As dental professionals, we’re constantly looking for ways to help patients feel safe and comfortable under our care.
Unfortunately, there’s little we can do to change the fact that dentistry is, by nature, quite invasive. We still have a ways to go when it comes to finding less invasive means to diagnose and treat our patients.
One promising solution in this area is saliva testing ‒ a fast, cost-effective diagnostic tool which requires no painful pokes or scrapes. Saliva tests are increasingly utilized as a noninvasive way to monitor oral health status, disease onset and progression, and treatment.
Here, we’ll look at the reasons why more and more dentists are welcoming saliva test kits into their practices.
Why Use Saliva Testing in Dental Practice?
Saliva is a truly flexible fluid. Yes, it helps us eat, speak and maintain good oral health ‒ but it also contains a wealth of biochemicals that can tell us a great deal about a person’s overall health.
Oral fluid can be analyzed for proteins and related molecules, nucleic acid components (e.g., human and microbial DNA, mRNA and microRNA), and endogenous and exogenous metabolites. Saliva tests can help dentists assess a patient’s risk of caries and periodontal inflammation by analyzing cariogenic bacteria, acidity, blood, leukocytes, protein and ammonia.
In addition to oral health conditions, trace amounts of proteins and other substances linked to other systemic diseases can filter into saliva from blood serum. These salivary biomarkers have been investigated for detection and monitoring of diseases such as:
- Human papillomavirus (HPV)
- Autoimmune diseases, including Sjögren’s syndrome
- Cystic fibrosis
- Various cancers, including oral squamous cell carcinoma
- Herpes simplex virus 1 or 2
- Chlamydia trachomatis and Neisseria gonorrhoeae
Unlike a blood sample, saliva (along with secretions from specific oral glands, mucosal transudate and gingival crevicular fluid) is painless and readily available to collect from patients for analysis.
In many cases, it is possible to collect and test saliva samples right there in the dental office using portable, rapid test kits. When laboratory analysis is required, saliva samples have greater stability than blood in transportation.
Applications for Saliva Testing in Dentistry
In an article for Dental Economics, Dr. Richard Nagelberg illustrates how saliva testing could be used to help dentists and hygienists provide evidence-based treatment for periodontal disease.
Suppose a patient comes to you with telltale signs of inflammation: painful, bleeding gums and the early stages of gum recession. You don’t need a saliva test to tell you that this patient is likely suffering from gingivitis. However, the results test could inform an individualized treatment approach that could provide the best possible outcome for them.
As Dr. Nagelberg explains, a salivary test report would specifically indicate which antibiotics are indicated for each type of bacteria found in the saliva sample. A patient who is dealing with high-risk, highly pathogenic bacteria such as Porphyromonas gingivalis and Tannerella forsythia would benefit from a treatment plan that is based on their increased risk of periodontal disease.
Efforts are underway to further the development of rapid, point-of-care tests to evaluate oral fluids. Ongoing research indicates that saliva could eventually be used to detect heart disease, diabetes, cancers and other conditions. Refinement of oral fluid tests may shed further light on our understanding of the oral-systemic link.
Imagine using a simple, chairside test to detect all manner of oral and systemic diseases. This could be the future of diagnosing periodontal disease, assessing cavity risk and more!
The Future of Saliva Testing in Dentistry
The development of salivary testing for the dental practice is still in its early stages.
Currently, there is still no established, uniform criteria for collecting human saliva in the dental practice. Although oral fluid testing by clinical laboratories is regulated to ensure test results are accurate, the regulations do not address the validity of the test. Additionally, to date, there are no FDA-approved salivary diagnostic tests for evaluating the risk of periodontal disease or dental caries.
Still, saliva testing for oral and systemic disease holds many advantages that make it ideal for use in dentistry. Surveys show that these types of chairside tests are appealing to dentists and patients alike.