Clinician-scientist focuses on orthodontics clinical care and research

Laura Jacox, DMD, PhD, MS, is a clinician-scientist at Adams School of Dentistry.

For Laura Jacox, DMD, PhD, MS, finding the ideal fit with varied interests has guided her career. As an assistant professor at Adams School of Dentistry, Jacox enjoys both research and teaching, and has found the ideal place to investigate ways to improve patient care.

She initially thought she’d be a lawyer, but while getting her undergraduate degree at Massachusetts Institute of Technology, she was exposed to mentors who opened her eyes to a different direction –research and patient care.

Jacox with some of her students. The students were honored with awards for their research, supervised by Jacox.

“I pursued research in a bioengineering lab with a clinician-scientist who was an MD and PhD. He encouraged me to pursue this career track. I thought I would make research and clinical care a dual-career, to always have options and keep things interesting,” she said. “My other mentor and pre-health advisor was an oral surgeon. He hosted me at surgical conferences at Harvard MGH, where I learned about jaw surgeries and orthodontics, sparking my interest in both dentistry and orthodontics. I also discovered that there was a nationwide need for dental academics, which also was encouraging.”

Jacox then got her DMD and PhD at Harvard University, studying craniofacial development in frog embryos and becoming a general dentist. When it came time to specialize in orthodontics, she decided to pursue her residency and post-doctoral training at UNC Adams School of Dentistry, where she found strong mentors in Ching-Chang Ko, DDS, PhD, and William Proffit, DDS, PhD. At UNC, Jacox could excel in both research and clinical care, with outstanding supported in these endeavors.

“[UNC’s] campus and dental school are beautiful, with great legacies. The residency was also cost effective, and I was granted a fellowship,” she said. “Importantly, I had several friends from Harvard School of Dental Medicine who attended UNC Orthodontics and raved about the quality of the faculty, the clinic, the resident community and their experience. People vouched for it and said it was a great program with strong clinical and research training. I also was able to join the lab of Dr. Ko, who was a positive, supportive mentor.”

As Jacox grew into the clinician-scientist she is today, she was able to grow her research interests and collaborative team along the way, eventually creating the Jacox Lab. Her work with animal assisted therapy and speech studies of jaw surgery patients offer great potential to help people who are scared of the dentist or who are trying to gain insurance approval for jaw surgery treatments to allow them to speak and function normally.

One of Jacox’s studies looks at patients undergoing jaw surgery for anatomical disproportions who often also have speech disorders. The research looks at whether surgical interventions and orthodontics benefit these patients’ articulation problems.

Jacox with student researcher Christine Bode during a Research Day presentation.

“We are asking: do these involved, invasive jaw surgeries and orthodontics help improve the speech of our patients with jaw disproportions? So far, our data is encouraging that the treatments are providing significant patient benefit. Not only is this exciting scientifically, but the data also help us to guide our patients’ care, since we as providers have a better understanding of treatment outcomes. When patients ask us if jaw surgery will help improve their speech distortions, we can now answer them to inform their treatment decisions,” she said. “Widespread insurance denial is a nationwide problem for our surgical patients with severe jaw disproportions. The jaw procedures are considered cosmetic by many insurers, necessitating oral surgeons to resubmit cases numerous times with more and more documentation before some surgeries are approved. Patients are left in limbo during this lengthy process, which is stressful and time-consuming for patients and providers.”

Jacox’s speech study is looking at speech before and after jaw surgery, to see if speech changes after the jaws are surgically moved to a normal position. So far, preliminary data indicate significant improvement in speech among certain patient groups. Results also suggest that speech therapists need to be part of the treatment planning team for jaw surgery patients. If speech therapy fails due to the underlying jaw structural problem, speech-language pathologists can document this to show that further surgical intervention may be required for improvement. “We hope to leverage our findings to advocate for our patient’s functional need for orthognathic surgical treatment. With this study, we’re so close, and I feel like we’re on the cusp of being able to implement real change.”

Animal-assisted therapy is another research direction providing encouraging results for young patients scared of the dentist. “We’re hoping that animal therapy can make people less likely to develop dental anxiety and can enjoy dental visits,” she said. “We’re studying whether we can make going to the dentist more fun with canine therapists!”

The study is currently enrolling children between the ages of 4 and 8. Participants get a free dental exam, a toothbrush, a cleaning, a full dental report of findings and a gift card incentive.

Jacox is proud of her lab and the work they do, and she enjoys working with students and other ASOD faculty and researchers across departments to achieve exciting outcomes.

Members of the Jacox Lab work hard but also enjoy time celebrating one another.

“We have a great research community in the triangle, with UNC, NC State and Duke, and as a result, my collaborators and students are amazing,” she said. “In my group, we treat each other with respect, kindness and support. That was important in my training, and I value it in my own lab. I want to set students up for success in research and ensure they learn to value it and critically analyze new recommendations and products, particularly for clinicians. I want conducting research to be a positive experience to keep students interested in science and discovery.”

Jacox said her research community, and constantly learning through science, are what she enjoys most about her job. She also credits caring mentors and smart, thoughtful coworkers with making ASOD a great environment.

“It’s a unique community that I love being a part of. I like the ability to plan ‘big picture’ and work with a team of good, smart people to make things happen. I enjoy working with the excellent students and my collaborators to improve how we treat patients,” she said.

When she’s not in her lab or in the clinic, Jacox enjoys spending time with her husband and one-year-old daughter. Though they spend a lot of time locally at gardens, parks and nature preserves, they are a family of avid travelers. Jacox has travel plans on the horizon, as she will be speaking at a conference in Greece hosted by the European Orthodontics Society. She is also a musician and plays the violin as part of the Durham Medical Orchestra, a group of health care providers that get together to play music.

“We like to play in our free time to help with the stress of academic life and patient care!” she laughs.