We have played a key role in national and international reports and guidelines including:
- Public Health England: Inequalities in Oral Health in England (Watt, Heilmann, Garay).
- Public Health England: Delivering better oral health (DBOH) 4thedition – Oral Cancer (Fedele, Porter).
- European Federation for Periodontology treatment guidelines for stage I-III periodontitis (D’Aiuto, Needleman).
We are key players in multidisciplinary projects that aim to achieve transformational changes in oral health and disease, with a focus on policy (Watt). We have been named a WHO collaborating centre of Oral Health Inequalities and Public Health. We have led a Lancet Series on Oral Health (July 2019) and contributed to establish the related Lancet Commission on Oral Health (March 2020).
Case studies:
Professor Anne Young leads the SMART study*
Referrals of children to the Eastman Dental Hospital for tooth extraction due to caries has more than doubled in the past six years and this is the most likely reason for a child in the UK requiring a general anaesthetic. With the ban on the use of amalgam fillings in July 2018 and complexity of placement of the “white” composite alternative, referrals can only increase.
The aim of this study is therefore to develop a composite that can be placed in general dental practice directly on disease affected dentine without the need for drill or anaesthetic Professor Anne Young began working on this topic in 2000 funded by Schottlander dental company. From 2010 it was supported first by the Engineering and Physical Sciences Research Council (EPSRC), then by a NIHR Invention for Innovation Product Development Award and more recently by NIHR University College London Hospitals Biomedical Research Centre (BRC).
A new single step dental composite has been produced that can bond directly onto disease affected tooth structure without need for the current multiple, complex and time-consuming methods of tooth preparation. Through effective cavity sealing, it halts the growth of bacteria that start the decay process and reduces subsequent enzyme activated tooth degradation. An optimised formulation has recently been commercially manufactured, fully tested and packaged.
MHRA approval for a First-in-Man clinical trial with EDI SMART composite was obtained in December 2018 and the material placed for the first time in paediatric patients in January 2019*. Preliminary clinical results confirmed the novel composite can be safely placed following minimal excavation of badly decayed tooth structure in a single step. These features removed the need for anaesthetic and greatly reduced the time required for restoration placement making it highly suitable for treatment of children.
This work will be followed by applications to undertake a larger pivotal trial to provide evidence of longer term efficacy to support CE marking. The material is to be manufactured and distributed through Davis, Schottlander and Davis.
*This article originally appeared on the UCL website here.
Professor Francesco D’Aiuto leads our work on linking gum disease to systemic diseases*
Gum disease is closely linked to diabetes and it is known that it can lead to a higher blood glucose level as well as chronic inflammation around the body, which both could promote the development of kidney and vessel damage if sustained for long periods of time. This was the first long-term, randomised study to show a substantial benefit of treating gum disease on diabetes control.
Over 250 patients with poorly-controlled diabetes and active periodontitis took part in our trial funded by both Diabetes UK and the NIHR Biomedical Research Centre. After 12 months, those who received more intensive gum therapy had reduced their blood glucose level by on average 0.6 per cent. They also showed reduced chronic inflammation - which could lower their risk of serious diabetes-related complications, such as heart disease, stroke and kidney disease. The findings have already led NHS England to recommend screening diabetic patients for gum disease as standard. Read more .
The researchers continue working with NHS authorities to increase awareness of the link between gum disease and diabetes amongst diabetes professionals, suggesting the inclusion of dental and gum assessments for people with diabetes as standard practice. The Team has gone on to also link periodontitis to high blood pressure (hypertension). Read more.
*This article originally appeared on the UCL website here.
