Brief Biography

Background

Nigel Pitts is a dentist / health researcher with an unusually broad range of additional qualifications, including a PhD in computer-aided radiographic diagnosis from the University of London, Fellowships from the Royal Colleges of Surgeons in London and Edinburgh, from the Royal Society of Edinburgh, from the Faculty of General Dental Practice (UK), as well as from the Faculty of Public Health.

He has been the recipient of several prestigious research awards including: the first British Dental Association (BDA) Research Foundation Award, the International Association for Dental Research (IADR) – H. Trendley Dean Award for research into Public Health and Epidemiology, the International Dental Federation (FDI) - award for innovative research in Preventive Dentistry and the European Organisation for Caries Research (ORCA) Zsolnay Prize (recognising outstanding international contribution to research into dental caries) and in March 2011 the International Association for Dental Research Distinguished Scientist Award: for Research in Dental Caries, presented by the IADR General Assembly in San Diego, USA.

He worked in London and Hong Kong before settling in Scotland and is a leading member of the IADR, ORCA (Past President), EADPH (the European Association for Dental Public Health, Past President) and BASCD (the British Association for the Study of Community Dentistry, Past President).

His research interests span a broad range from public health, health services and implementation research with a dental focus to also include cariology, remineralisation, diagnostic systems and evidence based healthcare. The accumulated total of external research grants and income awarded while at the University of Dundee exceeds £30 million.

 

Research Interests

Nigel is the lead for the

Centre for Primary Care and Population Research (CPCPR):

A distinctive feature of the translational research mission of much, but not all, of the current and planned work of CPCPR centres on: research into Getting Research-findings into routine Practice: (GRiP). There is particular attention across the variety of ways in which this process impacts on the behaviour of Patients, Professionals, Policy makers, Publishers and the Public (‘GRiP6’).

CPCPR Research Themes	Lead
Dental Health Services Research Unit (DHRRU)	Nigel Pitts
Quality, Safety & Informatics Research Group (QSI)	Bruce Guthrie
Disease Prevention	Annie Anderson
Human Brain Development	Fiona Williams

He is also Director of the

Dental Health Services Research Unit (DHSRU)

This world class research team, together with a wide range of collaborators across Scotland and internationally, play an integral part in developing the evidence base for more effective routine dental care with a focus on both primary care and population research.

The Unit’ s remit is:

• to contribute to improving oral health and effective dental healthcare in Scotland and beyond by undertaking and facilitating collaborative health related research and development which is delivered and implemented to international quality standards.

In parallel, the team continue to seek out gaps in the research, development and implementation arenas which are of relevance to their various NHS partners. The Unit continues to develop and sustain both Information Services and Knowledge Services and is one of the few holistic dental research locations where public health meets appropriate, safe, evidence based clinical care, which is enabled by IT.

He also Directs the

Centre for Clinical Innovations (CCI)

CCI's research aims centre on:

• Identification of novel and effective solutions to improve oral health & health care
• High quality research and development appropriate to modern health care
• Effective dissemination and exploitation of findings

CCI delivers these aims through a combination of externally funded science-based projects which may one day have the potential for clinical application and commercially supported research projects which meet the needs of Industry. The clear purpose of CCI is to identify and move forward technologies capable of helping clinicians improve the health of their patients.

Current DHSRU Projects

Directing the DHSRU’s portfolio of research, leading to more effective Information Services and Knowledge Services across three Programmes:

• Dental Caries Control Programme with Dr Chris Longbottom
• Oral Health & Health Research Programme , Directed by Prof Ruth Freeman
• Effective Dental Practice Programme, Directed by Dr Jan Clarkson

Co-Chairing the International Caries Detection and Assessment System (ICDAS) Foundation and Co-ordinating Committee. The vision for the International Charitable Foundation is that

• ICDAS is a clinical visual scoring system for use in dental education, clinical practice, research, and epidemiology.
• ICDAS is designed to: lead to better quality information to inform decisions about appropriate diagnosis, prognosis, and clinical management at both the indivdual and public health levels.

• ICDAS provides a framework to support and enable personalised
  total caries management for improved long term health outcomes

SDCEP Oral Health Assessment and Review (OHAR) Guidance Development

Nigel chaired the COHA Guidance Development Group of the Scottish Dental Clinical Effectiveness Programme (SDCEP). This guidance aims to promote a systematic and comprehensive approach to managing the overall oral health of each patient and to facilitate individualised long-term care of patients. Many aspects of the guidance will be familiar to dental team members. However, a newer concept is introduced that comprises assessing risk factors associated with the development of oral disease and assigning a ‘risk level’ to each patient in order to facilitate the development of a personal care plan and identification of a recall interval that is specific for each patient. The Guidance in Brief was published in March 2011.

Adult Dental Health Survey 2009 (England, Wales & Northern Ireland)

The NHS Information Centre awarded the contract to deliver the Adult Dental Health Survey (ADHS) 2009 to a consortium led by the Office for National Statistics (ONS). The consortium includes The National Centre for Social Research (NatCen), the Northern Ireland Statistics and Research Agency (NISRA) and Dental Centres from the Universities of Birmingham, Dundee, Cardiff, Newcastle and UCL London. This was the fifth in a series of national dental surveys that have been carried out every ten years since 1968. The purpose of the survey is to provide information on the current state of adults' teeth and oral health across the UK and to measure changes in oral health. The 2009 survey will cover England, Wales and Northern Ireland; Scotland has decided not to take part. The survey covers a random sample of the adult population, is carried out in households and includes two elements – an interview and a clinical examination by a qualified dentist. Interviews and examinations were carried out over a six-month period starting in October 2009, and the reports have been published on the NHS Information Centre website in March 2011.

INTERVAL Dental Recalls Trial (Investigation of NICE Technologies for Enabling Risk Variable-Adjusted-Length Dental Recalls Trial – A Feasibility Study and Follow-On)

He is co-PI with Dr Jan Clarkson on this Trial is funded by the NIHR Health Technology Assessment Programme (HTA) (06/35/05): £596,212. It will explore the outcomes of implementing NICE Clinical Guideline 19. (Dental recall: recall interval between routine dental examinations, National Institute for Clinical Excellence (NICE), Department of Health, London. www.nice.org.uk/ CG019NICEguideline, ISBN: 1-84257-801-4) in General Dental Practice across the UK. The principal research question being addressed is: for optimum, cost-effective maintenance of oral health in adult patients, what is the best recall interval from three alternatives:

• Every 6-months.
• Once every 24-months.
• A varying interval up to and including 24-months which is determined following an individual risk assessment.

The trial is being run with the Centre for Healthcare Randomized Trials (CHaRT) at the University of Aberdeen and a number of NHS and academic Collaborators across the UK.

FiCTION (Filling Childrens Teeth, Indicated Or Not?)

Nigel is a co-applicant on a new National Institute for Health Research Health Technology Assessment (NIHR HTA) programme funded £2.87 million study which will assess the benefits of different methods of managing tooth decay in children’s teeth. The Project is led by Dr Nicola Innes and Dr Jan Clarkson from the University of Dundee and Dr Gail Douglas (now at the University of Leeds) and includes a UK-wide research team from Universities in Cardiff, Dundee, Glasgow, Leeds, London, Newcastle and Sheffield. We are assessing the benefits of three different methods for treating tooth decay in baby teeth with cavities. The methods studied will be: conventional fillings (numbing with local anaesthetic injections then drilling away decay before placing a filling in the cavity); biological treatment of the decay (sealing the decay into teeth with filling materials or under crowns, generally without the need to use injections or dental drills); and using only preventive techniques recommended in national guidance (better toothbrushing, less sugar in the diet, application of high fluoride varnish and fissure sealants) to stop the decay. We will also investigate what children think of the different types of treatments. The study will involve children aged three to seven who already have decay in their baby teeth but have no toothache or abscesses. Participating dentists will be from general dental practices throughout the UK where children who attend for regular dental care will be invited to take part.

Selected Publications

Selected Publications (2006-11)

Papers in peer reviewed journals

1. Pitts N B, Boyles J, Nugent ZJ, Thomas N, Pine C M. BASCD Survey Report: The dental caries experience of 11 year old children in Great Britain 2004/2005. Surveys co-ordinated by the British Association for the Study of Community Dentistry. Community Dental Health 2006; 23: 44-57
2. Pitts N B, Chestnutt I G, Evans D, White D, Chadwick B and Steele J G. The dentinal caries experience of children in the United Kingdom, 2003. British Dental Journal 2006; 200: 313-320
3. Chadwick B L, White D A, Morris A J, Evans D, Pitts N B. Non-carious tooth conditions in children in the UK, 2003. British Dental Journal 2006; 200: 379-384
4. Fernandes M J, Ruta D, Ogden G, Pitts N B, Ogston SA. Assessing oral health-related quality of life in general dental practice in Scotland: validation of the OHIP-14. Community Dentistry and Oral Epidemiology 2006; 34: 53-62
5. Bonetti D, Pitts N B, Eccles M, Grimshaw J, Johnston M, Steen N, Shirran E, Thomas R, MacLennan G, Clarkson J E, Walker A. Applying psychological theory to evidence-based practice: Identifying factors predictive to taking intra-oral radiographs. Social Science & Medicine 2006; 63: 1889-1899
6. Chestnutt I G, Burden D J, Steele J G, Pitts N B, Nuttall N M, Morris A J. The orthodontic condition of children in the United Kingdom, 2003. British Dental Journal 2006; 11:609-12.
7. Morris A J, Nuttall N M, White D A, Pitts N B, Chestnutt I G, Evans D. Patterns of care and service use amongst children in the UK 2003. British Dental Journal 2006; 200(8):429-34.
8. Selwitz R H, Ismail A I, Pitts N B. Dental caries. Lancet 2007; 369: 51-59.
9. Ismail A I, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts N B. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dentistry and Oral Epidemiology 2007; 35: 170-178
10. Eccles M P, Grimshaw J M, Johnston M, Steen N, Pitts N B, Thomas R, Glidewell E, Maclennan G, Bonetti D, Walker A. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of managing upper respiratory tract infections without antibiotics. Implementation Science 2007; 2:26
11. Pitts N B, Boyles J, Nugent Z J, Thomas N and Pine. CM BASCD Survey Report: The dental caries experience of 5 year old children in Great Britain 2005/6. Surveys co-ordinated by the British Association for the Study of Community Dentistry. Community Dental Health 2007; 24: 59-63
12. Bourgeois D M, Llodra J C, Nordblad A, Pitts N B. Report of the EGOHID I Project. Selecting a coherent set of indicators for monitoring and evaluating oral health in Europe: criteria, methods and results from the EGOHID I Project. Community Dental Health 2008 25: 4-11
13. Clarkson J E ,Turner S, Grimshaw J M, Ramsay C R, Johnston M, Scott A, Bonetti B, Tilley C J, Maclennan G, Ibbetson R, MacPherson L M D, Pitts N B. Changing clinicians' behaviour: a randomized controlled trial of fees and education. Journal of Dental Research 2008; 87: 640-644.
14. Kuhnisch J, Berger S, Goddon I, Senkel H, Pitts N B, Heinrich-Weltzien R. Occlusal caries detection in permanent molars according to WHO basic methods, ICDAS II and laser fluorescence measurements. Community Dentistry and Oral Epidemiology 2008; 36: 475-484.
15. Bonetti D, Johnston M, Pitts N B, Deery C, Ricketts I, Tilley C, Clarkson J E. Knowledge may not be the best target for strategies to influence evidence-based practice: Using psychological models to understand RCT effects. International Journal of Behavioural Medicine 2009; Published online 20.09.09
16. Levin K A, Davies C A, Topping G V A, Assaf A V, Pitts N B. Inequalities in decayed, missing and filled teeth in 5-year old children in Scotland, 1993-2003. European Journal of Public Health 2009; 19: 337-342.
17. Pitts N B, Wefel J S. Remineralization/desensitization: What is known? What is the future? Advances in Dental Research 2009; 21: 83-86.
18. Fernandes M J, Ogden G R, Pitts N B, Ogston S A, Ruta D A. Incidence of symptoms in previously symptom-free impacted lower third molars assessed in general dental practice. British Dental Journal 2009: 207(5):218-9.
19. Splieth C H, Ekstrand K R, Alkilzy M, Clarkson J, Meyer-Luckel H, Martignon S, Paris S, Pitts N, Ricketts D J N, van Loveren C. Sealants in Dentistry: Outcomes of the ORCA Saturday Afternoon Symposium 2007. Caries Research 2010; 44: 3–13 2009.
20. Fernandes M J, Ogden G R, Pitts N B, Ogston S A, Ruta D A. Actuarial life-table analysis of lower impacted wisdom teeth in general dental practice. Community Dentistry and Oral Epidemiology 2010; 38(1):58-67.
21. Levin K A, Davies C A, Douglas G V, Pitts N B. Urban-rural differences in dental caries of 5-year old children in Scotland. Social Science & Medicine 2010; 71: 2020-7
22. Clarkson J E, Ramsay C R, Eccles M P, Eldridge S, Grimshaw J M, Johnston M, Mitchie S, Treweek S, Walker A, Young L, Black I, Bonetti D, Cassie H, Francis J J, MacKenzie G, Macpherson L M, McKee L, Pitts N B, Rennie J S, Stirling D, Tilley C J, Torgerson S, Vale L D. The translation research in a dental setting (TRiaDS) programme protocol. Implementation Science 2010; 5: 57.
23. Ormond C, Douglas G, Pitts N. The use of the International Caries Detection and Assessment System (ICDAS) in a National Health Service General Dental Practice as part of an Oral Health Assessment. Primary Dental Care 2010; 17: 153-159.
24. Bonner B C, Chan K P S, Bourgeois D N, Douglas G V A, Pitts N B. The feasibility of utilising European general dental practitioners and ICDAS caries codes to monitor population oral health at local, national and international levels. Primary Dental Care 2011; 18: 83-90(8).
25. Pitts N, Amaechi B, Niederman R, Acevedo A-M, Vianna R, Ganss C, Ismail A, Honkala E. Global Oral Heath Inequalities Dental Caries Task Group-Research Agenda. Advances in Dental Research 23(2): 198-200, 2011.
26. Longbottom C, Perfect E, Haughey A M, Krikelis A, Pitts N B. Bioluminescent Calcium Ion-Binder to assess Caries Lesion Activity. Journal of Biomedical Optics Accepted for Publication
27. Grimshaw J M, Eccles M P, Steen N, Johnston M, Pitts N B, Glidewell L, Maclennan G, Thomas R, Bonetti D, Walker A. Applying psychological theories to evidence-based clinical practice: Identifying factors predictive of lumbar spine x-ray for low back pain in UK primary care practice. Implementation Science. 6:55 DOI:10.1186/1748-5908-6-55.

Chapters, Books and Equivalent

1. Pitts N B. International Caries Detection and Assessment System. In. Symposium Report: Early Detection of Dental Caries, held at Baltimore during the 83rd General Session of the International Association for Dental Research, March 11, 2005. Thermametric Technologies Inc, Indiana 2006 pp 1-15.
2. Bourgeios D N, Llodra J C, Norblad A, Pitts N B (Editors). Health Surveillance in Europe – A selection of Oral Health Indicators recommended by the European Global Oral Health Indicators Development Project, 2005 Catalogue. European Commission Health and Consumer Protection Directorate-General Community Action Programme on Health Monitoring, 100pp. Also available at www.egohig.com
3. Clinical Pathways Project - DHSRU Dundee: The NHS Oral Health Assessment Final Report April 2006. DH Reference Number: ZPD/105/CP (CDO Website Department of Health, England).
4. Chesters R K, Balciuniene I, Matutliene G, Pitts N B and Matheson J. The Chesters model using the simplified DSTM. In: Stookey G (Ed), Clinical Models Workshop: Remin-Demin, Precavitation, Caries, Indiana 2005, published 2007 pp 117-141
5. Pitts N B. Conclusions from the 2002 Scotland Consensus Conference (ICW-CCT). In: Stookey G (Editor). Clinical Models Workshop: Remin-Demin, Precavitation, Caries, Indiana 2005 published 2007, pp17-34
6. Pitts N B, Topping G V A. Trends in Oral Health. In: Community Oral Health (2nd Edition). Editor Pine C M, 2008 pp 253-290 2007 pp 253-290
7. Pitts N B. Caries Epidemiology: The impact of diagnostic criteria on estimates of prevalence, extent and severity of dental caries. In: Dental Caries (2nd Edition) – the Disease and its Clinical Management. Editor Fejerskov O and Kidd E A M, 2008 pp 148-159.
8. Bourgeois D M, Llodra J C, Christensen L-B, Pitts N B, Ottolenghi L, Senekola E (Editors). Health Surveillance in Europe. Oral Health Interviews and Clinical Surveys: Guidelines. Lyon I University Press, 2008, ISBN 2-9526369 -2 – 3.
9. Topping G V A, Bonner B C, Pitts N B. Health Surveillance in Europe. European Global Oral Health Indicators Development Programme. Clinical Indicators. In Health Surveillance Europe. Oral Health Interviews and Clinical Surveys: Guidelines. (Edited Bourgeois, Llodra, Christensen, Pitts, Ottolenghi, Senekola).
10. Topping G V A, Yuan S, Smith P A, Pitts N B, Freeman R. Informing the Delivery of Oral Health and Oral Health Care in the North of Scotland: Secondary Care Services in Oral and Maxillofacial Surgery, Orthodontics and Restorative Dentistry. DHSRU, University of Dundee.
11. Eaton K A, Pitts N B. Dental Health Services Research Unit celebrates 30 years: Report of conference to mark the 30th anniversary of the Dental Health Services Research Unit (DHSRU) at Dundee, held on 1st December 2008. Primary Dental Care. 2009:51-4.
12. Topping GV, Pitts N B; International Caries Detection and Assessment System Committee. Clinical visual caries detection. Monographs in Oral Science 2009:15-41.
13. Neuhaus KW, Ellwood R, Lussi A, Pitts N B. Traditional lesion detection aids. Monographs in Oral Science 2009:42-51.
14. Ekstrand KR, Zero DT, Martignon S, Pitts N B. Lesion activity assessment. Monographs in Oral Science 2009:63-90.
15. Pitts N B, Richards D; International Caries Detection and Assessment System Committee. Personalized treatment planning. Monographs in Oral Science 2009:128-43.
16. Pitts N B. Background level care. Monographs in Oral Science 2009:144-8.
17. Ricketts DN, Pitts N B. Traditional operative treatment options. Monographs in Oral Science 2009:164-73.
18. Ricketts DN, Pitts N B. Novel operative treatment options. Monographs in Oral Science 2009:174-87.
19. Pitts N B. Implementation. Improving caries detection, assessment, diagnosis and monitoring. Monographs in Oral Science 2009:199-208.
20. Longbottom C L, Huysmans M C, Pitts N B, Fontana M. Glossary of key terms. Monographs in Oral Science 2009: 209-16.
21. Pitts N B. How electrical caries detection and monitoring with CarieScan can help deliver modern caries management. Oral Health July 2010: 34-43. www.oralhealthjournal.com
22. Fontana M, Young DA, Wolff MS, Pitts N B, Longbottom C. Defining Dental Caries for 2010 and beyond. Dental Clinics in North America. 2010: 423-40.
23. Oral Health Assessment and Review – Guidance in Brief. Scottish Dental Clinical Effectiveness Programme. Pitts NB (Guidance Development Group Chair) and the SDCEP Guidance Development Group pp25; March 2011; ISBN: 978 1 905829 11 8. http://www.sdcep.org.uk/index.aspx?o=3079
24. White D, Pitts N, Steele J, Sadler K, Chadwick B. 2: Disease and related disorders – a report from the Adult Dental Health Survey 2009. 55 pages, published March 2011; http://www.ic.nhs.uk/webfiles/publications/007_Primary_Care/Dentistry/dentalsurvey09/
    AdultDentalHealthSurvey_2009_Theme2_ Diseaseandrelateddisorders.pdf
25. Steele N, Pitts N, Fuller E, Treasure E. 3: Urgent Conditions – a report from the Adult Dental Health Survey 2009. 38 pages; published March 2011; http://www.ic.nhs.uk/webfiles/publications/007_Primary_Care/Dentistry/dentalsurvey09/
    AdultDentalHealthSurvey_2009_Theme3_Urgentconditions.pdf.
26. Chadwick B, White D, Lader D, Pitts N. 5: Preventive behaviour and risks to oral health - a report from the Adult Dental Health Survey 2009. 44 pages; published March 2011; http://www.ic.nhs.uk/webfiles/publications/007_Primary_Care/Dentistry
    /dentalsurvey09/AdultDentalHealthSurvey_2009_Theme5_Preventivebehaviourandriskstooralhealth.pdf.
27. Oral Health Assessment and Review – Full Guidance. Scottish Dental Clinical Effectiveness Programme. Pitts NB (Guidance Development Group Chair) and the SDCEP Guidance Development Group – in press April 2011 http://www.sdcep.org.uk/index.aspx?o=3079
28. Schulte AG, Pitts NB, Huysmans M-C, Splieth C, Buchalla W. European Cariology Core Curriculum. European Journal of Dental Education 2011, Accepted in press.
29. Pitts N B. Preventive and Minimal Intervention Dentistry in the Undergraduate Curriculum. Proceedings of the 10th International Kuwait Association for Dental Research (KuADR) Annual Conference on “Preventive and Minimal Intervention Dentistry, December 4−5, 2010. Journal of Dentistry, Accepted in press.