The tidal wave of saliva research

From the events that took place during the second North American Saliva Symposium that convened in Seattle, Washington, in December 2015, Dr. Richard Nagelberg shares about how health care is poised to take a giant leap forward through the latest advancements in salivary diagnostics. As dental professionals, we will be in an incredibly advantageous position to improve our patients' health and well-being far beyond the oral cavity. Consider the ability to monitor glucose levels or detect biomarkers associated with oral cancer simply by placing a couple of drops of saliva onto a cell phone-sized device. Read on to see how dental research will have positive effects on us much like good oral health affects oral-systemic health.

Richard H. Nagelberg, DDS

In December 2015, the second North American Saliva Symposium convened in Seattle, Washington. The meeting, jointly sponsored by the University of Washington and Oasis Diagnostics, provided an opportunity for globally recognized leaders in salivary research from dentistry, medicine, pediatrics, oncology, neuroscience, and industry, among others, to share ideas and forge collaborations to further advance research.

Among the esteemed speakers was John McDevitt, PhD. As one of the plenary speakers, he outlined the focus of his research, which is the use of oral fluid samples in nontraditional health-care settings. Dr. McDevitt envisions a linkage of chemical sensors to smartphones. This would be accomplished by means of a credit card-sized disposable lab on a chip, used in conjunction with a device that analyzes biomarkers found in bodily fluids, including saliva. The test results are then relayed to the patient's smartphone. The lab on a chip is called the Programmable Bio-Nano-Chip System (p-BNC), and it is being validated by six major clinical trials in the areas of heart disease, oral cancer, prostate cancer, ovarian cancer, and drug abuse testing. Dr. McDevitt serves as the chairperson for the Department of Biomaterials and Biomimetics at New York University College of Dentistry, among many other distinctions.

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Another plenary speaker was David Wong, DMD, DMSc, from UCLA. Dr. Wong is a world-renowned scientist working in oral cancer and saliva diagnostics research. He noted that current clinical practice includes tumor tissue biopsy- based genotyping; however, the invasive nature of biopsies can result in significant morbidity and issues related to sampling bias. To address these issues, Dr. Wong has developed a liquid biopsy technique that uses saliva to detect tumor-causing lung cancer mutations. The technique is noninvasive, cost-effective, and rapid. Clinicians could use this technology to adjust their therapeutic strategies in real time, improving clinical outcomes.

Wenjun Zhang, PhD candidate from Northeastern University in Boston, discussed the development of a glucose biosensor on a chip to provide noninvasive, accurate, low-cost, continuous glucose monitoring. This would provide real-time salivary glucose tracking, improving compliance, reducing complications, and improving overall disease management. This promising development has the potential to be impactful in the global battle against diabetes.

Jill Maron, MD, MPH, associate professor, is a neonatologist at Tufts Medical Center in Boston. She discussed the ability to perform assessment of the genome and real-time, ongoing, childhood development from mere drops of saliva. Dr. Maron noted that salivary diagnostics extend well beyond the detection of oral pathology and that saliva serves as a window into systemic diseases and developmental impairments.

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A unique, clever device to passively collect salivary samples in the neonatal and pediatric population is under development. The collection device includes a pacifier that is very familiar to infants. As the baby sucks on the pacifier, a reservoir in the pacifier collects the sample of saliva. This type of device, developed by Oasis Diagnostics, will streamline salivary collection for researchers involved with these vulnerable populations.

The variety of topics from some of the other presenters at the symposium included research involved in neurodegenerative disorders, including Alzheimer's disease and Parkinson's disease, oral cancer, and autoimmune diseases such as Sjogren's syndrome. Augustine Swinburne, PhD, who is with the Environmental Protection Agency, discussed salivary antibodies as biomarkers of infection with waterborne pathogens, and Alireza Sadr, DDS, PhD, from the University of Washington, discussed the role of saliva in maintenance and repair of tooth enamel.

The wide range of diseases and conditions that can be identified through salivary biomarkers is truly a game changer. The potential ability to identify the presence of heart disease, oral, prostate, ovarian, and lung cancer, drug abuse, and glucose levels, among many others, through the collection and analysis of a few drops of saliva was incomprehensible a short time ago. Every age category-from newborns to the elderly and everyone in between-will be the beneficiaries of these advances.

As dental professionals, we will be in an incredibly advantageous position to improve our patients' health and well-being far beyond the oral cavity. Consider the ability to monitor glucose levels or detect biomarkers associated with oral cancer simply by placing a couple of drops of saliva onto a cell phone-sized device.

It's a fact: health care is poised to take a giant leap forward through salivary technologies.


Richard H. Nagelberg, DDS, has practiced general dentistry in suburban Philadelphia for more than 30 years. He is a speaker, advisory board member, consultant, and key opinion leader for several dental companies and organizations. He lectures on a variety of topics centered on understanding the impact dental professionals have beyond the oral cavity. Contact Dr. Nagelberg at gr82th@aol.com.

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