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Rena D’Souza, D.D.S., M.S., Ph.D., wants everyone to better understand the close link between oral health and the rest of the body. Her passion for research led her to become Director of the National Institute of Dental and Craniofacial Research (NIDCR) in 2021. Dr. D’Souza aims to advance NIDCR’s research mission and help close nationwide gaps in oral health care. She talked to NIH MedlinePlus Magazine about her career and why oral health is about more than just teeth.

Tell us about your background and what led you to study dentistry.

I grew up in India in a family where education was a priority. I come from a long line of professors. “Be independent as a woman” was my mom’s advice. She also told me to always give back to those less fortunate and to society.

I’m passionate about finding answers to questions, so I was drawn to science. I love the joy of discovery, of peeling back layers of assumptions to reveal the truth. I was accepted into medical school but opted for dentistry. I knew that, in addition to seeing patients, I wanted to pursue other interests like piano, theater, and volunteer work.

I discovered that I was good with my hands and had excellent hand-eye coordination. These skills are important when drilling at high speeds to remove tooth decay. They are also key to crafting the filling material to closely match the shape of the original tooth. Even the tiniest mismatch can disturb the patient’s bite and cause discomfort. I’ve grown to appreciate dentistry as both an art and a science.

“Dentistry is tremendously rewarding, and there’s a place for everyone in it. Dentists can build long-lasting relationships with patients and their families.”

Could you talk about your career path?

I moved to the United States in my mid-20s, got married, and had children—all while repeating my education (my degrees were from India and not recognized in the United States), looking after my sick parents, and entering the workforce. I felt like everything around me was spinning!

For the next 30 years, I built my career at universities in Texas and Utah. It was a very difficult time, but I found a reservoir of resilience in myself. I became the first leader (dean) of the new School of Dentistry at the University of Utah. I ensured the school was focused on dental research. That made it stand out because most other new dental schools focused primarily on clinical training. I also taught, mentored, and supported dental and medical students at all levels.

When Dr. Larry Tabak [then-NIH Principal Deputy Director] asked me to apply for the NIDCR Director position, my sense of higher calling and purpose told me it was right for me. By then, I had served in many senior leadership positions at universities and had been president of the two major professional societies for dental research (the American and International Associations for Dental, Oral, and Craniofacial Research). I felt I had the necessary skills and credentials to lead an NIH institute.

Now when I look back at my career, I am proud of the way it allowed me to bridge the gap between foundational sciences and clinical applications. My work in research and at NICHD have made a difference in the lives of patients. That, and leading a talented and devoted team of staffers, motivates me every day.

What was it like to become NIDCR Director during the pandemic?

I moved to Maryland from Utah in January 2021. The previous NIDCR Director had begun work on a strategic plan for the institute but didn’t have a chance to complete it. I worked alongside NIDCR staff to finalize the plan. Doing so helped me draw my new community together under a unified vision. At the same time, the U.S. Surgeon General asked NIDCR to finalize a report on the status of oral health in America. It ended up taking more than a year. So that’s how I started—hitting the ground running and on the fast track.

 Outside of work, Dr. D’Souza likes to spend time with her husband Richard, seen here with Dr. D’Souza at Capitol Reef National Park in Utah.

NIDCR also does “craniofacial” research, but what does that mean?

It means anything to do with the cranium (skull) and face. NIDCR is responsible for understanding how these structures form. A previous NIDCR Director, Dr. Harold Slavkin, worked to have “craniofacial” added to the institute’s name. Doing so opened opportunities to work with a broader range of researchers, such as those with expertise in medicine, pharmacy, or public health.

Many genetic conditions affect the way a face is formed and the number, shape, position, and size of teeth. My own research worked on identifying the genes responsible for putting a simple tooth at the front of the mouth and more complex teeth (molars) at the back. We discovered a tiny genetic change that prevents back teeth from developing. The condition is not life threatening, but it is lifelong and could require expensive treatment. This discovery led us to explore ways to correct other craniofacial problems in utero (in the uterus). We focused on cleft palate disorders (gaps in the roof of the mouth), which are fairly common.

How does dental health impact overall health?

Dental health, or rather oral health, is about much more than teeth. The mouth is a gateway to the rest of the body. It is the entry point for food, alcohol, tobacco, e-cigarettes, and various drugs. It is also the mirror to the rest of the body as many diseases show up first in the mouth. We can track the progress of many diseases and medical treatments by observing oral tissues.

Oral health is essential to overall health.

How can science improve oral health and increase access to care?

Looking at how science and technology have advanced in the last 20 years, you might say, “Wow, we really accomplished a lot!” But when you look at public health, you see that 4 out of 5 children still have untreated tooth decay. Cleft palate remains common. And a type of oral cancer that can be prevented by the HPV vaccine is rising in young men.

Oral health is still not prioritized. That haunts me. We know how to improve oral health, but we don’t have policies in place that would ensure the necessary healthcare is available to everyone. Medical insurance in the United States doesn’t include dental coverage. We need to bring the mouth back into the rest of the body and treat it as connected to overall health.

NIDCR is working to address some of these issues by bringing together many different professionals. We also plan to support much more clinical research in the next few years.

Were you ever anxious about getting dental care yourself?

[Laughs] Of course, because I knew what the dentists and their staff were doing! I didn’t grow up with fluoride in the water, so I ended up with a few cavities. I still remember the vibrations through my body as the slow drill worked its way into my teeth.

“Dental health, or rather oral health, is about much more than teeth. The mouth is a gateway to the rest of the body.”

How do you think about diversity, equity, and inclusion as NIDCR Director?

As the first woman of color to lead an NIH institute and as Chair of the Women of Color Committee at NIH, I feel an enormous responsibility to model leadership in this area. At NIDCR, we call it DEIAB—diversity, equity, inclusion, accessibility, and belonging. That “B” is very important. We have several innovative ways to build belonging within the institute.

I had never really felt like a minority, but I was perceived as such because I am a brown woman. I grew up with a different understanding of race and also caste (in India, “caste” is the social or economic class you’re born into). When I realized that, things changed for me. I now recognize bias, prejudice, and discrimination differently than before. I read a lot and have learned to listen intently when faced with a conflict. I try to put myself in the other person’s shoes so I can better understand their perspective. This is central to creating a sense of belonging and inclusivity for all.

Do you still remember any of your mentors from when you were a student or teaching?

Yes, I do. I realized early in my career that I could become a better person by learning from people who had already walked the path I was on. I was blessed to be successful, despite struggles along the way. I also had access to the basic resources I needed. Some of my mentors were people who had far fewer resources than I did but who achieved twice as much.

I also reached out and mentored others. I stay in regular contact with many of my mentees around the globe. I learn a lot from them, perhaps more than they could possibly learn from me. They keep me humble and balanced.

What would you say to someone considering a career in dentistry?

Dentistry is tremendously rewarding, and there’s a place for everyone in it. Dentists can build long-lasting relationships with patients and their families. By teaching healthy oral hygiene behaviors early in childhood, dentists promote oral health for a lifetime, especially for those who can’t get to a dentist regularly. Plus, a smile with a full set of healthy teeth makes people feel happier and more confident.

What do you like to do to unwind from work?

I remain active, doing yoga and Pilates about three times a week. I work out at the gym most mornings. On weekends, I enjoy long, brisk walks, which allow me time to think. Most of all, I am a musician. I play piano and guitar, and I love to sing. I perform choral masterworks with an ensemble in the Washington, DC, area. If you come to my home, I’ll probably lead you to the piano for a sing-along.

My husband Richard and I are foodies. We love to cook and entertain friends and colleagues often. We are a close-knit family blessed with two amazing, compassionate, socially conscious children. One is a psychiatrist in Oregon who focuses on mental health in older people. The other is a biostatistician at Emory University. Both are musicians.

I often assess whether my time on earth is well spent. I measure success not by career achievements, but by my relationships and what I have passed on to the next generation. I am proud of my 44-year marriage to a loving spouse, my legacy of scientific mentees, and my children, who care about the right things in life.