Saliva Testing At Your Dentist
Your dentist may recommend saliva testing as saliva is an integral part of your dental and overall health. Your mouth is a mirror of what is going on in your entire body, and it offers a useful vantage point for detecting early signs of systemic disease. Systemic diseases are conditions that affect your whole body and not just one part of it. These disorders include cancer, diabetes, hepatitis or HIV.
What does oral balance mean in relation to saliva testing?
Oral balance is the equilibrium that exists between the demineralising effect on a tooth surface caused by acids, which are balanced out by the remineralising and buffering effects of saliva. Even though oral balance is influenced by other factors such as fluoride exposure and oral hygiene, the dominant stimulus is the daily battle between oral acids and saliva.
Oral balance must be maintained at all cost. Otherwise, when saliva flow reduces, oral health problems such as tooth decay or infections can occur.
If you have any pressing dental issues or questions regarding saliva testing, you can book an appointment online or contact us directly on (+356) 2125 7253 (Skyparks Business Centre, Malta International Airport), or (+356) 2155 7323 (Dingli Street, Victoria, Gozo). For international patients, it is recommended to request a free e-consultation where we can discuss your individual case and treatment options.
Benefits of saliva to your health
Saliva offers your teeth the most powerful defence against decay. Saliva contains a variety of hormones, antibodies, cytokines, antimicrobial constituents and enzymes which all play a significant role in the protection of your intraoral structures against damage caused by different pathogenic microbes and irritants. It also adds nutrients and minerals to toughen your teeth. Some of the benefits of saliva to your health include;
Remineralising the enamel
Saliva contains important elements like calcium, bicarbonate and phosphate. These elements not only remineralise the enamel, but they also help repair early tooth decay and damage.
Lubricating oral tissues
Saliva moisturizes the inside of the mouth, including the oral tissues, which help us speak, taste, breathe and swallow better.
Maintaining oral mucosa health
Saliva is also a mineralising agent; As it washes through the teeth, mouth and gums, it adds minerals and nutrients, which help to toughen the oral mucosa.
Assisting the sense of taste
The enzymes found in the saliva act as solvents for taste substances. Saliva dissolves these taste substances and the latter diffuse to the taste receptor sites.
What happens when saliva fails to protect your teeth
When saliva stops protecting your teeth, the clearance of food particles and bacteria from the mouth is reduced. The potential for remineralisation and buffering of acid also diminishes. As a result, oral balance is affected, leading to demineralisation. When demineralisation occurs, the external surface of your tooth softens, leading to:
Teeth erosion may occur from either internal or external acid sources like gastric reflux or acidic drinks or food
The labial (outside) surfaces of your teeth may wear or erode when brushing your teeth.
Increased occlusal and incisal attrition: Your teeth may undergo tooth wear, resulting in wedge-shaped lesions.
Situations that call for saliva testing
To diagnose new clinical conditions
When a patient goes to a dentist with new oral health problems, their saliva may be tested to help determine the reason why the oral balance is not supporting demineralisation. Once diagnosed, a lasting solution can be found to correct or control these problems.
When doing restorative treatment
Saliva testing is done before any major restorative treatment to determine the cause of the condition such as what induced the loss of tooth structure. It also helps to determine whether a different undiagnosed oral balance issue may compromise the success of the restorative treatment.
Risk assessment for all patients
Over the years, we all experience a lot of changes in lifestyle, habits, diet and health status, which can unsuspectingly impact our oral balance. For instance, diet changes can lessen the amount of saliva in your mouth.
Risk assessment measures help identify your current oral balance situation before a permanent loss of tooth structure occurs. Regular risk assessment should be considered as routine for all dental patients.
How Can I Tell Whether My Saliva Is Healthy Or Not?
Usually, most dental conditions such as decay or sensitivity do not happen overnight. However, if you can spot these conditions early, they can be corrected before they cause damage. The best way to know if your saliva is healthy is having it checked by an experienced dentist. Your dentist can perform a small saliva test to enable them to identify if your saliva is healthy or not.
Factors That Lead To Unhealthy Saliva
Some of the factors that contribute to unhealthy saliva include:
- Alcohol intake
- Caffeine intake
- Acidic foods and drinks
- Medication or general health
- Strenuous physical activities
- Hormone imbalance
Tell Tale Signs Of Unhealthy Saliva
This may be a sign of dry mouth also known as xerostomia. Dry mouth can be caused by salivary gland problems, continuously breathing through your mouth or as a side effect of various medications.
A change in taste of food
This could be as a result of various medical conditions, poor dental health, smoking or even a salivary gland disorder.
Dry mouth when you are sleeping or awake
Your mouth getting dry while sleeping or even when you are awake can be an indication of some severe health issues. It may also be due to particular over the counter or prescription medication, including cold, pain and allergy drugs.
White and clumpy
If your saliva is white and clumpy, it could mean that you have an oral infection known as thrush. Although it is a rare malady in healthy adults, people with diabetes are especially prone to this condition since the sugars in their saliva can lead to the growth of yeast.
Saliva is bitter or sour
This may be a sign of reflux. Reflux causes your stomach acid to bubble up into your throat, producing an icky flavour.
Saliva that feels sticky upon awakening
This could be a sign of sleep apnea. Sleep apnea occurs when you experience multiple pauses in breathing during sleep.
Saliva is too acidic
The normal saliva should be near or at a neutral pH. If your saliva is too acidic, this may be a sign of acid reflux, anxiety, nutritional deficiency, hormonal changes, depression or candidiasis. You should also be wary of tooth decay, bad breath and dry mouth, which are typically caused by increased acidity.
Top 5 Benefits of Saliva Testing At Your Dentist
1. Predisposition to Gum Disease & Tooth Decay
Saliva testing can be used to check which bacteria are triggering a patient’s gum disease or tooth decay. Your dentist can create a personalised hygiene treatment to help you get rid of these conditions once and for all.
2. To Test If HPV Virus (Higher Chance Of Oral Cancer) Is Present
Saliva testing helps to check if patients have oral Human Papillomavirus (HPV). Although this condition can be identified through skin lesions such as sores or warts, saliva testing helps to identify the disease early and allowing your dentist to treat it more efficiently.
Saliva screening is an important test for the identification of oropharyngeal Squamous Cell Carcinoma. Oropharyngeal Squamous Cell Carcinoma also known as throat or tonsil cancer is a type of head and neck cancer that occurs due to the presence of the Human Papillomavirus(HPV). An oral test allows for the detection of the presence of an infection with HPV strains with high and low oncogenic risk.
The clinician starts by taking a salivary sample using a special brush, which they rub against the oral mucosa. If suspicious lesions are found, the clinician must take a sample of the lesions as well. If the tests come out positive, they proceed to conduct a typing to identify 27 strains responsible for the infection. Saliva testing allows for the early detection of the presence of oral HPV, which is vital for early diagnosis. According to the Centers for Disease Control and Prevention, medical research shows that 90% of all cervical cancers are linked to some specific high-risk HPV types.
3. Measurement of Heavy Metals In Your Body
Saliva may be used for checking heavy metals levels in your body.
4. Identify Medicines Or Drugs That May Lead To Under Or Over Production Of Saliva
Saliva provides a quick and non-invasive specimen for drug testing.
Saliva testing costs less than similar serum tests.
What Do You Do If The Test Is Positive And You Are At Risk?
Consult with an experienced dentist and hygienist to discuss a treatment plan on how to manage your saliva. In most cases, the treatment plan may require you to change your teeth cleaning habits, diet, or even lifestyle. Therefore, the success of your treatment is majorly dependent on how committed you are to follow your dentist’s instructions. In other cases, protective application of fluoride or tooth surfaces may be needed. In severe cases, restoration work may be necessary. Your dentist will also refer you to a doctor if a predisposition to certain non-dentally related conditions are found.
Saliva testing parameters
Testing the right saliva parameters is crucial to understanding why it is not protecting the teeth as it should. These parameters include:
Saliva is termed as resting or unstimulated when no external or pharmaceutical stimulation is present.
Stimulated Saliva is derived when mechanical stimuli or pharmacological agents such as paraffin wax is used.
The 5 steps involved in saliva testing
The effectiveness of saliva is influenced by several properties including pH, viscosity, buffering capacity and flow rates. During saliva testing, each of these aspects is measured to get the most accurate results. The steps involved in saliva testing include;
Resting saliva hydration
The first phase of the test is done to assess how hydrated a patient’s mouth. The normal resting saliva flow rate is approximately 0.3-0.4ml/min. Resting saliva is derived from the submandibular glands.
While you may be asked to drool saliva into a collection cup, a simpler technique is to visually assess the production of saliva from the small salivary glands found in the lips.
Resting saliva flow (viscosity)
The second phase is done to measure the viscosity of saliva at rest. This test can be done visually. Healthy resting saliva is clear in colour and consistently watery. If the resting saliva is stringy, frothy, or is very thick, this could mean that the content of water is low due to a low production rate.
Resting saliva pH
This step measures the PH of unstimulated saliva. This is done by asking the patient to spit the saliva in their mouth into a testing cup.
A low pH indicates that the mouth is more acidic than normal. When the pH is low, acidic challenges result in mineral loss and demineralisation at a level that the saliva alone cannot repair.
Stimulated saliva quantity
This test measures the quantity of saliva produced. Stimulated saliva is produced by the parotid gland. This saliva is important as it helps flush away acids from diet, dental plaque and internal sources like gastric reflux.
The testing of stimulated saliva quantity requires you to obtain a sample over a period of 5 minutes. You will be asked to chew on a piece of paraffin wax to stimulate salivary flow. Spit the saliva into the testing cup after every 30 seconds of chewing for about 5 minutes.
Stimulated saliva buffering capacity
Stimulated saliva buffering capacity measures the ability of saliva to neutralize acids in the mouth, which can come from dental plaque, your diet, or from internal sources like gastric reflux. The saliva you provide in the step above is used to test for bicarbonate. Bicarbonate is the most important buffering element in saliva.
How long does the test take?
On average, a saliva test takes about ten minutes to complete.
Is saliva the future of diagnostics?
Saliva has proven to be a very successful tool for diagnostics. According to Science Direct, it has become an important resource for assessing pathological and physiological conditions in humans. The use of saliva also provides a simple and non-invasive method of collecting samples. These samples have been proven to produce rapid and highly accurate results. They are also a great addition to the early detection of oral problems.
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Savina Clinic – Dental & Implantology Centres are friendly, state-of-the-art practices in Malta and Gozo dedicated to comprehensive quality dental care. Savina Dental is an innovative dental practice in Malta and prides itself on the high-quality customer service, low waiting room times, attention to detail and the advanced dental technology at their disposal.
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