TAG: "Dentistry"

New reality of California ‘DREAMers’ takes shape at UCSF


Three undocumented immigrants chosen to join UCSF School of Dentistry’s class of 2019.

By Marc Fredson, UC San Francisco

José Carrasco Sandoval, Laura Aguilar and Angie Celis typify the caliber of talent UC San Francisco attracts. These California residents are standout students and want to give back to their communities after they graduate. All three have been chosen to join the School of Dentistry’s class of 2019.

Unlike most of their peers, all three are “DREAMers,” a term used to describe undocumented immigrants under the age of 31 who entered the United States before the age of 16 and have lived continuously in the country for at least five years while staying out of legal trouble. Those who meet these criteria outlined by the federal Development, Relief and Education for Alien Minors (DREAM) Act are often referred to as “DREAMers.”

Carrasco Sandoval, Aguilar and Celis’ acceptance and enrollment at UCSF represent a particular milestone in the midst of shifting political winds. They will join Jirayut Latthivongskorn, a first-year DREAMer student in the School of Medicine.

“I was always hopeful that this day would come,” said Celis, who was born in Guatemala and immigrated to the San Fernando Valley with her family when she was two. “It took me longer to make it, but now I’m here.”

“Ever since I was in high school, I knew I wanted to be a doctor,” said Carrasco Sandoval, who graduated from UC Berkeley with a degree in molecular and cell biology. “I also knew from an early age that our family had a special condition we called sin papeles, which means ‘without papers’ in Spanish, and that realizing my dream would be a challenge without having legal citizenship.” His parents left their native Jalisco, Mexico, and settled down in Napa when he was 2 years old.

Aguilar’s story is similar to Celis’ and Carrasco Sandoval’s. Her parents also made Napa their home after leaving Guadalajara, Mexico, when she was four. “I’ve wanted to be a dentist since I was young but remember thinking it didn’t seem possible because of my status,” she said. “I decided to just keep trying and to stay positive.”

The door to their dreams edged open with the Deferred Action for Childhood Arrivals (DACA) program, a new American immigration policy implemented by the Obama administration in June 2012. The policy allows certain immigrants — otherwise known as “DREAMers,” to receive a renewable two-year work permit and exemption from deportation.

Because of DACA, “for the first time, I could apply for programs, internships, jobs, scholarships and financial aid to help pursue my professional goals,” Aguilar said. “Not to mention simpler things like getting a driver’s license, establishing credit and opening a bank account.”

UCSF has a long-standing commitment to building a broadly diverse student community. As such, its leadership, faculty and staff work hard to create programs that provide additional support for students from underrepresented groups.

“Students with diverse backgrounds, such as those with DACA status, bring an important component to the University,” said John D.B. Featherstone, Ph.D., dean of the UCSF School of Dentistry. “One of my highest priorities is that we do everything possible to open the doors to dental education for the best and the brightest, regardless of their social or economic backgrounds.”

All three dreamers are products of the UC system. Carrasco Sandoval and Aguilar pursued their undergraduate studies at UC Berkeley and UC Riverside, respectively, while Celis received a Master of Science degree in oral biology from UCLA.

As an initial introduction to UCSF, Aguilar attended the Office of Diversity and Outreach’s “Inside UCSF” program, an annual two-day event geared toward students at two- and four-year degree schools who are interested in pursuing careers in health and science. “The students and faculty I met at ‘Inside UCSF’ were very inspiring, welcoming and supportive,” she said. “They encouraged us to keep working and made us aware of available resources.”

Carrasco Sandoval enrolled in a first-of-its-kind post-baccalaureate program offered by the School of Dentistry. “The purpose of the program is to help those who have demonstrated the ability to overcome hardship and who we think will ultimately be successful here,” said James Betbeze, assistant dean for enrollment management and outreach at the School of Dentistry.

“These students are three of the brightest, most driven individuals I’ve encountered,” said Daniel Ramos, D.D.S., Ph.D., a professor at the UCSF School of Dentistry who supported them through the process. “They’ve overcome insurmountable odds to be in a position to be able to help the community from which they came.

“DACA students are often particularly committed to underserved populations, because they may grow up in communities without ready access to dental care. They personally understand those challenges and have an inherent motivation to try and address them.”

Celis plans to continue being an activist in the immigrant community. “I feel an obligation to help the underserved community and to use my experience to help those who have hopes and dreams of going into higher education,” she said.

Carrasco Sandoval envisions working in a community dental practice. “At some point, I’d like to be a director for a community clinic, where I can help low-income and immigrant populations,” he said.

When Aguilar volunteered at a health clinic in Riverside, “I saw the adversities that others face and realized how lucky I was to have parents that supported my education,” she said. “I saw huge disparities, not just in health, but in education and in the way that people’s lives played out.” Aguilar tentatively plans to be a general dentist, and is also considering specializing in periodontics.

“The incredible and proud accomplishments of these students demonstrate that their aspirations go beyond the pursuit on an undergraduate degree,” said Alejandra Rincón, Ph.D., chief of staff to the vice chancellor of diversity and outreach, and an author of a book focused on undocumented immigrants’ access to higher education. “We welcome these students and congratulate their families as they enter this new face of their professional lives.”

Like other young people with DACA status, Carrasco Sandoval, Aguilar and Celis see themselves as more than future dentists. Because of their backgrounds and the opportunities they’ve been given, each seeks to make life better for others.

“I’ve seen the good that comes from when someone believes in you and gives you a chance,” said Aguilar. “It has shaped the kind of role model I want to become.”

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‘Sugar Papers’ reveal industry role in 1970s dental program


Sugar industry worked closely with NIH on research agenda on preventing tooth decay.

By Kristen Bole, UC San Francisco

A newly discovered cache of industry documents reveals that the sugar industry worked closely with the National Institutes of Health in the 1960s and ‘70s to develop a federal research program focused on approaches other than sugar reduction to prevent tooth decay in American children.

An analysis of those papers by researchers at UC San Francisco appears today (March 10) in the open-source scientific journal, PLoS Medicine.

The archive of 319 industry documents, which were uncovered in a public collection at the University of Illinois, revealed that a sugar industry trade organization representing 30 international members had accepted the fact that sugar caused tooth decay as early as 1950, and adopted a strategy aimed at identifying alternative approaches to reducing tooth decay.

Meanwhile, the National Institutes of Health had come to the conclusion in 1969 that focusing on reducing consumption of sucrose, “while theoretically possible,” was not practical as a public health measure.

Thus aligned, the sugar industry trade organization and the NIH worked in parallel and ultimately together on developing alternative research approaches, with a substantial portion of the trade organization’s own research priorities — 78 percent — directly incorporated into the 1971 National Caries Program’s first request for research proposals from scientists.

“The dental community has always known that preventing tooth decay required restricting sugar intake,” said first author Cristin Kearns, D.D.S., M.B.A., a UCSF postdoctoral scholar who discovered the archives. “It was disappointing to learn that the policies we are debating today could have been addressed more than 40 years ago.”

While tooth decay is largely preventable, it remains the leading chronic disease among U.S. children, according to the Centers for Disease Control and Prevention. The CDC estimates that more than half of American children and teens have cavities in their adult teeth, and 15.6 percent of children age 6 to 19 have untreated tooth decay, which can lead to tooth loss, infections and abscesses.

Kearns discovered the papers in a collection that was left to the University of Illinois library by the late Roger Adams, a professor emeritus of organic chemistry who served on the Sugar Research Foundation (SRF) and the scientific advisory board of the International Sugar Research Foundation (ISRF), which became the World Sugar Research Organization.

They include 1,551 pages of correspondence among sugar industry executives, meeting minutes and other relevant reports from between 1959 and 1971. Kearns and UCSF co-authors Stanton A. Glantz, Ph.D., and Laura A. Schmidt, Ph.D., analyzed the papers against documents from the National Institute of Dental Research (NIDR) to explore how the sugar industry may have influenced the research policies of the 1971 National Caries (Tooth Decay) Program.

The analysis showed that in the late 1960s and early 1970s, the sugar industry funded research in collaboration with allied food industries on enzymes to break up dental plaque and a vaccine against tooth decay. It also shows they cultivated relationships with the NIDR and that a sugar industry expert panel overlapped by all but one member with the NIDR panel that influenced the priorities for the NIH tooth decay program. The majority of the research priorities and initial projects largely failed to produce results on a large scale, the authors found.

“These tactics are strikingly similar to what we saw in the tobacco industry in the same era,” said Glantz, whose similar discovery in the 1990s of tobacco industry papers led to massive settlements between the industry and every U.S. state, and to the Department of Justice’s successful prosecution of the major tobacco companies and their research organizations under the Racketeer Influenced and Corrupt Organizations Act. The Legacy Tobacco Documents Library at UCSF now contains 14 million of those documents.

“Our findings are a wake-up call for government officials charged with protecting the public health, as well as public health advocates, to understand that the sugar industry, like the tobacco industry, seeks to protect profits over public health,” Glantz added.

While the authors recognize that the Adams papers provide a narrow window into the activities of one sugar industry trade association, they noted that the sugar industry’s current position remains that public health should focus on fluoride toothpaste, dental sealants and other ways to reduce the harm of sugar, rather than reducing consumption. They concluded that industry opposition to current policy proposals — including the World Health Organization’s newly released guidelines to reduce added sugar to less than 10 percent of daily caloric intake — should not be allowed to block this prudent public health standard.

“There is robust evidence now linking excess sugar consumption with heart disease, diabetes and liver disease, in addition to tooth decay,” said Schmidt, who also is principal investigator on the UCSF-led SugarScience initiative. “Times have definitely changed since that era, but this is a stark lesson in what can happen if we are not careful about maintaining scientific integrity.”

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Laughter is the best medicine for jittery dental students


Comedy improv class helps them communicate with patients.

By Brianna Aldrich and Judy Lin, UCLA

Seven students in a classroom at the UCLA School of Dentistry are cracking each other up.

In a course far removed from “The Fundamentals of Caries” and “Oral Pathology,” dental students pair off and take turns improvising scenes based on characters and situations suggested by their instructor and fellow classmates. Two students role-play madcap bank robbers. Another pair pretends to be obsessive-compulsive campers gushing over the high thread count of their bed sheets. Then there are the lovers who, stunned at the revelation that they have syphilis, respond by microwaving popcorn and tuning into Netflix.

It’s all part of the silliness that surfaces in “Medical Improv,” a highly unusual class that teaches dental students how to implant a bit of comedy improv into their personas. But it isn’t laughter they’re after, explained instructor Dr. Craig Woods.

Woods’ students don’t learn to perform funny routines to help their patients get rid of their pre-procedure jitters. To the contrary, the techniques they learn in class help them as dentists to “come out of themselves, be a little more relaxed and confident,” Woods said, especially when they start to work with live patients in the dental clinic for the first time.

Third-year student Roya Mahmoodi said she’s already noticed a change in her chair-side manner. “When I first started in the clinic, I was very caught up in what I would say to my patient. I thought I had to have this very serious persona,” she said. “But being in this class — letting loose and just being silly — I’ve started bringing out my personality. I can kind of joke around with my patients, and I feel closer to them.

“There should always be a doctor-patient professional relationship,” Mahmoodi said, “but you can definitely tweak that relationship a little bit.”

Woods is as unusual as his class. He’s an adjunct professor of oral medicine and orofacial pain, director of the Advanced Treatment Planning Clinic and the dental school’s psychological counselor with an M.A. in clinical psychology on top of his D.D.S. He’s also a cast member of JumpStart Comedy, a Hermosa Beach-based troupe.

He got hooked on doing improv when, on a whim, he took a workshop about five years ago and liked it so much he enrolled in ImprovOlympic, a training program that also produced Tina Fey and Amy Poehler.

“I was amazed at the number of parallels there are in improv comedy to interacting with patients,” Woods said. “Improv comedy became a way to release stress and to enhance my skills at picking up on other people’s emotional cues in my professional life.”

His class is based in part on the Medical Improv program developed by Dr. Katie Watson, a physician educator at Northwestern University’s medical school. She’s also a trainer for Second City’s comedy improv program in Chicago. After Woods took a workshop with Watson, he decided to create a dental-school version to help the many bright students he has seen suffer self-confidence meltdowns in the clinics.

“Something happens when they get into their clinical instruction, where they have to interact with patients and perform a procedure while being supervised by faculty evaluating everything they do,” Woods said. “Their command of the situation falls apart.”

Gaining that sense of “command” is often less about taking charge and more about going with the flow, a skill that Woods gets across with exercises like “Search and Toss.” Standing in a circle, students “toss” the name of a country to another student, who “tosses” the name of another country to another student until everyone has a turn. Then Woods asked them to continue with the country names but weave in a second layer, this time with car names, and then a third layer with something they might tell a patient at the end of an appointment.

“Canada … Honda … Remember to floss.” “Austria … Chevy … Call me if you have any problems” went the dizzying exercise, the students starting to sweat – and giggle — as they as they struggled to keep track.

In dentistry, it’s a familiar feeling, Woods said. “You’re juggling different things — seeing your patient, working with faculty and hearing from the front office that your next patient is waiting. Be open to crazy things coming up. Expect the unexpected” — like encountering a patient who swears she isn’t afraid of dentists but starts to cry the moment she sits down in the chair.

“You’re doing surgery in someone’s mouth,” Woods said. “You have to convince them that they need to allow you to put a drill in their mouth that’s going 400,000 rpm. You have to come across as being able to do that, and they have to have confidence and trust in you.”

Key to building trust is having deep listening skills that pick up not just words but emotional affect and body language. Confidence also comes through in clear, succinct communication. “Students have a tendency to ramble when they’re not comfortable,” said Woods, who took students through a scene where one explained a form of modern technology — an iPhone, for example — to another student who pretended to be a time-traveler from 250 years ago. The result: a huge download of incomprehensible information.

Keegan Quadros, a fourth-year student, commented that the exercise reminded him of talking with a patient about a procedure. “He doesn’t want to know everything … He just wants to know what it is, what it costs and what I recommend.”

International dental students taking the class report that it’s helped them better understand American culture and humor.

Reena Guttha, a student from India, said she’s been working with a patient who likes to “crack jokes with me. But I don’t get it,” she said. “He knows that I don’t get it, and he’s okay with that. But I will enjoy my work more when I can communicate with patients like him and their sense of humor.”

Woods said he would like to expand the class to include medical and nursing students to enhance teamwork among medical professionals.

“Life is improvised,” Woods said. “Everyone could benefit from a course like this.”

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Technology optimizes cancer therapy with nanomedicine drug combinations


UCLA bioengineers develop platform that offers personalized approach to treatment.

By Brianna Aldrich, UCLA

In greater than 90 percent of cases in which treatment for metastatic cancer fails, the reason is that the cancer is resistant to the drugs being used. To treat drug-resistant tumors, doctors typically use multiple drugs simultaneously, a practice called combination therapy. And one of their greatest challenges is determining which ratio and combination — from the large number of medications available — is best for each individual patient.

Dr. Dean Ho, a professor of oral biology and medicine at the UCLA School of Dentistry, and Dr. Chih-Ming Ho, a professor of mechanical engineering at the UCLA Henry Samueli School of Engineering and Applied Science, have developed a revolutionary approach that brings together traditional drugs and nanotechnology-enhanced medications to create safer and more effective treatments. Their results are published in the peer-reviewed journal ACS Nano.

Chih-Ming Ho, the paper’s co-corresponding author, and his team have developed a powerful new tool to address drug resistance and dosing challenges in cancer patients. The tool, Feedback System Control.II, or FSC.II, considers drug efficacy tests and analyzes the physical traits of cells and other biological systems to create personalized “maps” that show the most effective and safest drug-dose combinations.

Currently, doctors use people’s genetic information to identify the best possible combination therapies, which can make treatment difficult or impossible when the genes in the cancer cells mutate. The new technique does not rely on genetic information, which makes it possible to quickly modify treatments when mutations arise: the drug that no longer functions can be replaced, and FSC.II can immediately recommend a new combination.

“Drug combinations are conventionally designed using dose escalation,” said Dean Ho, a co-corresponding author of the study and the co-director of the Jane and Jerry Weintraub Center for Reconstructive Biotechnology at the School of Dentistry. “Until now, there hasn’t been a systematic way to even know where the optimal drug combination could be found, and the possible drug-dose combinations are nearly infinite. FSC.II circumvents all of these issues and identifies the best treatment strategy.”

The researchers demonstrated that combinations identified by FSC.II could treat multiple lines of breast cancer that had varying levels of drug resistance. They evaluated the commonly used cancer drugs doxorubicin, mitoxantrone, bleomycin and paclitaxel, all of which can be rendered ineffective when cancer cells eject them before they have had a chance to function.

The researchers also studied the use of nanodiamonds to make combination treatments even more effective. Nanodiamonds — byproducts of conventional mining and refining operations — have versatile characteristics that allow drugs to be tightly bound to their surface, making it much harder for cancer cells to eliminate them and allowing toxic drugs to be administered over a longer period of time.

The use of nanodiamonds to treat cancer was pioneered by Dean Ho, a professor of bioengineering and member of the UCLA Jonsson Comprehensive Cancer Center and the California NanoSystems Institute.

“This study has the capacity to turn drug development, nano or non-nano, upside-down,” he said. “Even though FSC.II now enables us to rapidly identify optimized drug combinations, it’s not just about the speed of discovering new combinations. It’s the systematic way that we can control and optimize different therapeutic outcomes to design the most effective medicines possible.”

The study found that FSC.II-optimized drug combinations that used nanodiamonds were safer and more effective than optimized drug-only combinations. Optimized nanodrug combinations also outperformed randomly designed nanodrug combinations.

“This optimized nanodrug combination approach can be used for virtually every type of disease model and is certainly not limited to cancer,” said Chih-Ming Ho, who also holds UCLA’s Ben Rich Lockheed Martin Advanced Aerospace Tech Endowed Chair. “Additionally, this study shows that we can design optimized combinations for virtually every type of drug and any type of nanotherapy.”

Both Dean Ho and Chih-Ming Ho have collaborated with other researchers and have validated FSC.II’s efficacy in many other types of cancers, infectious diseases and other diseases.

Other co-authors were Hann Wang, Dong-Keun Lee, Kai-Yu Chen and Kangyi Zhang, all of UCLA’s department of bioengineering, School of Dentistry, California NanoSystems Institute and Jonsson Cancer Center; Jing-Yao Chen of UCLA’s department of chemical and biomolecular engineering; and Aleidy Silva of UCLA’s department of mechanical and aerospace engineering.

The work was supported in part by the National Cancer Institute, the National Science Foundation, the V Foundation for Cancer Research, the Wallace H. Coulter Foundation, the Society for Laboratory Automation and Screening, and Beckman Coulter Life Sciences.

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Researchers shed light on how ‘microbial dark matter’ might cause disease


Scientific breakthrough may be roadmap for study of other elusive bacteria.

By Brianna Aldrich, UCLA

One of the great recent discoveries in modern biology was that the human body contains 10 times more bacterial cells than human cells. But much of that bacteria is still a puzzle to scientists.

It is estimated by scientists that roughly half of bacteria living in human bodies is difficult to replicate for scientific research — which is why biologists call it “microbial dark matter.” Scientists, however, have long been determined to learn more about these uncultivable bacteria, because they may contribute to the development of certain debilitating and chronic diseases.

For decades, one bacteria group that has posed a particular challenge for researchers is the Candidate Phylum TM7, which has been thought to cause inflammatory mucosal diseases because it is so prevalent in people with periodontitis, an infection of the gums.

Now, a landmark discovery by scientists at the UCLA School of Dentistry, the J. Craig Venter Institute and the University of Washington School of Dentistry has revealed insights into TM7’s resistance to scientific study and to its role in the progression of periodontitis and other diseases. Their findings shed new light on the biological, ecological and medical importance of TM7, and could lead to better understanding of other elusive bacteria.

The team’s findings are published online in the December issue of the Proceedings of the National Academy of Sciences.

“I consider this the most exciting discovery in my 30-year career,” said Dr. Wenyuan Shi, a UCLA professor of oral biology. “This study provides the roadmap for us to make every uncultivable bacterium cultivable.”

The researchers cultivated a specific type of TM7 called TM7x, a version of TM7 found in people’s mouths, and found the first known proof of a signaling interaction between the bacterium and an infectious agent called Actinomyces odontolyticus, or XH001, which causes mucosal inflammation.

“Once the team grew and sequenced TM7x, we could finally piece together how it makes a living in the human body,” said Dr. Jeff McLean, acting associate professor at the University of Washington School of Dentistry. “This may be the first example of a parasitic long-term attachment between two different bacteria — where one species lives on the surface of another species gaining essential nutrients and then decides to thank its host by attacking it.”

To prove that TM7x needs XH001 to grow and survive, the team attempted to mix isolated TM7x cells with other strains of bacteria. Only XH001 was able to establish a physical association with TM7x, which led researchers to believe that TM7x and XH001 might have evolved together during their establishment in the mouth.

What makes TM7x even more intriguing are its potential roles in chronic inflammation of the digestive tract, vaginal diseases and periodontitis. The co-cultures collected in this study allowed researchers to examine, for the first time ever, the degree to which TM7x helps cause these conditions.

“Uncultivable bacteria presents a fascinating ‘final frontier’ for dental microbiologists and are a high priority for the NIDCR research portfolio,” said Dr. R. Dwayne Lunsford, director of the National Institute of Dental and Craniofacial Research’s microbiology program. “This study provides a near-perfect case of how co-cultivation strategies and a thorough appreciation for interspecies signaling can facilitate the recovery of these elusive organisms. Although culture-independent studies can give us a snapshot of microbial diversity at a particular site, in order to truly understand physiology and virulence of an isolate, we must ultimately be able to grow and manipulate these bacteria in the lab.”

It was previously known that XH001 induces inflammation. But by infecting bone marrow cells with XH001 alone and then with the TM7x/XH001 co-culture, the researchers also found that inflammation was greatly reduced when TM7x was physically attached to XH001. This is the only known study that has provided evidence of this relationship between TM7 and XH001.

The researchers plan to further study the unique relationship between TM7X and XH001 and how they jointly cause mucosal disease. Their findings could have implications for potential treatment and therapeutics.

Other collaborators on the study were Drs. Xuesong He, Renate Lux and Anna Edlund of the UCLA School of Dentistry; Shibu Yooseph, Adam Hall and Karen Nelson of the Venter Institute; Su-Yang Liud and Genhong Cheng of the UCLA department of microbiology, immunology and molecular genetics; Pieter Dorresteine of UC, San Diego; Eduardo Esquenazi of Sirenas Marine Discovery; and Ryan Hunter of the University of Minnesota.

Dr. Shi is part-time chief science officer at C3 Jian Inc., which has licensed technologies from the University of California Regents that could be indirectly related to this research project.

The work was supported in part by the NIH’s National Institute of Dental and Craniofacial Research (grants 1R01DE023810-01, 1R01DE020102 and 1R01DE021108, and T90 training award DE022734) and the National Institute of General Medical Sciences (grant 1R01GM095373).

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2 UCSF-led programs receive funding to tackle S.F. health issues


Hellman Foundation supports fruit and vegetable voucher program, kids’ oral health program.

A woman shops for fresh produce at UCSF Parnassus' farmers market.

By Leland Kim, UC San Francisco

Two UC San Francisco-sponsored programs beat out more than 80 others to win major funding to help advance meaningful solutions to local health issues in San Francisco.

The Hellman Foundation announced the award of the first Hellman Collaborative Change Initiative grants to the EatSF Fruit and Vegetable Voucher Program and the Children’s Oral Health Collaborative. Each program will receive $400,000 — coupled with strategic support from the Hellman Foundation — to strengthen their partnerships and support their efforts to improve lives in San Francisco.

The EatSF Fruit and Vegetable Voucher Program is creating a San Francisco where underserved communities can enjoy fresh fruits and vegetables from their local market.

Diets low in fresh fruits and vegetables are associated with obesity, diabetes, cardiovascular diseases and some cancers.  But many low-income families simply do not have access to these vitally important foods. By creating a citywide network where vouchers are redeemable at local vendors for fresh fruits and vegetables, EatSF is improving nutrition for San Franciscans most in need.

“In 2012, it is estimated that San Francisco’s underserved population had to scramble to afford 67.8 million meals. That is appalling in a city that is as wealthy as ours,” said Hilary Seligman, M.D., an associate professor in the UCSF School of Medicine, who is leading the EatSF Fruit and Vegetable Voucher Program. “We are committed to finding strategies that allow all members of our community to eat the healthy foods that prevent the development of chronic disease.”

The Children’s Oral Health Collaborative is committed to eradicating health disparities in childhood tooth decay, with the aim of making San Francisco cavity-free. The program is co-led by UCSF’s Lisa Chung, D.D.S., M.P.H., and San Francisco Department of Public Health’s Margaret Fisher, R.D.H.A.P.

Tooth decay is the most common chronic childhood disease. In San Francisco, emergency department visits for preventable dental problems are higher than that for asthma and diabetes combined, and untreated tooth decay is two to three times more common for children of color.

“Our success is due to many dedicated partners, some individuals who have spent much of their careers to combat tooth decay, a pervasive health problem that all too often goes unacknowledged and untreated in children,” said Chung, an associate professor in the UCSF School of Dentistry’s Department of Preventive and Restorative Dental Sciences.

“Our collaboration recently formed thanks to the coordination and strong support from UCSF SF HIP (San Francisco Health Improvement Partnership) and SF DPH (San Francisco Department of Public Health), and funding from the Metta Fund. We hope this support from Hellman will bring greater awareness to the problem, our work to address it, and more partners to join us in our efforts.”

In choosing from an impressive array of active collaborations, the Hellman Foundation focused on cross-sector partnerships that had strong leadership, targeted a significant San Francisco challenge, and had the potential to make a real difference.

To learn more about the EatSF Fruit and Vegetable Voucher, please email eatsfvoucher@gmail.com. To get more information about the Children’s Oral Health Collaborative, please read its strategic plan.

Established in 2011, the Hellman Foundation finds and supports the creative change-makers improving the lives and livelihoods for all who call the San Francisco Bay Area home. For more information, visit its website.

Editor’s note: Content from the Hellman Foundation was used in this story.

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Student veteran gives back for all doors Army has opened for her


She will speak at UCLA’s Veterans Day salute on Nov. 10.

Tigon Abalos, now a dental student at UCLA, volunteered to work with Afghan refugees when she was in the Army stationed in Afghanistan. Abalos, a former Vietnam refugee, will speak about what her military service means to her at UCLA's Veterans Day ceremony on Nov. 10. (Photo courtesy of tigon Abalos)

When 9/11 happened, it jolted Tigon Abalos with such force that she felt she had to do something for the country that had given her and her family, former refugees from Vietnam, opportunities for a better life in a new country.

Two years later, Abalos, who was already serving part time in the California Army National Guard, interrupted her college career to enlist in the Army and train as a counter-intelligence specialist. That was the beginning of a six-year, military career that opened up more opportunities for Abalos: She met her future husband, a fellow soldier, and she discovered her life’s calling in Afghanistan when she began volunteering to help Afghan refugees.

Abalos, now a UCLA School of Dentistry student and one of more than 400 student veterans, will draw on her deep appreciation for her service experience when she speaks at UCLA’s annual Veterans Day ceremony Monday, Nov. 10, at 10:30 a.m. in Wilson Plaza, a time  when the campus community comes together to salute veterans and remember the sacrifices they’ve made. Also speaking will be Chancellor Gene Block and Kelly Schmader, assistant vice chancellor of facilities management at UCLA and a 28-year veteran of the U.S. Navy Civil Engineer Corps.

“Serving in the Army allowed me to see the world,” said Abalos. “My experiences gave me a whole new perspective on life. While serving, I also became motivated to complete my college degree.” And it was while working with the refugees in Afghanistan that Abalos became aware of a critical shortage of dentists.

The daughter of a former South Vietnamese former military police officer, Abalos knew very little English and nothing about American culture when she arrived with her family in Fresno in 1996, five years before the terrorist attacks of 9/11. Nevertheless, she managed to become the first in her family to finish high school, graduating with honors, and then enrolling at UC Berkeley, only to leave for military service two years later.

When Abalos was discharged from the Army in 2008 as a staff sergeant with a string of medals and an Army Combat Action Badge for working under enemy fire in Afghanistan, she set her sights on a college degree and a career in dentistry. In 2012, she graduated from Cal State Fresno with a degree in chemistry degree and an invitation to enter UCLA School of Dentistry, her top choice.

“I wouldn’t have even considered dental school had it not been for my humanitarian work in Afghanistan,” she said. “The military taught me about teamwork and to never give up, both traits that I now use in dental school.”

As an older dental student and a mother — she gave birth to a son about the same time she started at UCLA — Abalos has faced challenges with the same “can-do” attitude that she learned in the Army.

“I have my own struggles, much like anyone would in a demanding training program,” said Abalos. “But, I feel like I’ve lived a lot of life already, compared to some of my younger colleagues. I’ve seen the world. I can handle stressful situation and have realistic expectations.”

She and her husband, who is now stationed in Long Beach after transferring to the California Army National Guard, share in the care of their 2-year-old son. “It is a lot of time and sacrifice, but we make it work,” she said.

Even with these added responsibilities, Abalos has continued to be actively involved in veterans’ affairs. As an undergrad, she was part of Fresno State’s Student Veterans Organization and received the National Student Veterans Association STEM Scholarship Award.

At UCLA, she is currently on a student committee in the dental school that provides services and oral health education to veterans in the Los Angeles area. She also volunteers in the dental clinic assisting patients at the West Los Angeles VA Medical Center.

UCLA supports many such initiatives for veterans, ranging from programs that help student veterans navigate the benefits process to efforts to bring injured vets and their families to UCLA’s medical facilities through the nationally acclaimed Operation Mend.

After graduation, Abalos hopes to enter a hospital dentistry residency program that integrates medicine and dentistry. Patients who require this type of dental care have severe medical, physical or mental impairments. Her goal is to return to the military as an officer in the Naval Reserve and practice at a VA hospital somewhere in California.

“I feel that given my background in combat and the military, I can better relate to people who have experienced trauma,” said Abalos. “For example, patients who have posttraumatic stress disorder are going to trust someone that has gone through what they have gone through.”

For now Abalos is concentrating on graduating and going onto the next step of her career. “My career path has been a bit of a winding road,” she said. “But I know where I’m going now.

“The timeworn Army slogan when I enlisted was ‘Be all you can be.’ I guess I just really took that heart,” she said.

The campus community is invited to UCLA’s Veterans Day ceremony on Monday, Nov. 10, at 10:30 a.m. at Wilson Plaza. In addition to speeches, the event will also feature an ROTC color guard and information fair. Visit UCLA Veterans to learn more about campus programs and resources for veterans.

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‘Treasure in saliva’ may reveal deadly diseases early enough to treat them


UCLA research holds promise for diagnosing Type 2 diabetes, gastric cancer, other diseases.

Xinshu (Grace) Xiao and David Wong, UCLA (Photo by Reed Hutchinson, UCLA)

UCLA research could lead to a simple saliva test capable of diagnosing — at an early stage — diabetes and cancer, and perhaps neurological disorders and autoimmune diseases.

The study, the most comprehensive analysis ever conducted of RNA molecules in human saliva, reveals that saliva contains many of the same disease-revealing molecules that are contained in blood. It was published online today (Oct. 29) by the peer-reviewed journal Clinical Chemistry and will be published in the journal’s January 2015 special print issue, “Molecular Diagnostics: A Revolution in Progress.”

“If we can define the boundaries of molecular targets in saliva, then we can ask what the constituents in saliva are that can mark someone who has pre-diabetes or the early stages of oral cancer or pancreatic cancer — and we can utilize this knowledge for personalized medicine,” said Dr. David Wong, a senior author of the research and UCLA’s Felix and Mildred Yip Endowed Professor in Dentistry.

Wong said the test also holds promise for diagnosing Type 2 diabetes, gastric cancer and other diseases. “If you don’t look in saliva, you may miss important indicators of disease,” Wong said. “There seems to be treasure in saliva, which will surprise people.”

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$2M donated for endowed scholarship at UCLA dental school


Gift by Bob and Marion Wilson is largest scholarship donation the dental school has received.

Bob and Marion Wilson

A $2 million gift from Bob and Marion Wilson, longtime supporters of the UCLA School of Dentistry, will give a significant boost to scholarship funding for future generations of dentists. The Wilsons’ donation will establish the Bob and Marion Wilson Endowed Scholarship Fund, which will be used in support of annual scholarships to students who excel in the classroom and are dedicated to public service.

The Wilsons’ gift, which is the largest scholarship donation the dental school has ever received, comes at an optimal time, with state support having decreased substantially over the years. Scholarships help students defray educational expenses, ensuring that the broad array of professional options — including teaching, research and practice in underserved communities — remains open to each student after graduating.

“Being able to establish an endowed scholarship allows Marion and me to support future generations of dental students,” Bob Wilson said. “The UCLA School of Dentistry is a top choice among dental school applicants and our hope is that this donation will allow the school to support students who exhibit academic excellence and exemplary public service.”

The dental school attracts world-class students who go on to be leaders in the fields of oral and systemic health in California, the nation and the world.

The School of Dentistry awards an average of roughly $3 million per year in scholarships and grants to students. The Wilson endowed scholarship will increase the school’s ability to give even more financial aid.

“Increasing our scholarship endowment is one of our top priorities,” said Dr. No-Hee Park, dean of the UCLA School of Dentistry. “This very generous gift made by the Wilsons allows the school to reward those students who excel academically and give back to the community. I cannot thank the Wilsons enough for their investment in our students’ future.”

For nearly three decades, the Wilsons have been loyal supporters of the dental school. Bob Wilson is a dedicated member of the school’s board of counselors and now serves on the dean’s Centennial Campaign Cabinet for UCLA, which launched in May.

The Wilsons both attended UCLA. Bob graduated with a bachelor of science degree in 1953 and Marion graduated with a bachelor of arts degree in 1950. Bob went on to a successful career in commercial real estate development, and the couple has remained dedicated to helping their alma mater fulfill its mission of educational excellence. In 1989, they helped establish the Wilson-Jennings-Bloomfield UCLA Venice Dental Center, a community clinic that provides dental care to predominantly low-income patients.

The impact of the Wilson’s philanthropy is evident across the UCLA campus, most notably in Wilson Plaza, which was dedicated in their name in 2000 in recognition of their longtime generous support for the university. In 2006, they were awarded the UCLA Medal, the university’s highest honor.

For everything that the couple has done for the School of Dentistry and UCLA, the dental school will recognize them as an official honoree at the dental school’s upcoming 50th Anniversary Gala event next spring.

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Viewing dentistry in a new light


UCSF professor is a leading expert in a relatively new field of dentistry called biophotonics.

Michael Staninec (left) and Jacob Simon, a staff research associate, test a device that uses optical coherence tomography, which uses near-infrared light to view cavities in teeth better than traditional X-rays. (Photo by Susan Merrill)

Dental X-rays expose patients to radiation, require time to process, and can only “see” a limited amount inside the mouth.

Now new optical techniques developed by UC San Francisco’s Daniel Fried, Ph.D., use light to take instantaneous digital images that can provide a better picture of our teeth and could one day zap cavities with pinpoint precision.

Fried, a professor in the School of Dentistry’s Division of Biomaterials and Bioengineering in the Department of Preventive and Restorative Dental Sciences, is a leading expert in a relatively new field of light-based dentistry, called biophotonics. It uses optical techniques such as near-infrared lasers and spectroscopy for imaging and therapy.

“The field is strongly moving in the direction of what we call minimally invasive dentistry,” said John Featherstone, dean of the School of Dentistry, “and the technologies being developed by Dan’s team are a key part of that philosophy.”

One of those technologies, called optical coherence tomography (OCT), uses near-infrared light — a wavelength of light invisible to humans — to create high-resolution, 3-D images of teeth.

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Dental school’s diversity pipeline a success


UCLA School of Dentistry outreach program helps underrepresented students.

Raquel Ulma went from growing up in a poor neighborhood in Puerto Rico to graduating from UCLA School of Dentistry to getting accepted into the UCLA Plastic and Reconstructive Surgery program. (Photo by Brianna Aldrich, UCLA)

When Raquel Ulma moved to Los Angeles with her husband, Greg, in 2002, he knew that it was time for her to start making her lifelong dream of becoming a dentist a reality, even though she had no idea how.

So Greg encouraged her to attend the annual California Dental Association session with a friend. “I actually crashed the dentistry event,” confessed Ulma, who goes by “Rocky.” “I approached the Hispanic Dental Association booth and struck up a conversation with a female dentist who was approachable and welcoming.”

Soon Ulma was telling Dr. Lilia Larin about her goal of becoming a dentist. The two exchanged contact information and Larin told her to expect a call from a faculty member from UCLA School of Dentistry who was starting a program designed to help people apply to dental school.

The next day, Drs. Marvin Marcus and Bruce Sanders contacted Ulma. Marcus told Ulma that she was the perfect candidate for his new program aimed at recruiting disadvantaged and underrepresented students into dentistry. She was from a poor neighborhood in Puerto Rico and had the basic science foundation, having majored in chemistry at the University of Puerto Rico and had completed master’s level coursework in organic chemistry.

“To be honest,” Ulma said, “I was a little star-struck that a school such as UCLA would have an interest in me.”

Shortly after her first contact with Marcus, Ulma became one of the first students to participate in UCLA School of Dentistry’s then-fledgling recruitment initiatives and helped paved the way for the current Post-Baccalaureate program, which guides students step-by-step, through the daunting dental school application process. Since 2003, the program has mentored 40 post-baccalaureate students, 30 of whom have gone on to attend dental school. The program, which is funded in part by UCLA School of Dentistry Dean No-Hee Park’s office, is the first of its kind in Southern California.

“Our educational pipeline initiatives are something I am very proud of and are an important element of our outreach and diversity goals,” said Dr. Park. “Our Post-Baccalaureate Program has helped young people reach their full potential and has enriched the dental field with professionals from all backgrounds.”

For Ulma, the coaching began with a meeting at the School of Dentistry’s Office of Student Affairs where Marcus and Sanders reviewed her undergraduate transcripts, looked at her dental admission test (DAT) scores and went over a draft of her application essay. Ulma had strong grades from her undergraduate work, but needed to work on her DAT scores and wasn’t as strong in the interview portion. Knowing this, Marcus and Sanders helped set-up a mock-interview panel that resemble an actual interview she would eventually face.

“The mock interview panel was a lot harder than I expected,” she said. “They asked a lot of questions, such as why I would be a good fit for that particular school and what makes me a good candidate for dental school.”

They also advised her to do some volunteer work in dentistry, so Ulma immediately began volunteering at the Wilson-Jennings-Bloomfield UCLA Venice Dental Center – a community clinic in West Los Angeles that provides dental care to low-income adults and children.

The entire process took about a year and a half, from reviewing her prerequisites and retaking the DAT to applying to numerous schools and interviewing. After that though, Ulma was accepted to her top choice, UCLA, and began dental school in 2004.

“Looking back at how far I’ve come is sometimes unbelievable,” Ulma said.

Originally from Levittown, Puerto Rico, a rough, urban neighborhood outside of the country’s capital, Ulma recalls the area where she grew up as, “a very bad neighborhood with high pregnancy rates, drug dealers and teenagers getting shot.”

Ulma’s police officer father also owned a woodworking shop where he made furniture to supplement his salary, and he would regularly bring her to the shop to keep her out of trouble.

“It was the experience of working with my father in his shop where I fell in love with using my hands to make something beautiful, yet functional,” she said.

Rather than follow her father exactly, though Ulma chose to pursue dentistry to combine her love of working with her hands along with helping people.

With the support of her husband and faculty at UCLA, Ulma achieved her long-held dream of becoming a dentist when she graduated with the D.D.S. class of 2008.

“During dental school, I would often meet with Dr. Marcus for breakfast and he would remind me to take it day-by-day,” she recalled. The support she received from Marcus and Sanders has inspired Ulma to volunteer her time to assist other students with their dental school applications.

Dental school was just the beginning for Ulma. In 2008, she successfully applied to and was accepted to the UCLA Oral and Maxillofacial Surgery (OMS) residency program, a highly competitive program that only offers two slots per year out of approximately 100 applications. Ulma graduated from the OMS residency program with an M.D. degree and a certificate of specialization in oral and maxillofacial surgery this June.

“She is truly a remarkable individual and I believe she will be a model for many women and minorities in the future,” Marcus said.

While in the OMS residency program Ulma met Dr. Earl Freymiller, professor of clinical dentistry and chairman of the section of oral and maxillofacial surgery. Freymiller, an oral surgeon, introduced Ulma to the Thousand Smiles Foundation. Ulma and Freymiller, along with other oral surgeons travel to Ensenada, Mexico several times a year where they perform surgery on children with cleft lip and palate.

“Dr. Freymiller has been such an invaluable mentor to me,” Ulma said. “I’ve witnessed patients he’s worked on come back years later to introduce them to their families and thank him for what he’s done for them. He is an example of who I want to become.”

In summer 2015, Ulma will start a three-year residency in the Plastic and Reconstructive Surgery program, and learn to perform complex facial and body reconstruction to help replace congenitally or traumatically missing body parts.

“I wouldn’t be where I am today without the Post-Baccalaureate program,” she said. “People do what they know. For example, if there isn’t a role model for how to get into dental school or the health sciences, then younger minorities won’t even see it as an option. I look at where I’m at in my career and feel incredibly lucky for the people who have been role models to me.”

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UCLA dentistry student honored as advocate for oral health


Adrien Hamedi-Sangsari has pushed for more government funding for the profession.

Adrien Hamedi-Sangsari, UCLA

Adrien Hamedi-Sangsari always knew he wanted to become a dentist. The third-year UCLA School of Dentistry student grew up listening to and admiring several of his cousins who are dentists as they explained what dentistry was like and how it could be a fulfilling career path.

These family influences combined with an internship in 2013 at the American Dental Association’s offices in Washington, D.C., guided him to want to become more than a dentist but also an advocate who fights for issues that affect the profession.

“I want to make dentists and dental students understand that this is our profession and only we can change it and protect it,” said Hamedi-Sangsari, who graduated from UC Irvine in 2011 with a degree in biology. “We can’t just sit around and hope for the best. We need to have a voice to make an impact.”

This past March, Hamedi-Sangsari’s passion for the dental field was recognized by the American Association for Dental Research when he was selected as the first recipient of the association’s Student Advocate of the Year Award. This award was created to recognize a dental student for his or her outstanding contributions in advocacy for oral health research.

Hamedia-Sangsari’s interest in dental advocacy began while he was a student intern at the American Dental Association (ADA). His primary duties were to assist the ADA’s grassroots efforts: this entailed reaching out to dentists as potential new members and accompanying lobbyists to Capitol Hill to support candidates who were proponents for the profession.

During his internship, Hamedi-Sangsari learned more about the political issues that dentists and dental students face, which include staggering student debt after dental school, pro bono dental care, professional licensure and water fluoridation.

“Student debt reduction is especially important to dental students right now,” Hamedi-Sangsari said, “since the cost of training a dental student raises the bar higher than for the average graduate student.”

Addressing the growing problem of student loan debt is a major issue for the American Student Dental Association, which Adrien is also a member of. Many recent dental school graduates are shying away from pursuing postgraduate training or a career in dental education due to the debt burden, which could adversely impact the number of specialists, teachers and researchers.

“Student loans are at the top of the agenda for ASDA,” said Hamedi-Sangsari. Two out of the three bills being discussed by ASDA are about the burden of student loans. “There isn’t a perfect formula yet for how to reduce our debt burden, but at least it’s being talked about.”

In addition, Hamedi-Sangsari believes that government funding should be increased for pro bono dental care. He also feels that dental licensure needs to be a standardized nationwide exam, versus state-by-state and that the exam should eliminate live patients due to the number of variables involved. Hamedi-Sangsari also supports changing how dental students are evaluated from one day of assessment to reviewing a student’s entire case portfolio, because it’s a better gauge of ability.

Water fluoridation is another hot topic on Hamedi-Sangsari’s radar. He believes that water fluoridation should be mandatory in every major city, and that education is a major reason why dental cavities are still a problem for pediatric patients.

“I volunteer at a pediatric dentistry clinic in the Los Angeles area and I hear from young mothers, all the time, how they won’t let their child drink tap water,” said Hamedi-Sangsari. “People don’t realize that city’s tap water is beneficial to our oral health.”

Hamedi-Sangsari said that if dentists and dental students don’t advocate for these issues that affect their future and the patients they treat, who else would?

Hamedia-Sangsari heard about the award from a faculty mentor and thought he had a good chance to be selected for the honor. He has been president of the UCLA Student Research Group and last year, before even officially becoming president of the group, Hamedi-Sangsari encouraged UCLA students to write and email letters to and call politicians about the issues dentists and dental students face. He also participated in the 2013 American Association of Dental Research/American Dental Education Association Advocacy Day on Capitol Hill. He spent the majority of his time advocating for Congress to maintain funding for the National Institutes of Health and the National Institute for Dental and Craniofacial Research and funding for primary care training in general dentistry, pediatric and public health dentistry.

In August, Hamedi-Sangsari took the initiative and met with members of the California congressional delegation, including Henry Waxman, Karen Bass and Brad Sherman. During these meetings he discussed the groundbreaking research at UCLA and the importance of increasing funding for biomedical research.

“With recent budget constraints, the National Institute of Dental and Craniofacial Research have cut funding to advance dental research,” Hamedi-Sangsari said. “Every day there are new projects being shot down, due to funding, that could revolutionize the dental profession. As long as there are things to discover in dentistry, research needs to be at the forefront of the discussion.”

As he moves into his fourth year of dental school, Hamedi-Sangsari is starting to plan for life after UCLA. He said that he is leaning toward pursuing advanced training in orthodontics, and would like to work with adolescents in Southern California. Also, as a native of the San Fernando Valley, he would like to remain close to home. And of course, he plans to continue to advocate for the dental profession.

“There is so much more to dentistry than the private office,” Hamedi-Sangsari said. “I have come to understand that during my dental school experience, the future of the profession is in our hands and I refuse to sit around and watch it get restructured without our support.”

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