FACULTY Q&A DR. ELLIOT HERSH Professor, Dept. of Oral & Maxillofacial Surgery/Pharmacology
How did you get involved in research? What got you interested in it? Actually, when I was a dental student, research wasn’t even a twinkle in my eye. During my junior year, a new faculty member came in at Rutgers University. His name was Stephen Cooper and he had gotten his dental degree from University of Pennsylvania and his PhD degree from Georgetown University Medical School. He taught a course in the beginning of my senior year, called “Clinical Therapeutics,” which put a clinical flavor on the basic pharmacology course that we had. After that I was hooked. He was by far the best teacher I had in all of my dental school training. That January, two postdoctoral fellowships became available for graduating dental students; one was in Immunology with a different faculty member and one was in pharmacology to spend the year working with him. So, I applied, and the rest is history. Within the first 3-4 months of that one-year experience, another faculty member D.M.D. PhD came on named Paul Desjardins, who is a respected dentist/pharmacologist. They decided they wanted to send someone over to the medical school to get a master’s degree. They’ve never done that before. I decided that in order to really get a better understanding of science, ask hypothesis driven questions, be able to write up scientific data, and get things published in journals, this training would be great; and that led to a master’s degree. It also led to the first paper I ever published in “Anesthesia Progress” called “The Effect of Intravenous Meperidine on Various Reparatory Parameters in Normal Volunteers.” Meperidine is a very old opioid. It was a main stay of sedation regimens. We wanted to look if we could pick up some of the pre-morbid signs of respiratory depression at therapeutic dosages, and that was my first bonified research project. Toward the end of that master’s degree, I realized that if I wanted to learn science to a greater degree, I would need to get a PhD. So I ended up flipping over to the medical school at Rutgers, and they took me, they never had a dentist before. I ended up doing my PhD work with a professor, George Condouris. He was one of the first people to describe that local anesthetic action is due to a blockade sodium influx, so this was a perfect match. 4 EXPLORER . WINTER 2020
Both my MS and PhD thesis advisors allowed me to practice dentistry part time so that my wife and I didn’t starve to death. At the time, I applied for an NIH postdoctoral fellowship and it took me two shots to get it, as it usually does. The second time around I was funded and that suddenly put me at a salary level almost equivalent to an assistant professor. So I think having that funding played a role in me being appointed to an assistant professor here. It was a great learning experience as far as getting your writing critiqued, not taking things personally, and getting your research off the ground.
What were some of your previous research projects? My biggest claim to fame was this study at Penn with 210 subjects in 11.5 months-all wisdom teeth extractions. I did the study that supports the marketing claims that: “for tough pain nothing works better than Advil liquid gels, not even extra strength Tylenol.” It wasn’t even my conclusion at the end of the paper, that wasn’t the main focus of the study. But, it was clear that this rapid release formulation of solubilized potassium ibuprofen had much greater peak affects even at 200 mg, and much more staying power than maximum doses of acetaminophen (1000 mg). We did another pivotal study here at Penn that helped get a rapid release formulation of diclofenac FDA approved. Post-surgical dental pain is driven by inflammation and these NSAIDs work as well if not better than addictive opioids. I have been studying non-addictive pain relievers for the greater part of 30 years. The neat thing that we’ve been doing now is trying to predict who the best responders to non-addicting NSAIDs will be prior to surgery, because the time-action curves that I put in papers and give in class are averages. And even in cases with a super-duper pain reliever that works great on average, 15-20% of individuals said it was ok but they needed something more, and 5% said it didn’t work at all. My other field of research is on local anesthesia. We have done pivotal studies here with injectable and topical anesthetics that put a lot of drugs on the market. We had a large study involving topical benzocaine, an over-thecounter gel. The FDA challenged us to see if it works on toothache pain. We found that the maximum strength lasted about 20 minutes
