The Role of Salivary Diagnostic Testing in Patient Wellness

Reuss Dental has just started using a revolutionary approach in testing your saliva to see if you have risk factors that contribute to periodontal disease.  This new approach allows the clinician to determine which pathogens are present in your mouth and how they can affect your overall health.  During your periodontal therapy appointment we can discuss your risk factors and determine the best way to treat the pathogens that you have. Patients love this new approach because it is very simple to do. Below is some information taken from Oral DNA Labs Clinician’s Resources.

 

Our office is pleased to announce the availability of 3 laboratory tests relating to oral health. We think that some of our patients may benefit from these tests, but they are usually not covered by your insurance. Therefore, we will only perform them at your request. So, it’s important for you to understand the tests and their related conditions.
One of the conditions is gum disease, which can result in loss of your teeth. Bacteria and inflammation cause gum disease. More than 50% of Americans have gum disease. The other condition is oral cancer. Oral cancer can be caused by infection with a virus called HPV and by tobacco and alcohol use. HPV-related oral cancer occurs most often in people who don’t smoke or drink very much. A different kind of oral cancer occurs in smokers who drink a lot. About 36,000 Americans get oral cancer every year.
The MyPerioID® PST® test can tell if you have specific changes in your DNA. These changes might mean that you have a greater risk of getting gum disease.
The MyPerioPath® test is for patients who actually have gum disease. It finds out which bacteria are triggering the gum disease. Once we know which bacteria are in your mouth and at what amount, we can come up with a treatment plan that’s right for you. For example, this information can help us select the right antibiotic for you. We highly recommend this test if you have gum disease that has not responded to previous treatment.
The OraRisk® HPV test can tell if you have an HPV infection in your mouth. If you do, you might have a greater risk of getting HPV-related oral cancer. Like most cancers, it’s important to detect oral cancer early. If we know you have an HPV infection, we can watch you very closely for signs of oral cancer. We suggest you consider having this test if you are a non-smoker and don’t drink a lot.
All 3 of these tests are performed using a saliva sample, which is collected in our office. The sample is easy and fast to collect. Simply swish a sterile saline (salt) solution in your mouth and spit it into a container. The sample is then sent out for testing. When the results come back, we will tell you what your results are and what they mean to your oral health.

Periodontal Disease Overview

Prevalence of Periodontal Disease in the U.S.

Prevalence of gingivitis, the more common but less severe form of periodontal disease, is determined based on the presence of gingival inflammation and bleeding. According to data from the National Health and Nutrition Examination Survey (NHANES) III, about 50% of Americans have gingival bleeding.1

Prevalence data for periodontitis, the more severe form of periodontal disease, vary widely according to age of the individuals in the study population, the criteria used to define periodontitis, and the method used to examine the individuals (eg, partial-mouth vs full-mouth examination). In general, moderate periodontitis affects 30% to 50% of adult Americans, and 5% to 15% have severe periodontitis.2

Periodontal Disease Overview

The Perio-Systemic Link: Mouth, Body, Overall Health

Currently, it’s difficult to accurately predict which patients are at greatest risk of progressing to severe disease and which patients will be non-responsive to standard periodontal scaling, root planing, and debridement, complicating development of an optimal, patient-specific treatment plan.

Risk and prognosis of periodontal disease is affected by multiple factors.3,4 • Underlying pathogen(s) • Genetics: based on family and twin studies and some cytokine studies (eg, interleukin 1) • Lifestyle factors: tobacco use, stress, teeth grinding or clenching, poor nutrition • Co-morbid conditions: diabetes, cardiovascular disease, rheumatoid arthritis, osteoporosis/osteopenia,

obesity, pregnancy • Medications: long-term corticosteroids, calcium channel blockers, phenytoins, immunosuppressants,

chemotherapeutics

Periodontal disease, in turn, affects other health conditions. • Treatment of periodontal disease helps patients control their diabetes.5,6 • Periodontal disease may be a risk factor for heart disease.7-9

The underlying nature of these associations is still being investigated, but the periodontal pathogens and increased inflammation may be involved. For example, periodontal disease, diabetes, cardiovascular disease, and rheumatoid arthritis are all inflammatory conditions. Additionally, some small studies have found periodontal pathogens in atheromatous plaques.10-12 Regardless of the underlying mechanism, it’s clear that periodontal disease is linked to overall health.

Additional information can be obtained from the American Academy of Periodontology.

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