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From Trisha's Desk Trisha E. O’Hehir, RDH, BS Hygienetown Editorial Director

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Incredible, Edible Spit

Trisha E. O’Hehir, RDH, BS
Editorial Director,
Hygienetown Magazine		 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.

Inside This Section
3 Perio Reports
6 Short Commentary: Get a Grip
7 Message Board: Taking Radiographs After SRP
10 Hygienetown.com Poll: Pen Grasp
11 Profile in Oral Health: OUCH! Dentinal Hypersensitivity
15 Townie Clinical: Calculus Bridge Lower Incisors
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