Overview

Cohort: 6
PhD Start Date: August 2022

After gaining experience in a range of hospital dentistry specialities and primary care, David joined the Royal Army Dental Corps where he served in a number of UK and overseas assignments, including Kenya, Afghanistan and Northern Ireland.

After gaining a number of postgraduate qualifications and experience in medical education, research and restorative dentistry, he left the military to pursue a career in academia and specialist practice.

During his time as an academic clinical fellow in endodontics, he was awarded a number of grants culminating in the award of a Faculty of Dental Surgery (RCS Eng) Research Fellowship and Wellcome Trust 4Ward North Doctoral Fellowship.

PhD title

Exploring irreversible pulpitis and its treatment’s effects on peripheral and central pain mechanisms: ExtirPate study

Brief summary

Symptomatic irreversible pulpitis, or ‘toothache’, is usually a sequelae from the most common disease in the world, tooth decay. It represents the most frequent reason for urgent dental care, as well as being the most impactful on quality of life and most painful urgent dental condition. Despite this, our management is relatively poor, with up to 25% of patients returning within a week due to ongoing pain, and up to 10% developing persistent pain beyond six months despite removal of peripheral infection and inflammation.

The most common approach to managing this condition is to remove the dental pulp (neurovascular bundle within the tooth) followed by the application of a combined antibiotic/corticosteroid dressing. Existing evidence suggests this confers little benefit over simple excision of irreversibly inflamed pulp and placing damp cotton wool, questioning the effectiveness of these medications on inflammatory and pain mechanisms.

The ExtirPate study aims to develop a new model of irreversible pulpitis in the rat molar enabling exploration of inflammatory and pain mechanisms at the level of the tooth, trigeminal ganglion and the brainstem. Following characterisation of this model, the effectiveness of antibiotic/corticosteroids will be investigated before exploring new approaches to managing this painful condition.

Key collaborators/supervisors

• Dr Ilona Obara (Newcastle University) – Neuroscience
• Dr Vsevolod Telezhkin (Newcastle University) – Neuroscience
• Professor Justin Durham (Newcastle University) – Pain
• Professor David Brough (The University of Manchester) – Neuroscience
• Professor Nikita Gamper (University of Leeds) – Neuroscience
• Professor John Whitworth (Newcastle University) – Endodontology
• Dr Chris Nile (Newcastle University) – Immunology

Specialty interest/techniques

Whilst continuing to work clinically delivering complex restorative and endodontic treatment, David is building on his research skills in statistics, histology, immunohistochemistry, qPCR, sequencing, ELISA, multiplex assay and animal research including behavioural analysis.

Career aspirations

David is aiming to complete his speciality training shortly after completing his PhD. He will then work towards promotion to senior lecturer and honorary consultant. He would like to compete for an intermediate fellowship, enabling him to build on his research theme.

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