Smart diagnostics taken to a whole new level
Featured Products Promotional FeaturesPosted by: Dental Design 3rd August 2023
I came across an interesting article[i] this month predicting the development of a ‘smart tooth’ within the next two years, which could monitor health. It is an intriguing idea and led me to look into just how far such an idea could be taken.
It works on the concept of using saliva as a biomarker for disease. There is already evidence to show that saliva may be an effective indicator for the presence of early onset of various dental conditions. For example, high cortisol levels in the saliva have been associated with increased risk of Oral Linchen Planus, which is a potentially malignant disease that can develop into oral cancer.[ii] Several inflammatory, cell activity and growth markers found in saliva have also been linked to periodontal disease, while an increased amount of S100A proteins in the saliva has been associated with Primary Sjögren’s Syndrome.
Looking into the research a little further, salivary biomarkers may be useful in detecting systemic health concerns as well. A review of the literature,[iii] which focused primarily on epidemiology studies, found sufficient evidence to postulate that salivary markers were detectable for diabetes and tumour diseases. Though the authors postulated that the markers could be useful for identifying increased systematic inflammation, this does offer promising results that could be built upon in the future.
The idea that we can improve our patient care based on their risk of developing certain diseases is obviously not a new one. We already tailor treatment and routine care according in an attempt to balance an increased chance of periodontal disease or caries based on the patient’s lifestyle or dental history. However, if we could take this one step further and screen them for a much wider range of health conditions then we could deliver even more personalised advice and support. Prevention is at the core of everything we do as dentists, so this would be a useful tool to help us help our patients avoid problems altogether if it were to work in this way.
There may also be a way of monitoring a patient’s risk of different diseases over time and using any changes in biomarkers as a trigger to start or adjust treatment. Further still, such a way of working would prove very useful for interdisciplinary cases and even make collaboration between dental and medical teams that much easier.
Of course, the ability to more accurately predict future health concerns would have wider implications for patients. Such a comprehensive risk assessment would no doubt be utilised by health or life insurance companies, impacting the premiums that people would pay or even what type of cover they would be entitled to.
As to how all this would work with regards to a detector of some sort that is fitted in the mouth, is yet to be seen. Maybe it would be a type of dental crown we place with in-built salivary receptors, or a device that sticks to the roof of the mouth. Only time will tell. We may already often refer to the mouth as the ‘gateway to the body’, but all of this gives the expression a whole new meaning!
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[i] ‘Smart tooth’ uses oral health markers to monitor chronic disease. The Dentist Online. April 2023. https://www.the-dentist.co.uk/content/news/smart-tooth-uses-oral-health-markers-to-monitor-chronic-disease[Accessed April 2023]
[ii] Melguizo-Rodríguez L, Costela-Ruiz VJ, Manzano-Moreno FJ, Ruiz C, Illescas-Montes R. Salivary Biomarkers and Their Application in the Diagnosis and Monitoring of the Most Common Oral Pathologies. Int J Mol Sci. 2020 Jul 21;21(14):5173. doi: 10.3390/ijms21145173. PMID: 32708341; PMCID: PMC7403990.
[iii] Rathnayake N, Åkerman S, Klinge B, Lundegren N, Jansson H, et al. (2013) Salivary Biomarkers for Detection of Systemic Diseases. PLOS ONE 8(4): e61356. https://doi.org/10.1371/journal.pone.0061356
