The Forsyth Institute, which began 100 years ago as a free dental clinic for Boston children, is now a dental research institute looking to expand. But it’s running into some opposition.
Robin Orwant
Tucked away just behind the Museum of Fine Arts in Boston is a grand old building once frequented by needy children. With its neoclassical design and white marble facade, the building could easily be mistaken for a museum. But the children didn’t come for artwork. They came because of their teeth.
For more than five decades, the Forsyth Dental Infirmary for Children provided essentially free dental care for underprivileged children in the Boston area. In the 1960s, however, it began to shift its focus to dental research. Now the institute wants to expand its traditional programs and branch out into other areas of basic biomedical research, such as regenerative biology, by hiring researchers whose interests extend far beyond the mouth. Much depends on the Forsyth’s ability to gain more lab space. But plans to construct a new research building adjacent to the current one have encountered resistance from residents in the surrounding Fenway neighborhood, and it’s unclear when or if the proposed expansion might happen.
Walking into the Forsyth is a little like walking into the past. Lining the main entrance foyer are bronze busts of the four Forsyth brothers who donated a portion of their fortune made in the rubber manufacturing business to create the institution in 1912. A large room that once served as a children’s waiting area still bears the original tile friezes depicting fairy tale themes. A dental chair designed for children—the first of its kind—is prominently displayed along the first-floor corridor. Forsyth was one of the first clinics to use these chairs.
“Forsyth really established the profession of pediatric dentistry,” says Richard Pharo, the institute’s vice president for administration and unofficial Forsyth historian.
Dental students and newly graduated dentists from around the world worked at the infirmary for little or no pay in exchange for much-needed training in this new subspecialty.
But all that changed in the mid-1960s, when the American Dental Association decreed that pediatric dental training had to be carried out in hospitals. Though that decision was eventually reversed, it was a devastating blow to the Forsyth.
“Suddenly all the talent we had—the young dental graduates and dental students—could not get credit for doing their practice here,” Pharo says. “We couldn’t entice them to stay.”
Changing times
This apparent setback, however, nudged the institute in the direction of dental research. Research wasn’t entirely new to the Forsyth though. As early as the 1930s, dentists at the Forsyth had conducted scientific studies. But by 1969, research had become so important that the Forsyth constructed a new lab building.
Over the years, scientists at the Forsyth have made groundbreaking discoveries in dental research. For example, they showed that cavities are caused by a specific bacterial infection, identified the bacteria responsible for gum disease, and discovered the mechanism whereby fluoride prevents cavities. In 2005, Forsyth ranked fourth among U.S. research institutes receiving the most grant money from the National Institute of Dental and Craniofacial Research.
Today, 200 people work at the Forsyth, most of whom do research in oral biology. Research projects include developing a vaccine to prevent cavities and studying how saliva may be used to diagnose heart disease and cancer.
“The Forsyth is very highly regarded,” says Christoper Fox, the executive director of the International Association for Dental Research.
In the last few years, the institute has begun moving into other areas of biomedical research, including basic research. In 2003, the Forsyth hired Antonio Campos-Neto, an immunologist developing vaccines for tuberculosis and malaria. Another recent hire, Michael Levin, studies frog and chicken embryonic development and regeneration in worms.
Other dental research programs are also promoting basic research. For example, the Harvard School of Dental Medicine has a department of developmental biology in which scientists explore fundamental processes of embryonic development. Some Forsyth researchers, including Levin, have academic appointments within that department.
Fox says this expansion of focus shows that the Forsyth is adapting to a trend in biology: the convergence of various fields. “It makes perfect sense for Forsyth to broaden its research portfolio,” he says. “You cannot separate dental/oral research from other medical research. The biologic systems of the mouth are part of the overall biologic systems of the body.”
For instance, inflammation, an immunological response, has been shown to play an important role in gum disease. Studies in embryonic development may shed light on how and why cranio-facial defects form. Campos-Neto now spends about one-third of his time studying gum disease in the context of immunology.
Still, Campos-Neto admits that being a vaccine researcher at an institute where no one else studies malaria or tuberculosis can be a bit lonely.
“There are no people here [at Forsyth] who talk to me about tuberculosis,” he admits.
However, Campos-Neto is able to collaborate with Harvard researchers at Beth Israel-Deaconess Medical Center and the University of Massachusetts Medical Center in Worcester. He’s also an adjunct professor at Boston University. These affiliations give him access to patients, facilities, and potential new students for his lab. Without these external resources and contacts, the kind of work he does at Forsyth simply wouldn’t be feasible.
Levin also reaps the benefits of working within walking distance of Harvard Dental School and Harvard Medical School. But, the real selling point for him is the freedom he has to pursue unconventional areas of research. Most people in his field study the genetics and biochemistry of development. Levin’s lab focuses on how biophysical factors—bioelectric fields, for example—influence embryonic development and regeneration. Only a handful of scientists in the world are doing this sort of work, he says.
The next move
As part of Forsyth’s expansion plans, Levin is in the early stages of recruiting people to form a new Center for Regenerative and Developmental Biology, which he will head up. He hopes to recruit an interdisciplinary group of five to 10 new lab heads in the next few years. This is only one of several unconventional research centers the Forsyth is working to create. Meanwhile, the institute continues to cultivate and grow its existing research programs.
All this will require more lab space, and that turns out to be a sticking point. Getting the space for a new 150,000 square-foot building the institute wants to construct requires a land exchange between the Forsyth and the City of Boston Parks Department. Some have voiced opposition in public meetings, including a Boston City Council hearing. They oppose the idea of swapping public parkland for privately owned space. Forsyth officials continue to meet with the community in search of a compromise.
Although the Forsyth got the unanimous approval of the Boston Parks Commission and the Boston Conservation Commission for the land swap last year, it still needs to obtain approval from two-thirds of the Boston City Council, the mayor, two-thirds of the state legislature, and the governor.
Pharo wouldn’t speculate how long this process might take. But he is optimistic that the Forsyth will find a way to adapt to changing times, like it has in the past.