magazine - UCSF School of Dentistry

University of California, San Francisco
School of Dentistry
magazine
Volume 5 / 2010
CAN DO
Tackles
Tooth
Decay
A L S O I NSI D E:
Message from
Dean John D.B.
Featherstone
Pre-Clinical
Laboratory
Dedicated
Research
Faculty
Profiles
New Associate
Dean for
Research
Class
of 1959
Notes
University of California, San Francisco
School of Dentistry
Editorial Advisory Board:
John D.B. Featherstone
Dean
Susan Schultz
Associate Dean for Administration and Finance
Dorothy A. Perry
Associate Dean for Education and Student Affairs
Chris Ruetz
Senior Director of Development and Alumni Relations
Mission Statement
The UCSF School of Dentistry seeks to improve
public health through excellence in teaching,
research, patient care and public service in
the dental and craniofacial sciences. We foster
an inspired environment where individuals
identify themselves as scholars and realize
their scholarship through service as clinicians,
educators and scientists.
The goal of the School of Dentistry Magazine is to
advance the mission of the School of Dentistry.
The magazine is published annually for the alumni,
students, faculty, staff and friends of the UCSF
School of Dentistry.
The School of Dentistry Magazine is produced by:
UCSF School of Dentistry
513 Parnassus Avenue, Room S-630
San Francisco, CA 94143-0430
Editor/Writer: David Hand
Contributing Writers: Jeffrey Norris,
Mary Sornborger Porteous
magazine
VOLUME 5 / 2010
news
> Dean’s council Reaches Out for Support / PAGE 2
> class stats 2008 & 2009 / PAGE 2
> MASTER’S IN DENTAL HYGIENE UPDATE / PAGE 3
> pre-clinical simulation laboratory dedicated / PAGE 3
faculty profiles
> stefan habelitz — Investigating the secrets of enamel and dentin
collaboratively at Dentistry’s Marshall Lab / PAGE 4
> susan hyde — Engaging an interdisciplinary approach to making
knowledge and care more broadly available / PAGE 6
> ophir Klein — Seeking the role of oral stem cells in regenerative
medicine and possible clinical applications / PAGE 8
features
Design: Laura Myers Design
Can Do
Photography: Elisabeth Fall, David Hand,
Carmen Hipona
Jane Weintraub and the CAN DO team break new ground and win
support in the cause of children’s oral health / PAGE 10
© 2010 The Regents of the University of California
New Associate Dean for Research
Richard Jordan – from excellence in oral medicine to research
leadership / PAGE 15
alumni update
> BeAR BASH 2009
/ PAGE 16
> SCIENTIFIC SESSIONS / PAGE 16
> CLASS NOTES / PAGE 17
> alumni profiles / PAGE 19
> in memoriam / PAGE 20
ON THE COVER: Kaitlin Jennison (Class of 2013) offers child-
friendly dental hygiene information during the Hayes Valley Fair at
San Francisco’s John Muir Elementary School. (See story, page 10)
dentistry.ucsf.edu
Message from the Dean
Dear Alumni and
Friends of the UCSF
School of Dentistry:
2009 was a year of challenge and
transformation at the school, from
which we’ve emerged strong –
retaining our leadership and
dedication to excellence in the
teaching of clinical dentistry,
research and patient care.
With ideas and input from across the school
community, we made tough decisions and worked
together to significantly increase clinical and operational
efficiency, and with outstanding support from generous
donors we’ve moved forward on key projects,
including the implementation of digital radiography,
the ongoing renovation of patient reception areas,
and the floor-up modernization and rededication of
the Fleming Pre-Clinical Simulation Laboratory,
named for Dentistry Dean and UCSF Chancellor
Willard C. Fleming, DDS ’23.
At the gala dedication in November, we were
honored by the presence of UCSF’s dynamic new
chancellor, Sue Desmond-Hellmann, who has proven
to be a great friend of the school and a powerful
advocate for our mission.
Look for the story of the new Fleming Lab in this
magazine, along with an in-depth look at the widely
applauded work of CAN DO, recognized in 2008 with
a National Institutes of Health grant of more than
$1.3 million; profiles of three members of our faculty
who are redefining the frontiers of dentistry and
oral-craniofacial science; and a profile of our new
associate dean for research, among other features.
I’d like to invite you to stay in touch by visiting
the school and our sites on the Web, including
Facebook (facebook.com/ucsfdentistry) and Twitter
(twitter.com/ucsfdentistry).
As a new decade dawns, much exciting work and
discovery await. Please join us!
John D.B. Featherstone, MSc, PhD
Dean, UCSF School of Dentistry
Why We Give
Continued from back cover
“One who had a profound effect
on my professional development was
Dr. Perry Ratcliff, chair of the Division
of Periodontology at the time,” he
added, detailing efforts to establish
an endowed chair
“The culture
in his name (see
story, page 20).
of giving is
“It should become
now part of
a goal to have
our profesan endowed
chair for every
sional fabric
faculty position.
as graduates
Those sorts of
from UCSF.”
tributes last.”
In the Otago
– Gary C. Armitage,
DDS, MS
editorial, Armitage
distilled his
thoughts about giving into three
focused objectives:
n The majority of graduates should
become donors.
n Establish endowment funds for
specific educational programs in the
names of widely respected mentors
and teachers.
n Recruit and cultivate major donors
in order to form the financial base for
named distinguished professorships
and endowed chairs.
“The culture of giving is now part
of our professional fabric as
graduates from UCSF,” Armitage said.
“We give because we firmly believe
that it is essential for the future
existence of the University of
California as a first-rate institution of
higher learning. As University
graduates, it is our responsibility to
support the schools we attended to
make sure future generations have
the same opportunities we had.
“We have been recipients of the
many benefits that come with a
University education, and it is our
obligation to pay back the system so
it is still there for our grandchildren.
The UCSF School of Dentistry cannot
maintain its position as a premier
institution without strong alumni
support on a continuing basis.” n
1
news
Dean’s Council Reaches Out for Support
I
n summer 2009, Dean
Featherstone announced the
formation of a new volunteer
advisory board with the mission of
supporting the fundraising efforts
of the UCSF School of Dentistry.
The Dean’s Council, comprising
community and industry leaders
in addition to faculty, administration
and alumni, assists in the identification, cultivation, solicitation and
stewardship of individual, corporate
and foundation donors who will
financially support the projects
and programs of the school.
“I am pleased to have
assembled such a dedicated
team committed to raising the
financial resources so urgently
needed to support our school,”
said Featherstone. “With the
continued engagement of faithful
alumni, faculty, grateful patients
and friends, the UCSF School of
Dentistry will continue to maintain
its ranking as one of the top
dental schools in the nation.”
Quarterly Dean’s Council
gatherings have included serious
conversation and strategic
planning as well as fun social
activities, including a champagne
brunch at the dean’s residence,
an alumni-hosted wine tasting
and a reception at the dean’s
Lake Tahoe home.
Looking ahead, Featherstone
welcomes the participation of the
school’s extended family to help
increase sources of new funding.
“As dean, I am determined to
maintain the relevance and
academic significance of the
UCSF School of Dentistry degree,
but I cannot do that alone,” he
said. “We at UCSF are a proud
family, and when opportunities are
presented, families come together
and lend a helping hand.”
For more information about
the Dean’s Council and to
make a contribution to the UCSF
School of Dentistry, contact
Chris Ruetz, Senior Director,
Development and Alumni
Relations, at 415/476-3645 or
[email protected]. n
Class Stats: Graduating Seniors Surveyed
Class of 2008
Class of 2009
Educational Debt Comparisons
Postgraduate Studies Plans
Postgraduate Studies Plans
Advanced Education
in General Dentistry 5
Advanced Education
in General Dentistry
Average debt of dental students upon
graduation (2008 graduates)
10
Dental Public Health 1
Dental Public Health
0
1
Endodontics
Endodontics
General Practice Residency Oral & Maxillofacial Surgery 13
4
12
Oral & Maxillofacial Surgery
4
0
Oral Pathology
0
Oral Radiology 0
Oral Radiology
0
Orthodontics 3
Orthodontics
6
Pediatric Dentistry 2
Pediatric Dentistry
7
Prosthodontics 0
Prosthodontics
0
5
Other Graduate Program
Not Listed
4
None
59
None
Postgraduate Practice Plans
Solo private practice, full-time
Solo private practice, part-time
Group practice, full-time
Group practice, part-time
Not going into general
dental practice at this time
Solo private practice, full-time
Solo private practice, part-time
Group practice, full-time
Group practice, part-time
Not going into general
dental practice at this time
17
3
48
10
13
$170,367
$142,671
$139,390
53
Postgraduate Practice Plans
Source: UCSF School of Dentistry Educational Services
Graduating DDS and IDP Seniors Survey
2
3
General Practice Residency
Oral Pathology Other Graduate Program
Not Listed $204,734
13
1
45
11
23
All US
Dental
Schools
Public
Dental
Schools
Private
Dental
Schools
UCSF
School of
Dentistry
Source: Graduating Seniors Survey,
UCSF Office of Student Financial Aid;
ADEA Survey of Dental School Seniors,
2008 Graduating Class
Update: Master’s
in Dental Hygiene
Dean Featherstone and the School of
Dentistry are committed to including a
Master’s Degree Program in Dental
Hygiene on the UCSF campus.
The UCSF Graduate Council approved
the proposal for the Master’s Degree
Program in Dental Hygiene, citing it as one
of the best-developed curricula presented
for a master’s program. The approval on
March 7, 2008, was another successful
stride among the many steps involved
in the new program’s approval process.
The School of Dentistry Faculty Council
approved the Master’s Degree Program
in Dental Hygiene proposal on October
18, 2007, followed by the approval of
the Educational Policy Committee.
Margaret Walsh, with
the help of William Bird
and Jane Weintraub, has
devoted considerable time to
surmounting each hurdle in
the long approval process.
The Master’s Degree
Program in Dental Hygiene,
self-funded through tuition
fees, received approval from
Margaret
the Office of Budget and
Walsh
the Academic Senate at
UCSF, and has now been
approved by the systemwide Graduate
Council. All that remains is the signature
from the UC Office of the President.
Committed to the preservation
of the dental hygiene program, Dean
Featherstone and the Faculty Council
continue to bolster support for the
master’s program.
Hygienists interested in applying
to the Master’s Degree Program in
Dental Hygiene are encouraged to
continue checking the UCSF School of
Dentistry website, or to contact communication liaison Mary Porteous at mary.
[email protected] for program
status and updates. n
— Mary Sornborger Porteous, DH ’75
Willard C. Fleming Pre-Clinical
Simulation Laboratory Dedicated
L
ocated on the fourth floor of the Dental Clinics Building at
707 Parnassus Ave., the pre-clinical simulation laboratory space
has been a major part of the education of generations of
dental students since it opened in 1980. Over the intervening
decades, the lab has been incrementally upgraded with the aim of
keeping the technology current and creating ever-more-realistic
simulations of what students will face in working with real patients,
beginning in their third year. But the
2009 renovation of the lab, thanks
to the overwhelming generosity of
alumni, including a single donor of
$1 million, was a floor-up redesign
resulting in a completely new,
state-of-the-art facility.
The months-long renovation
completes the third phase of a
four-phase project, according to
Department of Preventive and
Read more about Willard C. Fleming at
Restorative Dental Sciences Interim
history.library.ucsf.edu/fleming.html.
Chair William Bird, DDS, DPH, who
oversaw the renovation. Bird described the new simulation
environment as providing not only a more accurate approximation of
“the real mouth,” but also an enhanced ergonomic simulation –
increasingly emphasized as an aspect of dental practice. The fourth
phase of the project, for which planning is complete and funding is
currently being organized, is the renovation of the smaller, adjacent
support lab.
The Willard C. Fleming Pre-Clinical Simulation Laboratory was
formally dedicated on November 2, 2009, at a gala evening that
included words from Bird, Dean Featherstone and UCSF Chancellor
Susan Desmond-Hellmann, as well as recorded words from Fleming
himself. Many of those present expressed the view that Fleming, who
passed away in 1972, would have been honored to see his name
attached to a facility so central to the training of UCSF dental
students.
Willard Corwin Fleming (pictured on computer screens above)
was an influential presence on Parnassus Heights for decades: as a
dental student at the UC College of Dentistry, as it was then known,
from 1918 to 1923; as a member of the faculty from 1924 to 1939;
and as dean from 1939 until 1966, during which time the college
became the UCSF School of Dentistry. Fleming was appointed
chancellor of UCSF in 1966 and served through tumultuous years
on campus until 1969. His leadership was widely applauded for his
characteristic thoughtfulness, openness and academic innovations,
including groundbreaking efforts to open paths to the health
professions for the socioeconomically disadvantaged.
“He was beloved by students, staff, faculty, alumni,” says
Professor Emeritus Sol Silverman, DDS, a faculty member since 1954.
“I thought the world of him.” n
3
faculty profile > > > Stefan Habelitz
Nature’s Crowning Achievement
N
ature favors the fittest, and tooth
enamel is one of evolution’s
success stories. Dinosaurs and
ancient sharks sported enamel on their
big choppers eons ago, as have newly
evolved creatures ever since. Treated
right, enamel lasts a lifetime.
“Enamel is the best crown material
there is,” asserts German-born Stefan
Habelitz, PhD, engineer and materials
scientist. Habelitz ought to know. He
worked on high-tech bio-ceramics for
bone implants and tooth restorations
for a decade before coming to UCSF
in 1999 to blaze a new research trail.
Now he’s investigating enamel at the
School of Dentistry’s Marshall Lab,
where researchers fruitfully focus on
every facet of teeth, knowing they’re
nothing to take for granted.
When enamel breaks down due to
tooth decay or trauma, dentists do an
admirable job of patching things up
with gold crowns and ceramic caps
or composites. But no man-made
material can compare to enamel,
Habelitz says. Enamel is designed to
crack at the sites of specific microstructures within it, and normally over
time it does. But enamel rarely cracks
all the way through or fails, as
ceramics often do. And better than
gold or composites, enamel remains
integrally attached to the underlying
dentin upon which it first forms.
With the aid of state-of-the-art
electron scanning, atomic force
and optical microscopes, Habelitz
at last is glimpsing the hidden secrets
of enamel.
Microscopic Engineers
This crowning achievement is the
work of a type of living cell called an
ameloblast. Ameloblasts make a
variety of specialized proteins that
guide different steps in enamel
production. Enamel buzzes with
cellular and biochemical activity as it
is being made, but within the finished
product, cells, proteins and other
signs of life have all but vanished.
Enamel is the most mineralized
substance in the body.
Habelitz lectures on mineralized
tissues, ceramics and composites to
first-year dental students, as well as
to postdoctoral fellows and to
postgraduates training in prosthodontics, orthodontics and pediatric
dentistry. The postgraduates joke
with Habelitz about whether he soon
Stefan Habelitz viewing an image of recombinant enamel matrix protein that self-assembled
into nanometer-thin ribbons, as revealed by atomic force microscopy.
4
will be growing replacement enamel
in test tubes and driving them out
of business.
That’s not on the horizon in the
near term, Habelitz concedes. Yet he
aims to catch up with nature’s
autopilot engineers, to steal a page
from their blueprints and to match
them with his own inventions.
“If we can understand how
proteins make enamels, we hope to
be able to design our own proteins
to make engineered structures,”
he says. It may indeed be possible
to grow enamel in vitro, or to grow
new ceramic structures very precisely,
at the smallest possible scale.
“Well-defined nanostructures,”
Habelitz calls them. Beyond dentistry,
such materials could serve as longer
lasting and better wearing surface
coatings in a wide range of applications, including bone implants,
bulletproof materials and microcircuits, for example.
With the Marshall Lab’s microscopes, Habelitz can see how enamel,
like ceramic, is constructed from
crystals. The crystals grow into fibers.
Each fiber is about 50 nanometers
across – 1,000 times finer than a
human hair. The fibers, in turn, are
packed into rods, with many rods
projecting from the underlying dentin
to the tooth surface. These rows
align into bundles, which bend into
the shape of the tooth crown. It’s
complicated, sophisticated and
precisely controlled – a remarkable
engineering feat accomplished by
engineers the naked eye cannot see.
Baby teeth left under the pillow
for the tooth fairy might have a pearly
shine, but enamel really is more
similar in its crystalline regularity to
the shells that enclose pearls. Enamel
is composed of the mineral calcium
phosphate, arranged in a crystal
structure known as hydroxyapatite.
Seashells are made from calcium
carbonate. Both teeth and seashells
are more complex than they might
first appear. To Habelitz, these
structures represent the pinnacle of
materials science in nature.
“I was fascinated to learn that
Mother Nature can organize and
control the formation and crystallization of materials on a level that
we cannot,” he says. “The research
now is mainly aimed at understanding
the principles of protein-guided
growth of crystals.” Habelitz is
singling out various proteins in
enamel for closer study. The main
protein present in enamel as it grows
and mineralizes is called amelogenin.
Already, Habelitz and his lab group
have discovered that amelogenin
makes protein sheets that slowly
elongate and that may guide the
growth of hydroxyapatite crystals.
It’s a Blast!
Habelitz also is looking at the
structure and formation of dentin,
the softer underlying material that
supports the enamel tooth crown.
“Dentin is another really fascinating
tissue,” he enthuses.
The biochemical events that give
rise to dentin are better understood
than those that contribute to enamel
formation. Dentin also consists largely
of hydroxyapatite, but dentin is more
similar to bone in that it contains the
structural protein collagen and other
organic materials. Compared with
enamel, dentin is more amenable to
study in humans because the cells
that give rise to dentin – called
odontoblasts – are long-lived, unlike
ameloblasts, which disappear once
tooth formation is complete.
Still, the more heterogeneous
structure of dentin and the cellular
arrangements that give rise to new
dentin within the tooth pulp are
extraordinarily complex, Habelitz
notes. Many mysteries remain,
despite decades of study.
In an effort to grow dentin in
vitro, Habelitz has partnered with
Tejal Desai, PhD, a bioengineer
with the School of Medicine. They
are not simply mixing the right
chemicals in a test tube. They are
working with living cells, positioning
odontoblasts on a microscopic
scaffolding, or matrix. The goal is to
re-create the structure of newly
formed dentin by mimicking the
natural configuration of odontoblasts
and the structures to which they
give rise within the tooth pulp.
A major focus is on the crucial
interface between odontoblasts and
ameloblasts – the junction where
dentin and enamel normally meet and
become tightly bound to each other.
The ultimate goal is to grow an entire
tooth, de novo.
“I think the engineering mind is
strong in me,” Habelitz says. “I want
to produce or create something. But I
also have a fascination about science,
and how things actually work in
living systems. I really enjoy bringing
the two together – to understand the
science and then to apply it.
“It’s a very collaborative
environment at UCSF, and that’s
very important to me,” he says. “It’s
impossible to do this kind of research
by yourself. You need to develop
many collaborations, and you need
input from different angles – biology,
engineering, chemistry. We have all
of that here.” n
5
faculty profile > > > Susan Hyde
Oral Health for a Lifetime
I
“
have a passion for quality of life,”
says Susan Hyde, DDS, MPH, PhD,
an award-winning teacher and
population scientist. Hyde knows
firsthand how seemingly small health
issues can become disabling over
time, threatening life quality. In all her
career endeavors, she promotes
practices that preserve oral health
and quality of life – not only for
patients, but for practitioners as well.
Hyde has a special interest in
populations that are underserved,
including minority children and the
homebound elderly. Her research on
health practices that prevent cavities
confirms that these groups fare
poorly; her research also probes for
reasons and remedies.
When Hyde, born and raised in
Canada, first came to the United
States as a recent college graduate,
she found satisfying employment in
cancer research. Yet she had always
wanted to be a dentist. Her father
was a professor of dentistry at the
University of British Columbia, and
Hyde got a taste for private dental
practice while working as his office
assistant. When she decided to stay
in the United States, she enrolled in
dental school at UCSF. Upon graduation, Hyde made a smooth and
happy transition into private practice.
Then she hit a roadblock. “My
body ergonomics were not well
suited to it,” she says, “and I became
disabled after only four years.”
Hyde soon came to see this setback
as an opportunity to return to
research, this time from a public
health perspective, while remaining
connected to dentistry.
Individuals to
Populations
She earned a doctoral degree in
epidemiology at UC Berkeley,
completing original research as part
of a US Department of Health and
Human Services program. Hyde
worked with welfare recipients, who
often have oral health problems that
affect appearance and quality of life,
as well as limited resources for
obtaining dental care.
Hyde developed new survey and
clinical data, and found that oral
health and use of dental care services
were positively associated with the
likelihood that study participants
would obtain employment. People
who actually used the dental services
provided through the program were
more successful in obtaining work,
she found.
Hyde then completed a fellowship
in geriatric dentistry at the San
Francisco Veterans Affairs Medical
Center, and joined the Department of
Preventive and Restorative Dental
Sciences in the UCSF School of
Dentistry in 2005. She soon signed
on with the Center to Address
Disparities in Children’s Oral Health
(CAN DO) project that sought to
prevent early childhood tooth decay,
which is on the rise and is worse
among minority and low-income
populations (see page 10).
In a study she co-led with School
of Medicine researcher Sally Adams,
RN, PhD, Hyde informed and
surveyed Hispanic and African
American mothers in San Francisco
about preventive treatments. The
treatments included three that were
targeted to children: brushing with
fluoride toothpaste, application of
fluoride varnish and having a child
eat foods that contain caries-fighting
xylitol sugar.
From left: Susan Hyde (right) with Shauna Woody (Class of 2012) and Shirin Mullen (Class of 2011) at the Hayes Valley Fair;
learning to thread floss with Dan Nguyen (Class of 2012).
6
However, the bacteria that colonize
the mouth and cause caries are
frequently transmitted from parent
to offspring, so two additional
treatments were targeted to mothers:
use of antimicrobial chlorhexidine
rinse and chewing xylitol gum.
“For the Hispanic population,
fluoride varnish and brushing with
fluoridated toothpaste ranked highest,”
Hyde reports. “They perceived
fluoride varnish to be very effective
and perceived brushing to positively
promote lifelong healthy habits.”
African Americans in the study
similarly valued toothbrushing, but
were more likely to express concerns
about other treatments. “If we were to
stage an intervention with African
Americans at the community level, we
would want to target respected elders
and spokespeople who could vouch
for the safety and efficacy of these
treatments.”
In another CAN DO-related project,
Hyde, working with School of
Dentistry colleague Jane Weintraub,
DDS, MPH, has been evaluating oral
health-related quality of life among
agricultural workers and their families
in Mendota, California, a Hispanic
community. The researchers found
that workers who were the least
acculturated and those with the lowest
wages had the worst oral health, and
that oral health problems that arise in
early childhood continue to have an
impact later in life.
Public health measures to improve
oral health might include making
dental treatment available at federally
qualified health centers, or improving
the acceptance and availability of
fluoridated water, Hyde suggests.
Interprofessional
Education
“I love CAN DO because it is so
interdisciplinary,” Hyde says. At
UCSF, she advocates the same
interdisciplinary collaborations that
mark her own research. She is an
active organizer of interprofessional
education initiatives, including classes
open to students and faculty from
all four of UCSF’s professional
schools. For example, Hyde, who
remains committed to research on
oral health and quality of life across
the life span, recently organized an
interdisciplinary “training of trainers”
program called “Oral Health and
Aging: Focus on Long-Term Care.”
“No matter what your practice is,
patients – especially older patients –
don’t usually have health issues
pertaining only to one organ system,”
Hyde says. “We’re not just mechanics
for the mouth. Oral health is intimately
tied to systemic health.”
A dentist might be the first to
observe that a middle-aged patient
has diabetes symptoms, for instance,
and in the first years of life, a
pediatrician may be the first to observe
early tooth decay.
In recognition of her exceptional
and innovative teaching, Hyde has
received the Dugoni Faculty Award
from the California Dental Association,
an Excellence in Teaching Award from
the School of Dentistry and a Junior
Faculty Award from the American
Dental Education Association.
“Ergonomics is a big issue in
dentistry,” she says. “Dentists are
perfectionists by training or personality.
But you have to use the mirrors and
develop your indirect vision because it
will serve you in the long run. Dentists
also must learn to take breaks and to
work effectively with assistants.” n
7
faculty profile > > > Ophir Klein
Teeth Star in Stem Cell Studies
B
y the time kids begin school,
most have learned that if they
lose any of their new, permanent
teeth, those teeth will be lost
forever. But did you know that some
mammals – mice, for instance –
have teeth that grow continuously?
In Greek mythology, sowing the
teeth of a fierce dragon caused
fully armed warriors to spring forth
and fight. Today, it’s no myth to say
that studies of the much meeker
mouse might guide researchers to
a more constructive harvest that
benefits humans.
Lessons learned about where,
when and how teeth grow throughout
life in mice may lead to strategies for
regrowing teeth and treating or
preventing human developmental
anomalies that impact the face and
dentition. These craniofacial
anomalies, the best known of which
are cleft lip and palate, are among the
most common of all birth defects.
Teeth recently have earned a starring role in the field of regenerative
medicine, and at UCSF, Ophir Klein,
MD, PhD, is a leading light. His lab is
a beacon for promising postdoctoral
fellows and graduate students who
want to explore how stem cells gener-
ate new teeth and how development
goes awry in craniofacial disorders.
Klein recently received a major
grant from the California Institute for
Regenerative Medicine. This $3 million
state grant funds a research proposal,
entitled “Laying the Groundwork for
Building a Tooth: Analysis of Dental
Epithelial Stem Cells.”
Humans and animals possess very
small, self-renewing populations of
stem cells. These vary in potential and
potency, depending on the developmental stage. At one extreme are
embryonic stem cells, which are only
obtainable at a certain time, a few cell
divisions after fertilization. These cells
can give rise to virtually any cell type
in the body. Other stem cells are
organ- or tissue-specific. Stem cells
are rare. The vast majority of our cells
are specialized and mature, and have
no stem cell capabilities whatsoever.
“We are not yet sure if these
particular stem cells in mice also exist
in humans,” Klein says. “There are
reasons to think that some of them
might. But what we really want to
understand are the mechanisms by
which stem cells can contribute to
dental renewal.”
This past August, Klein became
the director of the Craniofacial and
Mesenchymal Biology (CMB) program
at UCSF. “CMB is a relatively new
program that we are trying to build,”
Klein says. “Our goal is to have a
translational program that spans basic
research similar to my own and that
extends to clinical work.
“Probably half the basic researchers
in my lab are focused on trying to
understand the genes and cellular
behaviors that underlie the continuous
growth of the incisor in the mouse,”
he says. “The rest investigate the role
of different growth factor signaling
pathways in the development of
structures within the embryo.”
Klein wants to use stem cells to
grow new teeth. He views teeth as a
convenient starting point and proving
ground for all of regenerative
medicine. Teeth and the oral cavity
are very accessible in comparison
with the large, vital organs; yet what
Klein learns about teeth is bound to
apply to growing these other tissues.
“There are a lot of sophisticated
aspects of tooth function,” he says,
“but you might not have to form a
tooth as perfectly as a heart or kidney
in order for it to function adequately.”
Still, growing teeth is an ambitious
Ophir Klein consulting with Kerstin Seidel, PhD.
8
project. Klein is optimistic about
success, but it will require many years
to achieve, he says.
Late Bloomer
Given his credentials and relatively
young age, it’s odd to hear Klein
describe himself as a late bloomer.
But the Bay Area native initially
shunned the career path advocated
by his father, who was trained as a
scientist. However, even though Klein
earned his degree at UC Berkeley in
Spanish, an introductory chemistry
course led to an interest in biochemistry and eventually to a job in the
UC Berkeley lab of Daniel Koshland
Jr., PhD, a professor and luminary in
the field.
That experience, in turn, led Klein to
Yale University, where he completed a
combined MD-PhD program and then
a residency in pediatrics. He came to
UCSF for a postdoctoral fellowship
with developmental biologist Gail
Martin, PhD, and for training in medical
genetics, and before long was viewed
as a promising faculty candidate.
Today, Klein is an assistant
professor of orofacial sciences and
pediatrics, with a primary appointment
in the School of Dentistry and a
secondary appointment in the School
of Medicine. He is also a member of
the Institute for Human Genetics and
the Eli and Edythe Broad Center of
Regeneration Medicine and Stem Cell
Research at UCSF.
Much of Klein’s clinical practice
as a medical geneticist is based
at the UCSF Center for Craniofacial
Anomalies, where he handles
diagnostics, risk counseling and case
management as part of a medical
team that also includes plastic
surgeons, orthodontists, pediatricians,
pediatric dentists, pediatric
neurosurgeons, dermatologists,
otolaryngologists, speech pathologists,
nurses and social workers.
Many medical students, dental
students, and doctors and dentists
Mouse embryos prepared for dissection.
training for specialties spend time at
the Center for Craniofacial Anomalies,
and Klein has an opportunity to
share ideas with many colleagues
and students. “People in the clinic
are fantastic at providing patient care,
but they may not always have the
inclination to think of ways to integrate basic science into clinical practice,” he says. “I think people who
do research can add value to clinical
medicine when they inject underlying
ideas about biological mechanisms
into diagnosis and therapy.”
Klein leads clinical as well as
basic research. “We are trying both
to understand tooth and craniofacial
malformations in a variety of
syndromes, and to look for the
genes responsible for isolated tooth
malformations in humans,” he says.
Many patients’ parents are more than
happy to have Klein and his research
team learn more about the conditions
affecting their young children.
“If you happen to be a physician
interested in craniofacial anomalies,
and you’re lucky enough to be at a
place that has both a great dental
school and a great medical school,
then it’s a perfect job,” he says. “I
feel really happy to be a part of the
School of Dentistry. I believe they
really understand what I am interested
in, and they have been really
supportive.” n
9
feature > > > Center to Address Disparities in Children’s Oral Health
CAN DO
Counters Early Childhood Caries Trend
W
ith advances in dental
practice, kids today are
getting fewer cavities, right?
Not true, unfortunately. Tooth decay
among the youngest children is on the
rise, according to the US Centers for
Disease Control and Prevention (CDC).
Poor and minority populations have
been burdened disproportionately.
CDC data collected from 1999 to 2004
reveal that 42 percent of Mexican
American and 32 percent of African
American children ages 2 to 5 have
decayed or filled teeth, compared
with 24 percent of white children.
Limited access to dental care, lack of
knowledge and even cultural norms
in certain disadvantaged populations
may contribute to these disparities.
10
With an expanding network of
colleagues in California and beyond,
UCSF School of Dentistry researchers,
led by public health dentist Jane
Weintraub, DDS, MPH, are guiding
efforts to counter the trend through
research and innovation. A major
aim of the group, organized as the
Center to Address Disparities in
Children’s Oral Health (CAN DO),
is to identify and evaluate additional
preventive strategies and the best
means for making these treatments
available to the disadvantaged who
need them most.
The first series of CAN DO studies,
which demonstrated successful
interventions to prevent and lessen
the impact of tooth decay, already
has led to large-scale dental public
health policy changes in California
and across the country. The second
round of studies has just begun.
Last fall, the School of Dentistry
received $24.4 million in new funding
for CAN DO from the National Institute
of Dental and Craniofacial Research
(NIDCR), the largest grant in the
school’s history. CAN DO began in
2001, and the new grant is projected
to fund research through 2015.
CAN DO started with a few
researchers and now includes dozens.
“We’re not just dentists and oral
health experts,” Weintraub says.
“We have many kinds of expertise,
and studies range from basic
research to clinical and behavioral
public health interventions. We’re
trying to be a resource for the
state – and for the whole country.”
Primary Teeth Are of
Primary Importance
In the same way that being “just a
baby” may excuse a tot’s inconvenient behaviors, soon to be
outgrown, parents may think of
primary teeth as “just baby teeth”
– similarly transient and not worth
worrying about. But nothing could
be further from the truth. Although
primary teeth are meant to be lost,
it is still important to avoid making
them a home for tooth decay. One
reason is that young children afflicted
with tooth decay in primary teeth are
more likely to develop cavities in
permanent teeth as they grow older.
“The biggest risk factor for future
tooth decay is prior tooth decay,”
Weintraub says.
It’s not sweets alone that cause
cavities. The process of tooth decay,
called caries, is driven by certain
bacteria species that thrive on some
of the carbohydrates in our diets,
and we all know how food can stick
to teeth. But not everyone knows
that bacteria cause cavities, and
even those who do may be unaware
that the bacteria are infectious,
spreading from parent to child or
from child to child.
“An infection anywhere in the body
is not good, and dental caries is an
infection that has implications far
beyond the mouth,” Weintraub says.
The disease can result in deterioration
of not only teeth, but quality of life for
both children and their parents, in
many ways and for years to come.
Advanced dental caries can lead to
painful toothaches. Premature loss of
primary teeth to decay can result in
misaligned secondary teeth. Afflicted
children may find it more difficult to
eat, to concentrate and learn, to
sleep, and to develop language skills.
Self-esteem may suffer.
“A toothache that is not treated is
an infection that can spread,”
Weintraub says. It can spread not only
from person to person and from
primary teeth to secondary teeth,
but also beyond the mouth. In a case
that made news headlines in 2007,
a Maryland boy died because cariescausing bacteria from his untreated
tooth decay caused an abscess that
spread to his brain.
Mom and Dad may unknowingly
spread infection. “Parents should not
do some of the things they might be
doing routinely, like cleaning a baby’s
pacifier in the mouth and returning it
to the baby’s mouth, or sharing eating
utensils,” Weintraub says.
As soon as teeth erupt, usually by
age 1, they are susceptible to dental
caries, often called baby bottle tooth
decay. A sugary baby bottle drink may
help keep an infant calm and quiet for
hours on end, but it also is a major
contributor to tooth decay. Public
health agencies now favor the term
early childhood caries (ECC). ECC is
by far the most common chronic
disease condition of early childhood,
five times more common than asthma,
the runner-up.
Given how quickly ECC can take
hold, it’s no surprise that the
American Dental Association (ADA)
recently shifted the recommended
age for a child’s first dental exam
to 1 year instead of 3 years. But
many health care providers remain
unaware of the revised recommendation, Weintraub says. In addition,
in rural areas especially, finding a
dentist to treat young children may
not be easy. CAN DO researchers
are exploring alternative strategies to
provide preventive dental care for
young children.
Fluoride Varnish
Weintraub initially teamed up with
fellow School of Dentistry faculty
members Stuart Gansky, DrPH, a
biostatistician, and Francisco RamosGomez, DDS, MPH, a pediatric dentist
who grew alarmed after seeing a
steady stream of kids with cavities at
the UCSF-run family dental clinic at
San Francisco General Hospital
(SFGH).
“Early childhood caries is
preventable, and I felt strongly that
we needed to do something about it,”
Ramos-Gomez says. “We needed to
move away from being reactive – to
rely less on treatment and acute
care and to move toward effective
preventive strategies.”
Ramos-Gomez proposed
counseling parents and using an
inexpensive, easy-to-brush-on
varnish containing a 5 percent sodium
fluoride resin on their children’s
teeth to strengthen tooth enamel.
While the treatment was often used
in Europe and had been tested on
older children with permanent teeth,
its value had not been established
for protecting primary teeth,
Ramos-Gomez recounts.
Ramos-Gomez, Weintraub and
Gansky conducted their groundbreaking study on primary teeth in
376 children averaging just under
2 years old when first enrolled in the
study. The children, seen at SFGH and
at the San Francisco Department of
Public Health’s Chinatown Health
Center, were mostly low-income and
Chinese or Hispanic. Parents were
counseled on preventing tooth decay,
and children were randomly assigned
to receive fluoride varnish once or
twice a year, or not at all.
With two years of follow-up, the
result was clear. Children randomly
assigned to receive varnish twice
yearly were nearly four times less likely
to develop tooth decay, compared with
untreated children, and children who
received varnish once yearly were half
as likely as untreated children to
develop tooth decay.
The published results had great
impact. For children up to age 6,
Denti-Cal, the California Medicaid
11
program, began to cover fluoride
varnish application – reimbursing
not only dentists, but also physicians
as well as trained personnel in their
medical practices. Nationally, the
ADA now recommends the varnish
for the youngest children at high
risk of developing ECC.
Costly Lack of
Knowledge
During the first phase of CAN DO
research, investigators also began
exploring why disadvantaged kids
were so prone to cavities.
Judith Barker, PhD, a medical
anthropologist in the School of
Medicine and CAN DO associate
director, led an ethnographic study
in Mendota, a rural, largely Hispanic
farm town in California’s Central
Valley, and in an ethnically similar,
low-income neighborhood in urban
San Jose. One of the researchers
lived in Mendota for nine months,
establishing relationships in the
community. The researchers hired
local residents as interviewers
and sometimes even provided
transportation to clinics. Mothers
were more accessible, as fathers
often were at work.
Study results point to a need for
better oral health education, for
better prevention practices and for
better access to care, Barker says.
“We found that a majority of mothers
had a poor understanding of the
mechanisms that drive caries and a
poor understanding of when they
should be taking their children to
the dentist,” she explains. “Many
parents would not visit a dentist until
a child was 3 or 4 years old, and
often not until a child’s teeth were
extensively damaged and the child
complained of pain. The mothers
generally do not recognize early signs
of caries in children.”
Parents were shocked to learn that
what they thought were dark stains
that could be cleaned away by the
dentist were, in fact, cavities.
As with childhood obesity, sugary
drinks play an insidious role, but often
seem to fly under the radar. Barker
12
Community meeting at the Mendota
Rotary Club.
“Many parents would
not visit a dentist
until a child was 3 or
4 years old, and often
not until a child’s
teeth were extensively
damaged and the child
complained of pain.”
– Judith Barker
recounts an interviewer’s tale of a
mother and grandmother of a cavityafflicted 3-year-old discussing at
length their rationing of candy and
cookies, even as the child was
walking around the entire time
drinking from a bottle of chocolate
milk. “Neither the mother nor the
grandmother understood how much
sugar was in the milk,” Barker says.
Children often were put to bed
with a bottle of juice. Toothbrushing
was rarely supervised after age 3,
and some parents did not believe
brushing was merited until the child
had all of his or her primary teeth or
was eating an adult diet.
In the rural areas, dentists were
few and far between; the closest
pediatric dentists were in Fresno.
Furthermore, dentists in both rural
and urban areas often were unwilling
to treat children less than 6 years old,
largely because they had never
rotated through a pediatrics clinic
during their training and they felt
unprepared as a consequence. Many
dentists did not accept Denti-Cal.
Even where municipal water
supplies were fluoridated, most
Hispanic residents in the study
preferred to drink bottled water, which
usually does not contain fluoride,
believing it to be safer than tap water.
In new, related research, Barker
will gauge parents’ acceptance of
various measures – including
fluoridation of water or food supplies
– for preventing tooth decay in
Hispanic communities. Similarly,
Susan Hyde, DDS, MPH, PhD, from
the School of Dentistry, and Sally
Adams, RN, PhD, from the School
of Medicine, earlier explored
attitudes toward caries prevention
activities among mothers of young
children in urban minority populations
(see page 6).
Community-Based,
Participatory
Research
Like Barker, Ramos-Gomez knows
the importance of engaging the
community to achieve the success of
local research and health initiatives.
Ramos-Gomez, who recently joined
the faculty at UCLA but remains a
CAN DO project leader, launched
another clinical trial, this time at the
San Ysidro Health Center near the
California-Mexico border, with more
than 500 pregnant women.
The research team provided
counseling to all the mothers-to-be,
educating them about mother-tochild bacterial transmission. In
addition, once the children were born,
the researchers randomly assigned
half the women to use chlorhexidine
mouth rinse twice daily to kill
bacteria, and assigned the infants of
these same women to twice-yearly
fluoride varnish treatments starting
at age 1. The data for children up to
age 3 are now being analyzed.
Enrollment in the study proceeded
quickly, thanks to the community
connections nurtured by the research
team. An understanding of family
traditions and community social
structures and sensitivity toward
them are crucial, Ramos-Gomez
says, as is an active community
advisory board.
“Community-based, participatory
research is not business as usual,”
Ramos-Gomez says. “You really
have to establish links and relate to
the community. We felt strongly
that we had to start by engaging
pregnant women.”
The researcher recruited bilingual,
culturally competent promotoras,
women from the community who
serve as health communicators and
as links between the community on
one hand and researchers and health
care providers on the other. “You
need to have the personal touch,
and these women really connected,”
Ramos-Gomez says. There were few
dropouts. “For a border population,
the high retention rate in the study
is unheard of,” he says.
CAN DO, Round Two
School of Dentistry researcher
Lisa Chung, DDS, MPH, also believes
in the importance of reaching out
early to pregnant women. Chung is
project director of a new, two-year
Bay Area study led by Adams. The
researchers will develop and test an
intervention aimed at promoting oral
health by changing behaviors. The
intervention will be integrated into
the CenteringPregnancy® curriculum,
a group prenatal care model.
“Pregnancy is an opportune time
for health messages because women
are more receptive to behavior
change,” Chung says. “We hope
that the women will see a dentist
and become more inclined to
bring their babies to see a dentist.”
As it stands, only a small fraction of
low-income women see a dentist
during pregnancy.
For the most recent round of
CAN DO studies, the research team
has obtained a new clinical trials
management software system,
says Gansky, who heads the Data
Coordinating Center. The new software
will initially be used to manage six
randomized, controlled clinical trials.
“We’re trying to be a resource for the state – and for the whole country.”
– Jane Weintraub (below center with, from left, Margaret Walsh, Stuart Gansky, Francisco Ramos-Gomez and Judith Barker)
13
Oral health education in Mendota.
“Low-income children
have better access
to primary medical
care and to federally
funded nutrition
programs than they
have to dental care,
especially at age 1.”
– Margaret Walsh
14
These include not only NIDCR-funded
UCSF CAN DO trials, but also studies
led by Centers for Research to
Reduce Disparities in Oral Health at
Boston University and the University
of Colorado Denver.
Both of the large clinical trials in
the second round of CAN DO
research build on the success of
the initial fluoride varnish clinical trial.
In one of the new clinical trials, led by
Ramos-Gomez, half of the participating children ages 3 to 6 will be given
not only twice-yearly fluoride varnish,
but also an additional preventive
treatment – a new kind of fluoridecontaining sealant that will protect the
biting surfaces of primary molars.
Called a glass ionomer, the sealant
can adhere better to these rough
surfaces and is much easier to apply
than earlier generations of sealants.
All parents in the study will receive
preventive oral health counseling.
Treatment will be provided by dental
and other health care providers
at the San Ysidro Health Center –
as in the earlier study – and at
Comprehensive Health Center, also
in San Diego County.
Researchers guiding the second
CAN DO clinical trial will try to identify
the most effective means of disseminating fluoride varnish treatment to
children ages 1 to 3 who are at high
risk for ECC.
The School of Dentistry’s Margaret
Walsh, MS, EdD, leads the project.
Walsh has many years of experience
in conducting large-scale, communitybased public health interventions
to prevent periodontal disease and
cancer. Walsh and other CAN DO
researchers have established
partnerships across Northern and
Central California with primary care
medical clinics and sites that provide
food through the Women, Infants, and
Children program (WIC).
“Low-income children have better
access to primary medical care and to
federally funded nutrition programs
than they have to dental care,
especially at age 1,” Walsh says.
“Therefore, we are comparing
application of fluoride varnish at
primary care settings or at WIC centers
to referral of children in those same
settings to dentists for fluoride varnish
application. The idea is to see how
we can reach the most children who
can benefit from this procedure,
especially given the fact that many
dentists will not see infants and do
not accept Medicaid.
“Actually,” Walsh says, “we are
testing a one-two punch: strategies
for delivering fluoride varnish and
strategies for educating the parents
and other caregivers about things they
can do at home to help their young
children have healthy teeth.”
When prevention is neglected,
tooth decay in infants can become a
heavy burden, Weintraub emphasizes.
“You can’t get a 1-year-old to sit still
in a dental chair,” she says. “Often
when they need dental care, they
have to be treated using general
anesthesia in a hospital. That makes
it expensive and traumatic for the
family, and often those services are
not even locally available.
“We want to give parents and
health care providers tools to improve
the oral health of children,” Weintraub
adds. “Dentists can’t do it all by
themselves; there aren’t enough of
them to treat all the tooth decay that’s
out there.”
While the current budget picture
for dental public health programs
may appear daunting, that’s nothing
new to Weintraub, who launched
her career during another recession
in the early 1980s. At such times,
she says, “the need for preventive
measures does not diminish. It
becomes greater.” n
promotion > > > richard jordan
New Associate Dean for Research
R
ichard Jordan, DDS, PhD,
FRCPath, a leader in diagnostic
pathology and a UCSF School
of Dentistry faculty member since
2000, is the school’s new associate
dean for research, an appointment
effective since May 1, 2009.
Jordan succeeded John Greenspan,
BDS, PhD, FRCPath, who stepped
down after years of outstanding
service in the same role. Jordan has
retained his current faculty appointments as professor of oral pathology
and of pathology, chair of the Division
of Oral Medicine, Oral Pathology
and Oral Radiology, and vice chair of
the Department of Orofacial Sciences.
He also directs the largest universitybased oral pathology diagnostic
laboratory on the West Coast.
Jordan has taken on the challenge
of maintaining and improving
research excellence within the school,
which has ranked number one among
dental schools in research for nearly
two decades. Jordan, a research
scientist who is also trained in two
clinical specialties, has gained a
strong reputation for excellence in his
research focused on molecular techniques for early oral cancer detection.
Born and raised in Canada,
Jordan received his clinical training in
dentistry, oral pathology and oral
medicine at the University of Toronto.
He completed work on his doctoral
degree at the University of London, in
the laboratories of Paul Speight, BDS,
PhD, and Peter Isaacson, MB, ChB.
“I was able to work on a newly
identified form of lymphoma, developing a test to detect malignant white
blood cells prior to symptoms, at the
earliest stage of the disease,” he says.
“It was a very exciting time.” Jordan
continued in the same line of research
upon returning to North America,
shifting his emphasis to oral cancers.
Jordan helped develop a useful
technique for gauging which genes
had been switched on, or expressed,
in the vast majority of oral biopsy or
surgical specimens preserved in
formalin. Recently, he was honored
with membership in the Royal
College of Pathologists of the United
Kingdom, in recognition of his
distinguished scientific achievements.
Maintaining research excellence
is his highest priority, Jordan says.
He views stem cell science, early
disease detection, materials science
and research on health disparities
as being among the areas in
which opportunities are greatest
for continued advances and
programmatic development.
Jordan knows the bar is set high
in his new post. “We need to think
of ways to make ourselves more
competitive in a very competitive
environment, and of ways to become
more nimble and responsive,” he
says. “Our greatest strength is our
people. The pipeline for our future
success is to train the best people
we can – both dentists and dental
scientists.”
Jordan has worked to update
training opportunities in recent years,
partnering with Greenspan and
colleagues from UCSF’s Clinical and
Translational Science Institute to
develop the Training in Clinical
Research curriculum.
“Within the setting of team science,
we want to be better in communicating
with one another, and we want to be
better in coordinating our activities,”
Jordan says. “Within the University,
the School of Dentistry is part of a
comprehensive scientific and health
care enterprise that also encompasses
the schools of medicine, pharmacy
and nursing, as well as the UCSF
Medical Center. At UCSF and
beyond, I think there is still room for
us to become better integrated into
the broader world of science and
health care.”
Interdisciplinary communication
and collaboration contribute to
improved dissemination of new
scientific knowledge and the
translation of new discoveries into
public benefit, Jordan says. n
“I see the aim of science
as accomplishments that
help people.”
15
alumni
update
Bear Bash Night 2009
O
n Friday, October 9, 2009, the Dental Alumni Association held
its sixth annual Bear Bash Night. A popular and overwhelming
success, this is an event where students, dental and hygiene
alumni, faculty, and administration gather together to develop relationships
and share excellent food, wine, beer and an assortment of gifts.
This year’s Bear Bash, an unlimited pasta buffet, was extremely
well attended by students and new alumni. The Faculty-Alumni House
was filled to capacity. Students made every effort to meet most of the
alumni present, not only to gain fruitful information, but also to secure a
raffle ticket for the coveted A-Dec handpiece.
Many guests left with great door prizes donated by dental companies,
faculty and alumni. Lucky students won: dinner with Dean Featherstone;
lunch with Tony Ragadio, D ’76; dinner with Michael Lopez, D ’74, and
wife, Susan, DH ’72; Enzo wine from the cellars of Frank Casanova, D ’73;
dental products; assorted wine; and a variety of gift certificates.
Special thanks to Event Chair Carmen Hipona, D ’96, and husband,
Eduardo Castro, D ’96, for their time and energy in organizing such an
enjoyable event each year for the dental students.
Nurturing alma mater cohesion, the alumni association looks forward to
meeting and mentoring our new and upcoming colleagues. The Dental
Alumni Association Executive Council invites all alumni interested in
mentoring our students to join us on Friday evening, October 15, 2010, at
the Faculty-Alumni House for our seventh annual Bear Bash. All interested
alumni are welcome! For more information, please contact UCSF Alumni/
Student Liaison Carmen Hipona at [email protected].
Special thanks also to the following additional alumni for their
donations and participation: Doug Cowden, DDS; Christine Hayashi, DDS;
Herman Chang, DDS; Phoenix Sinclair, DDS; and Mary Porteous, DH.
Special thanks to A-Dec, Inc., and Waterpik Technologies, Inc. for their
generous donations that help make these events possible. n
— Mary Sornborger Porteous, DH ’75
Revelry at Bear Bash 2009, UCSF FacultyAlumni House: Dean John D.B. Featherstone
(at left, center) with UCSF Dental Alumni
Association Executive Council organizers and
student participants.
16
114th Scientific
Session
Joining Chancellor Susan
Desmond-Hellmann for the 114th
Scientific Session “Homecoming”
in mid-January were new DAA
President Douglas Cowden (D’65),
the Class of 1960, and JapaneseAmerican dental students who were
World War II internees, as honored
guests of the Alumni Association.
Save the Date:
115th Scientific Session
January 14-15, 2011
San Francisco Marriott Marquis
Confirmed Speakers:
Arun Sharma, BDS, MSC,
and Craig Yonemura, DDS
nIntegrating
Periodontics and Implants
into Comprehensive Dental Treatment
Christopher Marchak, DDS
nImplants:
Guided Surgery, Immediate
Loading and CAD-CAM Technology
Ann Eshenaur Spolarich, RDH, PhD
nPrescription
Drugs and Herbal
Therapies: Practice Management
Considerations for Dental
Professionals
nWomen and Medications: Health
Issues and Related Pharmacotherapies
nCommonly Prescribed Medications
and Managing the Oral Side Effects
of Medication Use
See you next year!
1959 Class Notes
with her husband, Mikkl. Her favorite
scalers are still UC #3 and #4.
Don Hermansen, D ’73, chair of
the 50-Year Reunion Committee,
presented the following “Class
Notes” recognizing the HalfCentury Club graduates honored
at the 114th Annual Scientific
Session Luncheon.
Cliff Horrell, DDS – practiced as
a general dentist in Sacramento
for 41 years, retiring in 2000 with his
wife, Sharon. They have 10 children,
23 grandchildren and 16 greatgrandchildren. They have traveled
throughout the United States,
numerous European countries, Japan
and the Caribbean. Cliff’s hobby
is stamp collecting, and he was a
part-time stamp dealer for many
years. He and Sharon enjoy family
activities, gardening and traveling.
Karen Ulrich, RDH – is still working
one day per week. She plays golf
and bridge and works out regularly.
She has two sons and seven grandchildren. She travels occasionally
with her good friend Ann Kerr,
a fellow dental hygiene graduate.
Last summer, they spent three
weeks in France.
Norman Abrahams, DDS – has
been married 58 years to the same
wife. He has two daughters and four
grandchildren. Norman retired in 1995
after having been president of his
local dental organization. He served
nine years on the CDA Ethics Council
and five years on the CDA Peer
Review Council. He was president of
the Santa Clara County Health
Systems Agency and is a current
member of the Santa Clara County
Human Relations Council.
Karen Olson, RDH – practiced dental
hygiene part-time for 35 years and
raised three children. She retired in
1997 and earned a master’s degree
in nutrition in 1999, exactly 40 years
after her BS in dental hygiene. She is
now fully retired and volunteers with
outreach programs for her church.
Billie L. Hays, RDH (Billie E. RuttLingo) – started her practice of dental
hygiene in Germany doing volunteer
work on an Air Force base. She
returned to work for Dr. Jack Hoffman
for eight years in Santa Clara. She
then worked for Dr. Burt Press in
Contra Costa County. Her present
office is in Cupertino with Dr. Prusa,
where she has been in general
practice for 38 years. She works four
days a week. She feels privileged to
have become close to many of her
patients over the years. Her most
motivated patient is her granddaughter Raquel, who brushes,
flosses, rubber tips and uses a tongue
scraper every day, all at the age of 5.
She likes to travel and deep-sea fish
Allen Short, DDS – has been in the
same location for 50 years, and
continues to practice 28 hours per
week. He was past Rotary president,
city councilman and volunteer
fireman. He still belongs to Rotary
and is a member of the Duck Club.
John Derdivanis, DDS – started
general practice in Alameda, then
went back to specialize in periodontics, completing the program at
UCSF in 1967. Since that time, he has
been practicing at the same location
in San Lorenzo. His dental hygienist,
Lillian Yee, has been with him since
1971, lasting longer than his marriage.
He is a member of several dental
associations and has been in the
OKU dental honor society since 1974.
He was a clinical instructor at UCSF
from 1961 to 1964, then a professor
in the postgraduate and undergraduate Division of Periodontology
from 1964 to 2000. He has been
vice president and president-elect
of the Northern California Society
of Periodontology and chairman of
the Western Society, 1971-1974.
Charles Soderstrom, DDS –
followed his father and brother to
UCSF School of Dentistry. In 1953,
he self-diagnosed type 1 diabetes
that made him 4F in the military
draft, and has had daily insulin
shots for 54 years. Marrying his wife,
Ruby, a nursing student at UCSF, in
1958, was the wisest thing Charles
ever did. After graduating, he worked
for pedodontists in San Jose before
moving to Chico in 1961. There,
Charles practiced as a pediatric
dentist until selling his practice in
1991. He and Ruby have three
children and four grandsons.
Kenneth Fletcher, DDS – says that
life has been good, even with its ups
and downs. He is married with two
children and three grandchildren.
He practiced in Honolulu, and found
it wonderful. When he retired, his
fulfilled his dream to live in Europe
and travel, which he and his wife,
Jennifer, did for approximately 10
years. Kenneth then bought a motor
coach and traveled across the USA.
He now lives in Los Angeles.
Joaquin Madrigal Jr., DDS –
practiced for three years in San Jose,
then 40 years in Fresno. He retired
seven years ago and is enjoying
retirement. He is healthy, thanks to
God. He and his wife, Louise, have four
sons and 10 grandchildren. It’s great!
Lynda Nicol Trowbridge, RDH –
moved back to California when her
husband, Hank, retired as chair of
the Department of Pathology at the
University of Pennsylvania School of
Dental Medicine. Since they have
always been associated with a
university, they decided to make Davis
their home. Performances at the
Mondavi Center for the Performing Arts
in Davis have been an important part of
their lives, and they both volunteer for
the Arts Education Program. Although
they are no longer involved in dentistry,
they stay very busy in retirement.
JoAnn Greenway, RDH – has three
roles in life: wife, mother and hygienist.
She has been married for over 47
years to Lyle Greenway, a UOP dental
graduate. They have four children.
She manages her husband’s dental
office in Fountain Valley, Orange
County. She loves to travel (Beijing,
Tibet, St. Petersburg, Istanbul,
among other places) and to share
good food and wine.
Mike Heon, DDS – appreciated his
dental education at UCSF that allowed
him to help others obtain a healthier
dental life. He met and married Jan,
his life’s partner, who transitioned into
a wonderful mother of four energetic
children. He spent two years in an
Air Force hospital that gave him the
opportunity to increase his skills in oral
surgery and general dentistry. Mike
completed five years as a senior dental
officer in the Air Force hospital dental
clinic. He started a dental practice in
north San Rafael, expanding and
Continued on next page
17
Continued from previous page
adding two associates over 15 years.
Mike then worked in a VA hospital
dental clinic, retiring in 1997 with
23 years of government service.
He feels that there is no other group
more deserving than those who have
served our country.
Evelyn Loo, RDH – says that her only
claim to fame might be as a dental
hygienist who owned an ice cream
parlor. A patient saw her there and
accused her of working both sides of
the fence. She practiced hygiene for
40 years, all for UCSF dental alumni:
Ken Mar, Lyle Tyler and Richard
Naismith. She is married to Edward
and has one daughter and one
granddaughter. They became political
activists in 2006 when the BART
headquarters in Oakland, where
seniors practiced tai chi, was slated
for demolition. They reclaimed
Madison Park that was previously
occupied by the homeless. Now, in
Madison Park, every morning between
7:30 and 9:30, hundreds of seniors
can again practice their morning
exercises, including tai chi and chi gong.
Gail Wiegmann Metcalf, RDH –
lives in Albany. She enjoyed being
a dental hygienist for 13 years. She
has one daughter and one grandson.
She is very grateful to the dedicated
faculty her class enjoyed and for
her wonderful classmates.
Linda Chamberlain, RDH – loved
the dental hygiene program and
San Francisco. She knows that she
received a wonderful education at
UCSF, and had fun in the process.
She worked for several dentists in
both general practice and periodontics for 12 years. She thought she
would work forever, but rheumatoid
arthritis ended her career. If she could
do it all over again, she would stay in
San Francisco and get an advanced
degree that would grant her an
opportunity to teach or do research.
She is married to Alan.
Ann Kerr, RDH – resides in the
East Bay, where she has practiced
continually for 45 years. She feels
privileged and honored to be part of
Dr. Gil Oliver’s periodontal practice in
Pinole. She works in the office now
with new owner Dr. Kourosh Harandi
three days per week. She has three
children and five grandchildren.
18
Robert Diamond, DDS – is still
practicing dentistry part-time. He also
works for a charitable foundation to
assist retired patients with dental
illness. He taught physical diagnosis
and oral pathology for 30 years at
UCLA. Robert is married to Vivian,
and has two children and three
grandchildren. He loves and
participates in skiing, boating, hiking
and restoration of classic cars.
Jack Hockel, DDS – retired from
practice nine years ago, when his
son Brian (Class of 1989) took over.
Jack continues as editor of a quarterly
journal for dentists who use the
Crozat appliance in their practice
of orthodontics. He published his
second book on the subject in
2008; his first was in 1983. Jack
and Judie, his wife of 49 years, are
expecting their 25th grandchild.
Stephen Dean, DDS – retired from
practice in 1993 and moved to
Camas, Washington. His wife, Sue,
died in 2005 after a long illness.
Stephen has excellent neighbors,
but misses the Bay Area, and enjoys
keeping in touch with friends.
Susan Havlina, RDH – retired from
the New Mexico State Dental Health
Department 20 years ago and has
been a yoga instructor ever since.
She lives in Idaho.
Donald Dal Porto, DDS – retired
in February, 1991. He moved to
La Quinta from Discovery Bay in
June 2008. He has two sons
(one a pediatric dentist) and five
grandchildren. Donald travels, plays
golf and enjoys the desert.
Leona Young, RDH – worked
as a dental hygienist in Berkeley
for 10 years. She has been raising
beef cattle in Acampo since 1970.
She still works part-time in
Cattlemen’s Livestock Market in
Galt, and enjoys country life.
R. Dean Robinson, DDS – moved
with his wife, Ramona, and their
three children to San Luis Obispo
after graduation, where he practiced
general dentistry until 1990. He was
active as president of the Boy Scouts
Council and served as bishop, stake
president and regional representative
of the twelve for the Church of Jesus
Christ of Latter Day Saints. He
learned to speak French when he
served for three years as mission
president of the Paris Mission.
After retirement, Dean moved to
Orem, Utah, where he manages his
family ranch in Star Valley. For the
past 18 years, he has been an
advocate for individuals with
disabilities, establishing an oral
health clinic for those who cannot
otherwise access quality dental care.
Jim Starr, DDS – with his wife,
Pam, moved to Vail, Colorado, where
they are deeply involved in skiing.
He worked with his son Jeff
(Class of 1989) at their practice in
Palo Alto before retiring in 1999.
Jim and Pam have three children.
Carl Schrieve, DDS – retired in
July 1997. He is 79 years old
and has some health problems.
He and his wife, Marlys, celebrated
their 50th wedding anniversary
this year. They have three children
and two granddaughters.
Ruben Burrell, DDS – enjoys sunny
Arizona with his wife and family (four
children, 12 grandchildren and six
great-grandchildren). Ruben is in the
process of selling his practice, but
loves being a dentist, and worked
part-time until October 2009, so that
he could complete his full 50 years!
At age 81, he works out four days a
week, and enjoys hiking, hunting,
fishing, dune buggying and water
skiing with his family. His family
expects him to live past 100.
Don Swatman, DDS – retired in
2002. He and his wife, Mary, have
enjoyed their extra time by traveling,
playing tennis, running their antique
business, gardening, houseboating
and managing real estate in Modesto
and Maui. They also enjoy time with
their children and grandchildren.
George Payne, DDS – has been
married to Marilyn (RDH ’56) for 53
years. They have four children, all
graduates of the UC system. He
taught part-time in the Division of
Orthodontics for 20 years, practiced
for 35 years and transitioned his
practice to his son Brian (UCSF
orthodontics class of 1988) in 1995.
He was CDA president in 1988-89,
ADA trustee from 1990 to 1994
and a TDIC board member from
1980 to 1986. He loves his profession
and can think of none better to
provide a necessary and rewarding
service to patients. n
alumni profiles > > > service to the nation
Profile:
William Metzler, DH’ 75
William Metzler (Metz) was the first
male hygienist to attend UCSF.
Juggling his education, softball games
and work at a bar that he co-owned
in downtown San Francisco, Metz
was a very colorful classmate.
Metz is an involved member of the
Hygiene Class of 1975. Each year, the
cohesive group enjoys a reunion in
conjunction with the Dental Alumni
Association’s Annual Scientific
Session. Traditionally organized by
Martha White, with restaurant and
venue selection by Jeanine Cardelli,
Lynda Oneto and Kathy Inouye Chu,
2009’s luncheon was again hosted
via the generosity of Metz and his
wife, Barbara.
However, this year, the classmates
were surprised with a new revelation
by their generous host. Not common
knowledge to the classmates of 34
years is the fact that Metz had served
in the Vietnam War and is actively
involved with improving the mental
health of fellow Vietnam veterans.
Metz presented each classmate
in attendance with the book Back
from War, written by his friend 1st Lt.
Lee Alley. Metz is a contributing writer
(chapter 13) for this book, which was
written about events in Vietnam and is
an attempt to help soldiers and their
families find hope and understanding
in life after combat. A heartwrenching, uplifting, warm and
enlightening glimpse into a soldier’s
life and emotions, this book is timely
for its parallels with life experienced
by our troops in the Middle East.
Metz encourages current
soldiers to place a roster of their
unit in safekeeping, for the day that
soldiers want to reunite with their
old military buddies. Camaraderie
is key for support with any group.
Metz is secretary of the 5th
Battalion, 60th Infantry Association,
and maintains the association website
(members.tripod.com/5thbattalion),
which serves as a network for aiding
Vietnam vets in finding comrades to
share in postwar healing and social
support. The nonprofit association’s
attendance has grown from a handful
of members to almost 800 currently.
Plans are underway for their sixth
reunion in 2010.
Metz served in Vietnam in
1967-1968 and received a Combat
Infantryman’s Badge, a Purple Heart
and a Bronze Star during his tour.
Though currently retired after working
in hygiene for many years with his
wife, Barbara, who was also a
hygienist, Metz spends time golfing,
working at the local library and
engaging his comrades who served
in Vietnam. n
Profile:
M. Ted Wong, D’ 84
Colonel M. Ted Wong (D ’84) became
the ninth commander of the US Army
Dental Command on July 10, 2008.
He is the senior Army officer
responsible for the operational
missions of all Army dental activities
and dental clinics around the world.
A Southern California native, Wong
entered active duty in 1984, following
graduation from the UCSF School of
Dentistry. He received a master’s
degree in healthcare administration
from Baylor University and a master’s
degree in strategic studies from
the US Army War College, and is
board-certified in prosthodontics.
Wong completed a General
Dentistry Residency Program at
Fort Sill, Oklahoma, and an Advanced
Prosthodontic Residency Program
at Fort Sam Houston, Texas. He is
a graduate of the Army Medical
Department (AMEDD) Officer Basic
and Advanced Courses, Combined
Armed Services Staff School,
Command and General Staff College,
US Army War College, and Joint
Medical Executive Skills Institute
CAPSTONE Symposium.
He has held a variety of clinical
and staff assignments, including
OIC, Kelley Barracks Dental Clinic,
Germany; staff prosthodontist,
Fort Sam Houston; chief, Dental Lab
Branch, AMEDD Center & School,
Fort Sam Houston; staff officer, HQ,
US Army Dental Command, Fort Sam
Houston; and dental executive fellow,
Office of the Surgeon General (OTSG).
Wong commanded the 665th
Medical Company (DS), Korea, and the
Presidio of Monterey Dental Clinic
Command, California. After attending
the US Army War College, Wong
served as the senior dental staff officer,
OTSG, HQDA, and as commander of
both the North Atlantic Regional Dental
Command and Walter Reed Dental
Activity, Washington, DC.
Wong’s awards and decorations
include the Legion of Merit, Meritorious
Service Medal (6 OLC), Army
Commendation Medal (2 OLC), Army
Achievement Medal (3 OLC) and
National Defense Service Medal with
one star. He holds the Expert Field
Medical Badge and Army Staff
Identification Badge, and is the
recipient of the Surgeon General’s
“A” proficiency designator. Wong is a
member of the Order of Military Medical
Merit and American Dental Association,
a diplomate of the American Board of
Prosthodontics and a fellow of the
American College of Prosthodontists
and the Pierre Fauchard Academy.
A son of Po Ping Wong (D ’65),
Colonel M. Ted Wong and his wife have
two sons and a daughter. n
19
in memoriam
Remembering Perry A. Ratcliff, DDS
Perry A. Ratcliff, DDS, teacher and mentor, who served as an
intellectual inspiration to residents and faculty in the Division of
Periodontology during his tenure as chairman of the division until he
retired from the University as professor emeritus, passed away on
Oct. 6, 2008, in Scottsdale, AZ. He is survived by his wife, Roberta
Ratcliff of Scottsdale; son, James Ratcliff (Barbara) of Pueblo, CO;
brother, Harold Ratcliff (Camille) of Peoria, IL; stepsons Todd Cretors
(Kellie) of Phoenix and Kurt Cretors (Sharlee) of Scottsdale; and
granddaughters Jordan and Kasey Cretors.
Born August 25, 1915, Ratcliff obtained his DDS degree from Indiana University in
1939. During World War II, he served in the US Navy Dental Corps and was awarded the
Presidential Unit Citation and five campaign Bronze Stars. A board-certified periodontist,
Ratcliff was past president of the American Academy of Periodontology. He was a
member of the AAP, ADA, FACD, FICD, FAAAS, the Western Society of Periodontology
and the Arizona Society of Periodontists.
Ratcliff had a private practice in Scottsdale for 25 years. He received many honors
and awards, published hundreds of papers and several books, and led countless
seminars nationally and internationally. As an inventor, he developed and formulated
dental products marketed through Rowpar Pharmaceuticals.
The UCSF Foundation has created a fund in Ratcliff’s name. With sufficient
financial support, the fund will be used to establish an endowed chair to honor him
and support a full-time faculty member in the Division of Periodontology. Memorial
donations in Ratcliff’s name can be made to the UCSF Foundation, Perry A. Ratcliff
Endowed Fund (S0478), and mailed to: Chris Ruetz, Senior Director, Development
and Alumni Relations,
UCSF School of Dentistry,
745 Parnassus Ave., Box 0970, San Francisco, CA 94143-0970. Ruetz can also be contacted at 415/476-3645 and
[email protected]. n
Remembering William H. Ware,
DDS, MDS
20
It is with deep regret that the School of
Dentistry notes the death on Aug. 24,
2008, of William H. Ware, DDS, MDS,
former professor and chairman of the
Division of Oral and Maxillofacial
Surgery, who gave a lifetime of service
to UCSF. Our sympathies extend to his
wife, Carmen, and his family, including
his brother, Robert, also a dentist, his
The late Dr. William H. Ware (center) with former Dean
sister, Betty, and children Bill, Julie and Charles Bertolami (to the immediate left of Dr. Ware), OMFS
Chair Tony Pogrel (to Dean Bertolami’s left), and OMFS
Nancy from his first marriage to Elise.
faculty. Taken at the William Ware lecture in January 2007.
Ware was a graduate of the
University of California, Berkeley, the UCSF School of Dentistry in 1954, and the UCSF
Oral and Maxillofacial Surgery Program in 1957. His 51-year academic career began as
instructor in dental medicine and oral surgery at UCSF in 1957, and culminated as
professor and chairman of the Division of Oral and Maxillofacial Surgery from 1976 to
1983. He remained on the faculty as professor emeritus of oral and maxillofacial surgery.
Ware made many contributions to the specialty of oral and maxillofacial surgery
during his distinguished career. Among the most important was his pioneering effort in
the field of growth-center costochondral graft transplant for temporomandibular joint
reconstruction in children. He was also an internationally recognized expert in the fields
of orthognathic surgery and temporomandibular joint surgery.
Throughout his career, Ware was a dedicated teacher beloved by students, residents
and faculty alike. He was a recipient of the UCSF Dental Alumni Medal of Honor, and
in recognition of his contributions, his former residents, patients and friends established
the William Ware Visiting Professorship in the Department of Oral and Maxillofacial
Surgery in 1990. In 2007, when an appeal was launched to establish the William Ware
Endowed Chair in Orthognathic and Reconstructive Surgery, the necessary funds were
raised in a record time of three months, with many of his former students, residents
and colleagues contributing. n
Alumni Deceased
Leonard Bellanca, ’29
James H. Kleiser Jr., ’35
Andrew J. Perry, ’37
Alvin H. Barbanell, ’45
Ralph P. Sanguinetti, ’47
A. Irving Jacks, ’50
M. Harvey Lee, ’50
Fenimore Cady Jr., ’51
Stanley B. Corwin, ’54
Thomas L. Gross, ’54
James V. Marino, ’54
Donald Soo Hoo, ’54
Dale A. Thompson, ’54
D. Stanley Powell, ’58
George S. Payne, ’59
O. L. Shoemaker, ’59
Park O. Stompro, ’60
Mary Wheeler Barnard, ’61
David M. George, ’66
Arthur Allen Amos, ’69
James K. Millsop, ’70
Dirk Richard Payne, ’93
Faculty Deceased
Sanford Plainfield, DDS
UCSF is grateful to the many alumni who
have given back by making a legacy gift for the
benefit of the UCSF School of Dentistry.
“Somebody gave me a chance, and I want to
give the same to others. As Ayn Rand said,
‘My best for your best.’”
Helyn Luechauer, DDS ’66, established three charitable gift
annuities with her late husband, Jarvis “Lick” Luechauer, DDS,
to support the UCSF School of Dentistry.
“I believe strongly that everyone should
contribute back to those who have helped
them. Because of the education and
encouragement given to me at UCSF, I feel I
have had an outstanding life and have been
able to provide the best care to my patients,
enabling them also to have a better life.”
Albert Landucci, DDS ’68, established the Albert O. J. Landucci
Endowment Fund to support the UCSF School of Dentistry in
retaining teaching faculty in the fields of orthodontics and pediatric
dentistry. He has also included the school in his estate plan.
“I decided to make UCSF School of Dentistry
the beneficiary of the IRA that I inherited from
my husband. By enabling other people to
practice dentistry, I hope they will carry out
some of the things Ron didn’t get to do, and
continue the things he did.”
Judy Gordon, widow of alumnus Ronald A. Gordon, DDS ’76.
Her gift will establish an endowed scholarship fund at the
UCSF School of Dentistry.
To learn more about making a planned gift to UCSF School of Dentistry,
please contact Chris Ruetz at 415/476-3645 or [email protected],
or go to ucsf.edu/support/trustsandbequests.
3
UniversityofofCalifornia
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Address Service Requested
Why We Give
Gary and Connie DeJong Armitage
“A case of wine” – a way to think about
the size of an annual gift that, contributed
regularly by each and every alumnus,
could make a tremendous difference in the
outlook for UCSF School of Dentistry
support through these financially troubled
times. So says UCSF Dentistry alumnus
Gary C. Armitage, DDS, MS (UCSF),
R. Earl Robinson Distinguished Professor
of Periodontology in the Department of
Orofacial Sciences, whose academic career
at the Parnassus Heights campus has
now touched on six decades.
“It has become apparent that the only
way to grow and thrive is to initiate and
sustain a perpetual fundraising campaign,”
Armitage says.
Armitage sat down recently with his
wife, Connie DeJong Armitage, to talk about
his career and their shared philosophy of
giving, alluding to an editorial on the
importance of strong and ongoing alumni
support he wrote during the summer of
2006 at the University of Otago at Dunedin,
New Zealand, as the Sir Thomas Kay Sidey
Visiting Professor. “The first step should
Gary Armitage, DDS, and Connie DeJong Armitage
be to change the perception of potential
donors that the existing governmental
support is sufficient,” he said. “Alumni need
to be convinced that it is their responsibility
to become donors.”
Speaking of his years on the faculty,
Armitage observed, “I’ve been with the
University since 1971, and back then,
about 90 percent of our operating
budget came from the state of California.
Now it’s reversed – UCSF has become
a state-assisted, instead of a statesupported, institution.”
The Armitages regard alumni financial
support as a critical component of any
strategy to maintain institutional academic
leadership. One way to achieve this is
through the recognition of distinguished
mentors, including current and former
faculty, observed Armitage.
Continued on page 1
> To support the UCSF School of Dentistry, contact Christopher Ruetz at 415/476-3645 or [email protected]