Notice of Special Interest (NOSI): Biologic Factors Underlying Dental, Oral, and Craniofacial Health Disparities
Notice Number:

Key Dates

Release Date:

October 7, 2021

First Available Due Date:
February 05, 2022
Expiration Date:
January 08, 2025

Related Announcements

PA-20-195 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Clinical Trial Not Allowed)

PA-20-196 - NIH Exploratory/Developmental Research Grant Program (Parent R21 Basic Experimental Studies with Humans Required)

PA-20-184 - NIH Research Project Grant (Parent R01 Basic Experimental Studies with Humans Required)

PA-20-185 - NIH Research Project Grant (Parent R01 Clinical Trial Not Allowed)

Issued by

National Institute of Dental and Craniofacial Research (NIDCR)

National Institute on Minority Health and Health Disparities (NIMHD)

National Cancer Institute (NCI)


The National Institute of Dental and Craniofacial Research (NIDCR) is issuing this Notice of Special Interest (NOSI) to encourage research studies designed to identify and understand the mechanisms by which biologic factors (microbial, immune, genetic) contribute to disparities in dental, oral, and craniofacial disease onset, progression, and persistence.


It is long recognized that certain racial and ethnic populations suffer from increased incidence of dental, oral, and craniofacial (DOC) diseases and conditions as well as poorer outcomes, such as oral/oropharyngeal cancers, dental caries, and periodontitis. According to 2011-2017 Surveillance, Epidemiology, and End Results (SEER) data, incidence rates for oropharyngeal cancers are more than twice as high in men as in women in all racial and ethnic groups, while the 5-year relative survival rate is much lower in Black Americans than Whites (51% vs. 69%). Early childhood caries, the presence of dental caries in any primary tooth in a child 71 months of age or younger, is more prevalent among Mexican American and non-Hispanic Black children than non-Hispanic White children. The prevalence and severity of periodontitis are also higher among Hispanic and non-Hispanic Black adults than non-Hispanic Whites.

Differences in the incidence and outcomes of DOC diseases and conditions by race and ethnicity are likely a reflection of the interplay of individual-, interpersonal-, community-, and societal-levels of influences such as microbiologic and genetic contributions, socioeconomic status, cultural beliefs and attitudes, health behaviors and practices, health care system accessibility and quality, and social environment. For example, low educational attainment and poverty are often identified as significant risk indicators for DOC diseases and conditions as is inadequate use of dental care services. These individual-level socioeconomic factors are undoubtedly influenced by societal factors such as structural racism, discrimination, unequal access to educational and occupational resources, and bias in health systems that may be disproportionately experienced intergenerationally by racial and ethnic minorities. Changes in immune function related to psychosocial stress, nutrition, smoking, or other environmental exposures could also alter host interactions with microbes. Furthermore, -omics research suggests that racial/ethnic groups may exhibit a distinct subgingival microbiome, with non-Hispanic Blacks having lower microbiome diversity than other racial/ethnic groups.

With advances in in-vitro technologies to examine the oral microbiome, inflammatory mediators of oral cancers and other DOC biomarkers, high throughput genomics and proteomics technologies and advanced computation and bioinformatics, there is an opportunity to elucidate the role of biology in DOC health disparities and how biology contributing to DOC health disparities interact with other relevant factors such as socioeconomic status and diet. Such understanding will help identify potential biomarkers for early risk or disease detection and improve intervention strategies and prognosis of DOC health status in populations disproportionately affected by DOC diseases and conditions.

Applicants responding to this NOSI are strongly encouraged to collaborate with a multidisciplinary team of investigators as appropriate for the proposed research. In addition, the research proposal must clearly define the population affected by DOC health disparities and strategies for accessing the target population. Examples of health disparity populations include African Americans/Blacks, Hispanics/Latinos, American Indians/Alaska Natives, Asians, Native Hawaiians and Other Pacific Islanders, socioeconomically disadvantaged populations, underserved rural populations, sexual and gender minority populations, and individuals with intellectual and developmental disabilities. Comparison groups or populations may be included as appropriate for the research questions posed. Because the goals of this NOSI is to better understand the underlying mechanisms of documented disparities in DOC diseases and conditions, studies whose sole purpose is to assess incidence and prevalence of these diseases and conditions in specific populations or subpopulations are not a priority for this NOSI. Existing biorepositories with matched oral health clinical data can also be used to accelerate specific areas of research. Potential applicants for this NOSI may use the research framework developed by the National Institute on Minority Health and Health Disparities (NIMHD) to model influential factors to consider in health disparities research. While this NOSI will not allow clinical trials, applications proposing a clinical trial (please see NIH’s definition of a clinical trial) are encouraged to use other funding opportunity announcements (FOAs) that allows clinical trials, such as the NIDCR Clinical Trial Planning and Implementation Cooperative Agreement (UG3/UH3 Clinical Trial Required) and NIDCR Behavioral and Social Intervention Clinical Trial Planning and Implementation Cooperative Agreement (UG3/UH3 Clinical Trial Required).

Scientific Areas of Interest

The scope of this NOSI includes but is not limited to, the following research areas:

  • Microbial and inflammatory mediators of DOC diseases in different racial/ethnic groups, and their contribution to racial/ethnic differences in disease prevalence, severity and/or outcomes.
  • The biologic responses to social, environmental, behavioral, cultural, and/or socioeconomic factors that contribute to DOC health disparities.
  • Mechanisms by which social factors lead to biologic changes that affect health disparities.
  • Biologic responses to conventional therapy for DOC diseases that may explain the persistence of these diseases in different health disparities populations.
  • Genetic/genomic risk or protective factors that might contribute to racial/ethnic differences in dental caries and periodontal diseases, and the interplay with other factors.
  • Genetic/genomic and other biological risk factors that could contribute to poorer health outcomes among various health disparity populations with oral and oropharyngeal cancers.

NIMHD Research Interest:

The mission of the NIMHD is to lead scientific research to improve minority health and reduce health disparities. NIMHD supports the study of many aspects of minority health and health disparities— from biological and population sciences to clinical, behavioral, and translational research, as well as research on health care services, health systems and workforce development. NIMHD is interested in etiologic studies focused on biological mechanisms and pathways that influence DOC-related health disparities, including mechanisms by which individual behavioral risk and protective factors and structural and cultural extrinsic factors such as neighborhood social environment (e.g., social cohesion, social capital, collective efficacy, community resilience), structural barriers and facilitators (e.g., access to healthy foods, access to dental preventive care), and environmental exposures affect physiological functioning at various stages in life and thereby influence health trajectories or modify disease risk.

NCI Research Interest:

The National Cancer Institute has interests in the basic biology of cancer focusing on mechanisms underlying the transformation of normal cells to cancer cells and the role of stromal cells (including immune cells) and the microbiome in tumor progression or tumor elimination. This research provides the building blocks to an improved understanding of the disease and new treatment regimens. To address the etiologic basis for health disparities in individuals with oropharyngeal cancers or with an underlying viral infection and oropharyngeal cancer, both basic science and translational studies are essential in the health disparity populations targeted in this NOSI. Proposed areas of cancer-related research topics could include, but are not limited to the following:

  • Effects of dietary patterns/drug exposures (antibiotics) on oropharyngeal cancer-associated microbes and their host interactions in different ethnic/racial populations;
  • Host response and mechanistic understanding of infectious agent-associated cancers and related biological determinants in different ethnic/racial populations including oropharyngeal cancers in HIV-infected individuals;
  • Immune responses to oropharyngeal cancers - among different health disparities populations - that either promote cancer progression or can be harnessed to eliminate cancer;
  • Characterization of the tumor immune microenvironment of oropharyngeal cancers associated with ethnic/racial populations; and
  • Health disparities associated with either natural or acquired resistance to immunotherapy.

Application and Submission Information

This notice applies to due dates on or after Fenruary 5, 2022 and subsequent receipt dates through January 8, 2025. 

Submit applications for this initiative using one of the following FOAs or any reissues of these announcement through the expiration date of this notice.

NIDCR encourages applicants to use the following FOAs in response to this NOSI:

  • PA-20-195 (Parent R21 Clinical Trial Not Allowed)
  • PA-20-196 (Parent R21 Basic Experimental Studies with Humans Required)
  • PA-20-184 (Parent R01 Basic Experimental Studies with Humans Required)
  • PA-20-185 (Parent R01 Clinical Trial Not Allowed)

NIMHD will not accept applications that propose to use only animal and/or in vitro model systems under this NOSI. The applications responding to this NOSI and NIMHD’s areas of research interest must use R01 parent FOAs as NIMHD does not participate in parent R21 FOAs.

All instructions in the SF424 (R&R) Application Guide and the FOA used for submission must be followed, with the following additions:

  • For funding consideration, applicants must include “NOT-IC-19-XXX” (without quotation marks) in the Agency Routing Identifier field (box 4B) of the SF424 R&R form. Applications without this information in box 4B will not be considered for this initiative.

Applications nonresponsive to terms of this NOSI will not be considered for the NOSI initiative.


Please direct all inquiries to the contacts in Section VII of the listed funding opportunity announcements with the following additions/substitutions:

Scientific/Research Contact(s)

Hiroko Iida, DDS, MPH
National Institute of Dental and Craniofacial Research

Telephone: 301-594-7404


Rina Das, PhD
National Institute of Minority Health and Health Disparities

Telephone: 301-496-3996


Kevin Howcroft, Ph.D.
National Cancer Institute (NCI)
Telephone: 240-276-6702

Peer Review Contact(s)

Examine your eRA Commons account for review assignment and contact information (information appears two weeks after the submission due date).

Financial/Grants Management Contact(s)

Diana Rutberg, MBA
National Institute of Dental and Craniofacial Research

Telephone: 301-594-8412


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NIH Funding Opportunities and Notices