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Title: School of Dentistry Deans Briefing You are not healthy if you do not have oral health' Surgeon Gener


1
School of DentistryDeans BriefingYou are
not healthy if you do not have oral health.-
Surgeon General Everett KoopThe mouth is
connected to the rest of the body. - Surgeon
General David SatcherApril 16, 2005
2
  • Introduction to
  • The Magnitude of the Problem

3
U.S. Surgeon Generals Report Oral Health in
America(May 2000)
  • Oral diseases affect health and well being
    throughout lifespan
  • Safe and effective preventive measures do exist
  • Lifestyle behaviors that affect general health
    such as tobacco alcohol use, and poor dietary
    choices, also affect oral health
  • Major oral health disparities
  • The mouth reflects general health and well being

4
A Case Study California
  • The Neglected Epidemic (1993-1994)
  • Halting A Neglected Epidemic (2000)
  • HRSA Oral Health Survey (2001)
  • USC Southern California Center Health (2001)
  • California in the New Millennium, Mark Baldassare
    (2000)

5
California in 2004
  • State population of 35.4 million projected 50
    million by 2028
  • Southern Californias 8 Counties (Santa Barbara,
    Ventura, Los Angeles, Orange, Riverside, San
    Bernadino, San Diego Imperial) 24.4 million
  • Largest ethnic group is Latinos gt 58 of State
    youth are Latino
  • States growth primarily driven by immigration
  • Approximately 224 languages/dialects spoken
  • The under-18 population grew gt 20 from 1990-2000
  • State Asian-Americans grew by 38 versus 35 for
    Latinos (1990-2000)
  • Major issues include education, health and
    challenges such as energy, water, and air quality

6
Californias Children
  • Only 30 of Californians receive the benefits of
    fluoridated drinking water
  • More than 25 of preschool children do not have
    dental insurance
  • More than 40 of high school students do not have
    dental insurance
  • Between 50 and 75 of minority high school
    students need dental care
  • Californias children have twice as much
    untreated tooth decay (dental caries) as the
    national average
  • Children living in poverty have increased in
    number with attendant increases in disease
    especially minority children.

7
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8
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9
From Conception thru Senescence A Developmental
Perspective and Oral Health/Oral Health Care
  • Preconception
  • Prenatal
  • Neonatal
  • Infant/Toddler
  • School Children
  • Adolescents
  • Young Adults
  • Mature Adults
  • Grandparents
  • Elderly
  • Terminal illness

10
Cleft Lip Cleft Palate
  • One of the most common birth defects
  • Prevalence is one per hour in the United States
    1 per 500 live births in California
  • Direct health costs are approximately 150,000
    per child

11
Oral Health Disparities - Children
  • Dental caries are caused by transmissible
    bacterial infections from caregiver to infant
  • Dental sealants are proven to be 100 effective
    in preventing dental caries on chewing surfaces
    of teeth
  • Fluoridation of community drinking water is the
    major factor responsible for the decline of
    dental caries in the US
  • Cleft lip and palate are the fourth most common
    birth defect
  • More than 52 million school hours are lost due to
    dental pain and suffering in children

12
Anhydrotic Ectodermal Dysplasia First Described
in India by Charles Darwin in the Late 19th
Century (Today known to be X-linked and caused by
TNF-alpha ligand and/or receptor
haploinsufficiency)
13
Oral Infection and Systemic Diseases (Viral,
Bacterial and Yeast Pathogens)
14
Oral Health Messages
  • Over 43 million Americans (including 10 million
    children) are without medical insurance, and more
    than 110 million including 25 million children
    are without dental coverage
  • In California, 11 million people do not have
    access to oral health care
  • Over 4.2 million live births each year
  • A major complication is low birth weight,
    premature babies
  • Most common birth defects being craniofacial,
    oral and dental deformities
  • The most common chronic disease in children is
    dental caries (58.6 of children 5-17 yrs of age)
  • Unintentional injuries to head and neck in
    children is a major health issue (home,
    automobile sports accidents)
  • Child and spousal abuse/violence/trauma have
    major oral-dental implications

15
Oral Health Messages (contd)
  • In 2004, 30 of high school females smoke
    cigarettes
  • An American dies every hour of oral cancer
  • Periodontal diseases are found in more than 60
    of adults (linked with tobacco products)
  • Oral infection is associated with many systemic
    diseases
  • Systemic diseases have oral complications (e.g.
    HIV, diabetes, vitamin deficiencies)
  • More than 20 of adults report chronic severe
    facial pain
  • By 2020, 1 out of every 5 Americans will be 65
    years of age or older
  • Osteoarthritis, osteoporosis, diabetes and cancer
    therapy have significant oral complications
  • In adults 65-69 yrs of age, 26 are edentulous in
    USA and 58 in this age cohort are edentulous in
    Canada
  • Tooth loss, tooth pain, swallowing and facial
    pain are major complaints of poor elderly

16
Genetic Factors in Oral Microbial Infections
17
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18
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19
Towards Understanding Oral Squamous Cell Carcinoma
  • Inherited and acquired gene mutations
  • Multiple and sequential gene mutations ( 110 oral
    cancer genes identified)
  • Multiple gene-gene and gene-environment
    interactions
  • Significant candidate gene mutations associated
    with transcription controls, mitosis, and
    apoptosis

20
  • California has 23,000 practicing dentists
  • 5 schools of dentistry
  • The largest state dental society in the nation
    - California Dental Association (CDA)
  • A coalition of deans, CDA and foundations
    (RWJ, Kellogg and California Endowment)
  • Beginning 2006, new fluoridation implementation
    by MWD that will effect 17 million people
  • Significant oral health disparities

21
  • School of Dentistry
  • An Introduction

22
The USC School of Dentistry in 1897 In 1900,
USCSD graduated the first class of 11
students Birthplaces included Vermont,
Michigan, Iowa, Ohio, California, Germany
Canada On May 2005, USCSD will graduate 38
dental hygiene students, 169 DDS students from 38
countries, 56 advanced dental specialty
residents, MS and PhD Craniofacial Biology
graduate students
23
Report of the President University of Southern
California
The College of Dentistry is equipped with the
best apparatus obtainable. In addition to the
regular work of such institutions, much research
work of great importance is being done.
Dr. George F. Bovard, 1912
24
The USC School of Dentistry was the first in
California and stood as the undisputed leader in
its field for 50 years
25
A Tradition of Innovation, Discovery and
Leadership
  • In 1897 USC began training students in
    dentistry, establishing what was to become the
    first dental school in Southern California, and
    for 56 years, the only dental
  • school in the southwestern United States.
  • Through the endeavors of its faculty and alumni,
    the USC School of Dentistry has garnered national
    and international recognition.
  • In 1921, George Hollenback pioneered dental
    materials and instrumentation.
  • In 1924, Floyde E. Hogeboom (19) published the
    first textbook on the treatment of children. The
    book was subsequently issued in six editions.
  • In 1924, Beverly McCollum (07), a pioneer in the
    field of gnathology (the study of jaw movements
    and occlusion of teeth), conducted research that
    proved the existence of a hinge axis within the
    temporomandibular joint and, working with Charles
    Stuart (40), developed the first device to
    record the movement of the mandible.
  • Rafael L. Bowen (53) conducted research on the
    development of resin composite and adhesive
    technology that revolutionized the modern
    practice of dentistry.
  • Wilma Motley (33), a noted historian and editor,
    served as president of the Southern California
    and American Dental Hygienists Associations as
    well as the International Federation of Dental
    Hygienists.
  • Oral surgeon Marsh E. Robinson (42) developed
    the vertical osteotomy for correction of
    mandibular deformities.

26
A Tradition of Innovation, Discovery and
Leadership (contd)
  • Founded in 1965, the School of Dentistrys Mobile
    Dental Clinic is the most enduring and most
    extensive, self-contained facility of its
    kindand one of the earliest. Our expertise in
    this area has served as a resource for others
    throughout the country who seek to bring dental
    care to underserved areas.
  • In the late 1960s, faculty members Lucien Bavetta
    and Marcel Nimni were among the first to
    understand how the major protein of the body,
    collagen, is formed into ligaments, tendons and
    bone.
  • Established in 1974, the School of Dentistrys
    Craniofacial Biology graduate program was the
    first of its kind in the country.
  • In 1983, researcher Malcolm Snead and his team
    were the first to identify, characterize and
    clone the dental gene amelogenin.
  • USC dentistry dean Harold Slavkin (65) is a
    former director of the National Institute of
    Dental and Craniofacial Research, one of the
    National Institutes of Health.
  • In 2003, alumnus and associate dean Eugene
    Sekiguchi (74) became the third USCSD graduate
    to serve as president of the American Dental
    Association and the first minority to hold the
    post.
  • Researcher Janet Moradian-Oldaks recent findings
    on the function of amelogenin in enamel
    biomineralization holds promise for biomimetic
    approaches to design and fabricate enamel for
    dental restoration and medical devices.

27
Building Strategic Capabilities for the
University
  • VISION
  • Research and scholarship that advances knowledge
    and at the same time addresses issues of critical
    importance to our community, the nation, and the
    world
  • Increase global presence that will increase
    international visibility, reach, and the impact
    of our research, scholarship, art, education and
    service
  • Focus our educational programs to meet the needs
    of qualified learners worldwide, from
    undergraduate thru continuing professional
    education programs this commitment will require
    a learner-centered approach that will guide our
    pedagogy, instructional technology, curriculum,
    admissions and support services

28
To ensure for dentistry a strong and fulfilling
future within the university setting, the leaders
and members of organized dentistry, as well as
the leaders and faculty in academic dentistry,
must make a greater commitment to the mission and
values of the university. The faculty members in
the nations dental schools must become much more
involved with colleagues on the campus, and must
more explicitly adopt the scholarly standards,
including first-class research and academic
service, of the larger parent university. Path
ways Strategies for Dental Education in the
Future ADA Future of Dentistry Report (2001)
29
Vision for School of Dentistry
  • We are health professionals with an emphasis on
  • oral health promotion, risk assessment and
    disease prevention, diagnostics, surgical and
    non-surgical treatments,
  • and therapeutics that optimize patient and
    community health
  • and well being. We function within a learning
    organization
  • that is a diverse community of learning
    students, faculty, staff,
  • alumni and friends. Our shared goals involve
    quality, service
  • and efficiency, and we strive for excellence and
    innovation
  • in what we learn, how we learn, and how we
    communicate
  • our innovations and discoveries to others. We
    take enormous
  • pride in being part of a major research-intensive
    private
  • university in California and we are positioned to
    collaborate
  • within our University and with other Colleges as
    well as
  • with Pacific Rim and Latin American countries.

30
Vision For USC Learners
  • Think critically
  • Access and absorb new knowledge utilization of
    information technology
  • Understand biological, chemical, physical and
    behavioral principles
  • Embrace science-based clinical health care
  • Embrace cultural diversity
  • Possess and renew clinical competencies
  • Communication management skills
  • Leadership, ethics, professionalism

31
Mission for School of Dentistry
  • We are committed to improving the health
  • of all people through education and training,
    innovation and discovery, patient
  • and community health programs,
  • and leadership.

32
Strategic Plan Goals 2003-2006 (Revised 12/03)
PATIENT CARE COMMUNITY ORAL HEALTH
EDUCATION LEARNING
INNOVATION DISCOVERY
LEADERSHIP FOR THE HEALTH PROFESSIONS
IIA. Provide major scientific innovations and
discoveries to advance theories, principles and
applications that improve health.
IIIA. Promote oral health as a fundamental
component of optimal overall health. IIIB.
Increase access to care for underserved
populations through focused community
outreach. IIIC. Ensure that quality patient care
and satisfaction are integral parts of all
educational programs and centers for oral health.
IA. Phase implementation of Problem Based
Learning (PBL) completed by 2005. IB. Expose
students to real-world problems and academic
health professional experiences enabling students
to pursue a broad range of professional career
pathways. IC. Achieve eminence for all advanced
dental specialty programs.
IVA. Foster participation in leadership
opportunities for students, faculty and staff to
serve our University, communities and professions
on local, national and international
levels. IVB. Provide leadership in the
development of PBL training models for training
of faculty from other Universities.
CRITICAL OPERATIONAL FACTORS HUMAN RESOURCES and
MANAGEMENT PRACTICES, COMMUNICATIONS, INFORMATION
TECHNOLOGY
HR. Align USCSD individuals and teams
(students, faculty, staff and alumni) and
management systems with the USCSD mission,
vision, values and priorities.
C. Ensure effective organizational and
interpersonal communication within USCSD, the
University and beyond.
IT. Enable Information Technology to support
present needs and future strategic directions of
USCSD.
33
Strategic Directions at USCSD
  • Four Major Strategic Directions
  • Education and Learning
  • Innovation and Discovery
  • Patient Care and Community Oral Health
  • Leadership in Health Professions

34
Education and Learning 2001 -
  • Four-year conversion to problem-based learning
    graduate first full PBL class in May 2005
  • New AEGD Program first class of residents in
    June 2002
  • Initiated GME thru University Hospital
    (2001-2006)
  • Initiated Deans Lecture Series, Faculty Staff
    Development Training Programs
  • Improved admissions, retention, graduation on
    time, National Board scores, State/Regional
    Board scores graduates pursuing advanced
    education
  • Initiated White Coat Ceremony and Professional
    Oath

35
Innovation Discovery 2001 -
  • Initiated Student Research Group with D.D.S.
    students win national competition awards from
    ADA, ADEA and IADR/AADR
  • Initiated entering dental student Summer
    Research Program
  • NIH research support increases
  • USCSD received its first NIH Small Business
    Grant and creates Oral Solutions
  • USCSD faculty continue to publish in tier 1
    journals in their respective fields (e.g.,
    Science, Development, Journal of Biological
    Chemistry, Structural Biology and Journal of
    Dental Research, and appropriate dental specialty
    journals)

36
Patient Care Community Oral Health 2001-
  • Created new USC Oral Health Center opened in
    January 2003
  • Created new USC Center for Dental Technology to
    open July 2005
  • Group Practices in predoctoral program increased
    from 6 to 9 to increase faculty supervision (goal
    is 12)
  • Acquired new Mobile Clinic to add to USC
    resources 14 different sites
  • New affiliation with Childrens Hospital, San
    Diego and Orange County for Pediatric Dentistry
  • New USC Rescue Mission to care for homeless
    opened
  • New California Endowment Grant to address access
    to oral health care and underserved minority
    students to enter oral health professions

37
Leadership for the Profession 2001-
  • Election of Gene Sekiguchi as President of ADA
    for 2003-04
  • Deans Leadership Seminar Series for DDS/DH
    students to engage with leading figures in the
    oral health professions
  • USC hosts first-time-ever Oral Health Summit
  • USC hosts California Dental Board of Examiners,
    CDA and five California Dental School Deans
  • USC engages with coalition to achieve increased
    fluoridation for 17 million people via MWD (March
    2003 effective 2006)
  • Increase USC student participation with ASDA,
    ADEA, CDA and Federal and California Legislature
  • Increase percent of residents becoming
    Board-Eligible in various dental specialties
    (goal is 100)

38
Administrative Leadership Team
Patients
Students
Part-time faculty
39
Reorganization Reconfiguration at USCSD
Health Promotion, Disease Prevention,
Epidemiology Jane Forrest
Diagnostic Sciences Mahvash Navazesh
Surgical, Therapeutic Bioengineering Sciences
Ilan Rotstein
Craniofacial Sciences Therapeutics Yang Chai
Primary Oral Health Care Terry Donovan Casey
Chen
40
The Five Academic Divisions are Supportedby
Seven Functional Areas
Division 1 Health Promotion Disease Prevention
Epidemiology
Division 3 Surgical Therapeutic And
Bioengineering Sciences
Division 4 Patient and OralHealth Care
Division 5 Cranio Facial Sciences And
Therapeutics
41
Performance Highlights 2001-
  • Applicant Pool Increase (25 of all dental school
    applications in nation)
  • Freshman GPA and DAT Scores Increase (3.4 and
    19/20)
  • PBL DDS National Board Scores Part 1 in 5th
    quintile for 8 years
  • Graduation On Time Increase (60 to 92)
  • Graduates Pursuing Advanced Specialty Program
    Education Increased (7 to gt20)
  • Western Regional Dental Board and California
    State Board Examination Success Increases
  • Faculty NIH Research Grants Increases (20)
  • Student/Resident Clinic performance Increases
    (March,2005 highest month in USCSD history at
    776,000 goal is 1 million per month) Faculty
    Practice goal is 500,000/month
  • Reorganize academic and administrative functions
  • Advance research infrastructure through
    recruitments (appointments and joint-appointments)
    , renovations, core facilities
  • School-wide information technology achieves
    connectivity within a virtual school of
    dentistry using Axium software
  • Numerous faculty recognitions through NIH Merit
    Awards, leadership, collaborative research
    activities and so much more

42
  • Academic Programs
  • and
  • Curricula

43
  • Evaluation of publications on the analysis of
    learning conducted by the National Academy of
    Science
  • Thorough analysis of the links between pedagogy
    and learning and the effectiveness of different
    strategies for creating learning environments.
  • Learner-centered education using case-based or
    problem-based learning coupled with
    service-learning as in health professional
    education

44
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45
Concepts, Facts Skills
Students abilities to acquire organized sets of
facts and skills are actually enhanced when they
are connected to meaningful problem-solving
activities How People Learn National Academy
Press 1999
Problems are learning opportunities in
disguisePam Kuhns
46
Problem Based
Small Group
Student Centered
USCSD Problem-Based Learning
47
The PBL Process
IDEAS What we think
LEARNING NEEDS What we need to know
FACTS What we know
48
Learner-Centered Education (USCSD PBL goals)
  • To develop dental student learners dedicated to
    life-long, self-motivated learning
  • To use learner-centered, inquiry-based methods of
    pedagogy
  • To encourage learners to question theory and
    practices and to engage and interact with faculty
  • To vertically integrate the entire DDS curriculum
  • To provide a solid fundamental background in the
    biomedical and behavioral sciences
  • To ensure that faculty members act to facilitate
    student learning
  • To introduce clinical experiential learning
    opportunities very early in the educational
    sequence of dental professional education
  • To use case-directed learning to introduce
    preclinical skills
  • To measure clinical competency by traditional
    standards
  • To deliver comprehensive patient-centered health
    care

49
Academic Programs - DH/DDS/ASPID
50
Academic Programs Advanced Specialties
51
Academic Programs Advanced Specialties (contd)
52
Academic Programs - Advanced Specialties (contd)

53
Academic Programs Graduate/Postdoctoral
54
  • Continuing Oral Health Professional Education

55
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56
Goals
  • Provide excellent life-long learning
    opportunities to all oral health care providers
    including
  • Dentists
  • Dental Hygienists
  • Dental Assistants
  • Dental Technicians
  • Oral and Health Care Managers
  • Increase the visibility and leadership role of
    USC nationally and internationally, with focus on
    the Pacific Rim and Latin America
  • Provide revenue to further advance the USCSD
    education programs and strategic directions

57
Number of Courses Per Year
Number of Hands-On Courses Per Year
Number of Multidisciplinary CoursesPer Year
58
Continuing Education
Course Revenue and Expenses
Revenue from Corporate Sponsorships Per Year
59
Future Goals
  • Strengthen our leadership role in life-long
    learning for all oral health professions
  • Increase the number of CE courses and programs
  • Introduce new courses and topics
  • Introduce more multidisciplinary programs
  • Increase number of hands-on and
    behind-the-shoulder clinical courses
  • Partner with other USC colleges to create joint
    programs (e.g., MBA Certificate in Oral Health
    with Marshall School of Business)
  • Partner with other universities, mainly in the
    Pacific Rim and Latin America, for joint symposia
    and programs (e.g., Mexico, Taiwan, Korea, China,
    Japan)
  • Increase enrollment
  • Increase revenue
  • Introduce distant learning opportunities
  • Broaden CE professional network
  • Increase partnership activities with Corporate
    America

60
  • Community
  • Health Programs

61
USCSD Affiliated Clinics
62
Hospitals and Higher Educational Institutions
Affiliated with USCSD
Programs include clinical treatment,
interdisciplinary teams, and didactic coursework.
63




USCSD Community Preventive Dentistry/Sealant
Program
64
Community Clinical Education
USCSD Mobile Clinics (Since 1964)
65
USC Dental Clinic
66
Preventive Care/Sealant Program
Educating Local Children on Oral Health
Sealant Process as shown to school kids
67
Seniors Hollenbeck Center
68
Birth
Childrens Hospital of LA
Queens Care Mobile Clinic
10
School Sealant Project
USC Mobile Clinic
Childrens Dental Center
USC Neighborhood Mobile Clinic
20
USC Union Rescue Mission
30
LAC/USC Medical Center
40
VA Health Systems, Long Beach
50
60
Solis Dental Arts Center
70
Lifeline of Dental Educational Experiences April
2005
80
Hollenbeck Home
90
Death
69
Money Awarded from Grants to Fund Community
Health Programs
FY 00
FY 05
FY 06
Baseline
70
Education and Care Community Partnerships
71
COMMUNITY PROGRAM EDUCATION, SERVICE LEARNING
AND RESEARCH
72
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73
  • International, Professional
  • Legislative Affairs

74
Advanced Standing Program for International
Dentists (ASPID)
  • First in the U.S. 1967 with 3 dentists 32
    dentists admitted in 2005
  • Total graduates through 2004 748
  • Class of 2004 Statistics
  • Most applicants have residency status in the U.S.
    prior to application
  • 30 specialize compared to 20 for U.S. graduates
  • Trend is to remain in the U.S. helping serve the
    underserved due willingness to practice in these
    areas
  • Number of first opportunity California Board
    takers increased by 100, first opportunity pass
    rate improved 13 (2003 to 2004)
  • National Board Part II pass rate is 100

75
International Affairs
  • Leadership in Global Oral Health
  • USC-UNAM
  • Bi-national Fluoresis/Fluoride Research Project,
    Oral Cancer Project, Faculty Exchange Program,
    Student Exchange Programs
  • USC-LaSalle
  • Bi-national Lecture series
  • USC-Taiwan Symposium
  • USC-Korea Symposium
  • USC-France Symposium
  • Thirty year history of international postdoctoral
    fellow research programs at CCMB
  • Faculty Service in International Leadership
  • ISO Dental Informatics Standards Committee
  • Delegate to Federation Dentaire International
  • Global Dental Education
  • Leadership in the International Association of
    Dental Research (IADR)

76
International Affairs (contd)
  • Global Dental Education
  • Faculty invited to lecture in 30 countries
  • Distance Learning with 2 countries additional
    countries to follow
  • Faculty provided training for PBL in Japan,
    Korea, Thailand and Mexico
  • Global Health Policy
  • El Salvador
  • Multidisciplinary-international USC
    collaboration to build an national inclusive
    healthcare system
  • Service Learning and Outreach
  • Belize, Mexico City, Tijuana, Guatemala, San
    Salvador
  • Pacific Rim Center For Dental Excellence
  • Develop relationships with countries to form a
    Center for Dental Excellence (13 countries)
  • Exchange of expertise, education, faculty,
    students, knowledge, expertise and technology
  • Latin American and Asiatic ties will enhance our
    student and faculty cultural and linguistic
    competencies

77
Current USCSD Policy Activities
  • Cultural and linguistic competency requirement
    for licensure
  • License by credential allowing movement from 39
    states
  • Reducing licensure by credential requirement for
    service to underserved populations
  • Special permits for dental school faculty
  • Participation in the National and California
    Pipeline project
  • National clinical examination and licensure
    reform
  • Restore Medicaid cuts
  • Single standard of care education
  • Regional Clinical Licensure Examination
  • Access solution w/foreign trained dentist

78
  • Innovation Discovery
  • (Research)

79
Federally Financed Research Expendituresat
Universities and Colleges for Fiscal Year 2003
  • USC ranks 10 among all private universities
  • USC ranks 20 among public and private
    universities
  • Funding increased from 149.9 million (1993) to
    210.8 million (2000) to 300 million in 2003
  • USCSD ranks 1 of all private, 9 of all dental
    institutions, and 7 of all dental schools

80
Comparison of USC Research Grant Awards by
School 2003-2004
  • Dentistry 8.094m
  • Gerontology 11.114m
  • Pharmacy 9.784m
  • Medicine 165.688m
  • Engineering 95.342m
  • Social Work 6.895m
  • LAS Natural Sciences 40.680m
  • Indirect Cost Recovery an additional 65
  • 2.5m for USCSD (April, 2003 April, 2004)

81
NIDCR Support for Dental Institutions FY 2003
  • 1 Forsyth 12.1M
  • 2 UCSF 11.6
  • 3 Minnesota 10.0
  • 4 Washington 9.6
  • 5 Michigan 8.5
  • 6 North Carolina 7.4
  • 7 Rochester 6.9
  • 8 Florida 5.7
  • 9 USC 5.6
  • 11 UCLA 5.0
  • 30 Harvard 1.36

82
Health Research Agenda
BASIC RESEARCH
Infectious Agents Cell and Organ Systems
CLINICAL RESEARCH
Translational Research
Pathways and Drug Discovery
Clinical Trials
Epidemiology
POPULATION SCIENCE
Behavioral Research
Groups at Risk
Outcomes and Health Services Research
Environmental Hazards
- Adapted from David Nathan presented at
the Clinical Research Roundtable meeting,
06/12/02
83
Patients 27 Million People in Southern
California 1/3 Underserved (Bakersfield to
Mexican Border)
Multidisciplinary Dentistry, Medicine, Nursing,
Pharmacy, Education, Gerontology, Public Policy,
Engineering, Social Work,Communications
Research at USCSD
Extramural Funding NIH, DOD, Foundation
Industry
Data Data Gathering, Data Management, Data
Processing, IT Infrastructure
Present Facilities NIH-Supported CCMB Norris
Research Themes Craniofacial Molecular Biology,
Craniofacial Human Genetics, Infection Mucosal
Immunity, Biofilms, Head Neck Cancers Patient,
Family Community Health Promotion, Disease
Prevention, Diagnostics, Treatments
Therapeutics, Dental Materials
Biomaterials, Health Services/Outcomes Saliva
Diagnostics
84
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85
Bacteria in all natural and pathogenicsystems
live predominantly in biofilms
86
Biofilm formation is controlled by simple
chemical signals.The process can therefore be
blocked by signal inhibitors
87
New Center for Biofilms
  • USC Affiliations
  • School of Dentistry
  • Chuck Shuler (CCMB) Casey Chen (Primary Oral
    Health Care) Steve Goodman (Diagnostic
    Sciences) Dennis Cvitkovitch (Visiting
    Professor)
  • Viterbi School of Engineering and Medicine
  • Florian Mansfeld (Materials Science) Paul
    Ronney (Aerospace and Mechanical) Teh Fu Yen
    (Civil/Environmental)
  • College of Letters, Arts Sciences
  • Ken Nealson (Earth Sciences) Tony Michaels
    (Wrigley Environmental Research) Steve Finkel
    (Computational and Molecular Biology)
  • Keck School of Medicine
  • Fred Sattler (Infectious Diseases) Michael
    Patzakis (Orthopaedics) Bert Shapiro (Pulmonary
    and
  • Adult Cystic Fibrosis Clinic)
  • Keck/Viterbi
  • Howard Phillips (Doheny Eye Institute and
    Biomimetics ERC)
  • CHLA/Keck
  • Roberta Williams (Pediatrics)
  • House Ear institute
  • Paul Webster

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New Center for Biofilms (contd)
  • Grant Activity (Funded or Pending)
  • Maurice Amado Foundation (funded)
  • NASA grant with Paul Ronney (pending)
  • NSF grant with Paul Majors of the Pacific
    National Lab (pending)
  • RO 1 with John Olerud (University of Washington)
    (pending)
  • RO 1 with Casey Chen (consultant)
  • K 21 with Parish Sedghizadeh (pending)
  • R 13 NIH Conference grant for Biofilm symposium
    (pending)
  • Conference grant from Philips Oral Healthcare
    (funded)
  • Research grant from Philips Oral Healthcare
    (pending)
  • Research grant from Bard Urological (pending)
  • Pioneer grant from NIH (pending)
  • SBIR with Intelligent Optical Systems (funded)
  • SBIR with Sequoia Sciences (funded)
  • SBIR with Atmospheric Plasma (funded)

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Genes That Regulate Tooth Morphogenesis
91
  • Examples of the Regulatory Genes that Control
    Tooth Position, Number, Size and Shape
  • Anhydrotic Ectodermal Dysplasia TNF- alpha
    ligand and receptor genes
  • A Novel Oligodontia PAX9 transcription factor
    gene
  • Cleidocranial Dysplasia (supernumerary teeth)
    CBFA-1 transcription factor gene
  • Rieger Syndrome (tooth number, size and shape)
    PitX2 transcription factor genes

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A novel form of oligodontia involving posterior
teeth and PAX9 mutations
  • Panoramic dental x-ray demonstrating the
    phenotype (Stockton, Das, Goldenberg, DSouza and
    Patel. NATURE GENETICS, January 2000)

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Sensory Neurosciences
David McKemy, Ph.D.
  • Chronic pain is a thief. It breaks into your
    body and robs you blind. With lightning fingers,
    it can take away your livelihood, your marriage,
    your friends, your favorite pastimes and big
    chunks of your personality. Left unapprehended,
    it will steal your days and your nights until the
    world has collapsed into a cramped cell of
    suffering.
  • - Time Magazine

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Research in the lab is focused on the molecular
mediators of pain
  • We and others have recently identified the
    molecular detectors responsible for the
    sensations of thermally-evoked pain.
  • These are ion channels located on peripheral
    nerves in the skin and mouth, and transform
    thermal stimuli into neuronal signals.
  • These ion channels are essential for not only
    temperature perception, but also neuronal
    hypersensitivity following injury.

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Anh Le, DDS, PhD
THE PROBLEM OF KELOIDS
  • Funding
  • NIAMS/NIH S11AR-47359
  • Hypoxia Regulation of VEGF/VEGF Receptors in
    KeloidsPI Anh Le
  • NIAMS/NIH R43 AR 051620
  • Scarless Wound RepairPI Chia Soo (Plastic
    Surgery/Scarless Technologies Inc.)
  • Co-PI Anh Le

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Craniofacial Developmental Biology/Developmental
Genetics Supported by National institute of
Dental and Craniofacial Research and National Eye
Institute, NIH March of Dimes Birth Defects
Foundation. Collaborators Keck School of
Medicine Harvard University Fred Hutchinson
Cancer Center NIDDK, NIH Vanderbilt University
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TGF-b Signaling Craniofacial Morphogenesis
Loeys et al., 2005, Nature Genetics 37, 275-281
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flox
TGF-b IIR
Wnt1 promoter
Cre
Exon 2
Exon 1
loxp
loxp
Wnt1 xpression
Cre-mediated recombination
Exon 1
WT
flox/D2
Wnt1-CreTGF-ß IIR
99
Functional Significance of TGF-b Signaling in
Regulating Calvaria Development
Tgfbr2 flox/flox Wnt1-Cre
WT
100
Bioimaging (Three Dimensional Craniofacial
Imaging) Supported by National Institute of
Dental and Craniofacial Research, NIH Private
Research Foundation Collaborators Viterbi
School of Engineering Harvard University Korean
National University
101
Examples of NewTom Images
102
Patient Care 21st Century?
VIRTUAL CRANIOFACIAL PATIENT
CURRENT PATIENT RECORD
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Head and Neck Cancer Center Goal To improve the
quality of life through the collaboration of
basic and clinical scientists. Supported by
Program Project Grant from NCI, NIDCR, NIH
Collaborators School of Dentistry Keck School
of Medicine Norris Cancer Center UCLA UCI Medical
Center Tata Memorial Hospital, Mumbai,
India National University of Mexico, Cancer
Hospital of Beijing, China Peking University, and
more
104
Regenerative Medicine Goal To establish a
center for tooth regeneration. Supported by
NIDCR RFA on tooth regeneration, California Stem
Cell Initiative. Collaborators School of
Dentistry Keck School of Medicine University of
Washington Finland Academy of Sciences Tulane
University, and more
105
  • Advances in Biomimetics Using Adult Stem Cells
  • Cartilage Tissue Regeneration
  • Muscle Tissue Regeneration
  • Bone Tissue Regeneration
  • Ligament Tissue Regeneration
  • Dentin Tissue Regeneration

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New Oral SolutionsSaliva, Diagnostics
Prognostics at USC Paul Denny, PhD Mahvash
Navazesh, DMD
  • Diagnosis using oral buccal cells for DNA
    genotyping
  • Therapy using salivary proteins as antimicrobial
    agents (e.g. histatins, proline-rich proteins,
    defensins)
  • Diagnosis and monitor substance abuse
  • Diagnosis and monitor systemic diseases such as
    immunodeficiency
  • Assess risk factors for dental caries (and
    beyond) using point-of-care devices for saliva to
    detect electrolytes, DNA, RNA and proteins (i.e.
    microfluidics, arrays, sensors, and
    nanomaterials)
  • Monitor clinical trials for drug studies
  • Example of NIH-sponsored Phase I and II Small
    Business Grant, creation of university
    incubator, followed by Venture Capitol support

107
Failing Dentition due to Periodontal Disease
Esthetic Dentistry A Case Study
108
Same Day 24 Extractions5 Implants in Mandible
Esthetic Dentistry A Case Study (contd)
Immediate Maxillary DentureImmediate Loading of
Mandible
109
Before
Esthetic Dentistry A Case Study (contd)
After
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New Concepts Opportunities
  • Health and Healthy Community USC-wide
    collaborative research (e.g. health promotion,
    health literacy, risk assessment, disease
    prevention, demonstration projects)
  • Norris Dental Science Building, Web Tower, Café
    84, Lyons Center and Student Health Center A
    Health Community (see Case Statement draft)
  • New six-story building with two floors for
    Student/Faculty/Staff Health and four floors for
    biomedical research (e.g. translational research,
    pre-phase 1 clinical research, etc.)
  • Research supported by federally sponsored
    research grants (direct and indirect cost
    recovery) foundations
  • Health Services supported by student, faculty and
    staff health insurance and USC
  • Integration and alignment of Dentistry,
    Occupational Physical Therapy, Pharmacy,
    Medicine (Adolescent Pediatrics/CHLA, Radiology,
    Internal Medicine, Primary care), Behavioral
    Sciences with Health Services for students,
    faculty and staff, and research collaborations
    that are inter-professional and interdisciplinary
    in nature

111
  • Infrastructure
  • Facilities

112
Strategies to Increase Research Infrastructure
  • Study Advisory Panel Consultants determine
    feasibility for 100 million capitol project
    (March-June 2005)
  • Plan Campaign and develop print media and visual
    media
  • Identify major prospects and define base support
  • Partners include Michael Jackson, Vice President
    for Student Life Larry Nienstein, Director of
    Student Health Services Students and Parents
    Consultants and Trojan Dental Community
  • Timeline Raise required funding, design/build
    and occupy by 2010
  • Alternative cost effective strategy is to
    renovate the entire 4th floor of Norris Dental
    Science Building for research, renovate part of
    the second floor for research, and build a
    single-story wing for faculty offices this would
    increase research space and faculty, increase
    research support from NIH (and beyond), decrease
    density of Norris, decrease clinic facilities,
    decrease students in DDS Program, increase
    external clinic rotations, and increase endowment
    thru chairs for magnet research faculty

113
  • Norris Dental Science Building
  • Originally Built as One-Story Building in 1952
  • Three Floors added in 1966-68

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New Research Building Prospects
  • Center For Biofilms Center For Oral Infection
    Immunity
  • Center For Craniofacial Human Genetics
  • Center For Biomimetic Approaches to
    Craniofacial-Oral-Dental Therapeutics
    Biomaterials
  • Center For Diagnostics Biomarkers Bioimaging
  • Center For International Consortium for Head and
    Neck Cancer
  • Center For Community Health
  • Center For Education Research

118
USC Oral Health Center at University Village
119
Faculty Group Practice
USC Oral Health Center (contd)
Informatics Digital Images
120
USC Oral Health Center - Utilization
  • OHC averages between 90-100 patients per day up
    from 40-50 patient per day at opening
  • New patients average 5 per day or 80-100 per
    month up from 1-2 per day or 40 per month at
    opening
  • OHC has a total of 24 chairs AEGD - 9 chairs
    Dental Hygiene 4-5 chairs, Faculty Practice -
    10-11 chairs
  • 23 USCSD faculty, 7 hygienists and 12 AEGD
    residents utilize the OHC
  • Faculty practitioners work an average of one day
    per week each, averaging 8-15 patients per day
    depending on type and length of procedures
  • Dental hygienists treat an average of 7 patients
    per day
  • AEGD residents average 2-3 patients per day

121
USC Oral Health Center Project Revenues (FY
2004-2005 and Beyond)
  • OHC revenue for FY 04-05 is projected to be
    4,243,912 on target to meet that projection by
    June 30, 2005 (net surplus 110,000)
  • Steady growth anticipated over the next few years
  • Goal of 5 million production and collection rate
    of 95 to be achieved in fiscal year 2005-2006
  • Increased in earnings due to marketing program,
    increased USC faculty providers, increased
    comprehensive services, increased access to
    services (evenings and Saturdays), increased
    referral base, and increased support staff
    efficiency and productivity

122
Center for Dental Technology at OHC
  • Center for Dental Technology, a 2,200 square feet
    state-of-the-art facility will be constructed in
    the Oral Health Center and should be operational
    by Fall 2005.
  • The Center for Dental Technology will be a
    revenue producing after initial start-up and will
    provide education (i.e. DDS, residents,
    postgraduate, and CE courses), research (industry
    related) and patient care.

123
New Center For Dental Technology Education,
Research Patient Care
124
Patterson Dental Technology Center
125
Patterson Dental Technology Center
  • Gift from the Patterson Dental Supply Company
    remodel of Row A in the 2nd floor clinic at
    Norris Dental Science Building
  • Enhanced clinical setting similar to the OHC
    design
  • Utilization of Cerec 3 (CAD/CAM by Sirona)
    technology to meet patients need by producing
    single unit all ceramic restorations at chair side

126
Example of Information Technology Innovation in
Infrastructure
  • AXIUM - investment in infrastructure to promote
    scholarly activity and improve student experience
  • Program provides capacity to eliminate paper
    records
  • Enhances data base capability for research
    opportunities
  • Enables mining data to answer significant
    health services questions
  • Reporting metrics enable more immediate feedback
    for students, residents and faculty to
    facilitate quality of learning
  • Connectivity throughout the virtual School of
    Dentistry (multiple locations such as OHC,
    Norris, USC-Rescue Mission, Mobile Clinics,
    etc.)
  • Enhances quality controls and accountability
  • Increases the business management of clinic
    activities

127
Axium
ROLODEX general patient selection module for
axiUm
The PATIENT CARD contains the patient
demographic information
SCHEDULER Allows patients to be scheduled by
students or staff
128
AXIUM Accomplishments
350 new PCs were installed in all operatories at
USCSD clinics
38 new PCs were installed at the Library Learning
Center in order to facilitate training activities
New patient triaging process for the Center for
Diagnostic Sciences
Emergency Clinic relocated to old Faculty
Practice area
Staff reorganization to support new processes and
functions
Activation of verticalized Undergrad DDS student
teams by Group Practice
129
AXIUM Accomplishments (contd)
Training, training, and more training
Phase 3 implementation Extramural clinics
Implementation of Digital Radiography/Digital
Imaging (pilot) at the 1st floor clinics
Integration of Student Evaluations (clinic)
Integration of Quality Assurance functionalities
(e.g. patient surveys)
Reporting/Data Warehouse implementation
130
Administration
131
Fundraising and Development
  • Endowment (increased from 35 million in 2000 to
    54 million in 2004)
  • Twelve new endowed scholarships
  • Three new endowed professorships
  • One new endowed lectureship
  • 2.5 million in renovations conference rooms
    (Blair Rooms) and clinic venues (dental hygiene,
    endodontics, periodontics, oral-maxillofacial
    surgery, pediatric dentistry)
  • 16 new Presidential Associates (total number at
    is 45)
  • Fundraising 3.1 million per year average over
    last 4 years in 2004 reached 4.6 million
    (highest in 4 years)
  • Fundraising for new faculty start-up packages
    500,000
  • Initiated feasibility study for major Capitol
    Campaign to build new research building (in
    progress)
  • Projected Capitol Campaign to build new building,
    renovate Norris Dental Science Building, and
    increase endowment thru endowed chairs and
    professorships for magnet research faculty
  • Key goal is to build a sustainable research
    infrastructure

132
Revenue Changes FY 2000 - FY 2005 (estimated)
133
Expense Changes FY 2000 - FY 2005 (estimated)
134
Major ReorganizationFY 2002
Streamlined Organization
Prior Administration
Current Administration
34 separate departments to
5 divisions/ 7 functions
16 Assistant/ Associate Deans
to 8
Assistant/ Associate Deans
13 Department Chairs
to 5
Division Chairs
54 separate budgets to
12 budgets
135
Administrative Leadership Team
Patients
Students
Part-time faculty
136
Accomplishments An Overview
  • Education and Learning
  • Phase-in School-wide PBL (2001-2005)
  • Increase DDS applicant pool by 30 improve
    applicant qualifications
  • Revise the curriculum, external service learning
    model, and community clinical venues (Hospitals,
    Clinics and Mobile Clinics)
  • New AEGD Residency (2002)
  • New Orofacial Pain Residency (2004)
  • Innovations and Discovery
  • Increase faculty scholarship
  • Informatics/Axium/Computer Technology
  • Strategic planning for research infrastructure
  • Recruit new research faculty, joint appointments
    (LAS, Medicine, Education)
  • Patient and Community Health
  • Major renovations of clinics in Norris Dental
    Science Building
  • New External Clinic Learning Venues from
    Bakersfield to Mexican Border
  • New USC Oral Health, USC Imaging, Patterson
    Technology, Dental Technology Esthetic
    Dentistry Centers
  • Leadership in Health Professions
  • MWD Fluoridation Policy
  • ADA Presidency
  • Increased faculty, staff, and student leadership
    in the domestic and international health
    community

137
Whats Coming? 2005-2010
  • Improve patient care (quality improvements)
  • Enhance information technology connectivity
  • Improve student and resident academic performance
  • Renovations for research, faculty staff
    offices, and clinics in Norris Building and
    University Village
  • New Center for Dental Technology in University
    Village Oral Health Center
  • Recruit new research profile faculty and increase
    USCSD
  • federally-sponsored research
  • Increase staff and faculty training development
  • Increase communication, coordination, cooperation
    between all stakeholders
  • Build new Research Building and renovations of
    4th floor of Norris Building
  • Increase the endowment

138
Where can the Provost Assist in 2005 and Beyond?
  • Plans to align and integrate Occupational Therapy
    Physical Therapy Programs into the School of
    Dentistry
  • Enable research advancement through brokering
    joint appointments, subvention when appropriate,
    support for critical core facilities when
    appropriate, and assistance with major research
    faculty recruitments
  • Advocacy and assistance in building a new
    research building vis-à-vis debt financing, or
  • Advocacy and assistance in building
    multifunctional building that integrates Student
    Health and dental research
  • Advocacy and assistance in renovations to
    decompress the Norris Building vis-avis
    University loans
  • Efforts to expand internal education and research
    activities

139
Together, We Will Achieve a Remarkable Future!
Rated 1 SOD in California
Expand Norris Building
USCSD 1st National Boards
USCSD STRATEGIC PLAN
Faculty Scholarly Activity
U.V. Oral Health Center
Increase Clinic Income
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