Clinical Research to Improve the Oral Health of Older Adults (R21 Clinical Trial Not Allowed) | PAR 19 240

Opportunity Information: Apply for PAR 19 240

The National Institutes of Health (NIH) released this funding opportunity, PAR-19-240, titled "Clinical Research to Improve the Oral Health of Older Adults (R21 Clinical Trial Not Allowed)," to encourage early-stage, exploratory research aimed at improving dental, oral, and craniofacial (DOC) health in aging populations. It uses the NIH R21 mechanism, which is designed for developmental or pilot work that can generate foundational evidence, refine concepts, and produce preliminary data needed to design larger, more definitive future projects. A key boundary in this announcement is that clinical trials are not allowed, meaning applicants should focus on clinical research that does not meet NIH's definition of a clinical trial, such as observational studies, analyses of existing clinical data, measurement development, validation studies, patient-centered outcomes research that is non-interventional, and other preparatory work that can shape later interventions.

The central goal is to stimulate research that clarifies what drives poor oral health outcomes in older adults and what stands in the way of better prevention and care. The FOA explicitly calls for studies that can inform future targeted interventions by improving understanding of risk factors, identifying access barriers, testing or refining oral health promotion approaches, strengthening disease prevention strategies, and improving clinical management approaches for DOC conditions tied to aging. In practical terms, the NIH is looking for projects that help answer questions like why certain groups of older adults experience higher burdens of tooth decay, periodontal disease, tooth loss, xerostomia (dry mouth), oral pain, mucosal conditions, or complications from chronic disease and medication use, and which modifiable factors or system-level barriers could be addressed in later intervention trials or implementation programs. Because it is exploratory, strong fit topics often include hypothesis-generating work, feasibility assessments, development of new tools or measures relevant to geriatric oral health, or studies that map care pathways and pinpoint where older adults fall through the cracks.

The announcement strongly encourages collaboration between researchers focused on aging and researchers focused on DOC health. That emphasis reflects the reality that oral health in later life is tightly linked to gerontology, chronic disease management, polypharmacy, cognitive impairment, disability, nutrition, and social determinants of health. Competitive applications would typically show an interdisciplinary team that can bridge dental research with aging science, health services research, epidemiology, behavioral science, community-engaged research, or implementation science, depending on the project. The intent is to move beyond siloed work and produce findings that meaningfully translate into better-designed interventions, more practical care models, or more equitable access strategies for older adults.

In terms of who can apply, eligibility is broad and includes many types of domestic organizations and government entities. Eligible applicants listed include state, county, and city or township governments; special district governments; independent school districts; public and state-controlled institutions of higher education; private institutions of higher education; federally recognized Native American tribal governments; public housing authorities and Indian housing authorities; Native American tribal organizations that are not federally recognized governments; nonprofits with or without 501(c)(3) status (as long as they are not institutions of higher education in those specific categories); for-profit organizations other than small businesses; and small businesses. The FOA also highlights a range of "other eligible applicants" to underscore NIH interest in diverse institutional participation, including Alaska Native and Native Hawaiian Serving Institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), Hispanic-serving Institutions, Historically Black Colleges and Universities (HBCUs), Tribally Controlled Colleges and Universities (TCCUs), eligible federal agencies, faith-based or community-based organizations, regional organizations, Indian/Native American tribal governments other than federally recognized, and U.S. territories or possessions.

Restrictions related to foreign involvement are specific. Non-domestic (non-U.S.) entities (foreign organizations) and non-domestic (non-U.S.) foreign institutions are not eligible to apply as the applicant organization, and non-domestic components of U.S. organizations are also not eligible to apply. However, the FOA allows "foreign components" as defined by the NIH Grants Policy Statement, meaning a U.S.-based applicant can include certain types of international collaboration or performance sites if they meet NIH policy requirements and are appropriately justified. This structure keeps the award anchored in an eligible U.S. applicant organization while still permitting limited global collaboration when it strengthens the science.

From a funding and administrative standpoint, this is a discretionary grant in the health category under CFDA 93.121. The opportunity was created on 2019-04-04, and the original closing date listed is 2022-09-07. The award ceiling provided is $200,000, which aligns with the exploratory nature of an R21 and signals that projects should be tightly scoped with clear deliverables that can be completed without the scale of a large clinical program. While the number of expected awards is not specified in the provided data, the overall structure indicates NIH is aiming to seed multiple smaller, high-potential studies that can mature into future, larger research efforts aimed at improving oral health outcomes for older adults.

Overall, this FOA is best understood as an NIH invitation to develop the building blocks for better geriatric oral health interventions: solid evidence on risk and barriers, stronger preventive and management strategies, and practical insights into how care can be delivered more effectively to older adults. The "clinical trial not allowed" requirement pushes applicants toward studies that prepare the ground for later trials rather than testing interventions directly, while the collaboration emphasis signals that NIH wants research that integrates oral health with the broader realities of aging, health systems, and equity.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Clinical Research to Improve the Oral Health of Older Adults (R21 Clinical Trial Not Allowed)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.121.
• This funding opportunity was created on 2019-04-04.
• Applicants must submit their applications by 2022-09-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

Apply for PAR 19 240

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