Oral Health Topics
Researchers are hard at work studying how saliva could be used to detect and diagnose oral disease and other diseases that affect one’s general health. This field of research, called "salivary diagnostics," has emerged as one of dentistry's most promising areas of research.
To date, researchers have studied saliva in an effort to detect tooth decay risk, periodontitis (gum disease), oral cancer, salivary gland diseases, and viral infections such as HIV and HCV.
The ease of collecting saliva is proving useful for determining hormone levels, including estrogen (estradiol), progesterone, testosterone, DHEA, and cortisol. This is particularly important in the case of estradiol, as it can be an indicator of premature birth and low birthweight babies.
A number of drugs can be detected in saliva. Saliva evaluation technology is currently used to test for drugs of abuse such as cocaine, ethanol and opiates. The technology can also be used for therapeutic monitoring of drugs such as digoxin, methadone and some anticonvulsants. In the future, dentists may have new technologies that will let them offer fast and effective saliva-based tests for screening various diseases.
For a more detailed discussion, read the ADA Council on Scientific Affairs Primer on Salivary Diagnostics.
Emerging research has generated widespread interest in the development of rapid, chairside tests that use saliva or other oral fluids for disease detection. Oral fluid samples are readily accessible as whole saliva or by sampling secretions from specific glands, mucosal transudate, or gingival crevicular fluid. Sampling oral fluids, instead of blood or urine, also offers an attractive medium for detecting a range of candidate biomarkers, such as proteins, electrolytes, hormones, antibodies and DNA/RNA.
Recent studies have demonstrated the advantages of using oral fluid for disease diagnostics, including ease of access, noninvasive sample collection, increased acceptance by patients, rapid results, and reduced risks of infectious disease transmission. New techniques for detecting small quantities of salivary proteins and other analytes at the molecular level have transformed salivary diagnostics into one of dentistry's most promising areas of study.
With funding support from the U.S. National Institutes of Health, charitable foundations, universities and others, researchers have reported promising findings in validating salivary biomarkers for potential use in the diagnosis of oral cancer and Sjogren's syndrome. Multidisciplinary research groups are also developing innovative chairside diagnostic tests that use "lab-on-a-chip" technologies to identify oral fluid biomarkers associated with good health and other biomarkers that may be associated with oral and/or systemic disease.
Salivary diagnostic research holds tremendous promise for improving patient access and developing rapid screening tools and early detection tests for malignancies such as oral squamous cell carcinoma. Their use in the dental office has potential to better integrate dentistry and medicine. Oral fluid diagnostic tests have already been developed to detect HIV status and substance abuse. Continued progress in validating salivary biomarkers and disease-specific oral fluid diagnostics will enhance point-of-care testing by delivering less invasive, more convenient test methods for patients.
- Primer on Salivary Diagnostics (ADA Council on Scientific Affairs, June 2009) (PDF)
- Statement on Oral Fluid Diagnostics (ADA Council on Scientific Affairs)
- Science in the News: Promising Salivary Protein Biomarkers Identified for Prediction of Oral Squamous Cell Carcinoma (October 2008)
- Science in the News: Recent Developments in Salivary Diagnostic Research for Cancer Detection (January 2008)
- Science in the News: Potential Salivary Biomarkers Identified for Detecting Primary Sjogren's Syndrome (November 2007)
- Salivary Diagnostics: The Future is Now (Journal of the American Dental Association, March 2006)