Mouth: A diagnostic indicator for general health

One day in medical clinics, the big picture of a patient's state of health may be found in little pictures from the mouth, says Li Mao, MD, a new professor at the University of Maryland Dental School.

The mouth or oral cavity area is an excellent indicator of the whole body's health, says Mao, who is the chair of the new Department of Oncology and Diagnostic Sciences at the School.

Mao recently joined the Dental School to be at the forefront of a movement to retool dental education, he says, to make dentists practice more within the bigger health care community.

Future lung cancer prevention trials, for example, could soon be designed so that surface tissues inside the cheek could be checked to detect tobacco-induced damage in the lungs, according to a study led by Mao last year published in the journal Cancer Prevention Research.

"We hypothesized that tobacco-induced molecular alterations in the oral epithelium are similar to those in the lungs," says Mao. "This might have broader implications for using the mouth as a diagnostic indicator for general health."

University of Maryland Dental School Dean Christian S. Stohler, DMD, DrMedDent, a leader in the movement to retool dental education, says, "I feel that dentists should play a major role in prevention of cancer and Dr. Mao is the leading oral cancer researcher in the country. He crosses the bridge between medicine and dentistry. Being a physician helps expand dental health care and he wants to change how patients are being treated because his background is in head and neck cancer."

Mao's previous position was at the University of Texas M.D. Anderson Cancer Center in Houston, the largest stand-alone cancer center in the country with more than 17,000 employees. However, he sometimes had difficulty recruiting patients with oral precancerous conditions for clinical trials to find novel early diagnosis and prevention measures. Mao decided to come to the University of Maryland Dental School, where, he says, "there are plenty of patients and plenty of opportunities" for testing his theories and conducting his research.

"That's why I came here. Dean Stohler is a visionary with great interest in research like this, in biological systems. He also believes that the Dental School should not be isolated from the general medical community," says Mao.

Mao believes that system biology-based approaches—the pinpointing of molecular changes in living tissue—is becoming an important technology in cancer studies and biomarker discovery. He says that 50 percent of oral cancer patients get diagnosed too late.

He plans to make significant changes in dental oncology research and education in his new position. "Dentists are trapped in their current technology," he says. "Most work in small operations that are procedure-oriented. Dentists are mostly individual practitioners with little interest in medical research. On the other hand, medical doctors often work within a hospital system" with more opportunities for research and development.

Mao brings to the Dental School a focus on revealing and defining molecular and genetic changes in complex upper lung and digestive tract malignancies, especially head and neck cancer and lung cancer. "The understanding of these alterations will allow us to develop novel strategies for assessment of cancer risk, early diagnosis of cancer, molecular classification, and treatment," he says.

He says his team in Houston was among the first demonstrating that molecular markers are potentially powerful in cancer early detection and risk assessment through a series of high-profile publications.

Under Stohler's direction, the Dental School last year increased its sponsored research funding by 47 percent, largely by focusing on cooperative medical projects reaching far beyond traditional dental sciences. Projects in tissue regeneration, carcinogenesis, pain and neuroscience, and microbial pathogenesis expanded the most, Stohler says.

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