
Trisha E. O’Hehir, RDH, BS
Editorial Director,
Hygienetown Magazine
Every day in dental practices around the world,
dentists and hygienists work together to diagnose
and plan effective treatment for their
patients. To bolster this natural collaboration,
feature stories, content from the message
boards of Hygienetown.com and Perio Reports
research summaries are presented in every
issue of Dentaltown Magazine. The goal of this
section is to present topics that will create discussions
between dentists and hygienists to ultimately
improve dental hygiene outcomes. |
Saliva will eventually become the diagnostic
fluid of choice for dental as well as systemic diseases.
The wealth of information about enzymes, proteins
and immunoglobulins found in saliva is incredible
and saliva sampling is easy to do and non-invasive.
Recently a consortium of three research groups published
the salivary proteome, identifying 1,166 proteins
in human saliva. These proteins are involved
with various levels of structural function and
immune response, providing information that
researchers have shown can be analyzed with a chairside
or at-home test, taking just three to 10 minutes.
The best clinical
diagnostic we have for
gingivitis and periodontitis
today is bleeding
on probing, with
the absence of bleeding
being the more accurate
predictor of health. Not
all bleeding on probing
leads to bone loss. Saliva
contains proteins of
both host and bacterial
origin, providing new
information about onset
and progression of disease.
It contains the bacteria associated with periodontal
disease and the host response mediators
including IgA, IL-1, MMP-8, and C-reactive protein,
which are discussed in several of this month’s Perio
Reports summaries. Gingival crevicular fluid mixes
with saliva to provide immediate information about
what’s happening inside the sulcus or periodontal
pocket. Salivary markers provide information about
the bacteria present in the pocket, inflammation, collagen
breakdown and bone turnover.
Saliva is already used to determine hormone levels
for estradiol, progesterone, testosterone, and cortisol.
It is also used for drug testing of both legal and
illegal drugs. Salivary diagnosis is now possible for
oral cancer, breast cancer, salivary gland diseases,
hepatitis, HIV and Sjögren’s Syndrome. These
recent research findings are just the start.
Seven research grants were awarded by the
National Institute for Dental and Craniofacial
Research for micro electromechanical systems for
salivary diagnostics or “lab-on-a-chip” prototypes.
The Oral Fluid NanoSensor Test is one of these prototypes.
It’s a handheld, automated, oral fluid sensor
for rapid detection of multiple salivary proteins.
Screening chips are designed with information to
test against the saliva. The screening chip is the size
of a credit card and is inserted into the machine
along with the saliva sample with diagnostic data
transferred to a Blackberry or iPhone type computer.
Data chips have been designed and tested for oral
cancer screening, Sjögren’s Syndrome screening, and
perio screening with C-reactive protein, MMP-8
and IL-1.
Using this technology to measure nicotine
metabolites with a 10-minute, in-office test for
general practice patients in a smoking cessation
program proved more successful than traditional
approaches. A higher smoking cessation rate of 23
percent vs. seven percent was achieved with immediate
data feedback to the subjects using the salivary
diagnostic test.
It won’t be long before dentists and dental
hygienists have greater involvement in the identification
and monitoring of oral and systemic diseases.
Incredible, edible spit will eventually be the fluid of
choice for clinical diagnostics.
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