Scientists at the University of Cincinnati have developed an at-home device that helps diagnose periodontal disease.
By Dr. Mehmood Asghar
A primary goal of regular dental checkups is to diagnose underlying, developing dental conditions that may cause more significant problems later in life. In addition to screening all tooth surfaces for decay, we also look for signs of gum disease, which affects over 46% of American adults (1). Unfortunately, gum disease has already caused its damage, even when detected early.
According to the American Academy of Periodontology, untreated gum disease not only increases the risk of various medical conditions such as diabetes, heart and respiratory disease, and cancer but can also cause various dental complications, including tooth loss (2).
But what if our patients could detect gum disease, one of the most prevalent dental infections worldwide, in the comfort of their homes?
Distinguished Research Professor Andrew Steckl and Senior Research Associate Daewoo Han at the University of Cincinnati collaborated with Sancai Xie, a principal scientist at Procter & Gamble Co. They set foot on a challenging task: Diagnosing periodontal disease using a simple-to-use device.
Saliva: The Versatile Biofluid
The plan was to use human saliva to detect a particular bacterium responsible for causing periodontal disease, Porphyromonas gingivalis (P. gingivalis). But this task was easier said than done.
“Saliva is a complicated biofluid,” stated Han.
“We wanted to target a biomarker in saliva. There are good reasons to use saliva,” added Steckl.
However, saliva is relatively plentiful and easy to obtain through non-invasive methods, and it has a lot of essential elements that can act as indicators of your health.
"But saliva is hard to use,” states Han, the lead author of this study, published in the Royal Society of Chemistry journal Sensors and Diagnostics (Han et al., 2023). He further explains that several constituents of the saliva can interfere with the test results. The first step was to remove a protein called amylase from the saliva using potato starch.
The At-Home Device That Detects Gum Disease-Causing Bacteria
Developing a sensor to detect P. gingivalis was an uphill task. The plan was to detect P. gingivalis lipopolysaccharide (PG LPS). A higher concentration of PG LPS in the saliva is a fairly reliable indicator of gum disease.
“Daewoo worked very hard on many dead-ends before he had success,” Steckl said. The scientists developed a point-of-care (POC) lateral flow assay (LFA) device that detects and quantifies PG LPS in human saliva using a sandwich capture approach.
This approach utilizes two antibodies that bind to different sites on an antigen or ligand, with the antigen sandwiched between the antibodies. The “capture” antibody is particular to the antigen and is attached to a solid substrate, followed by adding the antigen and the second antibody, called the detection antibody. As the antigen concentration increases, the concentration of the detection antibody increases as well, inflicting a higher measured response (Cox et al., 2019). This can be quantified using calorimetric methods.
What’s In Store for the Future?
This revolutionary at-home detection device is just the beginning. Various other products are in the development stage that can facilitate earlier disease detection and obtain more insights into the genetic aspects of common medical and dental ailments. For example, the Oral GenomeTM helps unlock oral health insights from saliva. Saliva is undoubtedly the best choice, as it is readily available and can detect various health-related problems.
The day is not far when at-home detection devices will be commercially available and used in every household for the timely detection of common dental and medical diseases.
Author: Dr. Mehmood Asghar is a dentist and Assistant Professor of Dental Biomaterials at the National University of Medical Sciences, Pakistan. Dr. Asghar received his undergraduate and postgraduate dental qualifications from the National University of Science and Technology (NUST). He is also currently pursuing a Ph.D. in Restorative Dentistry from Malaysia. Besides his hectic clinical and research activities, Dr. Asghar likes to write evidence-based, informative articles for dental professionals and patients. Dr. Asghar has published several articles in international, peer-reviewed journals.
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References
- Cox, K. L., Devanarayan, V., Kriauciunas, A., Manetta, J., Montrose, C. & Sittampalam, S. 2019. Immunoassay methods. Assay Guidance Manual [Internet].
- Han, D., Xie, S. & Steckl, A. J. 2023. Salivary endotoxin detection using combined mono/polyclonal antibody-based sandwich-type lateral flow immunoassay device. Sensors & Diagnostics, 2, 1460-1468.
