Grant Proposal First Draft
University of California, Irvine
Public Health 195W
4 May 2021
The National Institute of Dental and Craniofacial Research (NIDCR) has a mission to
improve oral, dental, and craniofacial health based on its research, training, and intervention
programs. The institute aims to accomplish this mission by supporting clinical research on oral
hygiene and conducting and funding research training that enables career development.
Furthermore, the research institute coordinates and assists in relevant research and related
activities in all sectors of community research and promotes transferring knowledge from the
study conducted, including its implications on public health, health professionals, policymakers,
and researchers (NIH, 2020).
NIDCR launched its 2030 goal in 2017. It envisioned an initiative to imagine a future
where most of the population understood dental, oral, and craniofacial health and its context on
how these aspects impacted an individual’s overall health. Besides, this initiative aims to promote
health, treat oral-related diseases, and propose overcoming health disparities. Because of the
necessity of this intervention program, NIDCR seeks help to develop and fund the 2020-2025
strategic plan (NIH, 2020). This strategic plan will guide the funding for the institute for the next
half-decade. In this case, strategic planning involves establishing priorities, setting
straightforward goals, and detailing the actions necessary to achieve set goals (NIH, 2020). The
NIDCR plan consists of focusing resources and energy on attaining common set goals with
agreed outcomes. NIDCR established five priority sections for the strategic plan, including oral
and overall health, precision oral health, regenerative medicine, health disparities, and a diverse
workforce (NIH, 2020). The institute also released a Request for Information (RFI) to solicit
feedback on these priority sectors to create an initiative to help accomplish the objectives.
Statement of Need
Oral hygiene begins with having clean teeth, having an awareness of daily habits, and
having proper dental care routines. Therefore, oral health care is significant because it lowers the
risk of developing diseases such as cavities, periodontal disease, gingivitis, cracked tooth
syndrome, bruxism-related conditions, among others (Coseo, 2020). Healthy oral practices allow
individuals to smell better, taste, chew, swallow, speak, and smile confidently.
Numerous oral conditions affect both children and adults. While some situations may be minor,
others can be significantly serious and result in health complications with time. Some of these
conditions include (WHO, 2020);
Â· Bruxism- this condition causes excessive teeth grinding, especially when asleep.
Â· Bad breath- also known as halitosis, this condition is characterized by chronic bad
Â· Dry mouth is a condition where salivary glands do not produce enough saliva and are
also known as xerostomia.
Â· Toothaches- this condition is characterized by pain near or in a tooth and is typically a
consequence of tooth decay or abscess.
Â· Cracked teeth- this condition involves having minor to severe cracks in teeth often
caused by bruxism, an injury, among other factors.
Â· Tooth sensitivity- this condition involves a tooth being sensitive to hot, cold, or sweet
Â· Temporomandibular Joint Dysfunction- this condition causes significant pain in the
Â· Mouth Breathing- this condition results in an individual regularly breathing through
their mouth in their sleep.
Â· Gum recession- this condition is where gums begin to pull back from the teeth, which
exposes the tooth or the root of the tooth.
Â· Burning mouth- this condition is a consistent burning or tingling sensation in the
Â· Gingival Hyperplasia- this condition is the overgrowth of the gum tissue around the
Furthermore, there are various oral diseases. Oral diseases are considerably more severe
than oral conditions, where when left untreated, they can cause tooth loss or permanent damage
to the surrounding areas. Some of the oral diseases include (WHO, 2020);
Â· Gingivitis- this disease is an irreversible minor gum disease.
Â· Periodontal disease- a severe gum disease that often results in permanent loss of bone.
Â· Cavities- this disease is tooth decay, whether minor or significant.
Â· Oral thrush- this disease is a yeast infection of the mouth.
Â· Dental Abscess- a pocket of pus in a tooth.
Â· Oral cancer- a form of cancer affecting the mouth or throat.
Excessive alcohol consumption, tobacco use, and unhealthy eating habits can cause oral
health to deteriorate over time. While general health conditions can typically worsen existing
oral health situations, poor oral hygiene has been a risk factor for several issues. One of the risk
factors of poor oral health is heart disease. Diseases such as gingivitis, when left untreated,
become periodontal disease. This gum disease links to increased rates of cardiovascular disease
because bad oral hygiene increases the risk of developing a bacterial infection that can reach the
bloodstream and spread to the heart valves (Coseo, 2020).
Furthermore, with untreated oral diseases, individuals risk developing chronic diseases
such as diabetes or increasing the risk of getting a stroke with age. Poor dental hygiene also
results in a weakened immune system, which increases the probability of developing infections,
illnesses, and diseases. Therefore, because of the adverse effects of neglected oral health, this
proposal by the NIDCR is necessary to create awareness on matters of oral hygiene and its
impacts on individuals, families, and the community.
According to WHO (2021), the threat of non-communicable diseases and the need to
provide urgent and efficient public health responses led to the formulation of a global strategy to
control and prevent these diseases. Similarly, the NIDCR aims to create designs for intervention
on oral health and oral diseases. The institute will prioritize diseases linked by common,
preventable, and lifestyle-related risk factors such as tobacco use or unhealthy diet. There is a
relatively high risk of oral disease relating to socio-cultural determinants, including low income,
low education levels, beliefs, and culture supporting oral health. According to Mejia et al.
(2018), socioeconomic status has long been an area of interest in its effect on oral health. A
majority of the evidence indicates that socioeconomic inequalities are typically associated with
oral health status, both subjectively and objectively (Mejia et al., 2018). Therefore, it is
necessary to monitor social inequalities and disparities in oral health to provide information on
the differences populations face, their oral hygiene needs, oral health priorities, and preventive
practices. Besides, previous studies demonstrate that socioeconomic positioning is negatively
associated with oral health and dental diseases. The higher the income a family has, the better
equipped they are to have information and experience fewer oral hygiene and dental conditions.
In addition, education and income become significantly relevant indicators used in the
epidemiology for socioeconomic status measurement, according to Mejia et al. (2018). Oral
health counts as a constituent of general health, relying on subjective perceptions, while disease
measurement utilizes objective indicators. Also, communities or regions with irregular exposure
to fluorides are at an increased risk of dental cavities. At the same time, the settings with poor
access to safe drinking water or sanitary facilities pose environmental risk factors to both oral
and general health (S & M, 2021). Also, controlling oral diseases significantly depends on the
accessibility and availability of oral health systems. However, reducing risks to oral disease is
only plausible if there is an orientation of services towards prevention. Further to the
socio-environmental aspects, this model emphasizes the role of intermediate and modifiable risk
behaviors such as oral health practices, diet, and alcohol and substance use (S & M, 2021). These
behaviors may affect not only the overall oral hygiene of individuals but also their quality of life.
Clinical and public health research indicates that individual, professional, and community
preventive measures are efficient in preventing oral diseases (WHO, 2021). However, the
optimal intervention measures for oral diseases are not available universally, nor is it affordable
because of the costs associated with dental health and limited resources. Coupled with the lack of
emphasis on primary prevention measures for oral diseases, there is a significant challenge for
many communities, especially for communities in low-income settlements that cannot access
such services. A considerable portion of the evidence relates to preventing dental cavities and
controlling periodontal diseases (WHO, 2021). Prevention of gingivitis is possible using proper
oral hygiene practices, including regular brushing and flossing. These procedures are also
valuable for controlling periodontal lesions, according to WHO (2021). Furthermore, an
initiative such as community water fluoridation is an effective method of preventing dental
cavities for adults and children. Water fluoridation works to benefit the community in its entirety
by supplying water regardless of socioeconomic status.
Milk and salt fluoridation schemes also have similar effects on dental health when used
as preventive programs for communities. Therefore, both individual and professional measures
such as fluoride mouth rinses, gels, kinds of toothpaste, and use of dental sealants are additional
methods of prevention of dental cavities (Oberoi et al., 2016). In several communities, poor
income communities, the introduction of fluoridated toothpaste has been a valuable strategy,
which has ensured that individuals remain appropriately exposed to fluorides. Therefore,
individuals can take personal actions for themselves and their families to prevent dental diseases
and maintain hygiene. Combined with proper nutrition and diet, the primary prevention of most
oral, dental, and craniofacial diseases is achievable. Lifestyle habits such as tobacco use, poor
dietary choices, and excessive alcohol consumption affect dental hygiene and have significant
effects on general health. Such behaviors are also associated with an increased risk of congenital
craniofacial disabilities, periodontal diseases, dental cavities, oral candidiasis, pharyngeal
cancers, among others (Oberoi et al., 2016).
Also, opportunities exist to further expand the prevention of oral disease and promote
health information and practices to the public using community programs and healthcare settings
(WHO, 2021). As oral health care providers, the institute plays a significant role in promoting
healthy lifestyles by incorporating tobacco cessation programs and utilizing nutrition counseling
in daily practices (WHO, 2021). However, there exist some essential oral health disparities
across various regions. These disparities typically relate to socioeconomic status, ethnicity, and
race, age, gender, or in some cases, the status of general health, according to WHO (2021).
While specific dental diseases are preventable, there is evidence that not all community members
are adequately informed or are in a position to benefit from measures for appropriate health
promotion. In this instance, the underserved communities and populations are evident in both
developed and developing countries. However, in most countries, oral healthcare lacks full
integration into the community and national programs, according to WHO (2021).
The strategies for intervention for oral health care involve utilizing intervention tools to
increase awareness about oral diseases and conditions and promote oral health habits among
community members (Mo Gov, 2021). NIDCR aims to use campaigns and promotions on media
outlets such as television and radio, and other modes of communication, including issuing
brochures with intervention messages. Furthermore, with public figures or celebrity figures, the
institute can endorse oral hygiene, diseases, conditions, and treatment options. Therefore, the
institute must utilize consistent messages across these various communication channels to ensure
the public remains aware. According to Mo Gov (2021), these oral health campaigns and
promotions can increase awareness of the health risks of oral diseases and conditions and
highlight their association with other health conditions. Furthermore, these campaigns aim to
promote behavioral changes, reduce the risk of oral infections and diseases, and improve the
knowledge and skills related to the benefits or challenges of proper habits for dental care. These
campaigns also aim to change community norms by encouraging protective mouth gear for
sports, reducing sugar and alcohol consumption, and ceasing tobacco use.
The significant challenges of the future of this intervention program will exist in
translating knowledge and experiences about the prevention of oral diseases into actionable
programs. The social, economic, and cultural factors and the shifting population demographics
rely significantly on delivering oral health services and how individuals care for themselves and
their families. Therefore, reducing the disparities requires a wide range of approaches that target
the high-risk populations for particular oral diseases and improve their access to proper care.
Meanwhile, the most significant challenge for communities in low-income areas is offering oral
health care within the context of primary health programs. These programs aim to meet the basic
health needs of these populations, improve active outreach to the community, facilitate primary
care, and pursue effective referral of patients, according to WHO (2021). Therefore, for these
interventions to be available for communities in the United States, the existing partnerships
require strengthening, especially with non-profit organizations. This participation of numerous
organizations includes collaborating, encouraging community participation, creating policies
towards oral health care reforms, and developing strategies for oral disease control in
To sum up, oral health is a significant issue in the community that requires addressing.
The NIDCR aims to facilitate intervention programs aimed at reducing oral health conditions and
diseases in communities. These interventions need reforms of oral health systems to change the
focus from invasive treatment options and towards prevention and use of minor treatments. The
NIDCR identified various strategies for improving oral health, focusing on low-income and
marginalized communities who have challenges accessing oral care. These strategies include
population-wide prevention measures that are cost-effective and having patient-centered primary
care. The NIDCR requires help in supporting the proposed interventions to accelerate the impact
on the community. Furthermore, the institute needs support in building capacity to provide
technical assistance to communities, support the population-based strategies of monitoring diet,
and reduce sugar and alcohol consumption. The organization also needs help in providing the aid
for strengthening the oral health systems to become integral to these communities and do not
cause further financial hardships.
Coseo, D. (2020). Why is Oral Health Care Important? | NewMouth. NewMouth. Retrieved 4
May 2021, from https://www.newmouth.com/oral-health/.
Mejia, G., Elani, H., Harper, S., Murray Thomson, W., Ju, X., & Kawachi, I. et al. (2018).
Socioeconomic status, oral health and dental disease in Australia, Canada, New
Zealand and the United States. BMC Oral Health, 18(1).
Mo Gov. (2021). Oral Health Intrvention. Retrieved 4 May 2021, from
NIH. (2020). NIDCR. Nidcr.nih.gov. Retrieved 4 May 2021, from
Oberoi, S., Sharma, G., & Oberoi, A. (2016). A cross-sectional survey to assess the effect of
socioeconomic status on the oral hygiene habits. Journal Of Indian Society Of
Periodontology, 20(5), 531. https://doi.org/10.4103/0972-124x.201629
S, S., & M, Z. (2021). Factors Affecting Oral Hygiene and Tooth Brushing in Preschool
Children, Shiraz/Iran. NCBI, 4(2). Retrieved 4 May 2021, from
WHO. (2020). Oral health. Who.int. Retrieved 4 May 2021, from https://www.who.int/news
WHO. (2021). WHO | Strategies and approaches in oral disease prevention and health
promotion. Who.int. Retrieved 4 May 2021, from
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