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A Life in Science
PROFILE
LIFE IN "s c i e n c e
D
r. Harald Loe makes a brief sweeping motion with his
right hand. “This,” he says, taking in his office a t the National Institute of Dental Research, “is not the NIDR. The NIDR is the 500 people on campus here and the thousand other researchers [funded by the institute] who are working in dental schools and universities across the country.” 522
JADA, Vol. 125, May 1994
Dr. Harald Loe, a true pioneer of periodontal research, retires next month after 11 years as director of the National Institute of Dental Research, in Bethesda Md. Dr. Loe discusses his life’s work and plans for the future. B Y
D A N IE L
M C C A N N
On June 1, Dr. Loe will step down as director of the NIDR. When he does, he’ll make his way back to th a t other world of dental research—the world where, early on in his career, he identified the cause of periodontal disease. That finding had two key effects for modern dentistry: it helped bring order to a field previously in chaos, and it underscored the pivotal role proper oral hygiene plays in
P R O F I L E
dentistry and practicing dentistry.” Born and educated in Norway—he received his D.D.S. in 1952 from Oslo University— Dr. Loe’s early academic career included professorships in the departm ents of periodontics at his alma m ater; Royal Dental College, Denmark; and Hebrew University, Israel. He arrived in the United States in 1972 to serve as professor and director of the Dental Research Institute at the University of Michigan, Ann Arbor.
enigma. Some researchers argued th a t it was caused by occlusal traum as; others cited nutritional déficiences; still others attributed the disease to systemic disorders, such as hormone imbalances. Dr. W aerhaug singled out bacteria. “Jens W aerhaug was my m entor,” says Dr. Loe. “We worked together very closely. He did a tremendous piece of work on bacteria and its relationship to oral lesions in dogs. “It was very exciting; I mean these were revolutionary thoughts. And to really understand w hat we were doing you have to know about the context of th a t whole period.” Dr. Roy Page, professor of periodontics a t the University of Washington, Seattle, remembers the era as a grab bag of confusion. “One leader in the field,” he recalls, “claimed th a t those who don’t get periodontal disease have some bone factor th at those with the disease lack. You name it and somebody was on the bandwagon pushing it.”
preserving dentition. But on this late winter morning, Dr. Loe’s retirem ent is still a few months away, and he’s agreed to set aside an hour or so to discuss advances in dentistry, his 11 years with the NIDR and where dental research seems to be headed. He’s an anim ated speaker. As he warms to a topic, his soft gravelly voice with its Norwegian lilt can pick up pace and stretch almost to a whispery rasp. When he says things like “Edentulousness is wo years later, Dr. going to disappear!” it’s with Loe moved on to the the excitement of revealing the University of solution to an age-old mystery. Connecticut, where he was And his hands accompany his named dean and professor in conversation: grasping at ideas, the school’s Departm ent of gently tapping the table for Periodontology. Dr. Loe would emphasis, framing his thoughts stay a t the University of as though holding the sides of a Connecticut for the next eight box. years, until 1983, when he was “I don’t think any other named director of the NIDR. health discipline has But it was in Norway, under accomplished w hat dentistry the tutelage of Dr. Jens has during the last 40 years,” says Dr. Loe. “The oral health of Waerhaug, th a t the foundation was laid for much of what the American people is probably unsurpassed. “Fifty percent of school children today have never had a cavity, never had a filling. That is an achievement “I don’t think any other health discipline has accomplished what dentistry has during the last th a t is 40 years,” says Dr. Loe. almost unbelievable for those of It was especially perplexing would follow in Dr. Loe’s us who grew up under very for dental students. “It seems different conditions. And this professional life. impossible today,” Dr. Page has all come about by having a During the 1950s and early ’60s the origin of periodontal continues, “but having been a close collaboration between student in the ’50s and a dental research, academic disease was something of an
T
JADA, Vol. 125, May 1994
523
PROFILE
the critical experiment.” The study opened new paths graduate student in the ’60s we for further research. For one, didn’t know w hat to think; “the whole area of plaque nobody did.” inhibitors in mouthrinses and In 1965 th a t all changed. In toothpastes grew out of its May-June issue th a t year, H arald’s work,” says Dr. Genco. the Journal of Periodontology With proper oral hygiene, published a study called periodontal disease, in short, “Experimental Gingivitis in could be prevented. Moreover, Man,” with Dr. Loe as the lead a t about the same time, other researcher. researchers had established the The paper documented the link between bacteria and onset of gingivitis among 12 caries. The findings provided previously modern healthy people dentistry with “I think what who ceased all two key planks oral hygiene in its campaign we did was to practices. to prevent oral take the In the sum disease. mystery out of mary to the “Those were periodontal study, Dr. Loe very exciting wrote: “The time times,” says Dr. disease. I’ve necessary to Loe. “And I been very develop gingivitis think w hat we fortunate to be varied from 10 to did was to take a part of all 21 days. Con the mystery out current of periodontal this. I think it bacteriological disease. I’ve has shaped my examinations been very life.” showed th a t the fortunate to be number of a part of all microorganisms in the gingival this. I think it has shaped my area increased and th a t distinct life really, and my way of changes in the relative thinking also.” composition of the flora Prime among Dr. Loe’s goals occurred.” when he arrived a t the NIDR But all of the subjects’ were to broaden dental research gingiva returned to normal with to areas beyond caries and the réintroduction of oral periodontal disease, strengthen hygiene measures. ties—as well as the transfer of Dr. Robert Genco, professor scientific information—between of oral biology at the State the institute and practitioners University of New York at and encourage dental students Buffalo, recalls that Dr. Loe’s to pursue research. paper “put the concept [of the “First of all,” he says, “[in the bacterial origins of periodontal early ’80s] we were beginning to disease] on a solid footing see a reduction in caries and because it was proof th at plaque some impact on periodontal caused gingivitis. diseases. And it occurred to me “Jens Waerhaug didn’t have to look into other areas th at th a t kind of proof; he had the could be im portant to our insight, but Harald really did future: it was im portant to look 524
JADA, Vol. 125, May 1994
at the entire oral cavity, all the craniofacial tissues and the saliva. “I strongly believe th a t the future general practitioner is going to be dealing not only with caries and periodontal disease, but also with oral cancer, temporomandibular disorders, smell and taste disorders and a variety of other problems. The day is not going to be filled with restorations. Edentulousness is going to disappear!” From 1982 to 1994, the NIDR budget more than doubled, from $72 million to $169.5 million. The broadened scope of research includes molecular biology investigations of oral infections caused by systemic diseases such as AIDS; bone and joint diseases; salivary gland dysfunction; oral cancer; acute and chronic pain; and genetic disorders. In 1984, the Epidemiology and Oral Disease Prevention Program opened at the institute, and has recently been expanded to include a molecular epidemiology and disease indicators branch th a t conducts basic research into genetic diseases and risk factors. Iso, Dr. Loe increased the number of NIDR comprehensive research centers and added new clinical facilities to investigate aging, m aterials science, craniofacial anomalies and pain research. “I think this is the most exciting time in dental science,” he says. “There is so much th a t can be done using the new biotechnology, molecular biology and genetic technology to study oral disease.” As an example, he continues,
PROFILE
increasingly dependent on saliva to provide a picture of a patient’s health, says Dr. Loe. “Saliva will be the diagnostic medium of the future,” he continues. “We use it now as an early m arker for oral cancer, periodontal disease and caries. In the future, the saliva profile
findings to the profession and the public has been an NIDR priority under Dr. Loe. The NIDR researchers are using institute has hosted lectures, genetic technology to regenerate continuing education salivary glands th a t had been conferences and workshops and destroyed by radiation has used prin t and electronic treatm ent. media to ensure th a t dentists Other scientists are and th eir patients benefit from analyzing the functions and the latest characteristics scientific of saliva. findings. “For In 1988, instance,” says Surgeon Gen Dr. Loe, “we eral C. Everett know that Koop bestowed saliva has an on Dr. Loe the antifungal Surgeon Gen capacity, th a t eral’s there is a Exemplary protein in saliva Service Award called histatin in recognition of produced by the his contri glands to keep butions “to yeast growth to improve the a minimum.” health of the NIDR American scientists are at people.” work on a More procedure th a t recently, the could provide former surgeon the gene for general said of histatin to Dr. Loe’s patients, such stew ardship of as those with NIDR, “Dr. Loe AIDS, who have bridged the gap problems “Dr. Loe bridged the gap between medicine and dentistry, and that’s between controlling what I appreciated about him,” says former Surgeon General C. medicine and Candida Everett Koop, here chatting with the retiring NIDR director. dentistry, and infections. th a t’s w hat I “It gives you might be the first thing a dentist appreciated about him. an example of w hat one can do performs on a new patient.” “He talked about the mouth with saliva in the future,” says as being the m irror of the To encourage dental students Dr. Loe. “We could, for instance, health of the body,” continued increase the antibacterial to pursue research careers, Dr. Loe in 1985 established the Dr. Koop. “He talked to capability of saliva by physicians as peers. And I think introducing genes th a t would Dentist Scientist Award Program. th a t’s because the tools of promote the production of Thus far, more than 100 research he used in dentistry antibacterial compounds.” students have graduated from are the same tools of research Already, researchers and people use in medicine. the program, which involves others use saliva to determine “I am lavish in praise for him an individual’s vitamin, hor five years’ training in dental because I think he brought a mone and drug levels. And research. real presence of integrity to dentists are going to be Communicating research JADA, Vol. 125, May 1994
525
To Someone Who Stutters, It’s Easier Done Than Said.
P
R
O
F
I
L
E
dentistry and to the campus of the National Institutes of Health. He served his profession and the country well.” Dr. Loe will return to the University of Connecticut, where he served as dean for 10 years. “I want to continue some research I have ongoing,” he says. Twenty-five years ago, he continues, he and other
“Saliva will be the diagnostic medium of the future. In the future, the saliva profile might be the first thing a dentist performs on a new patient.”
T he fear of speaking keeps many people from being heard. If you stutter or know someone who does, write or call for our free informative brochures on prevention and treatm ent of stuttering.
S t u t t e r in g Fo u n d a t io n of A m e r ic a FORM ERLY SPEECH FO U N D A TIO N OF A M E RIC A
A Non-Profit Organization Since 1947— Helping Those Who Stutter P.O. Box 11749 Memphis, T N 38111-0749
1 800 992-9392 -
-
researchers began to collect periodontal data on populations in Sri Lanka and Norway. The aim was to study the initiation and progress of periodontal disease. Since the start of the project, Dr. Loe and his colleagues have examined the populations several times. But because of his increased responsibilities during the past 12 years, Dr. Loe hasn’t had much opportunity to analyze the mountain of data th at has accumulated in th at time. “So now I want to concentrate on this research,” he says, “and try to make a contribution to the understanding of the natural history of periodontal disease.” ■ Mr. M cCann is senior editor, ADA News.
LIFE IN "s c i e n c e
D
r. Harald Loe makes a brief sweeping motion with his
right hand. “This,” he says, taking in his office a t the National Institute of Dental Research, “is not the NIDR. The NIDR is the 500 people on campus here and the thousand other researchers [funded by the institute] who are working in dental schools and universities across the country.” 522
JADA, Vol. 125, May 1994
Dr. Harald Loe, a true pioneer of periodontal research, retires next month after 11 years as director of the National Institute of Dental Research, in Bethesda Md. Dr. Loe discusses his life’s work and plans for the future. B Y
D A N IE L
M C C A N N
On June 1, Dr. Loe will step down as director of the NIDR. When he does, he’ll make his way back to th a t other world of dental research—the world where, early on in his career, he identified the cause of periodontal disease. That finding had two key effects for modern dentistry: it helped bring order to a field previously in chaos, and it underscored the pivotal role proper oral hygiene plays in
P R O F I L E
dentistry and practicing dentistry.” Born and educated in Norway—he received his D.D.S. in 1952 from Oslo University— Dr. Loe’s early academic career included professorships in the departm ents of periodontics at his alma m ater; Royal Dental College, Denmark; and Hebrew University, Israel. He arrived in the United States in 1972 to serve as professor and director of the Dental Research Institute at the University of Michigan, Ann Arbor.
enigma. Some researchers argued th a t it was caused by occlusal traum as; others cited nutritional déficiences; still others attributed the disease to systemic disorders, such as hormone imbalances. Dr. W aerhaug singled out bacteria. “Jens W aerhaug was my m entor,” says Dr. Loe. “We worked together very closely. He did a tremendous piece of work on bacteria and its relationship to oral lesions in dogs. “It was very exciting; I mean these were revolutionary thoughts. And to really understand w hat we were doing you have to know about the context of th a t whole period.” Dr. Roy Page, professor of periodontics a t the University of Washington, Seattle, remembers the era as a grab bag of confusion. “One leader in the field,” he recalls, “claimed th a t those who don’t get periodontal disease have some bone factor th at those with the disease lack. You name it and somebody was on the bandwagon pushing it.”
preserving dentition. But on this late winter morning, Dr. Loe’s retirem ent is still a few months away, and he’s agreed to set aside an hour or so to discuss advances in dentistry, his 11 years with the NIDR and where dental research seems to be headed. He’s an anim ated speaker. As he warms to a topic, his soft gravelly voice with its Norwegian lilt can pick up pace and stretch almost to a whispery rasp. When he says things like “Edentulousness is wo years later, Dr. going to disappear!” it’s with Loe moved on to the the excitement of revealing the University of solution to an age-old mystery. Connecticut, where he was And his hands accompany his named dean and professor in conversation: grasping at ideas, the school’s Departm ent of gently tapping the table for Periodontology. Dr. Loe would emphasis, framing his thoughts stay a t the University of as though holding the sides of a Connecticut for the next eight box. years, until 1983, when he was “I don’t think any other named director of the NIDR. health discipline has But it was in Norway, under accomplished w hat dentistry the tutelage of Dr. Jens has during the last 40 years,” says Dr. Loe. “The oral health of Waerhaug, th a t the foundation was laid for much of what the American people is probably unsurpassed. “Fifty percent of school children today have never had a cavity, never had a filling. That is an achievement “I don’t think any other health discipline has accomplished what dentistry has during the last th a t is 40 years,” says Dr. Loe. almost unbelievable for those of It was especially perplexing would follow in Dr. Loe’s us who grew up under very for dental students. “It seems different conditions. And this professional life. impossible today,” Dr. Page has all come about by having a During the 1950s and early ’60s the origin of periodontal continues, “but having been a close collaboration between student in the ’50s and a dental research, academic disease was something of an
T
JADA, Vol. 125, May 1994
523
PROFILE
the critical experiment.” The study opened new paths graduate student in the ’60s we for further research. For one, didn’t know w hat to think; “the whole area of plaque nobody did.” inhibitors in mouthrinses and In 1965 th a t all changed. In toothpastes grew out of its May-June issue th a t year, H arald’s work,” says Dr. Genco. the Journal of Periodontology With proper oral hygiene, published a study called periodontal disease, in short, “Experimental Gingivitis in could be prevented. Moreover, Man,” with Dr. Loe as the lead a t about the same time, other researcher. researchers had established the The paper documented the link between bacteria and onset of gingivitis among 12 caries. The findings provided previously modern healthy people dentistry with “I think what who ceased all two key planks oral hygiene in its campaign we did was to practices. to prevent oral take the In the sum disease. mystery out of mary to the “Those were periodontal study, Dr. Loe very exciting wrote: “The time times,” says Dr. disease. I’ve necessary to Loe. “And I been very develop gingivitis think w hat we fortunate to be varied from 10 to did was to take a part of all 21 days. Con the mystery out current of periodontal this. I think it bacteriological disease. I’ve has shaped my examinations been very life.” showed th a t the fortunate to be number of a part of all microorganisms in the gingival this. I think it has shaped my area increased and th a t distinct life really, and my way of changes in the relative thinking also.” composition of the flora Prime among Dr. Loe’s goals occurred.” when he arrived a t the NIDR But all of the subjects’ were to broaden dental research gingiva returned to normal with to areas beyond caries and the réintroduction of oral periodontal disease, strengthen hygiene measures. ties—as well as the transfer of Dr. Robert Genco, professor scientific information—between of oral biology at the State the institute and practitioners University of New York at and encourage dental students Buffalo, recalls that Dr. Loe’s to pursue research. paper “put the concept [of the “First of all,” he says, “[in the bacterial origins of periodontal early ’80s] we were beginning to disease] on a solid footing see a reduction in caries and because it was proof th at plaque some impact on periodontal caused gingivitis. diseases. And it occurred to me “Jens Waerhaug didn’t have to look into other areas th at th a t kind of proof; he had the could be im portant to our insight, but Harald really did future: it was im portant to look 524
JADA, Vol. 125, May 1994
at the entire oral cavity, all the craniofacial tissues and the saliva. “I strongly believe th a t the future general practitioner is going to be dealing not only with caries and periodontal disease, but also with oral cancer, temporomandibular disorders, smell and taste disorders and a variety of other problems. The day is not going to be filled with restorations. Edentulousness is going to disappear!” From 1982 to 1994, the NIDR budget more than doubled, from $72 million to $169.5 million. The broadened scope of research includes molecular biology investigations of oral infections caused by systemic diseases such as AIDS; bone and joint diseases; salivary gland dysfunction; oral cancer; acute and chronic pain; and genetic disorders. In 1984, the Epidemiology and Oral Disease Prevention Program opened at the institute, and has recently been expanded to include a molecular epidemiology and disease indicators branch th a t conducts basic research into genetic diseases and risk factors. Iso, Dr. Loe increased the number of NIDR comprehensive research centers and added new clinical facilities to investigate aging, m aterials science, craniofacial anomalies and pain research. “I think this is the most exciting time in dental science,” he says. “There is so much th a t can be done using the new biotechnology, molecular biology and genetic technology to study oral disease.” As an example, he continues,
PROFILE
increasingly dependent on saliva to provide a picture of a patient’s health, says Dr. Loe. “Saliva will be the diagnostic medium of the future,” he continues. “We use it now as an early m arker for oral cancer, periodontal disease and caries. In the future, the saliva profile
findings to the profession and the public has been an NIDR priority under Dr. Loe. The NIDR researchers are using institute has hosted lectures, genetic technology to regenerate continuing education salivary glands th a t had been conferences and workshops and destroyed by radiation has used prin t and electronic treatm ent. media to ensure th a t dentists Other scientists are and th eir patients benefit from analyzing the functions and the latest characteristics scientific of saliva. findings. “For In 1988, instance,” says Surgeon Gen Dr. Loe, “we eral C. Everett know that Koop bestowed saliva has an on Dr. Loe the antifungal Surgeon Gen capacity, th a t eral’s there is a Exemplary protein in saliva Service Award called histatin in recognition of produced by the his contri glands to keep butions “to yeast growth to improve the a minimum.” health of the NIDR American scientists are at people.” work on a More procedure th a t recently, the could provide former surgeon the gene for general said of histatin to Dr. Loe’s patients, such stew ardship of as those with NIDR, “Dr. Loe AIDS, who have bridged the gap problems “Dr. Loe bridged the gap between medicine and dentistry, and that’s between controlling what I appreciated about him,” says former Surgeon General C. medicine and Candida Everett Koop, here chatting with the retiring NIDR director. dentistry, and infections. th a t’s w hat I “It gives you might be the first thing a dentist appreciated about him. an example of w hat one can do performs on a new patient.” “He talked about the mouth with saliva in the future,” says as being the m irror of the To encourage dental students Dr. Loe. “We could, for instance, health of the body,” continued increase the antibacterial to pursue research careers, Dr. Loe in 1985 established the Dr. Koop. “He talked to capability of saliva by physicians as peers. And I think introducing genes th a t would Dentist Scientist Award Program. th a t’s because the tools of promote the production of Thus far, more than 100 research he used in dentistry antibacterial compounds.” students have graduated from are the same tools of research Already, researchers and people use in medicine. the program, which involves others use saliva to determine “I am lavish in praise for him an individual’s vitamin, hor five years’ training in dental because I think he brought a mone and drug levels. And research. real presence of integrity to dentists are going to be Communicating research JADA, Vol. 125, May 1994
525
To Someone Who Stutters, It’s Easier Done Than Said.
P
R
O
F
I
L
E
dentistry and to the campus of the National Institutes of Health. He served his profession and the country well.” Dr. Loe will return to the University of Connecticut, where he served as dean for 10 years. “I want to continue some research I have ongoing,” he says. Twenty-five years ago, he continues, he and other
“Saliva will be the diagnostic medium of the future. In the future, the saliva profile might be the first thing a dentist performs on a new patient.”
T he fear of speaking keeps many people from being heard. If you stutter or know someone who does, write or call for our free informative brochures on prevention and treatm ent of stuttering.
S t u t t e r in g Fo u n d a t io n of A m e r ic a FORM ERLY SPEECH FO U N D A TIO N OF A M E RIC A
A Non-Profit Organization Since 1947— Helping Those Who Stutter P.O. Box 11749 Memphis, T N 38111-0749
1 800 992-9392 -
-
researchers began to collect periodontal data on populations in Sri Lanka and Norway. The aim was to study the initiation and progress of periodontal disease. Since the start of the project, Dr. Loe and his colleagues have examined the populations several times. But because of his increased responsibilities during the past 12 years, Dr. Loe hasn’t had much opportunity to analyze the mountain of data th at has accumulated in th at time. “So now I want to concentrate on this research,” he says, “and try to make a contribution to the understanding of the natural history of periodontal disease.” ■ Mr. M cCann is senior editor, ADA News.