Launching the future: The ADRF and Australian dental research

For over 50 years, the Australian Dental Research Foundation has formed an integral part of the dental and oral healthcare fabric in Australia, even internationally. Its funding capabilities and rigorous management allow research projects to not only go ahead, but provide scaffolding for them to be encouraged, promoted and developed beyond anything that could be accomplished alone.

The ADRF is regularly approached by students as well as researchers and academics at every stage of their career, from early though to senior levels, for funding and support. On the other side of the coin (quite literally), the Foundation is also contacted in order to receive funds to invest in research, whether it be via a legacy donation, bequest or through donations from ADA members, professional organisations and many other sources.

This vital role, to objectively and conscientiously receive funds and to then organise the informed and ethical disbursement of those funds to most effectively support research, serves to further the oral health of Australia and its residents. The country’s academic enrichment, economic strength in healthcare practice and industrial intellectual property is also benefited, while the ADRF’s successes advocate for the dental profession in proving its continued worth and innovative power in the wider healthcare landscape.

The funding process in a nutshell

- Applications for the financial year’s Grant Round are received in the first quarter of the year.

- The successful applicants emerge from a rigorous process that involves countless hours of assessment by the highly
experienced and qualified academics who make up the ADRF Research Advisory Committee.

- In December, abstracts of completed research are published in a Special Research Supplement in the Australian Dental Journal (ADJ).

New directions

In the second half of 2022, the commencement of the $5-billion Australia’s Economic Accelerator (AEA) program meant renewed funding for research projects in five priority areas, including medical products, signalling a renewed commitment by the Government in the arena of oral care and public health.

The ADRF’s inaugural Dental Research Symposium was held in the same year during ADX Sydney, wherein funding for dental research was identified as a challenge for academic and industry stakeholders and discussed by a panel of experts. This was a major moment in a year that saw the ADRF pausing its grants program in 2023 in order to review the way forward, before taking a new strategic direction into this year.

Associate Professor Munira Xaymardan, a critical and long-standing member of the ADRF’s Research Advisory Committee, describes the ADRF’s trend towards now awarding grants that are fewer in number, but greater in allocated funding amount. “Although with relatively small amounts of funds, the organisation has played an important role in developing the dental research workforce and supporting dental academics in Australian universities, however the previous funding scheme funded many relatively small grants,” she says. “Many of them could not reach a meaningful social or scientific impact or provide sufficient resources to generate large-scale clinical data or high-throughput basic science data (e.g. omics) that is usually required for higher-impact publications, limiting track record build-up for researchers to attract Tier 1 and 2 national grants. Additionally, administering a large number of small grants was laborious, making it difficult to manage project progress and provide feedback to the applicants.”

Adjunct Professor Deb Cockrell, Chair of the same committee, agrees that this move towards ‘less but greater’ grants has opened the door for research projects to reach loftier goals, but also for the ADRF to improve its processes on a number of levels. “I think it’s fair to say that funding in the past has been spread across numerous groups of current and potentially future researchers,” she says. “There’s no doubt that exposing undergraduate students to research gives them insight into the value and rewards, however providing multiple small grants was the one that was least successful in terms of completion and impact. Grants have therefore been increased and aimed at supporting ECR (early-career researchers) as leaders of teams so that students can still have the exposure as co-investigators.

“We have also refined our processes and introduced research management software and again, the new system was trialled this year,” continues Dr Cockrell. “Of course there were hiccups but as we review and refine, it will become so much easier for us to track applications, progress and research outcomes and impact.”

The committee has tried to focus on a specific research theme – ‘addressing the burden of dental disease’ – for the first round in this new funding model, with the plan to meet soon to determine the theme for the next round of funding. This adds another layer of satisfaction to a complex but rewarding role in determining the direction of funded research in Australian dentistry and oral care.

The people who make it happen

As the Chair of the Research Advisory Committee, Dr Cockrell has a particularly pivotal role. “Our team helps the Board to determine the annual themes for research, we assess and rank all of the applications (using a customised version of the NH&MRC criteria), monitor progress of projects and approve final reports,” she explains.

Dr Cockrell currently works at Concord Hospital at the Centre of Education and Research in Ageing, and is the President of the Dental Council of NSW, but was drawn to give of her time to the ADRF as well, due to her passion for supporting emerging researchers and academics.

“Having been involved with the Australian Dental Council and seen the problems facing our universities, I thought that this was a good way to try to support those colleagues who work in academia and who need to undertake high-quality research for career progression. There is so little funding available for dental research and I wanted to see if there was any way we could develop a strategy to support our Early Career Researchers (ECR) and therefore the future of our profession,” she says.

“Australian academics recently published information about the dearth of funding provided to support oral health research, in the ADJ last year. The big funding bodies do not provide anywhere near the support for research into the burden of oral disease as they do other areas of health. The ADRF allows ECR access to smaller amounts of funding that can be used to complete pilot and preliminary projects that can then be used to support applications to larger funding bodies.”

“ADRF is the sole funding body that is approachable for the broader Australian dental research community,” adds Dr Xaymardan. “The ADRF funds research projects by early-career dental academics and research students and has been essential in sustaining many of the dental research laboratories.” She cites research breakthroughs as proof positive of the power of the ADRF funding model.

“Academic workforce building and dental education, too,” she says. “As Deb describes, many senior researchers have benefited from this fund when they were PhD students, developing passion in research which has kept them in academic and dental education, thus contributing to highly skilled dental graduates and the workforce in Australia.

“National funding bodies such as NHMRC have a general success rate of 10-12%, with dentally focused topics achieving one or two grant successes occasionally. The Medical Research Future Fund (MRFF) has specific theme focuses that are usually directed to consortium initiatives concerning severe systemic diseases, and that favours the investigators with existing resources. Most Australian dental researchers are unlikely to be part of such efforts. Industrial linkage funding is one of the options to fund dental research that are limited to immediately clinical applications. ADRF funding is crucial to maintain a certain level of research in Australian dental schools.”

A wide zone of impact

The multidisciplinary nature of academic research means that the impact ‘zone’ of ADRF funding assistance is able to reach far beyond simply dentistry. Dr Xaymardan points to research advancements in the fields of microbiology, population oral health, dental material and tissue regeneration, all putting Australia at the forefront of global research efforts. One grant recipient, Professor Stan Gronthos received assistance for his work with dental stem cells, but this work now informs his wider remit in stem cell biology and regenerative medicine as Founder and Head of the Mesenchymal Stem Cell Laboratory in the Adelaide Medical School, Faculty of Health and Medical Sciences.

The change in the ADRF’s funding strategy to provide greater funds to fewer projects means that such vital research can surpass its smaller goals and aim big, for better oral health outcomes nationally, and to achieve Tier 1 or 2 funding, significant intellectual property wins, and attract major industrial collaborations.

“We have improved the ADRF grant review process, enabling cost-effective management of the Foundation,” says Dr Xaymardan. “In the long term, we will be able to show the real impact of our research to the improvement of Australian oral heath practices or scientific advances. This then attracts stakeholder and community engagement and in turn increases the pool of ADRF funds.”

Considering these clear outcome benefits, there is a need to get the word out, to ensure maximum funding reach.

“I think the Board of Directors’ efforts to raise further funds to support Australian oral health research is commendable but the journey is difficult,” says Dr Xaymardan. “For example, we organised a raffle ticket sale in 2024, with the Board members putting in personal and professional time to raise funds, but were only able to raise $3,000, indicating both the effort and difficulty of fundraising for research in Australia. As our dental professionals benefit so much from new materials and technology derived from research, ADA members can be certain that any contribution they make toward research fundraisings effort can directly benefit oral health management outcomes.”

The good news is, though, that every little bit counts. “Seriously, the most useful way for ADA members to get involved is to make a small donation on a regular basis,” says Dr Cockrell. “If every member donated the equivalent of a cup of coffee a week ($20 a month), we would be able to provide our emerging and established researchers with so much more support.

“If our universities do not obtain research funding and achieve impactful outcomes from this research, the education of future colleagues will be impacted even more than it is at the moment.”

To date, the Foundation has supported well over 2,000 research projects. As the visibility of the ADRF increases apace, it is exciting to imagine what innovations could be brought into being thanks to future funding efforts.

What research has been funded lately?

Each year, the ADRF receives more than double the number of applications than it is able to fund. This year, more than $250,000 was distributed to support projects and research dedicated to:

Enhancing the dental health of young children and the nutritional well being of older Australians by:

- Developing a deeper understanding of the role of vertical transmission from mother to child in the establishment and maturation of the oral microbiome;

- Providing pregnant women with timely advice about the link between their oral health care and the subsequent risk of early childhood dental caries;

- Developing patient advice for eating well with dentures. 

Preventing dental caries, dental disease and tooth loss by:

- Enabling early diagnosis of gingivitis and periodontitis using in-depth biomarker exploration; 

- Developing alternate and more effective methods to control formation of biofilms utilising mechanisms to disrupt inter and intraspecies communication of bacteria;

- Using a state-of-the-art technique, such as single-cell RNA sequencing, to identify novel factors that could be targeted to suppress alveolar bone loss, stimulate bone repair and treat periodontitis;

- Early diagnosis and treatment of oral cancer; improving the quality of life and survival rates of patients by providing the evidence base to shape curriculum design to improve preparedness and capability of dental students to make critical diagnosis of suspicious mucosal disorders.

Improving restorative dentistry through development of:

- Optimal surface designs at the implant-soft tissue interface, improving soft tissue attachment and ultimately promoting long-term maintenance of implants;

- Enhanced longevity of resin-detin and resin-zirconia bonded interfaces by improving adhesive solutions and inhibiting bacteria activities;

- Viable, aesthetic, non-metallic alternatives for dental implant fabrication.

Eliminating the health risks associated with dentistry:

- Development of improved antibacterial products for the treatment of periodontitis and peri-implantitis to reduce the risk of bacterial infections around teeth and implants potentially contributing to increased glycosylated haemoglobin levels, progression of Alzheimer’s Disease, and heart disease.

Decreasing anxiety associated with dental treatment:

- Working collaboratively with the Deaf community to establish the specific clinical needs of this population group, identify potential areas of improvement, provide an evidence base for inclusion of a Deaf Awareness training module to be included in dental studies.

Developing new products that will offer cost effective and aesthetically pleasing dental treatment options:

- Using 3D technology to test and optimise the effectiveness of the next generation of bioactive dental implant screws with controlled release of active proteins to advance the therapeutic potential of current dental implants;

- Development of a novel glass fibre reinforced polymethylmethacrylate together with fused filament fabrication that can be used effectively for the construction of intraoral devices (e.g. dentures) with enhanced clinical properties.