Having just attended the Greater New York Dental Meeting, which is the largest dental meeting in the country, piqued my curiosity about new technology.  As technology changes, the way we practice dentistry changes.  For example, I no longer use silver fillings, fewer dentists do.  I was considering what changes the next 10 years may bring.   I believe that salivary marker testing, currently in its infancy, will become routine.  Kits made by a company called OralDNA can be used now to measure causes of periodontal infection, risk of severe periodontal infection, and HPV or human papilloma virus status. (HPV is linked to oral cancer.)

Saliva is not a homogonous liquid.  There are three pairs of major salivary glands, the sublingual, submandibular, and parotid gland that produce it.  As we previously have discussed, the parotid also has an endocrine function.  In addition there are numerous minor salivary glands as well as gingival crevicular fluid. One of its functions of saliva is to “sweep” dead epithelial cells. Another is as a first line defense against bacteria and viruses. Thus it is rich in the immunoglobulins, mostly IgA.  With saliva you have a lot of information in one easy to biopsy spot.

Right now when you receive a professional examination and radiographs, the dentist will make his recommendations for treatment based on those limited criteria.  Imagine in a few years you are contemplating having a few implants placed.  Now implants have a very high, but not perfect, success rate.  Before treatment begins you have a salvia analysis and it shows high inflammatory markers and high levels of certain bacteria linked to implant failure.  With the proper treatment both of these conditions are easily rectified. Increased information will lead to better diagnoses, more individualized treatment plans, and success rates will only increase.  Follow up testing will prove the success or failure of the treatment.

These are only some of the dental benefits of salivary testing.  The epithelial cell component in saliva contains DNA.  This means they have all the genetic information that is shared with every other cell in your body.  This can now be sequenced but so can any bacterial and viral DNA as well.  The systemic implications of this are huge.  Imagine finding out that your recently developed allergy to (insert allergen here) is mediated by a bacterial protein in your saliva or your DNA sequencing indicates that you have a gene that puts you at risk of skin cancer or diabetes.  The earlier you know these things the earlier you can make lifestyle changes and avoid getting these conditions.  This is one instance where the old adage that an ounce of prevention is truly worth a pound of cure.

As DNA sequencing becomes common, the oral cavity is where it will be collected.  Immunoglobulins can be evaluated and their quality and quantity can provide a window onto the immune and inflammatory status.  Since the basis for fighting all disease in the human body is inflammation tracking this marker over time can give insight into immune system function.  Glycosylation status of salivary proteins will provide insight into the viscosity of the saliva.  Lack of saliva or poor quality or low flow as seen in Sjogren’s syndrome or radiation therapy is linked to rampant decay and periodontitis

Currently the greatest dental interest in this technology is in the realm of periodontics but I believe that as the technology becomes more widespread and lower in cost more uses for it will be found. We will all benefit from that.