Dr. Noel Childers
Noel K. Childers,
Joseph F. Volker Professor
Chair, Department of Pediatric Dentistry
Email: nkc@uab.edu
Phone: (205) 934-3230
Fax: (205) 934-7013
Research Focus: Pathogenicity, Immunology, and Epidemiology of Dental Caries.
Research Interests: Dental Caries Vaccine and other preventive approaches; Virulence of mutans streptococci in dental caries; Oral Complications in medically compromised children
RESEARCH SUMMARY FOR DR. NOEL CHILDERS
Dental caries is a worldwide infectious and transmissible disease. This disease is multifactorial and complex and the basic concepts of the host/parasite relationship important to pathogenesis. Although various bacteria are involved in the disease process, the mutans streptococci (MS) are most consistently implicated in the initiation of caries in humans. Current studies involve investigations aimed at identifying safe and effective mucosal immunization delivery systems. Specifically, studies examine the characteristics of liposomes that are important in potentiating immune responses to orally or nasally administered S. mutans antigens. Following animals studies of the efficacy of liposomal S. mutans antigen vaccines, studies have been initiated for human FDA Phase I clinical trials studying the safety and immunogenicity of liposomal oral and nasal immunization. The overall goal of these studies are to identify a safe and effective oral immunization strategy which is protective against dental caries.
Observations in infants indicate that the initial colonization of the oral cavity with MS occurs with eruption of the primary teeth. The normal source of the initial MS infection in young children appears to be vertical transmission from the mother; however, horizontal transmission may also occur from other family members, caretakers or playmates. In addition to the natural history of infection and availability of colonization sites as well as dietary sucrose intake, there is data to indicate that the development of the host’s immunity to MS is also involved in MS colonization. Caries in the primary dentition often corresponds with subsequent higher risk for caries in permanent teeth. Therefore, it is important to better define important characteristics of MS infections regarding their clonal development and temporal stability within dental plaque biofilms in humans. Dr. Childers' laboratory is investigating the host/parasite relationship that is important in the pathogenesis and epidemiology of dental caries in a high caries risk population of families and children of two age groups corresponding with important tooth eruption events (i.e., primary and permanent molar teeth) associated with caries. These studies utilize the latest technologies including polymerase chain reaction and pulsed-field gel electrophoresis to establish the commonality of MS genotypes and stability in a defined population of children and family members. An interdisciplinary team of physicians, dentists, basic scientist, epidemiologist and statisticians has been assembled to improve our understanding of the host-parasite relationship of dental caries in children. The results of these studies should provide key information for the development of strategies to prevent this infectious disease.
Clinical research interests also include studies to determine risk factors for oral complications in children with cancer and HIV infection. These studies have assessed various clinical and immunological factors involved in the development of oral lesions in medically compromised children. The goal of this research is to develop and test protocols that will prevent the occurrence or severity of oral complications in children identified to be at risk.
Research efforts have involved assessment of the prevalence of dental disease in children as related to access to care. Related studies have assessed the effectiveness of dental sealants in prevention of dental caries using Medicaid claims as well as Jefferson County Department of Public Health records.
Select Publications: (PubMed for Dr. Noel K. Childers)
- Childers, N.K., Tong, G., Mitchell, S., Kirk, K., Russell, M.W., and Michalek, S.M. 1999. A controlled clinical study of the effect of nasal immunization with a Streptococcus mutans antigen alone or incorporated into liposomes on induction of immune responses. Infect. Immun. 67:618-623.
- Childers, N.K., Miller, K.L., Tong, G., Llarena, J.C., Greenway, T., Ulrich, J.T., and Michalek, S.M. 2000 Adjuvant activity of monophosphoryl lipid A for nasal and oral immunization with soluble or liposome associated antigen. Infect. Immun. 68:5509-5516.
- Childers, N.K., Tong, G., Li, F., Dasanayake, A.P., Kirk, K., and Michalek, S.M. 2002. Humans immunized with Streptococcus mutans antigen by mucosal routes. J. Dent. Res. 81:48-52.
- Li, F., Michalek, S.M., Li, Y., Kirk, K., and Childers, N.K. 2003. Intranasal immunization of humans with Streptococcus mutans antigens: Low dose differentiates responses to soluble versus liposomal antigens. Oral Microbiol. Immunol. 2003: 18: 271-277.
- Dasanayake, A.P., Li, Y., Kirk, K., Bronstein, J., Childers, N.K., 2003. Future restorative cost savings related to dental sealants: An 8-year retrospective follow-up. Pediatric Dentistry. 25: 572-576.
- Dorantes, C., Childers, N.K., Makhija, S., Elliott, R., Chafin, T., Dasanayake, A., 2005. Assessment of Retention Rates and the Clinical Benefits of a Community Sealant Program. Pediatric Dentistry, Vol. 21(3):212-216.
- Childers, N.K., Li, F., Dasanayake, A.P., Li, Y., Kirk, K., Michalek, S.M. 2006. Immune Response in Humans to a Nasal Boost with Streptococcus mutans Antigens. Oral Microbiol. Immunol. Vol. 21:309-313.
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Makhija SK , Childers NK, Chafin T, Dorantes CE, Johnson LS, Dasanayake, AP. 2006. Evaluation of Initial Caries Score and Caries Incidence in a Public Health Sealant Program: A Retrospective Study. Pediatr Dent. Vol. 25 (5):420-421.
- Dasanayake, AP, Li Y, Chhun N, Bronstein J, Childers NK 2007. Challenges faced in minority children in obtaining dental care. J Health Care Poor Underserved Vol. 18: 779-788.