Saliva test

This article is about the tooth decay risk test. For the oral mucosal swab as a DNA test, see saliva sample , for hormone saliva tests see hormone replacement therapy , for saliva tests for drugs see drug wipe test .

A caries risk test is called a saliva test . Tooth decay is an infectious disease , i. That is, it is triggered by cariogenic bacteria ( Streptococcus mutans , Lactobacillus ) in plaque (dental plaque) and in saliva . There are various test methods available to the dentist to determine the risk of caries .

Bacterial saliva test

Chewing a piece of chewing gum or a piece of wax ( paraffin ) for 2 to 5 minutes stimulates the secretion of saliva, so that bacteria from the plaque are flushed into the saliva. The saliva is collected in a plastic cup. In a bacterial saliva test, a carrier with a special nutrient medium is moistened on both sides with the saliva, placed in a special culture vessel and incubated in an incubator at 37 ° C for 2 to 4 days . The sample is then compared to a scale to determine the number of bacteria.

Lactic acid indicator

The saliva is removed from the tongue with a lactic acid indicator stick. This is put in a blister in which an enzymatic reaction chain takes place. The indicator stick changes color, with the degree of coloration of a nine-step color scheme indicating the amount of indicator available . The test result can be read after a reaction time of two minutes . The sugar on the test stick forms lactic acid through the action of the cariogenic bacteria . This is converted with the help of the enzyme lactate dehydrogenase and produces a blue-violet reaction product.

Critical appraisal

For expectant mothers, the theory of caries germ transmission and the importance of saliva tests for their prevention is emphasized, although there is no evidence (= evidence ) for this.

A four-year study by the University of Witten / Herdecke also does not show any agreement between the determination of the risk of caries using the lactic acid indicator and the clinical examination. The determination of lactic acid production is only suitable as an additional test to determine the risk of caries.

Determination of the saliva flow rate

The determination of the saliva flow rate (sialometry) is the only objective method for the detection of an existing hyposalivation (oligosialia) or dry mouth (xerostomia). The frequent consequence of dry mouth is dental caries in the absence of the protective substances accompanying normal salivation. The normal saliva contains a number of antimicrobially active components, including a. Immunoglobulin A ( antibody ), lysozyme ( enzyme ), lactoferrin and histatin ( protein ).

Based on literature data and based on the measurements at the Westphalian Wilhelms University in Münster, the following reference ranges for four different flow rate groups are suggested for adults (18 to 70 years of age):

Resting saliva

Hypersalivation	> 1 ml / min
Normal salivation	0.25-1 ml / min
Hyposalivation	0.1-0.25 ml / min
Xerostomia	<0.1 ml / min

Stimulated saliva

Hypersalivation	> 3.5 ml / min
Normal salivation	1.0-3.5 ml / min
Hyposalivation	0.5-1 ml / min
Xerostomia	<0.5 ml / min

Since the stimulated saliva flow rate, in contrast to the resting saliva flow rate, is time-dependent, all sialometric examinations of the stimulated saliva secretion should be based on a stimulation duration or collection duration of two to four minutes for the calculation of the flow rate.

More saliva tests

Saliva tests are also used for various other examinations, such as

• Toxicological issues (e.g. drug test )
• Hormonal imbalances
• Determination of the personal hormone profile
• Menopausal symptoms
• Performance profile
• Course of pregnancy
• Detection of hormonal agents
• Desire for children
• sleep disorders

Saliva hormone test

The following hormones can be determined by saliva tests:

• Cortisol
• DHEA
• Estradiol
• Estriol
• Melatonin
• progesterone
• testosterone

→ Main article : hormone replacement therapy

Web links

Wiktionary: Saliva test  - explanations of meanings, word origins, synonyms, translations

• Pharmaceutical newspaper Sabine Schellerer, dry mouth, a life without spit

S2k guidelines for hypersalivation of the German Society for Ear, Nose and Throat Medicine, Head and Neck Surgery. In: AWMF online (as of 2013)

Individual evidence

1. ↑ German Society for Dental, Oral u. Kieferheilkunde (DGZMK) 1994: Importance of saliva diagnostics in the context of caries prevention
2. ↑ Strippel, H. 2002: Questionable “germ theory” - example of nipple bottle caries . Public Health Forum 10 (35), pp. 8-9
3. ↑ Wörle, P. 2004: "Update" Caries prophylaxis. Correct professional and home prophylaxis , Bayerisches Zahnärzteblatt 4/2004, p. 54. (PDF; 254 kB)
4. ↑ Wörle, P. 2004: "Update" Caries prophylaxis p. 55 (PDF; 254 kB)
5. ↑ Azrak, B., Callaway, A., Willershausen, B., Ebadi, S., Gleissner, C .: Comparison of a new chairside test for caries risk assessment with established methods in children ; Switzerland Monthly Zahnmed (2008) 118: 702–708, 2010
6. ↑ Azrak, B., Gleissner, C., Willershausen, B., Stöcker, JJ., Callaway, A .: Accuracy of a chair-side test for predicting caries risk compared with established methods . Switzerland Monthly Zahnmed, 2010, 120: 409–414
7. ↑ ^{a b} ZM Heft 22/2000, Udo Stratmann, Kai Mokrys: Dry mouth
8. ↑ Cancer information on oral and dental care by the dkfz
9. ↑ Patient information from the German Medical Association (PDF; 95 kB)
10. ↑ Karin M. Höld, BS; Douwe de Boer, Jan Zuidema, Robert AA Maes: Saliva as an Analytical Tool in Toxicology . Ed .: Int J Drug Test. 1996 ( researchgate.net [PDF]).

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !