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COHRA Smile Studies


Pregnant African American women are needed to participate in a research study to better understand why children in Pittsburgh and surrounding areas have more cavities than most other children. 

Enroll in the COHRA Smile Childhood Cavity Study


Oral disease remains a major health burden that affects some populations disproportionally, including communities in regions of Appalachia. The University of Pittsburgh School of Dental Medicine Center for Craniofacial and Dental Genetics (CCDG) has received a grant that will expand its ongoing Factors Contributing to Oral Health Disparities in Appalachia project, part of the Center for Oral Health Research in Appalachia (COHRA). The new grant will help CCDG researchers to determine the sources of oral health disparity in high risk, Northern Appalachian populations.

COHRA’s long-term goal is to design and implement preventive interventions for oral disease, particularly childhood caries, a bacterial infection that causes corrosion of a young child’s teeth due to bacteria that is passed from mother to child. The new grant, valued at $4 million, will be dedicated to enrolling pregnant African-American women in the COHRA project, which was previously limited to Caucasian women and their children.

Both increased sugar intake and frequency of exposure alter the oral microbial community, triggering a disease process that leads to caries. Additional factors associated with caries in children include genetic risk, household socioeconomic status, maternal caregiving behavior and stress, access to care, and ethnicity.

“Through the ongoing work of the existing COHRA study, progress has been made in understanding many of these factors that lead to caries,” said Dr. Mary Marazita, CCDG director and principal investigator of the COHRA study. “However, much remains to be done in order to further characterize individual risk factors, but just as importantly, to determine how interactions between them lead to oral health disparities.”

The aim of COHRA is to develop strategies to address this disparity through simultaneous study of multiple risk components (ideally within families) to determine their roles, interactions among them, and their transmissibility patterns. 

The new project seeks to replicate the success of COHRA in a representative sample of African-American mother-child pairs from Northern Appalachia, with the hope that most will complete the protocol through age 2 in the same time period as the parent grant.

The COHRA protocols will be followed in the new African-American cohort, thus augmenting the value of the COHRA project with a large, high-quality data set from an underrepresented population. The important influence of race as a factor in oral health disparities can then be added to the genetic, dietary, behavioral, microbiological, medical, and demographic factors already in hand.

In addition to Dr. Marazita, investigators from Pitt’s School of Dental Medicine include Drs. Robert WeyantDeborah PolkAlexandre Vieira, and Seth Weinberg. The team also includes Drs. John Shaffer and Lisa Bodnar from Pitt’s Graduate School of Public Health, and Dr. Debra Bogan from Children’s Hospital of Pittsburgh of UPMC. 

As with the parent project, the extension of the COHRA grant is a collaboration with West Virginia University and the University of Michigan. Dr. Dan McNeil serves as PD/PI from West Virginia University and Dr. Betsy Foxman serves as PD/PI from the University of Michigan.