANCE
Dr. María Teresa Canto, Health Scientist Administrator and Program Director, Epidemiology Research Program, Clinical Research Branch, DCRHP, presented a proposed concept to support an epidemiological study of possible health effects of composite restorations. Proposals for investigator-initiated research grants (R01s) would provide a study design to assess associations between exposure to dental composite restorations and observable disruptive endocrine effects and, secondarily, potential effects on neurological and immunological systems.
Dr. Canto noted that, in animal models, bisphenol A (BPA) has been found to be an endocrine disruptor and that exposure to BPA has been associated with unwanted estrogenic effects. An animal study dealing with the placement of dental sealants showed the presence of BPA and other monomers in saliva, and subsequent studies showed that two compounds produce deleterious effects in vitro and disruptive endocrine effects in some animal models. Yet, the results of animal studies of BPA are equivocal and vary by strain of animal, mode of administration, diet, and other unknown factors.
In addition, data on BPA levels in human saliva, blood, and urine that are associated with exposure to environmental sources of BPA are insufficient. Dr. Canto noted that BPA-based resins have been used in dentistry for the past 40 years. Sealants are recommended as a preventive measure for pit and fissures in occlusal surfaces of posterior teeth, and composite restorations that incorporate BPA are widely accepted and used. However, the possible health effects of dental sealants and composite restorations in humans have not been studied and are not known.
Discussion
Two Council members had reviewed the concept in detail. They noted that the question of possible health effects of BPA in humans is important and unanswered. They also noted that an epidemiological study to resolve the question at this time would be large and costly and that the implications of the findings could be significant for dentistry. The members encouraged NIDCR to “table” the concept until more data become available and to consider the convening of a workshop to assess the evidence on BPA in sealants quantitatively and qualitatively and to address methodological issues.
Dr. Tabak said that NIDCR would like to be proactive in documenting the level of exposure to BPA in sealants and composites. He noted that the NIDCR recently began collaboration with the National Institute of Environmental Health Sciences (NIEHS), Department of Defense (DoD), and Commissioned Officers Dental Clinic (CODC) to survey exposure to BPA in humans. This study will collect data on the feasibility of conducting meaningful measurements of BPA exposure in dentistry. The Council noted that this study is a crucial first step. A critical question will be whether incremental determinants of BPA from different environmental sources (e.g., plastics, adhesives) can be measured. Dr. Tabak commented that the staging of research questions is important and that relevant questions must be answered in an appropriate sequence. Data from all studies, including those supported by various NIH components, need to be compiled and analyzed.
The Council did not approve the concept as presented. The Council unanimously approved a motion to table the concept pending (i) a review of the findings of the NIDCR/NIEHS/DoD/CODC study and the ability to determine incremental exposure to BPA from multiple environmental sources and (ii) a workshop to review the most recent literature on the contribution of BPA to possible health effects.
X. POSTER SESSION
Twelve DIR fellows presented and discussed their posters with Council members. The topics demonstrated the breadth and importance of intramural research at NIDCR. They included three-dimensional imaging applications in Fanconi’s anemia, molecular–genetic mechanisms of clinical pain and analgesia mediated by cyclooxygenase-2, microvessel injury and irradiation damage in salivary glands, activation of store-operated Ca2+ entry, the relationship between overexpression of transforming growth factor–B1 in teeth and enamel defects and cysts, and the function of fibroblast growth factors during the branching morphogenesis of submandibular glands.
Other topics included the expression of the protein Semaphorin 4D in head and neck carcinomas as a mechanism for induction of angiogenesis, molecular characterization of the microflora during initial bacterial colonization of enamel, the molecular basis for the structure and function of streptococcal receptor polysaccharide, postnatal salivary stem cells, use of selective venous catheterization to localize phosphaturic tumors, and isolation and characterization of postnatal stem cells from human dental pulp.
CLOSED PORTION OF THE MEETING
This portion of the meeting was closed to the public in accordance with the determination that it was concerned with matters exempt from mandatory disclosure under Sections 552b(c)(4) and 552b(c)(6), Title 5, U.S. Code and Section 10(d) of the Federal Advisory Committee Act, as amended (5 U.S.C. Appendix 2).
There was a discussion of procedures and policies regarding voting and confidentiality of application materials, committee discussions, and recommendations. Members absented themselves from the meeting during discussion of and voting on applications from their own institutions, or other applications in which there was a potential conflict of interest, real or apparent. Members were asked to sign a statement to this effect.
XI. REVIEW OF APPLICATIONS
Grant Review
The Council considered 543 applications requesting $102,929,450 in total costs. The Council recommended 373 applications for a total cost of $71,113,326 (see Attachment II).
ADJOURNMENT
The meeting was adjourned at 4:00 p.m. on June 10, 2005.
CERTIFICATION
I hereby certify that the foregoing minutes are accurate and complete.
________________________ _________________________
Dr. Lawrence A. Tabak Dr. Norman S. Braveman
Chairperson Executive Secretary
National Advisory Dental and National Advisory Dental and
Craniofacial Research Council Craniofacial Research Council
ATTACHMENTS
I. Roster of Council Members
II. Table of Council Actions
III. Director’s Report to the NADCRC, June 2005
NOTE: A complete set of open-portion handouts is available from the Executive Secretary.