Rena D’Souza, DDS, MS, PhD is assuming a key leadership position on the international stage. As the new president of the International Association of Dental Research, D’Souza will be leading an organization of more than 11,000 members from about a 100 countries worldwide. She is only the ninth woman to serve in the position of president in the IADR’s near 100 year history. “IADR opened up windows to the outside world. It is a huge honor to be elected as IADR’s 95th President and to have an opportunity to give back to an organization that has given me so much,” said D’Souza. “It is a privilege like no other to serve this community.”
D’Souza describes her new role with the IADR and outlines her vision for the future of dental research.
Can you tell us about IADR – its history, membership, organizational structure and mission?
It's a very exciting history! Between 1910 and 1917 William Gies, a professor of biochemistry at Columbia University in New York was researching the bacteriology of dental caries or decay. He became fascinated with the biological process that unfolds when bacteria break down hard tissues of the tooth and that got him thinking -- 100 years ago -- that there were others like him who viewed the oral cavity as a scientific playground with tissues and organs that are not present anywhere else in the body. So, he founded an organization, the IADR and its flagship Journal of Dental Research to unite a community of like-minded researchers and clinicians to promote excellent science related to the dental, oral, and cranial facial structures.
In doing this, Gies took dental education and dentistry and elevated them into the status of a health profession. Before that, dentistry was seen as a trade, like that of a backstreet barber-surgeon or blacksmith. Now, the organization is now almost 11,000 strong, and it represents close to 100 countries worldwide.
How broadly does IADR define dental research?
Dental research involves studies on the tripartite complex of dental, oral, and craniofacial tissues. Dental is mostly reserved for teeth and surrounding soft tissue, oral involves the tongue, salivary glands and soft palate, and craniofacial is all about the complex structures of the head and face. All of those are included in dental research.
In addition, dental research encompasses population health sciences, behavioral and social science as well as personalized diagnostics and precision medicine. .
Why is dental research so important?
In the broadest sense dental research is an all-inclusive area of interdisciplinary science.
First of all, it’s important to recognize that having a smile, and a face, and a head shape that is considered “normal” gives one a sense of well-being and identity. Having a single missing tooth in the front of the mouth can take you down several notches. Dental caries and periodontal diseases rank as the most common of infectious diseases of mankind with a global economic impact of over $600 billion..
In addition, the tissues you find in the mouth are very interesting models for research. You have a tongue with distinct taste buds that is also a muscular organ that allows you to speak. You have salivary glands that have so many functions. Saliva is immunoprotective and has enzymes that help you digest your food. Then you have two sets of human teeth that are arranged in a very particular pattern and are great developmental models to study biomineralization and natural regeneration. All of these are biological entities that are not found anywhere else in the body.
So, there's the scientific value, there's the aesthetic, well-being value, and there is another value which is diagnostic or predictive. Many diseases are manifested in the mouth first. Take for example HIV/AIDS which may present as Kaposi sarcoma lesions in the mouth that indicate that there's something wrong.
The IADR believes all countries should invest in dental research. Why?
I think the IADR believes very strongly that everyone should be at the table. All countries should invest in research because there are unique demographics and patterns of disease prevalence in each country that can teach us something new. For instance, populations in Southeast Asia may be able to teach us something about the rise of root decay in aging populations that is a common problem there.
The discussion occurs in the U.S. amongst dental schools about whether every dental school be engaged in in research. Our idea is that, yes, they should. Each school can define it differently and pick one or more areas to focus on. While NIH-funded research covering every element of the spectrum is not expected, engaging in scholarship is important.
What are your concerns about the future of dental research?
I worry that dental schools have lost the momentum for research. They just find it too expensive an investment. They have other huge problems in keeping clinics solvent. That lack of overall commitment to dental research in dental schools is compromising that translation from bench-to-clinic-to-community. Since we live in an unprecedented golden era of science and technology when translation is more possible than ever before, I find this trend quite disturbing.
IADR will be celebrating its 100th anniversary. What are the most important research findings of the last century?
There are many discoveries to mention here but I will only cite a few.
I think if you look back, fluoride and the introduction of fluoride in public water supplies is probably one of the most successful public health experiments ever done. It really did have an impact. Fluoride makes the tooth more resistant to acid break down. The fluoride discovery, I think, was the highlight of the century.
We still do a lot of studies on fluoride use. There's a lot of controversy from the naturalists that fluoride is not good for you. So, IADR looks at all the data very objectively and disseminates and showcases all the recent findings.
We’ve also had a whole breed of very innovative dental materials that you can add to the tooth through bonding. And, of course, implants rank as a key development and involve the placement of a titanium implant into bone. They are now the gold standard for treating tooth loss but failures arising from peri-implantitis are on the rise.
I think there's also excitement in the salivary diagnostics field. Saliva-derived biomarkers predict certain cancers and serve as monitors of the effect of drugs.
Finally, we’re focusing more on how to reverse genetics disorders of the craniofacial defects using non-surgical methods. We’re also coming up with ways in which we can use natural materials to repair dental tissues by exploiting host tissue responses. Now, it is possible to regenerate tooth structure and also to bioengineer tooth forms. These are all exciting future prospects that will soon become available in the clinic.
Tell us about your role and responsibilities as well as the priorities for your term in office.
I look at this as a real responsibility of caring for worldwide populations. I have the privilege of leading this very talented board of directors in strategic governance. To be sitting on the cusp of the past century and having to envision the next century is exciting and a bit daunting for me. We’re recognizing the past, we are gauging where we are in the present and we are also thinking, “How do we secure the association’s future success?" That puts it in a very visionary context.
In addition to promoting our global network of women in science, and helping to grow STAR, our student research forum, I will be visiting institutions all around the world and meeting with the administration, faculty, and groups of student trainees. I plan to present a vision for the future of dental research, IADR’s missions and my own research. I also will be meeting with government officials and policy makers.
In instances where we are looking at policy change – for instance with the World Health Organization that now wants to make oral health part of their universal public health agenda – I will be working closely with stakeholders … the United Nations, the Fédération Dentaire Internationale, or the ISO which sets the international standards for dental materials, including the phase down of dental amalgams, worldwide.
IADR will publish a special centennial issue in 2019 about the journeys that are distinguished women scientists and leaders have taken. As guest editor, I hope that by showcasing such success stories we will inspire our global membership of women and early career researchers.
How does this international group leadership experience compare with other roles you’ve played in academia?
This is very different because you have a board of directors, very talented people, each of whom are deans and administrators in their own organizations. They are all thought leaders for the profession. So when you go in with an idea, it really isn't your idea to execute. But the inclusive culture that provides equal opportunity for all allows you to bring a group along while considering socioeconomic, geopolitical and cultural factors.
Normally, in any other administrative position it's typically the person on the top that dictates the changes. That is not the case here. A different set of skills is needed that allows me to lead by example, from the heart and also from a position of helping others less fortunate than me.
What happens at IADR’s General Session in London, July 25-28, 2018?
With over 5,000 attendees, this meeting involves interactive, inter-disciplinary scientific sessions. If you looked at the spread of organizations across the world, there are not that many that would offer such a diverse portfolio of scientific topics. If you're a salivary gland biologist, you can listen to someone working on enamel, the temporomandibular joint or public health interventions for caries prevention. So, the meeting is unique from that perspective and offers unparalleled opportunities for learning about new research advances and challenges while networking and interacting with early career researchers.
It is a wonderful opportunity for everyone in the organization to come together not only to learn, but also to network and to renew our commitment to furthering dental research worldwide.