Could Saliva be the Key to Unlocking the Door to Early Intervention?

 Is the current system of disease detection and identification sufficient?

It is not hard to see the value in early detection and intervention of disease. It is well known that early detection of cancer significantly increases treatment success rates. Many diseases progress “silently” for a period of time in the cells of the body before the infected person has physical manifestations that would prompt an evaluation by their physician. In other worlds the only way to detect the presence of disease before the phenotypical characteristics are noted is by screening the biological tissues at a cellular level. The analysis of blood and urine are a common way that doctors identify genetic markers for disease, chemical imbalances, or the presence of pathogens. Unfortunately, most people do not typically see a physician regularly for these types of tests. A person who feels generally healthy, may never see a physician at all. Parents are encouraged to take their children to their pediatrician once a year for a “well-child” visit. But even these visits do not include the gathering of genetic material unless there is a cause for concern.

• I know a 4-year-old girl with Leukemia. Her parents had taken her to all of her routine doctor’s visits. No one had any reason to draw her blood and check her DNA for markers of this cancer. One night she got a bloody nose that wouldn’t stop bleeding. After a few hours they took her to the emergency room where they drew her blood and analyzed it. As soon as the doctors received the results of the test they rushed her and her parents onto a helicopter and flew her to Primary Children’s Hospital. When they got there, the doctors told the parents that she had Acute Lymphoblastic Leukemia and that they wanted to start treatment immediately. They spent the next week in the hospital grappling with the thought that they might lose their daughter. There is no one to blame for not detecting the cancer earlier. But imagine the difference it would have made for the family to know before it came to an emergency situation and battling advance stage cancer. (This little girl is responding well to the treatments and doctors are hopeful she will recover.) 

So, what can be done about this problem? Everyone could benefit from routine biological screening. But it is not currently the standard of care for medical doctors to recommend these tests. In addition, blood samples are invasive, and many people have anxiety about needles. Having blood drawn usually involves going to a lab separately from a doctor’s visit, and the cost to patients is considerable. And even if doctors did start recommending routine screenings, there is still the issue that most people do not see a physician regularly. There is an emerging field of science that may have the solution. Salivary diagnostics may be the answer.

Retrieved from http://www.mdpi.com/2075-4418/7/1/7/htm

Researchers have been making great strides in the field of salivary diagnostics. Biomarkers in saliva are very similar to the biomarkers in blood, except that blood contains more of them. Biomarkers in blood are measured in micrograms and in saliva they are measured in picograms. This has been a limiting factor for salivary diagnostics until technology advancements that have made measurement in picograms not only possible, but reliable. Dr David Wong, Director of UCLA Center for Oral/Head & Neck Oncology Research, has assembled teams of researchers to develop a point of care salivary testing unit that can analyze a small amount of saliva in less than an hour. In 2016 Dr Wong and associates Austin Wang, Chris P. Wang, and Michael Tu, published a review of their research in the article titled Oral Biofluid Biomarker Research: Current Status and Emerging Frontiers. Point of care means that a clinician can gather the saliva and run the test in the office without having to send a sample to a lab and wait for results. But that doesn’t solve the problem of how to screen patients who do not see a physician for regular examinations. What type of medical professional sees patients on a regular basis throughout their lifetime regardless of age? A dentist.

Not only are salivary diagnostics able to detect biomarkers for diseases such as cancer, diabetes, and heart disease but saliva can also detect a myriad of oral disease pathogens indicating periodontal disease and dental caries making this point of care technology ideal for a dental office. Currently there are no point of care salivary diagnostic units approved by the FDA for use in clinical practice. But there are clinical trials being produced that will soon bring this technology to the public. 

SW