Saliva testing could revolutionise periodontitis monitoring,

Dental Tribune International

Thu. 30. January 2025

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PHILADELPHIA, US: Periodontitis is one of the world’s most prevalent health conditions, affecting between 20% and 50% of the global population—roughly 64 million people in the US alone. A new study from Penn Dental Medicine in Philadelphia has proposed that tracking certain proteins in saliva could provide an accessible way to monitor the progression of periodontal disease, offering potential benefits for both dentists and patients.

Led by Dr Flavia Teles, an associate professor in the Department of Basic and Translational Sciences at the dental school, the research followed over 400 patients for up to 18 months. The study found that individuals with periodontitis progression had notably elevated levels of nine inflammation-related signalling proteins in their saliva compared with those whose condition remained stable.

“One can imagine a saliva test kit, based on such findings, that dentists could use and even periodontitis patients could use at home—it could be a very useful personalised-dentistry tool for assessing risk and tailoring care delivery,” said Dr Teles in a university press release.

Despite its prevalence, predicting the transition from mild to severe periodontitis has proved challenging. Prior studies attempting to use molecular markers from saliva or blood have faced limitations, such as small sample sizes and single time point measurements rather than ongoing monitoring. Dr Teles and her co-researchers designed their study to avoid these issues.

The researchers enrolled 302 patients with early to severe periodontitis, along with 113 individuals without signs of the disease. The participants underwent detailed periodontal assessments every two months for a year, during which saliva and blood samples were collected and analysed for inflammatory proteins. Those with periodontitis received standard non-surgical therapy and were re-evaluated three and six months after treatment.

The patients with the most significant disease progression—defined as three or more sites with loss of clinical attachment—exhibited higher salivary levels of inflammatory markers such as interferon-gamma, interleukin-6, vascular endothelial growth factor, interleukin-1 beta and matrix metalloproteinase-8. These biomarkers decreased after treatment. In contrast, inflammatory protein levels in blood samples did not strongly correlate with disease progression, although some, including matrix metalloproteinase-8, matrix metalloproteinase-9 and C-reactive protein, showed declines after treatment.

The findings suggest that monitoring inflammation-related proteins in saliva over time could help both patients and clinicians assess periodontitis risk and treatment efficacy. While blood biomarkers may have a secondary role in evaluating treatment outcomes, saliva appears to be a more reliable indicator of disease progression.

Building on these insights, Dr Teles and her team are now analysing bacterial species and metabolites from the same patient samples to explore additional markers of disease progression or stability. “We are also using artificial intelligence to analyse broader sets of clinical and laboratory data,” Dr Teles explained. “Our hope is that, through this data analysis, we can further refine this approach and provide more tailored and accessible oral care.”

The article, titled “Salivary and serum inflammatory biomarkers during periodontitis progression and after treatment” , was published in the December 2024 issue of the Journal of Clinical Periodontology.