Cross-programme oral and dental health commissioning brief
The National Institute for Health Research (NIHR) is interested in receiving research proposals evaluating public health measures, healthcare interventions and health and social care services to promote good oral and dental health, and to improve the prevention, detection and treatment of diseases and disorders of the teeth, gums, oral cavity or jaw across the whole life course.
Applicants should justify the importance of their proposed research and identify how the work supports aspirations to reduce health inequalities, improve health outcomes, enable individuals to better manage their own health, extend or support the roles of health and social care staff or improve the delivery of health and social care services. Proposals should also reflect the role of social care in delivering improved outcomes for individuals and the health and social care system. A social care component/outcomes should be included, where appropriate.
Specifically for the purposes of this call, applicants are encouraged to include geographic populations with high disease burden, which have been historically underserved by NIHR research activity in order to ensure that NIHR research is conducted in the areas where health needs are greatest. We would encourage applicants to bring on one or two centres with high disease burden that have been relatively inactive in this area to date.
We would welcome applications that span the remit of one or more of the participating research programmes and which comprise of co-ordinated teams of investigators spanning different specialties/disciplines and geographical centres. Please ensure you familiarise yourself with the remit and scope of the participating programmes using the links below and by referring to the Stage 1 guidance notes for each programme. Do not hesitate to contact us if you have any queries regarding this.
Applications should be co-produced, demonstrating an equal partnership with service commissioners, providers and service users in order to provide evidence and actionable findings of immediate utility to decision-makers and service users. Applicants may wish to consult the NIHR INVOLVE guidance on co-producing research.
The following programmes are participating in this call:
- Efficacy and Mechanism Evaluation (EME)
- Health Services and Delivery Research (HS&DR)
- Health Technology Assessment (HTA)
- Public Health Research (PHR).
N.B. Applications received in response to this NIHR PHR commissioned call may be eligible for a contribution towards intervention costs if Local Authorities (LA’s) or other commissioner organisations are unable to fund the intervention costs. Researchers are expected to work closely with the commissioning organisations to explore and secure intervention cost requirements but in exceptional circumstances where it has not been possible to secure funding, researchers may be eligible to access funding. This is a UK-wide pilot initiative and intervention costs can be covered within England, Wales, Scotland and Northern Ireland. For the Stage 1 application, if you think you are may need to make a case for accessing intervention costs, please enter the amount being requested in the ‘Estimated non-NHS intervention costs’ section of the form and also highlight in writing at the start of the Research Plan section of the form that you may wish to access these funds and the likely amount. Please note that there is an expectation that throughout the commissioning process applicants will continue to try and source these costs from partnering organisations. Please note that these costs are not intended for the development of new interventions. Please visit the PHR remit for more information on eligibility. Proposals applying for intervention costs will be assessed via the standard PHR funding process.
Deadline for proposals:
Application forms will be available from participating programmes websites in December 2019. Please note that submission dates vary and completed forms must be submitted by the date specified on the relevant programme's website.
- 19/153 EME Oral and Dental Health - 1 pm, 11 August 2020
- 20/42 HSDR Oral and Dental Health - 1 pm, 10 September 2020
- 20/40 HTA Oral and Dental Health - 1 pm, 2 September 2020
- 20/41 PHR Oral and Dental Health - 1 pm, 28 July 2020
For further information on the participating programmes, please visit the NIHR website.
The World Health Organisation (WHO) defines oral health as 'a state of being free from chronic mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing'.
Oral health is considered a key indicator of overall health, wellbeing and quality of life. Poor oral health is associated with high disease burden to individuals, health services, and society overall, resulting in reduced quality of life, lost work or school days, and high treatment costs.
Most oral diseases and disorders are chronic and often either preventable or treatable at an early stage. However, data collated by NHS and Public Health England suggest a high prevalence of dental conditions among both adults and children, mainly tooth decay and gum disease, although it is acknowledged that dental health overall appears to be gradually improving.
Oral health inequalities are common in the UK and globally. Social determinants and socioeconomic status have been shown to affect oral health, resulting in economically or socially disadvantaged and vulnerable people experiencing disproportionately poorer oral health than other populations.
This call for research underlines the NIHR's commitment to address this key area of national and global health.
Research areas of interest
Research may involve any aspect of the promotion of good oral and dental health and the improvement of the prevention, detection and treatment of diseases and disorders of the teeth, gums, oral cavity or jaw across the whole life course. Both primary and secondary research are welcome.
The NIHR is particularly interested in applications that address the research needs identified by
- The James Lind Alliance (JLA) Oral and Dental Health Priority Setting Partnership
- The National Institute for Health and Care Excellence (NICE) Oral and Dental Health guidance, and
- Public Health England
Special consideration may be given to individuals and populations at increased risk of poor oral and dental health, including, but not limited to, children, older people, people living in care homes or other institutions (including prisons), people with disabilities or special needs, and to other economically or socially disadvantaged or vulnerable populations and communities.
Research following patient need
The locations of NIHR Clinical Research Network (CRN) supported oral and dental health research in the UK, as defined by the number of recruiting research studies categorised as 'oral and dental health' since 2010/11 do in part map onto regions with high proportions of deprivation or with high proportions of young children with caries (both indicators are associated with high prevalence of dental health conditions across all age groups). However, some regions associated with higher risk of poor oral and dental health among their populations had less access to research.
The shading in Figure 1A below illustrates the number of NIHR CRN supported studies that have recruited participants in each Clinical Commissioning Group (CCG) area in the specialty of 'oral and dental health' (all sub-specialties included), while Figure 1B shows the 'Index of Multiple Deprivation' (Department for Communities and Local Government 2015) among local authority districts based on the proportion of their neighbourhoods in the most deprived decile nationally.
Figure 1: Number of recruiting NIHR CRN supported research studies categorised as ‘oral and dental health' (image A) in comparison to the index of multiple deprivation among local authority districts (image 2), based on the proportion of their neighbourhoods in the most deprived decile nationally (England)
Map A: Open Data Platform Research Targeting Tool, NIHR CRN, accessed 26 November 2019. Data source: NIHR CRN Central Portfolio Management System.
Map B: The English Indices of Deprivation 2015, Department for Communities and local government, Statistical Release 30 September 2015.
Figure 2 indicates the percentage of five year-old children with experience of visually obvious dental decay (Public Health Profile Child and Maternal Health). Compared with the benchmark (England 23.3%), counties and unitary authorities (UAs) marked in red were found to have a higher percentage of five year-old children with caries, whereas the percentage of five year-olds in counties and UAs marked in yellow or green are 'similar' to (yellow) or 'better' (green) than the benchmark.
Figure 2: Map of county and UAs in England for percentage of five year-olds with experience of visually obvious dental decay (image A) in comparison to Benchmark 2017 (Image B).
Image: Public Health Profile Child and Maternal Health. Data source: Dental Public Health Epidemiology Programme for England: oral health survey of five-year-old children 2017. Benchmark: England 23.3%. Accessed 27 November 2019.
Please note that the enclosed maps are provided to illustrate the potential mismatch between research and burden of disease. The data in Figure 1A is derived from the NIHR Clinical Research Network (CRN) in England. The CRN does not have direct responsibility outside of England and currently, equivalent data from the Devolved Administrations is not included in the Research Targeting Tool. However, the NIHR is keen to ensure that research is conducted in the areas where health needs are greatest across the UK and therefore, applicants from the Devolved Administrations will also be expected to justify their choice of recruitment sites.
How to apply
Applicants should note that:
- Proposals must be within the remit of at least one participating NIHR Programme. However, we expect to receive applications that span the remit of one or more programmes.
- Patient and public involvement must be included within the application and study design to ensure the research is relevant and appropriate to patients and the public.
- Ambitious applications consisting of more than one clearly linked work package as well as applications for individual studies will be welcomed. We would also encourage the building of research capacity through the research process.
- The participating NIHR programmes fund rigorous, problem-focused research to assess the impact of existing health technologies. Applicants must demonstrate that the proposed methodology is appropriate and robust, with consideration given to methodological limitations.
- Applicants should clearly state how their proposed research addresses an explicit evidence gap and how the research adds value to the existing NIHR research portfolio
- This call represents an ongoing area of interest for the NIHR and following this opportunity, the NIHR research programmes would still be interested in receiving applications in this area to their researcher-led work streams.
Applicants who require further guidance about the call or the remit of the programmes should contact their local RDS in the first instance or email:
- 19/153 EME Oral and Dental Health - firstname.lastname@example.org
- 20/42 HSDR Oral and Dental Health - email@example.com
- 20/40 HTA Oral and Dental Health - firstname.lastname@example.org
- 20/41 PHR Oral and Dental Health - email@example.com