Belinda Nicolau is as an Associate Professor at the Faculty of Dentistry at McGill University. She obtained her DDS degree from the Federal University of Paraná, Brazil and a MSc in Dental Public Health from Barts and The Royal London School of Medicine and Dentistry, London, UK. Belinda completed her PhD degree in Epidemiology and Public Health at University College London, London, UK under the supervision of Aubrey Sheiham. After a brief stint with Paul Speight also at University College London, she pursued a postdoctoral fellowship with Paul Allison and Eduardo Franco at McGill University, Canada. In the spring 2005, Belinda took up a faculty position as an Assistant and then an Associate Professor at INRS-Institut Armand-Frappier, after which she moved to McGill University in December 2011.

My main research interests lie in the field of oral epidemiology; specifically I study the aetiology of chronic oral diseases (COD), including oral cancer and oral inflammation, using epidemiological and life course approaches. The goal of my research program is to better understand the causes of COD and their potential links with major chronic diseases. Currently my work focuses on two main projects: The life-course approach to studying the etiology of cancer in the upper aero digestive tract: The HeNCe Life Study Head and neck cancers (H&NC) occur in the mouth, throat and larynx. Yearly, there are 300,000 deaths and over half a million new H&NC cases in the world. They are the 8th most common cancer worldwide representing nearly 8% of male cancers, with 5-year survival rates of 50%. These low survival rates have not improved in the past 30 years despite advances in diagnosis and treatment. Known risk factors include tobacco smoke, alcohol consumption, diet and in a subset of H&NC, human papillomavirus (HPV) infections. So far, understanding the risk factors has been of little benefit; while the overall H&NC incidence has decreased in some populations, the incidence of oropharyngeal cancer has been rising. Moreover, observed global disparities in H&NC incidence cannot currently be explained on the basis of the geographical distribution of known risk factors. Our research group is conducting a hospital based case-control study at multiple urban health centers in Canada (Montreal), Brazil (São Paulo) and India (Calicut) - the HeNCe Life study (Head & Neck Cancer Life Course study) - to investigate the role of genetic, viral, behavioural, psychosocial and socioeconomic factors in H&NC aetiology. It uses the life course framework to investigate how these factors act either cumulatively or independently to increase H&NC. The current hypothesis is that there are two distinct pathways for the multistage carcinogenesis of H&NC: one linked to tobacco and alcohol, and the other related to HPV infections. Based on the different clinical and molecular-genetic characteristics of these H&NC, the hypothesis proposes that distinct risk factors will be related to the distinct pathways. We use the life course framework to study whether H&NC have different risk profiles. This unique approach permits measuring several domains of exposure throughout life while taking into consideration the multiple effects of duration and timing of exposures. The use of the life course framework allows for the integration of multiple (environmental, behavioural, biological) exposures over time and thus is ideal for the study of H&NC since exposures do not manifest immediately as disease. This framework will identify potentially modifiable targets (behavioural and environmental) early in life. HeNCe Life Study Control Group Quebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort – Oral health component http://www.etudequalitystudy.ca/index.php?mid=2&p=10&smid=11&lang=en Increasing empirical evidence suggests an association between common COD (e.g., dental caries, periodontal diseases) and other major chronic conditions (e.g., obesity, diabetes type II (DMII), coronary heart disease (CHD)) in adults. Although the biological plausibility linking these diseases is strong, the nature of these associations remains debatable. Two biological pathways, inflammation and infection, have been used to explain the associations between COD and major chronic diseases. The inflammation pathway is based upon the evidence that excess adipose tissue produces a hyper-inflammatory response that affects immune and inflammatory systems, which in turn increases susceptibility to oral infections. By contrast, the infection pathway hypothesizes that inflammatory mediators produced by oral infections have systemic metabolic impacts. Indeed, the mechanism that explains the association between COD and obesity, DMII and CHD is complex and multi-directional. The unravelling of these associations is further complicated by the fact that behavioural and environmental factors at different life stages are known to influence COD, obesity, CHD and DMII. The long term aim of this study is to monitor inflammatory markers (e.g., TNF levels (in gingival tissues, saliva and serum), composition of the oral biofilm and clinical signs of COD) throughout childhood, adolescence and early adulthood in children at risk of developing obesity. This longitudinal assessment will not only permit us to examine the associations described above, but also allow us to understand the underlying mechanisms by which they are related. The oral health component is nested in an ongoing longitudinal cohort study, the QUALITY Cohort, which investigates the natural history of obesity in Quebec youth. It includes Caucasian children aged 8-10 years at entry at high-risk of overweight/obesity due to the obese status of one or both parents. A total of 634 children and their biological parents were recruited through schools located within 75 km of Montreal and Quebec City. Baseline data were collected from 2005 to 2008 and the 1st follow-up started 2 years after baseline measures (2007), when children were 10-12 years old, and finished in 2011. The 2nd follow-up is scheduled to start in 2012 when the adolescents will be 13-15 years of age. We plan to study these children and their families until early adulthood. The QUALITY Cohort uses a longitudinal assessment of oral health in children at risk of obesity, collecting data on an array of exposures, which allows an investigation of the influence of these factors concurrently in the development of COD and other major chronic conditions. By better understanding if and how these diseases relate in youth, public health practitioners will be able to design more effective programs (i.e., targeting obesity and oral health simultaneously).