RHD interviewed oral hygiene expert Karen Davis on risk assessments that prevent dental disease. One of the questions was on how salivary diagnostics can aid in the instruction of home care practices.
Davis replied that it is “phenomenally common” to see patients with low accumulated hard deposits, but substantial bleeding after probing or instrumentation that reveals a significant inflammatory response. Commonly these patients have no symptoms and rate plaque control to be a low priority.
Salivary diagnostics enable the detection of an excessive load of pathogens that cause significant amounts of periodontal disease. These tests can also identify an increased genetic risk for the progression of disease. Upon realizing this, patients frequently become concerned about their bleeding gums and become invested in mitigating disease progression and tooth loss.
Dental Economics discussed the use of salivary diagnostics for patients considering implants. Testing for which bacteria are found in a patient’s saliva can determine bacterial loads and ID specific high-risk bacterial species. The same high-risk species that cause periodontitis are also high-risk for implant failure.
Improvements in molecular genetics technology make it possible to receive a report on both the amount and types of bacteria in a patient’s mouth. In addition, this testing can reveal specific genetic susceptibility traits. This enables the dental team to prevent periodontitis, make sure that the oral environment is suitable for implant surgery, and detect disease at an early stage. Treatment decisions can be made on an individual basis.
Specific information that can be obtained from the analysis of saliva include:
- Oral pathogens known to be causative agents of periodontal and peri-implant disease
- Genetic traits that increase the risk for more severe tooth and implant infections
- Types of HPV that increase the risk for orapharyngeal cancer
Treatment may entail local antiseptics, biofilm removal, host modifying meds, site-specific antibiotics, and systemic antimicrobials. Knowing which bacteria are involved enables dental professionals to suggest specific antibiotics.
The prevalence of peri-implantitis ranges from 12-43% for most implant systems. By performing salivary diagnostics, oral specialists can take appropriate treatment before the implants are placed in the patient’s mouth.
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