Professor Nigel Pitts
BDS, PhD, FDS (RCS Eng), FDS (RCS Edin), FFGDP (UK), FFPH, FRSE

Chairman: CarieScan Scientific Advisory Board

Background
Nigel Pitts graduated in Dentistry from the University of London (with honours) and has since had an unusually broad career spanning, clinical practice, scientific and clinical research and public health. This has led to a wide 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. Following appointments in London and Hong Kong, he joined the University of Dundee where he has held a variety of positions including being Dean of Dentistry and Head of the Dental School from 1997-2000. He is a co-inventor of the ACIST technology which was published in Nature Medicine in 1996 and which  then led, ultimately, to the development of the CarieScan PRO device.

Nigel 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).

At the end of 2008, with colleagues from (Dr Chris Longbottom) and collaborating with (Professor John Girkin and Dr Simon Poland of the University of Strathclyde) the Centre for Clinical Innovations, Nigel’s project on Oral and Dental near Infrared Imaging received three awards at the Medical Futures Innovations Awards. The team was the only entrants to win more than one prize at the Awards, which cover a full range of clinical topics. They won the:

• Overall Dental and Health Innovations Award,
• Best Diagnostic in Dental and Oral Health Award, and
• NHS Technology Innovation Award across all sectors.

Current Positions
Nigel is currently Director of the Centre for Clinical Innovations (CCI), Director of the Dental Health Services & Research Unit (DHS&RU) and leads the Medical School’s Centre for Primary Care and Population Research (CPCPR). He is Professor of Dental Health (University of Dundee) and Honorary Consultant in Dental Public Health (NHS Tayside). He is also acknowledged as a global opinion leader on dental caries. He 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 range from public health, health services and implementation research with a dental focus to also include clinical cariology, remineralisation, diagnostic systems and evidence based healthcare. Nigel Pitts has published over 190 original peer reviewed papers and has attracted an accumulated total of external research grants and income, awarded while at the University of Dundee, which now exceeds £20 million.

Research Interests
a) Nigel Directs the Centre for Clinical Innovations (CCI)
The purpose of CCI is to innovate in order to identify and move forward technologies capable of helping clinicians overcome un-met needs to improve the health of their patients. Implicit in this activity is an awareness of the commercial challenges in moving technologies from the laboratory setting to commercially available products, devices or “vehicles”.

CCI's research and development 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. CCI has a range of grants with collaborating Universities in the UK and has developed a series of patents and international commercial links, has had Knowledge Transfer Partnership (KTP) awards with the University of Abertay and an Edinburgh based technology Company - with which it also holds a Technology Strategy Board (TSB) grant.

b) Nigel is also 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’).

The CPCPR Research Themes are:

c) He is also Director of the Dental Health Services & Research Unit (DHS&RU):
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.

Current Projects include:
Co-Chairing the International Caries Detection and Assessment System (ICDAS) Foundation and Co-ordinating Committee. The vision for the International Charitable Foundation (www.icdas.org) 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; and
• ICDAS provides a framework to support and enable personalised total caries management for improved long term health outcomes.

Recent Publications (2004-9)

• Pitts N B.  Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice?  Caries Research 2004; 38:294-304
• Pitts N B.  Understanding the Jigsaw of Evidence Based Dentistry 1: Introduction, Research & Synthesis. Journal of Evidence Based Dentistry 2004  5: 2-4
• Pitts N B, Boyles J, Nugent Z J, Thomas N and Pine C.  BASCD Survey Report:  The dental caries experience of 14 year old children in England and Wales.  Surveys co-ordinated by the British Association for the Study of Dentistry in 2002/2003.  Community Dental Health 2004 21: 45-57
• Pitts N B and Stamm J.  ICW-CCT Statements.  Journal of Dental Research 2004  83: Special Issue C: 125-128.
• Pitts N B.  Modern Concepts of Caries Measurement.  Journal of Dental Research 2004  83:Special Issue C: 43-47
• Bahrami M, Deery C, Clarkson J, Pitts N B, Johnston M, Ricketts I, MacLennan G, Nugent Z J, Tilley C, Bonetti D and Ramsay C.  Effectiveness of strategies to disseminate and implement clinical guidelines for the management of impacted and unerupted third molars in primary dental care.  British Dental Journal 2004 197:691-696
• Pitts N B.  Understanding the Jigsaw of Evidence Based Dentistry 2:  Dissemination of Research Results.  Journal of Evidence Based Dentistry 2004 5 issue 2: 33-35
• Clarkson JE, Pitts N, Richards D, Shaw W, Treasure ET and Worthington H.  Virtual centre for improving oral health – vC-IOH.  Evidence-Based Dentistry 2004 5: 5-6
• Eccles M, Bonetti D, Johnston M, Steen N, Grimshaw J, Baker R, Walker A and Pitts N B.  Implementation of evidence-based practice:  Experimental simulation of complex intervention trials.  International Journal of Behavioural Medicine 2004 11: 322-323
• Pitts NB (Editorial).  “ICDAS” – an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management.  Community Dental Health 2004  21: 193-198
• Pitts N B. Understanding the Jigsaw of Evidence Based Dentistry 3:  Implementation of Research Findings. Evidence Based Dentistry 2004  5: 60-64
• Zeedyk M S, Longbottom C and Pitts N B.  Toothbrushing practices of parents and toddlers:  A study of home-based videotaped sessions Caries Research  2005 39: 27-33
• Bonetti D, Eccles M, Johnston M, Steen N, Grimshaw J, Baker R, Walker A and Pitts N. Guiding the design and selection of interventions to influence the implementation of evidence-based practice: an experimental simulation of a complex intervention trial. Social Science & Medicine 60 2005 2135-2147
• Pitts NB, Nugent ZJ, Thomas N and Pine CM BASCD Survey Report:  The dental caries experience of 5 year old children in England and Wales (2003/4) and in Scotland (2002/3), Surveys co-ordination by the British Association for the Study of Community Dentistry.  Community Dental Health 2005  22: 46-56
• Ekstrand K E, Ricketts D N, Longbottom C and Pitts N B.  Visual and tactile assessment of arrested initial enamel caries lesions: an in vivo examination. Caries Research 2005 39: 173-177
• Pitts NB.  Oral health assessment in clinical practice:  New perspectives on the need for a comprehensive and evidence based approach.  British Dental Journal 2005 198: 317
• Tilley CJ, McIntosh E, Bahrami M, Clarkson JE, Deery C and Pitts NB An economic analysis of implementing the SIGN third molar guideline:  implications for the design and analysis of implementation studies.  Journal of Health Services Research and Policy 2005 10: 143-149
• Hally JD, Pitts NB.  Developing the First Dental Care Pathway: The Oral Health Assessment.  Primary Dental Care 2006 12: 117-121
• Pitts NB, Boyles J, Nugent ZJ, Thomas N and Pine CM 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
• Pitts NB, Chestnutt IG, Evans D, White D, Chadwick B and Steele JG:  The dentinal caries experience of children in the United Kingdom, 2003.  British Dental Journal 2006 200: 313-320
• Chadwick BL, White DA, Morris AJ, Evans D and Pitts N B:  Non-carious tooth conditions in children in the UK, 2003.  British Dental Journal 2006 200: 379-384
• Fernandes MJ, Ruta D, Ogden G and Pitts N B.  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
• Bonetti D, Pitts NB,  Eccles M, Grimshaw J, Johnston M, Steen N, Shirran E, Thomas R, MacLennan G, Clarkson JE and Walker A.  Applying psychological theory to evidence-based practice:  Identifying factors predictive to taking intra-oral radiographs.  Social Science & Medicine 2006; 63: 1889-1899
• Selwitz RH, Ismail AI, Pitts NB. Dental caries. Lancet 2007 369: 51-59.
• Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB.  The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries.  Community Dentistry and Oral Epidemiology 2007 35: 170-178
• Eccles MP, Grimshaw JM, Johnston M, Steen N, Pitts NB, 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
• Pitts NB, Boyles J, Nugent ZJ, 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
• Bourgeois DM, Llodra JC, Nordblad A and Pitts NB. 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
• Clarkson JE ,Turner S, Grimshaw JM, Ramsay CR, Johnston M, Scott A, Bonetti B, Tilley CJ, Maclennan G, Ibbetson R, MacPherson LMD and Pitts NB.  Changing clinicians' behavior: a randomized controlled trial of fees and education. J Dent Res 2008, 87: 640-644. 
• Kuhnisch J, Berger S, Goddon I, Senkel H, Pitts NB and 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.
• Levin KA, Davies CA, Topping GVA, Assaf AV, Pitts NB. Inequalities in dental caries of 5-year-old children in Scotland, 1993–2003. European J  Public Health 2009: 1–6
• Levin K A, Davies C A, Topping G V A, Assaf A V, and Pitts N B. (2009) Inequalities in decayed, missing and filled teeth in 5-year old children in Scotland, 1993-2003 European Journal of Public Health 19: 337-342.
• Pitts N B and Wefel J S. (2009) Remineralization/desensitization: What is known?  What is the future? Advances in Dental Research 21: 83-86.
• Splieth C H, Ekstrand K R, Alkilzy M, Carvalho J C, Clarkson J, Meyer-Luckel H, Martignon S, Paris S, Pitts N, Ricketts D J N and van Loveren C.  Sealants in dentistry: dental education, knowledge and guidelines.  – Caries Research – accepted for publication, 2010
• Bonetti D, Johnston M, Pitts NB, Deery C, Ricketts I, Tilley C, Clarkson JE.  Knowledge may not be the best target for strategies to influence evidence-based practice:  Using psychological models to understand RCT effects.  International Journal of Medicine -  accepted for publication, in press
• Splieth CH, Ekstrand KR, Alkilzy M, Carvalho JC, Clarkson J, Meyer-Luckel H, Martignon S, Paris S, Pitts N, Ricketts DJN and van Loveren C.  Sealants in dentistry: dental education, knowledge and guidelines.  – Caries Research – accepted for publication, 2009, in press

Books, Book Chapters and Reports (2004-9)

• Office of National Statistics. Decline in obvious decay in children’s permanent teeth - 2003 Children’s Dental Health Survey - First Release. 2004 www.statistics.gov.uk
• Clinical Guideline 19. Dental recall: recall interval between routine dental examinations National Institute for Clinical Excellence (NICE), Department of Health, London October 2004. www.nice.org.uk/CG019NICEguideline, ISBN: 1-84257-801-4
• National Collaborating Centre for Acute Care, National Institute for Clinical Excellence (NICE). Dental Recall – Recall Interval between routine dental examinations: Methods, Evidence and Guidance. pp118, Royal College of Surgeons of England, London, October 2004. www.nice.org.uk/CG019fullguideline
• Pitts NB, Harker R.  Obvious Decay Experience Children’s Dental Health in the United Kingdom 2003.  Office for National Statistics October 2004. http://www.statistics.gov.uk/children/dental/health 
• Pitts NB and Stamm J ICW-CCT International Consensus Workshop on Caries Clinical Trials: Preface.  Journal of Dental Research 2004 83(C): 4-5.
• Pitts N B.  Review of the ICW-CCT Meeting, The Importance of Early Detection and the Philosophy/Approach of ICDAS.  In:  Stookey G (Ed), Early Detection of Caries III p1-17 Indiana University, Indiana 2005.
• 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.
• Bourgeios DN, Llodra JC, Norblad A, Pitts NB (Eds.)  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, 2006.  Also available at www.egohig.com 
• Chesters RK, Balciuniene, Matutliene G, Pitts NB 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
• Pitts NB.  Conclusions from the 2002 Scotland Consensus Conference (ICW-CCT).  In: Stookey G (Ed). Clinical Models Workshop: Remin-Demin, Precavitation, Caries, Indiana 2005 published 2007, pp17-34
• Pitts N B, Topping G V A.  Trends in Oral Health.  In: Community Oral Health (2nd Edition). Ed. Pine C M, 2008 pp 253-290 2007 pp 253-290
• 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.  Ed. Fejerskov O and Kidd E A M, 2008 pp 148-159.
• Bourgeois DM, Llodra JC, Christensen L-B, Pitts NB, Ottolenghi L, Senekola E (Eds). Health Surveillance in Europe. Oral Health Interviews and Clinical Surveys: Guidelines.  Lyon I University Press, 2008, ISBN 2-9526369 -2 – 3.
• Topping GVA, Bonner BC, Pitts NB.  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). Lyon I University Press, 2008, ISBN 2-9526369 -2 – 3.
• Topping GVA, Yuan S, Smith PA, Pitts NB, 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. 2008
• Detection, Assessment, Diagnosis and Monitoring of Caries – Editor NB Pitts, Karger Monographs in Oral Science Vol. 21, ISBN 978-3-8055-9184-3, S. Karger AG, Basel (Switzerland) 2009.