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Belinda Nicolau

belinda [dot] nicolau [at] mcgill [dot] ca (Email)

Belinda NicolauBelinda Nicholau, Ph.D.
INRS-Institut Armand-Frappier
531 boulevard des Prairies
Laval, Québec, H7V 1B7

Phone: (450) 687-5010
Fax: (450) 686-5501

Faculty of Dentistry
Oral Health and Society Research Unit
3550 University Street
Montreal, QC H3A 2A7

Phone: 514-398-7203 ext.09465

Belinda Nicolau is as an Associate Professor in the Faculty of Dentistry at McGill University. She obtained her DDS degree from the Federal University of Paraná, Brazil and an 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 in Montreal. From 2005-2011, she was Assistant Professor and then Associate Professor at INRS-Institut Armand-Frappier, after which she moved to McGill University in December 2011.

Research Interests

My main research interests lie in the field of oral epidemiology; specifically, I study the aetiology of chronic oral diseases, 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 chronic oral diseases 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.

Quebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) cohort – Oral health component  http://www.etudequalitystudy.ca

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 pathwayisbased uponthe evidencethat 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., TNFa 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).

Research Group

Research Associate

Geneviève Castonguay

Research Assistant

Nicolas Drolet
Heidi Gaied

Graduate Students

Khady Ka, PhD 3rd year; project: Body composition and oral inflammation in children

Patricia da Rosa, PhD 3rd year; project: Neighbourhood characteristics and children’s dental caries experience

Nada Farsi, PhD 2nd year; project: The role of HPV on the aetiology of Head and Neck Cancer: HeNCe Life study-Canadian site

Akhil Soman, PhD 1st year; project: Genetic susceptibility, life course material adversities, and oral cancer in Indian subjects

Manuela Mandu, PhD 5th year; project: Sleeping problems and malocclusion

Farnaz Rashid-Kandvani, MSc 2nd year; project: Dental access among people with disability

Shahul Hameed, MSc 2nd year; project: The relationship between periodontal health and oral cancer among Indian subjects

Sreenath MD, MSc 1st year; project: The role of psychosocial stress in the association between socioeconomic position and oral cancer in Indian subjects

Undergraduate Students

Tsedey Tamir, project: Neighborhood characteristics and head and neck cancer (literature review)

Former students

Larissa Vilela, postdoctoral fellow; project: The role of HPV on the aetiology of Head and Neck Cancer: HeNCe Life study –Brazilian site

Sophie Arpin, postdoctoral fellow; project: Characteristics of the built environment and chronic oral diseases

Akhiil Soman, MSc; project: Life course socioeconomic position and oral cancer risk [HeNCe Life study-India site]

Beatriz Ferraz, MSc; project: Identifying curriculum challenges to reduce oral health inequities

Nada Farsi, MSc; project: Risk factors for head and neck cancer highlighting the importance of HPV viruses

Patricia da Rosa, MSc; project: « Indices de défavorisation des écoles comme facteurs prédictifs de l’état de santé buccodentaire des élèves au Québec »

Hilina Hitimana, MSc; project: The association between functional foods and dental caries experience

Roozbeth Khosravi, MSc; project: « La maladie parodontale et l’obésité chez les enfants »

Cherine Nouheid, MSc, project: An investigation of the effect of neighbourhood characteristics on traumatic dental injuries among a sample of Quebec children


Nicolau B,Marcenes W. How will a life-course framework be used to tackle wider social determinants? Community Dentistry and Oral Epidemiology, in press.

Legault V, Burchell A, Goggin P, Nicolau B, Brassard P, Guenoun J, Forest P, Mayrand M-H, Franco E, Coutlee F. (2011) Generic Microtiter Plate Assay for Triaging Clinical Specimens prior to Genotyping of HPV DNA via Consensus PCR. Journal of Clinical Microbiology;49(11):3977-9. http://www.ncbi.nlm.nih.gov/pubmed?term=%20Legault%20and%20nicolau

Lambert M, Van Hulst A, O’Loughlin J, Tremblay A, Barnett T, Charron H, Drapeau V, Dubois J, Gray-Donald K, Henderson M, Lagacé G, McGrath J, Mathieu M-È, Mark S, Maximova K, Nicolau B, Paradis G, Pelletier C, Poirier P, Sabiston C. Cohort Profile: The QUebec Adipose and Lifestyle InvesTigation in Youth (QUALITY) Cohort. International Journal of Epidemiology, online publication http://ije.oxfordjournals.org/cgi/reprint/dyr111?ijkey=ul6DDcCHxKujkiF&keytype=ref

Farsi N*, Nicolau B. (2011) Safety of Oscillating-Rotating Powered Brushes Compared to Manual Toothbrushes: A Systematic Review. Journal of Evidence Based Dental Practice  11(4):168-70. http://www.ncbi.nlm.nih.gov/pubmed?term=farsi%20and%20nicolau

da Rosa PC*, Nicolau B, Brodeur JM, Benigeri M, Bedos C, Rousseau M-C. (2011) Associations between school deprivation indices and oral health status. Community Dentistry and Oral Epidemiology 39(3):213-20. http://www.ncbi.nlm.nih.gov/pubmed/21091525

Kâ K*, Rousseau M-C, Nicolau B. (2009) Supportive periodontal care for patients with chronic periodontitis may produce better clinical outcomes when delivered by a specialist instead of a general practitioner, but at a higher cost. Journal of Evidence Based Dental Practice 9(4):231-233. http://www.ncbi.nlm.nih.gov/pubmed/19913746

Khosravi R*, Tran SD, Lambert M, O’Loughlin J, Kâ K*, Feine JS, Caron C, Tremblay A, Nicolau B. (2009) Adiposity and gingival crevicular fluid tumour necrosis factor-alpha levels in children. Journal of Clinical Periodontology 36(4):301-307. http://www.ncbi.nlm.nih.gov/pubmed/19426176

Pluye P, Grad R, Levine A, Nicolau B. (2009) Tensions between quantitative and qualitative data: An exercise for novice mixed methods researchers. Journal of Mixed Methods Research 3(1):58-72.


Nicolau B, Rousseau M-C. (2008) Association of height with inflammation and periodontitis: the study of health in Pomerania. Journal of Evidence Based Dental Practice8(2):95-96. http://www.ncbi.nlm.nih.gov/pubmed/18492585

Chaput J-P, Gilbert J-A, Caron C, Nicolau B, Tremblay A. (2007) Addressing the obesity epidemic: What is the dentist’s role? Journal of the Canadian Dental Association 73(8):707-709. http://www.ncbi.nlm.nih.gov/pubmed/17949536

Nicolau B, Netuveli G, Kim M*, Sheiham A, Marcenes W. (2007) A life-course approach to assess psychosocial factors and periodontal disease. Journal of Clinical Periodontology 34(10):844-850. http://www.ncbi.nlm.nih.gov/pubmed/17850603

Nicolau B, Thomson M, Steele J, Allison P. (2007) Life course epidemiology: concepts and theoretical models and its relevance to chronic oral conditions. Community Dentistry and Oral Epidemiology 35(4):241-249. http://www.ncbi.nlm.nih.gov/pubmed/17615010

Vilela L, Nicolau B, Mahmud S, Edgar L, Hier M, Black M, Franco E, Allison P. (2006) Comparison of psychosocial outcomes in head and neck cancer patients receiving a coping strategies intervention and control subjects receiving no intervention. Journal of Otolaryngology 35(2):88-96. http://www.ncbi.nlm.nih.gov/pubmed/16527026

Bedos C, Brodeur JM, Arpin S, Nicolau B. (2005) Dental caries experience: A two-generation study. Journal of Dental Research 84(10):931-936. http://www.ncbi.nlm.nih.gov/pubmed/16183793

Sheiham A, Nicolau B. (2005) Evaluation of social and psychological factors in periodontal disease. Periodontolgy 39(1):118-131. http://www.ncbi.nlm.nih.gov/pubmed/16135067

Nicolau B, Marcenes W, Bartley M, Sheiham A. (2005) Association between socio-economic circumstances at two stages of life and adolescents’ oral health status. Journal of Public Health Dentistry 65(1):14-20. http://www.ncbi.nlm.nih.gov/pubmed/15751491

Nicolau B, Marcenes W, Allison P, Sheiham A. (2005) The life course approach: Explaining the association between height and dental caries in Brazilian adolescents. Community Dentistry and Oral Epidemiology 33(2):93-98. http://www.ncbi.nlm.nih.gov/pubmed/15725171

Allison PJ, Edgar L, Nicolau B, Archer J, Black M, Hier M. (2004) Results of a feasibility study for a psycho-educational intervention in head and neck cancer. Psychooncology 13(7):482-485. http://www.ncbi.nlm.nih.gov/pubmed/15227717

Allison PJ, Nicolau B, Edgar L, Archer J, Black M, Hier M. (2004) Teaching head and neck cancer patients coping strategies: results of a feasibility study. Oral Oncology 40(5):538-544. http://www.ncbi.nlm.nih.gov/pubmed/15006628

Nicolau B, Marcenes W, Hardy R, Sheiham A. (2003) A life course approach to assess the relationship between social and psychological circumstances and gingival status in adolescents. Journal of Clinical Periodontology 30(12):1038-1045. http://www.ncbi.nlm.nih.gov/pubmed/15002889

Nicolau B, Marcenes W, Bartley M, Sheiham A. (2003) A life course approach to assessing causes of dental caries experience: The relationship between biological, behavioural, socio-economic and psychological conditions and caries in adolescents. Caries Research 37(5):319-326.  http://www.ncbi.nlm.nih.gov/pubmed/12925821

Nicolau B, Marcenes W, Sheiham A. (2003) The relationship between traumatic dental injuries and adolescents’ development along the life course. Community Dentistry and Oral Epidemiology 31(4):306-313. http://www.ncbi.nlm.nih.gov/pubmed/12846854