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5 The Mission of Research
Pages 144-173

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From page 144...
... Many of the basic science discoveries that will be most influential in shaping future oral health and oral health practice will occur outside dental schools in university science departments, in medical schools, and in government, industrial, and other research laboratories. This means that dental school research programs must be linked to basic research programs outside the school.
From page 145...
... It remains the major source of support for oral health research and for training of oral health researchers. This chapter begins with a discussion of broad goals for dental schools.
From page 146...
... As the advancement of the profession, and ultimately the health of the public, depends upon the development and dissemination of new or improved knowledge, dental education institutions must accept the obligation to do research. Research, whether basic, clinical, behavioral or that leading to improved oral health care delivery, must be in evidence.
From page 147...
... In addition to basic and clinical research, both behavioral research and health services research are essential for the improvement of oral health in individuals and populations. Basic scientific discoveries and clinical advances do not automatically benefit individuals or communities.
From page 148...
... In 1985, training for oral health research was covered solely under the topic of clinical sciences; the 1989 report did not even consider it (NAS/ 1985J 19891. Putting oral health research on the agenda for the 1994 OSEP report required a special effort from the dental research community.
From page 149...
... Oral health research does and should draw on researchers trained in medical schools and graduate schools, but a stronger dental school role in research education is an important means to strengthen the link between the basic and clinical sciences in dental schools, solidify the position of dental schools in research-intensive universities and academic health centers, and direct research to oral health problems. Expanding and strengthening the pool of capable basic science and, especially, clinical researchers are, at the same time, preconditions for expanding and strengthening the research productivity of dental schools.
From page 150...
... {Of the 4,300 3About 10 percent of these revenues involve sponsored educational programs. Examples can, however, illustrate the range of organizations that might reasonably fund research in dental schools: the National Cancer Institute for work on oral cancer; the National Institute for Arthritis and Musculoskeletal and Skin Diseases for research on connective tissue biochemistry and bone mineralization; the National Institute on Aging for studies of oral health problems in geriatric populations; and the National Institute of Allergy and Infectious Diseases for AIDS research.
From page 151...
... FOCUS OF RESEARCH AND RESEARCH TRAINING As indicated by the ADA expenditure data reported above, clinical research accounts for the major part of dental school research, with basic research a relatively close second. Although ADA reports do not further identify the substantive focus of research, NIDR data are helpful here.
From page 152...
... indicate that the majority of articles published by extramural researchers supported by NIDR concerned "bioscientific" topics not confined to oral conditions. In addition to individual research projects, NIDR supports 29 research centers, most of them affiliated with dental schools.
From page 153...
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From page 154...
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From page 155...
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From page 156...
... A recent analysis of these data iSolomon, 1993J conservatively defined oral health research workers as fulltime faculty at dental schools or advanced dental education institutions who had a primary appointment in the dental institution and who either had a Ph.D. or held a primary research appointment {i.e., spent at least 80 percent of their time on research and other noninstructional activitiesJ.
From page 157...
... 825~. EXPANDING RESEARCH CAPACITY AND ACCOMPLISHMENTS If new knowledge is to continue to advance the oral health of the public, the dental school must support the fundamental commitment of the university to research and scholarship.
From page 158...
... 80) argues that "dental schools in and of themselves will not be able to develop the manpower and
From page 159...
... In particular, strengthening aggregate capacity in oral health research faces twin problems of limited overall funding and limited research capacity. FUNDING The best organizational predictors of dental school research productivity, according to a 1987 study, were level of NIDR funding, student-to-faculty ratio, and number of dental-related books in the library {Harrington, 1987~.
From page 160...
... Definition of indirect costs and support for faculty salaries are major issues.6 Health professions schools have become increasingly con 6Indirect costs are negotiated between individual institutions and the government according to guidelines on reimbursable expenses. For a given institution, one of the federal agencies sponsoring research at the institution negotiates a rate that
From page 161...
... 4~. One industry-based researcher has described what dental schools interested in support from industry should be capable of doing to meet industry expectations {Sakkab, 1983~.
From page 162...
... Creating Dentist Scientists Although dental schools recruit basic scientists without dental training, they also need to recruit or train research faculty who are dentists to help focus research on oral health problems rather than on problems that other research sites could pursue equally well. Since its birth, NIDR has made the training of dental scientists a high priority.
From page 163...
... A second problem, reported by dental school deans, involves salary disparities. The stipend for those in some NIDR training programs may be higher than starting salaries at dental schools.
From page 164...
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From page 165...
... For example, although Chapter 4 argues that a master's degree in a dental specialty is not sufficient training for a research career, it can help prepare clinical faculty to participate as partners in clinical research under the direction of fully trained researchers. In addition, those in specialty fellowship programs could be placed in clinical research centers or laboratories of established investigators inside or outside the dental school to learn the scientific method by participation.
From page 166...
... . EXTENDING RESEARCH OPPORTUNITIES In addition to building oral health research capacity by training more and better researchers and seeking additional research funds, researchers and policymakers should also explore creative strategies to extend traditional avenues for acquiring clinical knowl
From page 167...
... Among the key elements are sophisticated statistical controls, broad eligibility requirements, and streamlined data collection. Implementation would require regional training programs, a national support hotline and electronic mail network, and a roster of participating clinicians who would be paid for data collection and have their records audited periodically.
From page 168...
... Dental schools, dental societies, and other organizations interested in oral health research {e.g., NIDR, AADS, American Association for Dental Research, ADA, American Dental Hygienists' Association) should evaluate the opportunities for expanded use of simple clinical studies in dentistry and consider collaborating on protocols and priorities for such studies.
From page 169...
... Dental schools provide a practical place to conduct clinical studies because they have available large numbers of eligible patients who, in the normal course of events, will receive treatments of interest to researchers. The simplest studies would impose protocols to structure clinical observations and assessments, while more ambitious studies could attempt quasi-experimental designs.
From page 170...
... RESEARCH AND THE MISSION OF EDUCATION The ardent pursuit of research funding and reputation can strengthen or weaken the educational mission of the dental school. A research-oriented school also needs to recognize and reward excellence in teaching, incorporate a scientific perspective into all elements of dental education, and invigorate the curriculum with the spirit of faculty research.
From page 171...
... that a substantial increase in oral health research graduates is needed {NAS, 1994~. It also recognizes the problems facing schools that are trying to build or maintain a strong research program.
From page 172...
... To build research capacity and resources, as well as foster relationships with other researchers, all dental schools should develop and pursue collaborative research strategies that start with the academic health center or the university and extend to industry, government, dental societies, and other institutions able to support or assist basic science, clinical, or health services research. To strengthen the research capacity of dental schools and
From page 173...
... Improving research productivity in dentistry will require leadership from inside and outside that is, from the university and the academic health center, from the public and private sectors, and from the practice community. The key objectives are to establish research as a priority; to secure new funding and redistribute existing resources; to develop creative strategies to extend the scope of oral health research; to attract qualified new people and develop existing faculty; and to sustain this capacity over time.


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