EHRs and Salivary Diagnostics

Imagine collecting a saliva swab and having insight into patients’ health. Knowing right away if his or her bones and teeth are healthy, if there’s an infection, and what medication will work best–and how much to give.

Many health problems and diseases can be detected through tests of salivary proteins. Gingivitis, candida infections and other oral health concerns can all be discovered in this way. Periodontitis and osteoperosis can both be detected this way as well–and the biomarkers in the saliva can identify the progression of the disease and predict oral health needs. The emerging field of pharmacogenomics offers clinical and translational research and medical information about a patient using salivary diagnostics. Saliva contains biomarkers that can indicate susceptibility to particular disease, medication responses and doses required.

This is happening; for instance, see this Human Genome site for a quick overview, or the Mayo Clinic’s brief explanation. The Pharmacogenomics Journal is now publishing frequently.

And, as you can imagine, dentists will be key in implementing and receiving this data. Knowing the bone health, appropriate anesthesia, possible complicating infections, current status of periodontal disease–and the predicted status for periodontal disease. Researchers Giannobile et al. say that those predictions are coming, and coming soon.

Clearly, this kind of transformation in dental information will require updated and different data storage. Knowing the risk level of individual patients provides new methods for behavioral, interventional and even advice to medical treatment. The EHR will become ever more pivotal as salivary diagnostics provide patient-specific information that affects overall health.

Another research article says this:

“Saliva biomarkers provide dentists with the capability to assess patients with a painless, non-invasive aid to evaluate oral fluid chemicals, analytes, electrolytes, hormones, proteins, antibodies, and RNA. Identifying patients at risk and referring them to physicians for definitive diagnosis and treatment provides dentists the opportunity to expand their role on the healthcare team.” (Slavkin, Fox & Mayer, 2011)

With appropriate electronic information exchange in a true electronic health record, dentists could become the key sentinels for the health of their patients. Embracing and utilizing EHRs allows for dentists to become ever-more important to and well-placed to ensure the overall health of the populace.

Lessons Learned:

  • As health information is increasingly captured and mined, dentists can become forefront in health data and treatment.
  • Preventative and early detection diagnostics may be clinical care that dentists lead in.
  • Correct anesthetic selection and dosages will be easier in the future and tracking that information in an EHR will improve patient care.

W.V. Giannobile, J.T. McDevitt, R.S. Niedbala, & D. Malamud (2011) “Translational and Clinical Applications of Salivary Diagnostics” ADR October 23: 375-380

H.C. Slavkin, C.H. Fox & D.M. Meyer (2011) “Salivary Diagnostics and Its Impact in Dentistry, Research, Education, and the Professional Community.” ADR October 2011 23: 381-386