Salivary testing for periodontal disease diagnosis and treatment

Dent Today. 2010 Jun;29(6):53-4, 56, 58-60; quiz 61.

Abstract

For more than 50 years, clinicians have relied primarily on the same visual and mechanical assessment methods to diagnose and classify periodontal disease. Clinical signs are simply a measurement of the past damage of a disease process. While clinical presentation and probing depths are indicators that the disease exists, these alone cannot determine the types and quantities of the responsible pathogens. Likewise, clinical signs alone cannot determine if therapy has achieved the goal of suppression of the etiological agent(s). Genetic presymptomatic testing complements bacterial DNA testing by providing insight into the patient's genetic predisposition to periodontal disease before symptoms appear, or when disease is already present. DNA-PCR testing of saliva can help the clinician provide an earlier and more specific diagnosis of disease based on causation. Treatment planning is also enhanced, as therapy can be appropriately modified based on both clinical and biological inflammatory factors. Finally, patient communication and case acceptance can be more readily achieved because the test reports elicit a persuasive "seeing is believing" attitude when reviewing test results with patients. Through the use of accurate periodontal charting, medical and dental risk assessments, and other diagnostic screening tests such as OralNA's MyPerioPath and MyPerioID PST tests, highly personalized periodontal therapy can be developed and carried out by the general practitioner. There has never been a better time to become more aware, and keep tighter control, of the periodontal status of one's patient base. Many patients are asking dentists about the connection between periodontal health and general health, While it currently would not be appropriate to suggest a causative relationship, there is abundant ongoing research that suggests a correlative relationship between periodontal disease and other whole-body ailments. Many patients have refused periodontal care or denied the importance of maintaining their periodontal health. The use of tools such as the OralDNA test report can assist in achieving patient acceptance of needed treatment and cooperation with the clinician to improve their periodontal health. The contents of the report and the visual presentation demonstrate that many patients have an active infection that can be stabilized if treated. Patients also provide more information about other factors that may contribute to their periodontal condition. Further, the OralDNA report enhances dentist-physician communication and a team approach to patient care.

MeSH terms

  • Bacterial Proteins / analysis
  • DNA, Bacterial / analysis
  • Genetic Testing
  • Humans
  • Interleukin-1 / genetics
  • Periodontal Diseases / diagnosis*
  • Periodontal Diseases / microbiology
  • Periodontal Diseases / therapy
  • Saliva / chemistry*
  • Saliva / microbiology*
  • Salivary Proteins and Peptides / analysis

Substances

  • Bacterial Proteins
  • DNA, Bacterial
  • Interleukin-1
  • Salivary Proteins and Peptides