Dentistry

U of T startup targets harmful side effect of cancer treatment

Christopher.Sorensen — Wed, 06 Mar 2024 16:17:45 +0000

U of T startup targets harmful side effect of cancer treatment

Christopher.Sorensen Wed, 03/06/2024 - 11:17

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Nabanita Nawar and Pimyupa Manaswiyoungkul, co-founders of HDAX Therapeutics, met while they were pursuing doctoral studies at U of T Mississauga’s department of chemical and physical sciences (photo by Matthew Volpe)

Geoffrey Vendeville

Topic

Our Community

Black Founders Network

Entrepreneurship Week

Alumni

Dentistry

Entrepreneurship

Health Innovation Hub

Research & Innovation

Subheadline

HDAX Therapeutics is focused on developing treatments for peripheral nerve damage, which can result from chemotherapy or radiation

Pain, numbness, sore muscles and even paralysis. These are some of the symptoms of peripheral neuropathy, an often-debilitating condition associated with chemotherapy, radiation and other cancer treatments.

Such peripheral nerve damage can be temporary, but for some, it never goes away.

“There’s often really nothing for these patients except just symptom management and putting fingers and toes in a bucket of ice,” says Nabanita Nawar, who holds a PhD in medicinal chemistry from the �ؿ�ζSM.

Nawar is the CEO and a co-founder of HDAX Therapeutics, a startup that grew out of technology developed in U of T Mississauga’s department of chemical and physical sciences. The company is currently working on treatments that focus on HDAC 6, a protein that has been implicated in cardiovascular diseases and neurodegenerative disorders – including the peripheral nerve damage experienced by many cancer patients.

“We are essentially developing new medicine for diseases that have a transport problem in the body,” Nawar says, referring to the protein’s key role in multiple cellular processes.

HDAX’s patented mechanism targets HDAC 6 to return damaged neurons to health.

“Our target, HDAC6, plays a key role in regulating microtubule stability and thus, affects axonal transport,” explained Pimyupa Manaswiyoungkul, who also earned a PhD at U of T and is now chief operations officer at HDAX. “In diseased states for indications that we are targeting, these axonal transports are impaired resulting in nerve degeneration, which results in symptoms in patients.”

By using a “two-site binding modality,” the startup’s technology essentially holds the target with two figurative hands instead of one – like many of its competitors – providing a tighter grip on the protein and a key competitive advantage.

The treatment, still in pre-clinical testing, would be delivered in the form of an oral pill.

(photo by Matthew Volpe)

The HDAX team also plans to apply the startup’s technology to target transport mechanisms in cardio-metabolic diseases, including heart failure.

Manaswiyoungkul met Nawar in the lab when they were pursing doctoral studies. She says Nawar, who was on the medicinal chemistry side, would give her compounds to evaluate.

“The flow of how we worked in the lab helped us connect,” Manaswiyoungkul says.

Working with fellow researchers Elvin de Araujo and Olasunkanmi Olaoye, it wasn’t long before Nawar and Manaswiyoungkul shifted their focus to the challenges of translating their promising research into a viable business.

The team established HDAX in 2021 and received its first big funding injection – and a confidence boost – a few months later when it won a bio-venture pitch competition hosted by Medicine by Design, a U of T institutional strategic initiative focused on regenerative medicine and cell therapy.

“That was the first thing that made us think, ‘OK, this may be a real company – this could really be something.’ It wasn’t just in our heads,” Nawar says.

HDAX has since attracted a total of $1.3 million in funding, Manaswiyoungkul says, noting the company and its five full-time employees is now preparing for its first seed round funding.

The work of Nawar, Manaswiyoungkul and their teammates hasn’t gone unnoticed. The two founders recently earned an unexpected individual accolade: inclusion in the Forbes list of 30 under 30 Torontonians. When the Forbes email landed in Nawar’s inbox, she says she was so surprised she wondered if it was spam.

As it turns out, the duo were nominated by one of their early U of T mentors, Paul Santerre, a professor in the Faculty of Dentistry and the Institute of Biomedical Engineering in the Faculty of Applied Science & Engineering.

“The [HDAX] technology circumvents toxicity in neuro and cardiac drugs, with amazing efficacy demonstrated in their neuro models,” Santerre says, adding that Nawar and Manaswiyoungkul “not only accomplished novel, impactful findings during their PhD/post doc training, but did the work to accelerate their evolution to becoming serious entrepreneurs.”

Along the way, the startup received extensive support from the U of T entrepreneurship community, which ranks first in Canada for research-based startups and among the top five globally for university startup accelerators. In particular, HDAX worked with UTEST, the Health Innovation Hub (H2i) and the Black Founders Network.

Santerre says one of the keys to U of T’s successful entrepreneurial support network is its “no wrong door” policy.

“This means, regardless of where you come from at U of T, you will be supported by the incubators that best fit your venture,” he says.

Manaswiyoungkul’s advice for students thinking about making the leap into entrepreneurship? Just go for it.

“U of T is a very accepting community and there’s always someone who has more experience and the willingness to help take your ideas forward.”

After fleeing Syria, Aiman Ali finds a new home as co-ordinator of a U of T dentistry lab

geoff.vendeville — Thu, 21 Jul 2022 19:15:52 +0000

After fleeing Syria, Aiman Ali finds a new home as co-ordinator of a U of T dentistry lab

geoff.vendeville Thu, 07/21/2022 - 15:15

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After fleeing the Syrian war, Aiman Ali came to Canada where he found a job that matches his qualifications at the Faculty of Dentistry (photo by Jeff Comber)

Aiman Ali and his family fled war in Syria six years ago and came to Canada in hopes of a better life. But the move to a new a country wasn't easy, especially at first.

“I came here on a Visiting Scholar Visa for six months – our transition to Canada was extremely arduous and we faced many financial difficulties at the beginning,” Ali says. “We were living cheque to cheque and it wasn’t easy to make ends meet.”

Despite having two advanced degrees in dentistry from universities in Syria and Spain – a doctor of dental surgery and PhD in oral cancer – Ali initially struggled to find a job that matched his qualifications. But earlier this year he became the manager and lab co-ordinator for the Histopathology Research Unit at the Faculty of Dentistry.

Histopathology refers to the branch of pathology dealing with tissue changes characteristic of disease. The lab uses both human and animal samples for precise experiments to determine the role of specific proteins in cells and their role in the progression of cancer and other diseases.

As manager, Ali is responsible for everything that goes on in the lab, including experiments, ordering materials and chemicals and training students and researchers to use the equipment.

Ali programming one of the automated machines in the Histopathology Research Unit (Jeff Comber)

The job put Ali and his family on firmer financial footing, and it's a good fit with his credentials, he says.

Ali took it upon himself when he arrived to modernize the lab with newer equipment so that it could provide more services, including the ability to perform immunostains experiments and full soft- and hard-tissues services for anything related to histopathology and immunohistochemistry.

“Now researchers are sending us work from Sinai and MARS because we can do it all in house,” he says. “Having the ability to deal with dental implants, mineralized tissue in the teeth, [and] bone and jaw puts us at an advantage as it’s difficult for a lot of other labs to complete.”

Ali says he's enthusiastic about using the lab's new machinery to help researchers in Canada and beyond. He says the new equipment has made the lab more efficient by automating certain procedures, thereby saving time and improving accuracy.

“Our lab is an example of the way forward in histopathology,” he says. “I’m excited to see what the future holds for this type of research.”

Staying engaged: U of T Faculty of Dentistry student makes community volunteer work a priority

Christopher.Sorensen — Wed, 02 Feb 2022 19:03:53 +0000

Staying engaged: U of T Faculty of Dentistry student makes community volunteer work a priority

Christopher.Sorensen Wed, 02/02/2022 - 14:03

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In her final year of the Faculty of Dentistry's Doctor of Dental Surgery program, Marta Thorpe's volunteer work ranges from high school outreach to helping visually impaired runners train (photo by Anna Dzieciol Photography)

Topic

Undergraduate Students

Despite her hectic schedule, �ؿ�ζSM student Marta Thorpe makes time to stay connected to the community through volunteering – and says she wouldn’t have it any other way.

“It’s easy to get caught up in the idea of having limited time, but I’ve found if something is really important to you, you find a way to prioritize it,” says Thorpe, who is in her final year of the Faculty of Dentistry’s Doctor of Dental Surgery (DDS) program. “Volunteering helps me stay grounded. It reminds me of what I value.”

Thorpe has many volunteer commitments both inside and outside of the university. Last summer, she worked with U of T’s Black Medical Students' Association to organize presentations and meetings with Toronto high school students. The goal was to encourage young, disadvantaged students to pursue careers in health care.

“I think it’s really important to plant the seed early and show young students that they can have a career in health care,” Thorpe says. “I also think representation in dentistry is valuable so students can see themselves in the person they want to become.

“We are serving a diverse population so ideally we’d have diversity in the profession. It helps students see their place in the dental office as a patient, as an assistant and as a dentist.”

That mentality carries through with Thorpe’s work on the Faculty of Dentistry’s equity, diversity and inclusion (EDI) committee. She was nominated by Dean Daniel Haas to be a committee member in her second year and has served ever since. The EDI committee is composed of staff, faculty and students, and is currently putting together an action plan on how to improve equity, diversity and inclusion efforts at the Faculty of Dentistry.

Thorpe is also involved in the Association of Canadian Faculties of Dentistry EDI working group as a student representative, thanks to the nomination by Haas. The group’s aim is to collect data and identify shortcomings of both individual schools and dentistry as a profession overall. The findings will be used to determine the best way to affect change related to EDI.

Thorpe also volunteers with the Out of the Cold program in downtown Toronto to provide lunches and other donations to those who struggle with housing insecurity or who have low incomes. She spends a few hours every Sunday assisting with food preparation. Some of her other volunteer engagements, including being a guide for the visually impaired runners who are training for races, have been put on hold due to the COVID-19 pandemic.

“It's very important to me to stay engaged in the community weekly even in the busiest times of the school year,” Thorpe says. “I do better when I have time to separate myself from my schoolwork and get to know my community. Prioritizing these types of involvement may come at cost, but it’s such a worthy one to me.”

'A mindset that needs to change': U of T researcher promotes gender equality on the global stage

Christopher.Sorensen — Wed, 04 Mar 2020 19:47:45 +0000

'A mindset that needs to change': U of T researcher promotes gender equality on the global stage

Christopher.Sorensen Wed, 03/04/2020 - 14:47

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U of T's Grace De Souza is the vice-president of the Women in Science Network, a subgroup of the International Association of Dental Research (IADR), a global academic research association with over 10,000 members worldwide (photo by Jeff Comber)

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Grace De Souza, an associate professor in the �ؿ�ζSM’s Faculty of Dentistry, wants to raise awareness about the impact of gender-based discrimination on the careers of female scientists, which she says is ubiquitous.

Even the language used in reference letters can lead to bias against women, says De Souza, who adds that her eyes were opened when she attended a U of T workshop on anti-discrimination and unconscious bias in grant reviews.

That led De Souza to get involved with the Women in Science Network, a subgroup of the International Association of Dental Research (IADR), a global academic research association with over 10,000 members worldwide.

“There is a mindset that needs to change. The least we can do is open up a conversation,” says De Souza, who was elected vice-president of the network in January and is now holding those conversations on a world stage.

The Women in Science Network formed in 2011 after a review conducted by the IADR showed that, despite gains, women in science continue to face barriers to equal pay, tenure, and grant success. They also receive significantly fewer major recognitions. Now boasting over 300 active members from institutions across North America and internationally, the network organizes events throughout the year that bring greater awareness to gender barriers and propose strategies to dismantle them.

Leadership is one such barrier. “Historically, we may have seen an increase of women in dentistry, in academia, but not in leadership roles,” says De Souza, who adds that the situation may be starting to change in part due to network members’ efforts to improve equal gender representation.

Current and past presidents of the IADR are women, for instance, marking an important new trend in the organization’s 100-year history. Only 10 women have ever been elected to its leadership, with the first taking office in 1981 and the second being elected in 1999. At the upcoming centennial meeting of the IADR in March, the network will host a mentorship event, with the goal of helping more women step into leadership positions.

A large part of the network’s mandate is to organize events that prompt dialogue on issues of gender. They run a successful symposia series, for example, that deals with topics ranging from harassment in academic institutions to the importance of scientific rigour, and published a special issue of the IADR’s Advances in Dental Research this past November.

Recognition platforms are another means to improve gender equality, according to De Souza. Awards are handed out by the Women in Science Network at the IADR’s annual meetings, and they have developed a program to fund research projects that promote better representation of female scientists.

But while these interventions are important for dentistry’s largest academic research organization, they shouldn’t stop there, says De Souza. “We are always looking for initiatives to improve the conversation,” she says, and those conversations should continue at the members’ home institutions, as well.

At the end of her tenure as vice president in 2021, De Souza will step into the role of president of the Women in Science Network.

The smile doctors: U of T Dentistry instructor, students help thousands through overseas volunteer effort

Christopher.Sorensen — Fri, 29 Nov 2019 21:15:18 +0000

The smile doctors: U of T Dentistry instructor, students help thousands through overseas volunteer effort

Christopher.Sorensen Fri, 11/29/2019 - 16:15

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Courtney David and Elahe Behrooz with volunteer supervisor Izchak Barzilay in Kabale, Uganda (photo courtesy of David Chvartszaid)

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Izchak Barzilay has been an instructor at the �ؿ�ζSM’s Faculty of Dentistry for over 33 years while maintaining a successful practice. But about five years ago he branched out into volunteer dentistry – a decision that took him all the way to Kabale, Uganda.

Now he travels annually to the region with his not-for-profit Build Your Smile Dental Foundation, each time bringing with him two fourth-year U of T students who are pursuing doctorate degrees in dental surgery. Over the course of eight days, the group sets up make-shift dental hospitals in fields and villages, where they perform hundreds of procedures.

It’s vital aid for communities that can lack even basic oral hygiene supplies. “Many of the stores we saw didn’t have tooth care products,” says Elahe Behrooz, one of the first students to go on rotation in Uganda in 2016. “They didn’t even carry toothbrushes.”

Over the years, the team has shifted their emphasis from emergency dental care – mostly fillings and extractions – to restoring people’s teeth via dentures. They bring supplies donated from the Canadian dental community, and co-ordinate treatment in conjunction with local health authorities.

Students benefit as much as the patients, according to volunteer supervisors such as Barzilay. On the cusp of graduation, fourth-year students become faster at performing procedures, more adaptable and learn to think outside the box. They also gain insight into how their skills and knowledge can support underserved populations. A number of students, like Behrooz, have become repeat volunteers post-graduation or support the foundation’s work in shelters across the Greater Toronto Area.

“We have seen wonderful things come from these students,” Barzilay says.

Dentistry student Elahe Behrooz at work in Uganda (photo courtesy of David Chvartszaid)

Alongside his dentistry skills, Marshell Kurniawan’s rotation in Honduras last February taught him what he truly valued in a future career path. Working under William Kerr – a U of T Scarborough graduate and the site supervisor of the programs in Honduras and Haliburton County in Ontario – Kurniawan realized that mentorship “is so important as part of the profession. It goes such a long way to develop you professionally and as a person.”

Kerr began volunteering as a dentist in El Porvenir, Honduras in 2009. He’s been supervising the faculty’s students on international rotations since 2017, offering free dental care to the children of the economically depressed area. “Many of [the town’s] young children had rampant decay,” he explains.

The team’s interventions have had a massive impact. Over the past 11 years, Kerr and his small crew have attended to over 6,000 young patients. That breaks down to 1,295 extractions, 1,832 restorations, 263 root canals and 14 partial dentures for the children of the town.

The team at work inside the Ugandan facility (photo courtesy David of Chvartszaid)

It wasn’t long before Kerr’s international work led to a project closer to home: the Volunteer Dental Outreach for Haliburton County, a charity offering free dentistry to low income adults. A pilot project rotation with the school’s doctor of dental surgery students began in 2016.

The Haliburton placement was – and is – a family affair. “The two students stayed at our home and spent two days treating many adult patients,” says Kerr, who estimates that the charity has provided over $2.7 million in free dental care to the region.

The successful pilot project quickly expanded to up to 34 students annually – all hosted by Kerr and his family (two at a time).

The Central American teams have also grown. Two students have attended the Honduras site each year since 2017 while an additional two-student rotation began in Guatemala in 2018.

“I try to teach students that, ultimately, they always have to do their very best for every patient and, as they prepare to graduate, they need to hone their skills to get better and faster.”

Bill Kerr (left) and Izchak Barzilay (right) with Daniel Haas, dean of the Faculty of Dentistry at U of T’s Arbor Awards, which recognize exceptional volunteerism (photo courtesy of Dave Hanson)

For the dentists who supervise the students on these trips, it’s not just about the work.

“I love to see joy in a student’s eyes when they accomplish something they have never done before or develop a new skill or technique,” Kerr says. “It is very rewarding to see the students help someone who needs their help and can’t afford their help.

“I hope we are helping build up the next generation of volunteers.”

The students are just as affected.

“He’s my Yoda,” Kurniawan says of Kerr, a reference to the Star Wars character. “I’m going to do more of this in the future. I want to do what Dr. Kerr is able to do.”

#WeTheNorth: U of T students, faculty and staff cheer on the Raptors

davidlee1 — Fri, 31 May 2019 18:50:37 +0000

#WeTheNorth: U of T students, faculty and staff cheer on the Raptors

davidlee1 Fri, 05/31/2019 - 14:50

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Support for the Raptors was on full display at U of T before, during and after the team's Game 1 win over the Golden State Warriors (UTSC photo via Twitter.com)

Topic

Faculty of Arts & Science

Faculty of Kinesiology & Physical Education

Undergraduate Students

Varsity Blues

The Toronto Raptors’ long road to the NBA Finals started before most �ؿ�ζSM undergraduate students were born. But that didn't stop them from being among the loudest, proudest fans cheering on the team last night.

Students – as well as many faculty and staff – held viewing parties on campus and took to social media to celebrate as the Raptors defeated defending champions Golden State Warriors in the opening game, 118 to 109.

“Their defense was great, and it wasn’t our best night,” Golden State coach Steve Kerr told reporters after the game. “We just got outplayed.”

The win came as no surprise to John Campbell, head coach of men’s basketball at U of T, who predicted the Raptors will win the series.

And it made total sense to U of T’s Jeffrey Rosenthal, a professor in the department of statistical sciences and author of Knock on Wood: Luck, Chance, and the Meaning of Everything. Rosenthal predicted a Game 1 win and gave the Raptors the edge to win the NBA Finals.

As for simply being Raptors fans, here's a snapshot of what took place elsewhere among the U of T community over the past 24 hours:

Students, faculty and staff show off their Raptors gear at U of T Mississauga.

Wisdom Tettey, vice-president and principal of U of T Scarborough, added a Raptors tee to his wardrobe.

Faculty member Ron Levi weighed in on U of T’s support of the Raptors and their history-making NBA Finals appearance.

Students gather to watch the game on a big screen at a viewing party at U of T Scarborough.

U of T’s Joe Wong rubs social media shoulders with Raptors “superfan” Nav Bhatia.

President Meric Gertler is a Raptors fan, too.

The �ؿ�ζSM Archives takes a historical look at the situation.

Faculty member Mark Fitzpatrick is decked out in Raptors gear at U of T Scarborough.

Some members of the U of T community have been monitoring the Raptors closer than others.

_______________________________________________________________________________

Can’t wait for Sunday’s game? Need more Raptors’ content? We’ve got you covered:

Jurassic Doc: Howard Petroff Keeps the Raptors in the Game

U of T basketball coach Tamara Tatham joins Raptors 905 as first Canadian woman in the role

Basketball, charity, family: Raptors President Masai Ujiri speaks at U of T's Black History Luncheon

A deal with the Raptors: U of T dance-tech startup builds industry cred

Raptors' dentist preps for NBA All-Star Game: “When they're hit, they're hit hard”

Government of Canada provides almost $5 million for U of T cutting-edge research

ullahnor — Fri, 03 Mar 2017 15:50:07 +0000

Government of Canada provides almost $5 million for U of T cutting-edge research

ullahnor Fri, 03/03/2017 - 10:50

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Canada Foundation for Innovation’s John R. Evans Leaders Fund awarded $5 million in total to 19 U of T researchers (photo by James Poremba)

Topic

Faculty of Arts & Science

Dentistry

UTM

KPE

Nineteen scholars at the �ؿ�ζSM have been awarded almost $5 million to support research in everything from using stem cells to fix injured hearts to creating an advanced laboratory to develop large astronomical telescopes.

“Our government understands the important role Canada's scientists and researchers play in developing the evidence we need to make decisions that impact our environment, our health, our communities and our economy,” said federal Finance Minister Bill Morneau, who announced the funds for Toronto-area universities today. “Strengthening our support for research innovation and infrastructure and improving access to post-secondary education is fundamental to our government's plan for a strong middle class and a growing economy.”

The investment was made by the Government of Canada through the Canada Foundation for Innovation’s John R. Evans Leaders Fund, which is designed to help universities attract and retain the best and brightest researchers from around the world by giving them access to state-of-the-art research tools.

“I’d like to congratulate our 19 researchers and thank the Government of Canada and the Canada Foundation for Innovation for their continuing support,” said Vivek Goel, U of T’s vice-president of research and innovation. “As recognized leaders in their fields, this funding will help them acquire research infrastructure that is internationally competitive and enable research to be conducted that will lead to significant results for Canadians.

“Every day, our researchers are engaged in an outstanding array of research aimed at tackling real-world challenges that have the potential to benefit all of us. This funding will ensure that work can continue at the highest level.”

The John R. Evans Leaders Fund recipients affiliated with U of T are:

Faculty of Applied Science & Engineering

Mohsen Ghafghazi, $150,000, for “Investigating the response of gravelly soils to earthquake loading through large scale cyclic simple shear testing.”

Suresh Sivanandam, $138,000, for an “Advanced optical instrumentation laboratory for large astronomical telescope instrument development.”

Faculty of Arts & Sciences

Mark Wilson, $250,000, for “Infrastructure for the study of excitonic materials and the development of nanocrystal-sensitized photon upconversion.”

Faculty of Dentistry

Boris Hinz, $250,056, for “Developing new strategies and technologies to fight fibrosis.”

Faculty of Kinesiology & Physical Education

Tyson Beach, $199,090, for “Movement assessment and retraining for the prevention of musculoskeletal disorders.”

Katherine Tamminen, $61,341, for “Developing the �ؿ�ζSM Sport and Performance Psychology Lab.”

�ؿ�ζSM Mississauga

Rob Ness, $120,000, for “How recombination alters selection in the genome.”

Michael Phillips, $140,000, for “Control and adaptive responses of the plant metabolome.”

Faculty of Medicine

Sheena Josselyn, $798,057, for “Observing and manipulating brain function.” Josselyn is also a senior scientist at SickKids.

David Andrews, $615,894, for “High content screening to identify and validate potential therapeutic targets.” Professor Andrews is also a director and senior scientist at the Sunnybrook Research Institute.

Deryk Beal, $108,791, for “Non-invasive brain stimulation for speech and language development.” Beal is also a clinician-scientist at the Bloorview Research Institute.

Bryan Coburn, $259,938, for “Personalized microbiology, infection and immunity. Coburn is also a clinician-scientist at the University Health Network.

Alan Davidson, $399,980, for “Electron microscopy for the engineering of novel bactericidal nanomachines derived from bacteriophages.”

James Ellis, $188,744, for “Stem cell derived neuron phenotyping and drug screening platform.” Ellis is also a senior scientist at SickKids.

Adam Gehring, $218,378, for “Immunotherapy for chronic viral hepatitis.” Gehring is also a scientist at the Toronto General Hospital Research Institute, UHN.

David Jaffray, $396,428, for “Robotic radiobiology.” Jaffray is also senior scientist, Princess Margaret Cancer Centre, UHN.

Michael Laflamme, $214,569, for “Remuscularization of injured hearts using stem cells.” Laflamme is also a senior scientist at the Toronto General Hospital Research Institute, UHN.

Tracy McGaha, $398,219, for “Laboratory for mechanistic studies of myeloid-driven immune suppression. McGaha is also a senior scientist at Princess Margaret Cancer Centre, UHN.

Darlene Reid, $75,000, for “Rehabilitation aimed at muscle performance (RAMP).

Meet U of T’s newest Canada Research Chairs

ullahnor — Fri, 02 Dec 2016 17:33:09 +0000

Meet U of T’s newest Canada Research Chairs

ullahnor Fri, 12/02/2016 - 12:33

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Federal Minister of Science Kirsty Duncan announces the 25 new Canada Research Chairs at U of T (photo by Johnny Guatto)

Topic

Our Community

Research & Innovation

Canada Research Chairs

Faculty of Arts & Science

Faculty of Social Work

Faculty of Applied Science & Engineering

Dalla Lana School of Public Health

Dalla Lana School of Public Health

Andrea Tricco
Canada Research Chair in Knowledge Synthesis

In the fast-paced world of health-care research, having the most up-to-date research at your fingertips is imperative for doctors, policymakers and patients to make the best, most informed decisions.

But the sheer amount of complex research available – and the fact not all of it is consistent in findings and conclusions – means it’s impossible to read everything quickly and accurately. That’s where knowledge synthesis can make all the difference.

Andrea Tricco, Canada Research Chair in Knowledge Synthesis, is leading research to advance the science of knowledge syntheses within health, including identifying and validating the best rapid review methods. She is also leading research to improve the reporting of scoping reviews and a type of systematic review that uses advanced statistical methods called network meta-analysis.

In the field of knowledge syntheses, there are systematic reviews, rapid reviews and scoping reviews to summarize all pertinent studies on a question, improve the understanding of inconsistencies and define future research agendas.

The results from knowledge synthesis can then be used to create policy briefs, clinical practice guidelines and patient decision aids.

Systematic reviews, which are the gold standard in reviewing research, take thousands of hours to complete while rapid reviews, a type of knowledge synthesis, typically take just six to 12 weeks. But it’s unclear if rapid reviews are susceptible to biased results because of short-cuts in the process. What is clear is that decision-makers need and expect the information quickly – often in three months or less.

The results of Tricco's research will be used to directly inform knowledge synthesis groups that exist in Canada, as well as internationally, on how to provide relevant, timely and high quality information to health decision-makers.

Read more about Gilbert and Hatzopoulou

Faculty of Arts and Science

Rachel Barney
Canada Research Chair in Ancient Philosophy

Debate has long raged over the role of the sophists in the development of Western philosophy. Derided even in their own time in ancient Greece as tricksters and corruptors of youth, this group of learned men gave paid lessons to upwardly mobile Athenian men to teach them how to win political arguments, regardless of their virtue.

Philosophers have commonly believed they had little influence over the ancient Greek philosopher Plato, a student of Socrates and teacher of Aristotle, who forcefully denounced their teachings in his influential dialogues such as the Protagoras and Gorgias more than 2,000 years ago.

Rachel Barney, Canada Research Chair in Ancient Philosophy, has offered another way of looking at Plato’s philosophy and the ancient debate to which it belongs. One that shows both Plato and his sophist contemporaries such as Protagoras made contributions to – and are continuing to influence – both our ways of thinking about ethics and methods of philosophical argument in general.

She argues Plato both responds to and appropriates the ideas and methods of the sophists in his work. As such, she will offer a new account of their debates, one which will make it accessible and exciting to a wide range of scholars, contemporary philosophers and students.

Did Plato believe virtue could be taught like the sophists? And what did he believe virtue was? Is it a kind of knowledge or mental health or perhaps a learned skill?

She will also study the origins of sophistic thought and argue it was so successfully incorporated by Plato and others into the bloodstream of philosophy that their origins tend to be forgotten, and their primary significance and functions overlooked.

John Cunningham
Canada Research Chair in Addictions

It is an unfortunate reality that most people with addictions will never seek formal, face-to-face treatment with an expert. Common obstacles include a lack of available treatments, particularly in rural settings, concerns over stigma and a desire for self-reliance.

An effective new option to promote recovery is to develop and design interventions for problem gamblers, drinkers, smokers and illicit drug users they can administer on their own.

John Cunningham, the Canada Research Chair in Addictions, is a world-leading expert in the development and evaluation of assisted self-change interventions for addictions, including pioneering research on Internet interventions for hazardous drinking.

In Canada and Australia, he’s conducting several randomized controlled trials, including Internet interventions for heavy drinkers and mailing nicotine patches to smokers to help them quit.

His research will also encompass ways to treat addictions in high-risk situations, in vulnerable or hard-to-reach populations, among illicit drug users and in integrating assisted self-change with face-to-face treatment.

For example, using gaming and intervention apps, Cunningham will target heavy drinkers with limited literacy to teach safe drinking techniques and encourage them to employ interventions based on their own reporting of situations where they’re in danger of drinking, such as the holiday season.

The long-term goal is an improved system of care for people with addictions, fully integrated within the larger health-care system and widely accessed both in Canada and internationally.

Such research will lead to sustained improvements for those suffering from addictions and contribute toward a reduction in the health and societal costs associated with this challenging health problem.

Marie-Josée Fortin
Canada Research Chair in Spatial Ecology

Understanding how many species will respond to global change is a central challenge in ecology because their population health is vital for the overall ecosystem and the survival of humans.

To understand and predict the impacts of global change on animal movement and the survival of isolated populations of the same species, the field of spatial ecology examines everything from the size of the “patch” where communities live to the predators that threaten prey survival and their adaptability to changes in climate, food availability, disease and reproduction rate.

Through her work, Marie-Josée Fortin, Canada Research Chair in Spatial Ecology, will provide ecologists with novel network analytical methods that can be used to propose management strategies to facilitate species dispersal in fragmented landscapes, to maintain the resilience of ecosystem services, or to prevent disease spread.

By doing so, she will provide novel perspectives on how to address fundamental and applied issues in the field of conservation biology by making novel network analytical models available to ecologists and evolutionists allowing the analysis and modeling of the complex spatial dynamics of species interactions across scales, trophic levels and ecosystems.

Collectively, the proposed conceptual and analytical models will have important implications for the protection of biodiversity and its valuable role in the maintenance of ecosystem functions as well as human health.

This research will provide fundamental and applied contributions that will significantly advance the fields of conservation biology, ecology, evolution, landscape genetics and landscape epidemiology.

Paul Frankland
Canada Research Chair in Memory Research

Memory disorders affect millions of Canadians. In some cases, such as Alzheimer’s disease, important memories can be lost, while persistent memories tied to traumatic events can lead to depression and post-traumatic stress disorder.

To develop better treatments for these disorders, it’s critical to understand how memories are organized and stored in the brain and how they can be altered after they are formed – sometimes by disease.

Paul Frankland, Canada Research Chair in Memory Research and a global leader in the field, combines behaviour, imaging and molecular approaches to study memory.

In particular, his research focuses on how changes in memory organization – from their creation in the hippocampus to their reorganization in the cortex for long-term storage – affects their quality.

He and his team are also building on their discovery that new neurons generated in the hippocampus throughout our lifetimes help the brain create new memories and forget older ones.

Like in artificial systems, there is a trade-off in brain networks between plasticity – the ability to incorporate new information – and stability, which ensures that incorporating new information does not degrade information already stored in the network.

Frankland will use whole brain mapping approaches in mice and zebrafish to define memory networks, identify areas of network vulnerability and use this knowledge to develop strategies to restore memory function.

His team will also use genetic interventions and compounds that emerge from pro-neurogenic drug screens conducted at SickKids to manipulate neurogenesis.

By weakening memories after they’ve formed – like in the movie, Eternal Sunshine of the Spotless Mind – we can develop more effective treatments for addiction and other disorders associated with abnormal memory persistence or rumination.

Sheena Josselyn
Canada Research Chair in Systems Neuroscience

Memory impairments are a hallmark of aging, mental illness, developmental disorders, as well as several neurological disorders.

Examining how the brain normally encodes and uses information is an important goal in and of itself, but also may serve as a first step to developing treatments when these complex processes go awry in conditions ranging from autism to Alzheimer’s disease.

The development of new tools has enabled the lab of Sheena Josselyn, Canada Research Chair in Systems Neuroscience, to identify, understand and even manipulate memory traces (engrams) in rodent brains.

First, they erased a memory. Now, they’re working on more sophisticated problems such as altering memories or recalling them at will by choosing what brain cells to turn on or off. To help in their research, Josselyn’s team has developed a state-of-the-art, 1 photon fluorescent mini-microscope that enables them to observe the brains of mice at the cellular level as they form and retrieve a memory.

They’ve also made significant progress in advancing our understanding of why certain nerve cells are used in engrams and others aren’t. Her team has successfully selected and manipulated nerve cells to boost their CREB function, which plays a role in binding DNA and regulating gene expression, after noticing that factor leads to preferential recruitment by engrams. One of their most interesting experiments shows promise for potential addiction treatments.

Martin Krkosek
Canada Research Chair in Population Ecology

The ability of the oceans to feed humanity is under threat from a number of sources including the rise and spread of infectious diseases.

As global fisheries landings have either plateaued or declined, the world has turned to aquaculture as a way to provide seafood and relieve overfishing on existing ocean stocks. The blue revolution has been so successful that most salmon people eat are now grown in open sea pens that dot the coastal seas of countries such as Canada, Norway, and Chile.

But intensive aquaculture production hasn’t been without risk. Parasites and diseases like sea lice and infectious salmon anemia virus have emerged, challenging aquaculture industries and perhaps contributing to the decline of wild marine ecosystems and fisheries.

Martin Krkosek, Canada Research Chair in Population Ecology, is studying salmon in British Columbia to probe what causes infectious diseases to emerge in wild and farmed fish and the ways to control disease spread.

His work includes how domesticated environments can cause pathogens to evolve antibiotic resistance and increased virulence, and how changes in host abundance and distribution can abruptly cause epidemics.

This research will help protect ocean biodiversity, as well as human health and food security.

Ito Peng
Canada Research Chair in Global Social Policy

Contracting out the care of our young children and rapidly aging populations is producing significant societal changes around the world – even changing migration patterns, as females are drawn from poorer countries to work in wealthier nations.

Research by Ito Peng, Canada Research Chair in Global Social Policy, has shown this urgent demand is also being driven by shifts in traditional family obligations, the growing service economy and in an ironic twist, gender equality as more and more women are working outside of home.

This has contributed to growing demands for government services. National governments have responded by providing more public care services and/or subsidies and tax incentives for families to purchase care privately. In almost all cases, care is increasingly being commodified as a service to be purchased in the market.

This change isn’t confined to Western countries. It’s even happening in many southern Mediterranean and Asian countries, which have strong cultural traditions of families providing care, Peng has found. In Spain and Italy, the government care allowance has enabled a large proportion of elderly people to hire foreign migrant caregivers. This is helped by the increased intake of foreign caregivers. But there remain holdouts such as Japan, which has resisted opening its doors to increased immigration.

Peng is globally known for her research in showing how changes in domestic factors interact with global institutions and actors in shaping social policy development within countries.

In the case of care workers, she is studying policies in North America, Asia, Oceania and Europe to examine broad theoretical issues around how care and immigration policies are informed by societal and cultural norms, expectations and trends, and how these policies in turn help influence societal and cultural norms and trends. Her research also looks at the implications of these policies for the migrants performing care work.

This knowledge will make an important contribution to public and policy debates, particularly in current socio-economic contexts where international migration continues to accelerate amidst the intensification of immigration politics and growing calls for national and regional governments to develop effective social policy and governance to address the issue.

Amar Vutha
Canada Research Chair in Precision Atomic and Molecular Physics

Atoms and molecules can be used as extremely precise tools to advance fundamental physics and practical technology.

For example, highly accurate clocks based on laser-cooled atoms can now keep time to better than one part per quintillion (1 followed by 18 zeros). Such accuracy forms the basis of our global system of measurement standards, and allows ventures ranging from deep space navigation to cellular communications networks to precision manufacturing.

Amar Vutha, Canada Research Chair in Precision Atomic and Molecular Physics, is taking this precision one step further – by developing a portable version of such atomic clocks.

These clocks have potential applications in improving metrology, navigation and mapping the earth’s gravitational field. Excitingly, these clocks could also open up a new way to “see” gravitational waves emanating from black holes and other hitherto invisible inhabitants of our universe.

Vutha’s research group will also develop other atomic and molecular tools to reveal unexplored physics. For example, very precise measurements on cold, confined molecules can shed light on physical and chemical processes occurring millions of light years away in gas clouds in space. New techniques that are needed to make such precise measurements, using lasers and terahertz radiation, will be studied in his group.

A big puzzle about the universe is the absence of natural anti-matter anywhere. While lots of anti-matter is believed to have formed after the Big Bang, the fate of all that anti-matter remains a mystery. One approach to unraveling this puzzle is to precisely probe the shape of certain atomic nuclei. Vutha’s group will develop new experiments to measure such properties of nuclei, which could also lead to practical payoffs such as improved gyroscopes for navigation.

Faculty of Dentistry

Celine Levesque
Canada Research Chair in Oral Microbial Genetics

A biofilm is a collection of microbes – such as bacteria – that stick to each other and to a surface to survive. When biofilm bacteria attack the human body, they can be difficult to fight. In fact, antibiotics need to be 100 times more concentrated than usual in order to kill biofilm bacteria.

Biofilm bacteria have also developed clever ways to stay alive. Some bacteria in biofilms can essentially commit suicide – known as “programmed cell death” (PCD) – to enable other microbes to become stronger and better able to survive. They can also remain dormant until antibiotic treatment is completed. As a result, microbes can persist for months or even years in the body and lead to recurrent infections that are very difficult to eradicate.

Celine Levesque, Canada Research Chair in Oral Microbial Genetics, is investigating how biofilm bacteria develop the means to survive and grow by studying an oral pathogen that can lead to tooth decay.

Levesque’s research will result in better understanding of the genetic networks that regulate PCD and the formation of “sleeping” bacteria. It will also help lead to better treatments for such biofilm infections as tooth decay, children’s ear infection, cystic fibrosis pneumonia and necrotizing fasciitis, the so-called flesh-eating disease.

Faculty of Medicine

Ana Andreazza
Canada Research Chair in Molecular Pharmacology of Mood Disorders

One in 10 Canadians suffers from highly disabling mood disorders including bipolar disorder, major depressive disorder and schizophrenia. Currently, diagnosis is based upon self-reported symptoms or behavioural observations that lack substantial biological validation.

Ana Andreazza, Canada Research Chair in Molecular Pharmacology of Mood Disorders, is an emerging international leader in this field, which is searching for affordable, easy-to-use and clinically relevant biological markers that can be used for biological confirmation of a mood disorder diagnosis or to identify people at risk of developing a mood disorder.

The identification of biological targets will open doors to the development of new treatments strategies that treat abnormalities or impairments in oxidation processes in the periphery that contribute to mood disorders.

Her research, in collaboration with other laboratories, has produced some of the most convincing insights to date into the mechanisms that underlie mood disorders by focusing on metabolic processes known as oxidation and reduction reactions or redox modulations.

Oxidation in our cells is a natural process that converts energy from food to ATP, a molecule that carries energy to where the body needs it. But the oxidation process isn’t always well modulated.

For example, Andreazza's research demonstrates increased mitochondrial dysfunction and redox modulations in brain and blood cells of patients with mood disorders. This discovery led to treatments with antioxidants that have shown promising results when used with other therapies in treating mood disorders.

She is currently furthering her study of the role these redox abnormalities or impairments play in mood disorders and is exploring the possible effects of redox modulations on molecular pathways leading to synaptic alterations, particularly those that might provide potential avenues for therapy. She is also investigating the role these redox mistakes and inflammation in signalling white matter changes in mood disorder.

Anne-Claude Gingras
Canada Research Chair in Functional Proteomics

Inside a living cell, proteins associate with one another to perform their activities in a tightly regulated manner to maintain proper cellular function, similar to the different parts of an assembly line and temperature controlled rooms in a factory.

Research by Anne-Claude Gingras, Canada Research Chair in Functional Proteomics, is developing a map showing how the factory is organized, in order to better understand the processes that go awry in disease.

Using advanced protein identification instruments known as mass spectrometers, she will identify the precise physical interactions and location of a large number of proteins to begin constructing a physical blueprint of a human cell.

Her research team will make this blueprint openly available to researchers to accelerate health research worldwide.

This dovetails nicely with the significant contributions they’ve made in the field of protein-protein interactions by creating tools that enable researchers worldwide to analyze their own mass spectrometry data, increasing the impact of Gingras’ research beyond the specific biological questions she’s investigating.

In addition, she will create an in-depth analysis of specific signalling pathways, part of a complex system of communication governing and coordinating the basic activities and actions of cells, and how errors in processing can lead to diseases, such as cancer. Her systematic analysis of normal and mutated proteins is already paving the way for new opportunities for therapeutic options.

Mikko Taipale
Canada Research Chair in Functional Proteomics and Protein Homeostasis

Proteins perform a wide variety of important jobs in cells. But in their crowded milieu, stressors can easily derail their finely tuned network, leading to mutant, misshapen proteins that have been implicated in human diseases such as cancer, cystic fibrosis and sickle-cell anemia.

How this network – known as cellular protein homeostasis (proteostasis) network – coordinates all these processes is poorly understood, making it difficult to develop targeted treatments.

Mikko Taipale, Canada Research Chair in Functional Proteomics and Protein Homeostasis, is drawing on his expertise in protein quality control, high-throughput biology and chemical biology to understand how this network is organized – with particular focus on deciphering the Hsp70 chaperone and its co-chaperones – and how it contributes to human diseases.

Chaperones are the most prominent class of proteins that shape the proteostasis network. They briefly bind thousands of substrate proteins in the cell and promote their folding, trafficking and degradation. In fact, they act as guardians controlling the fate of mutant proteins.

Studies have shown the Hsp70 network is at the crux of devastating neurodegenerative diseases such as Parkinson’s, Alzheimer’s and Huntington’s and plays also a central role in rare Mendelian diseases.

By focusing on Hsp70, Taipale and his team will generate the largest and most comprehensive interaction network for cellular quality control factors and their client proteins including 2,500 mutant variants associated with 1,100 Mendelian diseases.

This network will be complemented with followup studies to further develop chaperone-based thermodynamic and conformational sensors for biotechnological applications, and to develop innovative methods to detect drug/target interactions in human cells.

How bacteria invade: U of T research sheds light on age-old mystery

lavende4 — Thu, 25 Aug 2016 14:28:19 +0000

How bacteria invade: U of T research sheds light on age-old mystery

lavende4 Thu, 08/25/2016 - 10:28

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Tara Moriarty (standing) and student (Jeff Comber, Faculty of Dentistry, photo)

Erin Vollick

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They’re small, unassuming – and potentially deadly. And while most bacteria are rendered harmless by the body’s defense mechanisms, to date there has been very little understanding of exactly how bacteria are able to navigate the blood stream to invade organs, where they can cause massive damage and in some cases, death. But in a study published in the journal Cell Reports this week, scientists at the �ؿ�ζSM have used a new live-imaging system to shed new light on this ancient mystery. To their surprise, the researchers found that bacteria utilize the same strategies for invasion that the body’s immune cells use for defense.

The team focused its study on the bacterium B. burgdorferi, known to cause Lyme disease which can invade joints, brain, heart and other tissues. This bacteria is part of the spirochete family of bacteria associated with diseases such as relapsing fever, leptospirosis, and periodontal disease – a major cause of human disease worldwide.

To uncover the secrets behind this bacteria’s massive success, the team developed novel imaging analysis methods to capture and study thousands of films of the individual bacterium in flow chambers and blood vessels.

“It’s always been hard to understand why spirochete bacteria are so highly invasive,” explained Tara Moriarty, assistant professor at the Faculty of Dentistry and the Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, and senior author of the study.

That’s because once bacteria enter the bloodstream – say, from the bite of a tick – they face a great deal of force. Imagine a fast-flowing river: the bloodstream should exert enough force to sweep the bacteria through the circulatory system and into the liver, spleen and lungs, where they would be met by the body’s immune system and eliminated.

But in fact, the bacteria’s catch bonds grow stronger as they encounter more force from blood flow, which makes them particularly good at sticking to blood vessels.

Likening their imaging process to “plucking a single cell out of a haystack,” and filmed in real time, the researchers deduced that individual bacterium use ‘catch bonds’ and ‘tethers’, something like an anchor on a rope, to hook onto the blood vessel’s endothelial cells and slow down. The propeller-like structures which help bacteria propel forward appear to allow the bacteria active control of their movements, enabling them to wriggle out of the flowing river of blood and make their way into other parts of the body.

“This is the first time we’ve seen this with any bacterium,” said Moriarty.

But perhaps the most striking feature of the bacteria’s invasion tactics is that they are eerily similar to those of the body’s own immune cells. Different in terms of their shape, size and surface proteins, bacteria and white blood cells nonetheless seem to move about the body using the same catch-tether techniques. “It’s pretty surprising and fascinating that you’d see bacteria [use these methods], too,” Moriarty added.

The study’s first author, Faculty of Dentistry PhD student Rhodaba Ebady, hopes that the study’s novel imaging technique can be used in other in vitro studies. “I’m still pretty amazed at the behaviour of the bacteria when they are interacting with the endothelial cells. They do some very interesting things sometimes,” Ebady said.

“I hope to see this research continue for other bacteria that require vascular dissemination to cause infection [and that] it will lead to finding ways to prevent the dissemination of bacteria,” she added.

To floss or not to floss? U of T experts explain

krisha — Fri, 19 Aug 2016 16:58:26 +0000

To floss or not to floss? U of T experts explain

krisha Fri, 08/19/2016 - 12:58

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(photo by G M via flickr)

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Flossing

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Flossing.

You likely don’t love it. You may think everyone in the world is doing it but you. And now, thanks to a recent study suggesting that flossing may not be all that effective, you may think you can give it up for good.

But should you throw out that dental floss?

Writer Erin Vollick of the Faculty of Dentistry put that question and more to a panel of experts at U of T:

Amir Azarpazhooh, associate professor and dental public health specialist, Faculty of Dentistry
Laura Dempster, associate professor and expert in preventive health, Faculty of Dentistry
Wafa El-Badrawy, associate professor of restorative dentistry, Faculty of Dentistry
Jim Lai, vice-dean, education at the Faculty of Dentistry and head of the graduate specialty program in periodontology

Flossing is supposed to help prevent periodontal disease and gingivitis. Can you explain what these are?

Jim Lai: Periodontal diseases are a group of inflammatory diseases. The presence of bacteria leads to a host inflammatory response. The mildest form is gingivitis where the gums become red, swollen and bleed easily. Gingivitis is reversible. A more destructive form is periodontitis where if untreated, periodontitis will lead to tooth loss. These are complex diseases with multifactorial risk factors.

As a result, oral home care needs to be specific to the patient. Some patient will benefit from flossing while other patients, the use of interdental brush would be more effective. These types of decision requires the clinical experience of the practitioner and in addition to the understanding of the evidence available.

The study says flossing does not prevent cavities, or caries. What are these, and what causes caries?

Wafa El-Badrawy: Caries is formed when a specific type of bacteria (streptococcus mutans), normally present in the oral environment, reacts with carbohydrates found in plaque and food debris. The reaction produces an acid that attacks the enamel surface causing demineralization with loss of calcium and phosphorous. If the situation does not change, demineralization will continue until a cavity is formed.

How was flossing traditionally thought to help prevent this disease?

Wafa El-Badrawy: Proximal caries (caries that forms in between the teeth) starts typically below the contact areas between the teeth. Flossing is the mechanical process that helps to clean these inaccessible areas that the toothbrush cannot reach. Flossing removes plaque formed on these in-between surfaces and, as a result, helps to prevent acid formation necessary for progress of caries.

Based on the evidence, is dental floss still a good tool to prevent gum disease and caries?

Laura Dempster: What we do know is that no matter how well you brush your teeth, you cannot remove plaque and food debris from all tooth surfaces with a toothbrush. You need to use floss or some other product to clean between your teeth. Figure out what works best for you! The best idea is to consult your dentist or dental hygienist, as they can help you find the right product that works for you, and to show you how to use it properly.

Wafa El-Badrawy: If an individual does not floss, plaque accumulation below the contact area will build up and remain attached to the tooth surface. Bacteria will then react with it to form acid that causes demineralization of enamel with subsequent formation of a carious lesion (a cavity).

This study sparked huge media interest – and also confusion - what should we conclude?

Amir Azarpazhooh: Overall there was insufficient evidence to claim or refute a benefit for flossing in reducing plaque at 1, 3 or 6 months. Furthermore, it is not possible to state whether flossing may be beneficial in reducing the risk of dental caries as no studies were found that investigated caries as an outcome.

That said, flossing plus toothbrushing showed a statistically significant benefit in reducing gingivitis compared to toothbrushing alone at these three time points, with a moderate effect at 6 months. Overall studies are not reporting adverse effect, or for a small number, gingival trauma from improper use of floss – hence the desirable benefits of flossing in reducing gingivitis appear to be greater than the undesirable harms.

Laura Dempster: It is often difficult to directly compare research studies because they rarely investigate the same factors. As a result, findings vary across studies, which adds to the confusion of knowing which product to use. So the answer to whether floss or another product is more effective depends on many things … the answer is, the most important is the user (their dexterity and skill, and motivation) and the conditions in their mouth (tooth alignment and oral health).

The evidence to support flossing to control dental decay and gum disease is not undisputable. However, not many things are. The reality is that floss can be very effective in cleaning between teeth, but it depends on whether floss is used correctly and regularly.

If you're buying floss, what should you keep in mind?

Laura Dempster: Because there are so many different products on the market, it is difficult for consumers to know which one to use and which one is most effective. The answer is … it depends! It depends on many factors, such as a person’s motivation, personal preference, oral health, tooth alignment, dexterity, skill using the product, and willingness to use it on a regular daily basis. It also depends on whether you are interested in reducing cavities or gum disease.

Amir Azarpazhooh: The brand is not as important as making it work, and using it properly. Dental offices usually give samples for free: try several samples and buy the one that you are comfortable using.

(Visit flickr to see the original of the photo used above)

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How bacteria invade: U of T research sheds light on age-old mystery

To floss or not to floss? U of T experts explain