Senior Clinical Investigator
Clinical Research Collaborative
Clinical Instructor in Dental Care Administration,
Harvard School of Dental Medicine
email:
St. Peter's College, B.A., 1971, Sociology
Tufts University School of Dental Medicine, D.M.D., 1977, Dentistry
Harvard School of Public Health, M.P.H., 1980, Public Health
Boston University School of Graduate Dentistry, Certificate, 1981, Public Health
Members of the Tavares group are interested in the public health and clinical care aspects of oral health. We have been involved in designing and carrying out a variety of studies to learn about attitudes and concerns regarding oral health among patients from a wide range of backgrounds, with a particular focus on groups that experience oral health disparities. Our current focus is on integrating oral and systemic health, finding ways for the dental profession to expand its scope. We continue to be active in clinical trials and pilot testing clinical products.
We have developed a child obesity intervention tool specifically designed for dental clinics and offices. The tool, which we call the "Healthy Weight Intervention" can be applied during the routin bi-annual dental cleaning and exam visits. This intervention consists of taking height and weight and calculating BMI. Children are asked to describe their eating and physical activity habits and then, to set goals for improving those habits, sometimes in conjunction with their parents. We have found this tool to be easily adaptable to clinical settings and well received by patients, parents and providers. Currently, we are expanding this model into clinical sites in Maine. We are also examining the feasibility of including this intervention in school-based dental programs in Boston and Portland, Maine.
The focus of work in the Tavares group has been on issues. in both the clinical and policy arenas, that have an impact on the oral health of the public. In the past years, we have explored the area of clinical outcomes research,designed and tested a patient satisfaction survey directed at dental implants. This survey continues to be used for research and clinical purposes.
As part of the Northeast Regional Minority Oral Health Center based at New York University, we worked with our NYU colleagues to determine the oral health status, needs, and attitudes of six of the largest immigrant populations in the New York area, as well as resident minority populations. In addition to clinical examinations in the community, we developed and tested survey instruments to learn more about health behaviors and attitudes toward dental health.
A major research direction addresses issues of public health through our work in clinical trials. A ten-year-long prospective clinical trial to evaluate the health effects of dental amalgam in children ended in August, 2006. The "New England Children's Amalgam Trial" was funded by a grant from the National Institute of Dental and Craniofacial Research (NIDCR) to New England Research Institutes (NERI) and The Forsyth Institute. Collaborating investigators included researchers from Children's Hospital in Boston, the University of Rochester School of Medicine and Dentistry, and the University of Maine at Farmington.
Five hundred children between the ages of six and ten who never had amalgam fillings but were in need of treatment, were enrolled into the study from sites in Boston, Cambridge, and Farmington, Maine. Subjects were randomly assigned to receive amalgam or composite fillings, and followed every six months for five years with collection of blood, urine, hair samples, and educational/psychological testing.
The final results of this trial were published in the Journal of the American Medical Association in April, 2006. The conclusions were that no statistically significant differences in adverse neuropsychological or renal effects were observed in children whose teeth were restored with dental amalgam compared to composite resin. The findings indicated that the health effects of dental amalgam need not be the basis of treatment decisions when choosing a restorative dental material.
More recently, we have worked on testing an anesthetic reversal agent for children. After receiving local anesthesia for dental fillings, the residual soft tissue numbness leasves some children vulnerable to injury from inadvertent lip and cheek bites. Sometimes, these injuries can be servere. Our group was part of a multi-site study of the use of phentolamine mesylate in children under the age of 12.
By investigating data from our epidemiology studies and clinical trials, we are able to ask importnat clinical and public health questions; seek the answers, or formulate additional questions, from data that has been rigorously collected.
Tavares M, Chomitz V. (2009) A healthy weight intervention for children in a dental setting. A pilot study. J. Am. Dent. Assoc. 140(3):313-315.
Trachtenberg F, Maserejian N, Soncini JA, Hayes C, Tavares M. (2009) Does fluoride in compomers prevent future caries in children? J .Dent. Res.88(3):276-279.
Tavares M, Goodson JM, Studen-Pavlovich D, Yagiela JA, Navalta LA, Rogy S, Rutherford B, Gordon S, Papas AS. (2008) Reversal of soft-tissue local anesthesia with phentolamine mesylate in pediatric patients. J. Am. Dent. Assoc. 139(8):1095-1104.
Maserejian NN, Tavares MA, Hayes C, Soncini JA, Trachtenberg FL. (2009) Prospective study of 5-year caries increment among children receiving comprehensive dental care in the New England Children’s Amalgam Trial. Community Dent. Oral Epidemiol. 37(1):9-18.
Niederman R, Gould E, Soncini J, Tavares M, Osborn V, Goodson JM. (2008) A model for extending the reach of the traditional dental practice: The ForsythKids program three-year outcomes. J. Am. Dent. Assoc. 139(8):1040-50.
Maserejian NN, Tavares MA, Hayes C, Soncini JA, Trachtenberg FL. (2008) Rural and urban disparities in caries prevalence in children with unmet dental needs: the New England Children's Amalgam Trial. J. Public Health Dent. 68(1):7-13.
Maserjian NN, Trachtenberg F, Hayes C, Tavares M. (2008) Oral health disparities in children of immigrants: dental caries experience at enrollment and during follow up in the New England Children's Amalgam Trial. J. Public Health Dent. 68:(1):14-21.
Soncini JA, Maserejian NN, Trachtenberg F, Tavares M, Hayes C. (2007) The longevity of amalgam versus compomer/composite restorations in posterior primary and permanent teeth: findings from the New England Children's Amalgam Trial. J. Am. Dent. Assoc. 138(6):763-772.
Bellinger DC, Trachtenberg F, Barregard L, Tavares M, Cernichiari E, Daniel D, McKinlay S. (2006) Neuro-psychological and renal effects of dental amalgam in children. A randomized clinical trial. J. Am. Med. Assoc. 295(15):1775-1783.
Goodson JM, Tavares M, Sweeney M, Stultz J, Newman M, Smith V, Regan EO, Kent R. (2005) Tooth whitening: Tooth color changes following treatment by peroxide and light. J. Clin. Dent. XVI (3)78-82.
