magazine School of Dentistry Tackles Tooth Decay CA N D O Message from Dean John D.B. Featherstone Pre-Clinical Laboratory Dedicated

Transcription

1 University of California, San Francisco School of Dentistry magazine Volume 5 / 2010 CA N D O Tackles Tooth Decay ALSO INSIDE: Message from Dean John D.B. Featherstone Pre-Clinical Laboratory Dedicated Research Faculty Profiles New Associate Dean for Research Class of 1959 Notes

2 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 Editor/Writer: David Hand Contributing Writers: Jeffrey Norris, Mary Sornborger Porteous Design: Laura Myers Design Photography: Elisabeth Fall, David Hand, Carmen Hipona 2010 The Regents of the University of California 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 Can Do Jane Weintraub and the CAN DO team break new ground and win support in the cause of children s oral health / PAGE 10 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 dentistry.ucsf.edu ON THE COVER: Kaitlin Jennison (Class of 2013) offers childfriendly dental hygiene information during the Hayes Valley Fair at San Francisco s John Muir Elementary School. (See story, page 10)

3 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 in his name (see story, page 20). It should become a goal to have an endowed chair for every faculty position. Those sorts of tributes last. In the Otago editorial, Armitage distilled his thoughts about giving into three focused objectives: The culture of giving is now part of our professional fabric as graduates from UCSF. Gary C. Armitage, DDS, MS 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

4 news Dean s Council Reaches Out for Support In 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 Class Stats: Graduating Seniors Surveyed 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/ or cruetz@support.ucsf.edu. n Class of 2008 Postgraduate Studies Plans Advanced Education in General Dentistry 5 Dental Public Health 1 Endodontics 1 General Practice Residency 13 Oral & Maxillofacial Surgery 4 Oral Pathology 0 Oral Radiology 0 Orthodontics 3 Pediatric Dentistry 2 Prosthodontics 0 Other Graduate Program Not Listed 5 None 59 Class of 2009 Postgraduate Studies Plans Advanced Education in General Dentistry 10 Dental Public Health 0 Endodontics 3 General Practice Residency 12 Oral & Maxillofacial Surgery 4 Oral Pathology 0 Oral Radiology 0 Orthodontics 6 Pediatric Dentistry 7 Prosthodontics 0 Other Graduate Program Not Listed 4 None 53 Educational Debt Comparisons Average debt of dental students upon graduation (2008 graduates) $170,367 $142,671 $204,734 $139,390 Postgraduate Practice Plans Solo private practice, full-time 17 Solo private practice, part-time 3 Group practice, full-time 48 Group practice, part-time 10 Not going into general dental practice at this time 13 Postgraduate Practice Plans Solo private practice, full-time 13 Solo private practice, part-time 1 Group practice, full-time 45 Group practice, part-time 11 Not going into general dental practice at this time 23 All US Dental Schools Public Dental Schools Private Dental Schools UCSF School of Dentistry 2 Source: UCSF School of Dentistry Educational Services Graduating DDS and IDP Seniors Survey Source: Graduating Seniors Survey, UCSF Office of Student Financial Aid; ADEA Survey of Dental School Seniors, 2008 Graduating Class

5 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 Margaret Walsh fees, received approval from the Office of Budget and 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. porteous@comcast.net for program status and updates. n Mary Sornborger Porteous, DH 75 Willard C. Fleming Pre-Clinical Simulation Laboratory Dedicated Located 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 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 Restorative Dental Sciences Interim Read more about Willard C. Fleming at 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 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 I thought the world of him. n 3

6 faculty profile > > > Stefan Habelitz Nature s Crowning Achievement Nature 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 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 Stefan Habelitz viewing an image of recombinant enamel matrix protein that self-assembled into nanometer-thin ribbons, as revealed by atomic force microscopy. 4

7 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

8 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 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

9 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

10 faculty profile > > > Ophir Klein Teeth Star in Stem Cell Studies By 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 generate 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

11 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 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 Mouse embryos prepared for dissection. 9

12 feature > > > Center to Address Disparities in Children s Oral Health CAN DO Counters Early Childhood Caries Trend With 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. 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 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 10

13 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 Ramos- Gomez, 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

14 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 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 12

15 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

16 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 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 14

17 promotion > > > richard jordan New Associate Dean for Research Richard 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, 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

18 alumni update Bear Bash Night 2009 On 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 teethfirst@aol.com. 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 th 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 Japanese- American 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 n Integrating Periodontics and Implants into Comprehensive Dental Treatment Christopher Marchak, DDS n Implants: Guided Surgery, Immediate Loading and CAD-CAM Technology Ann Eshenaur Spolarich, RDH, PhD n Prescription Drugs and Herbal Therapies: Practice Management Considerations for Dental Professionals n Women and Medications: Health Issues and Related Pharmacotherapies n Commonly Prescribed Medications and Managing the Oral Side Effects of Medication Use See you next year! Revelry at Bear Bash 2009, UCSF Faculty- Alumni House: Dean John D.B. Featherstone (at left, center) with UCSF Dental Alumni Association Executive Council organizers and student participants. 16

19 1959 Class Notes Don Hermansen, D 73, chair of the 50-Year Reunion Committee, presented the following Class Notes recognizing the Half- Century Club graduates honored at the 114th Annual Scientific Session Luncheon. 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. Rutt- Lingo) 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 with her husband, Mikkl. Her favorite scalers are still UC #3 and #4. 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. 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 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 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 He has been vice president and president-elect of the Northern California Society of Periodontology and chairman of the Western Society, 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 There, Charles practiced as a pediatric dentist until selling his practice in 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

20 18 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. 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 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, He moved to La Quinta from Discovery Bay in June 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 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 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 Jim and Pam have three children. Carl Schrieve, DDS retired in July 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 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 He was CDA president in , ADA trustee from 1990 to 1994 and a TDIC board member from 1980 to He loves his profession and can think of none better to provide a necessary and rewarding service to patients. n