The OPTISMILE Podcast 107 - Saliva Testing and DNA Diagnostics
In this episode of Save Your Money, Save Your Teeth, Eon Engelbrecht speaks with Dr Clifford Yudelman from OptiSmile about saliva testing, DNA diagnostics, and the future of personalised dentistry.
While these tests may sound futuristic, the idea is simple: understanding a patient's risk before dental problems become painful, expensive, or difficult to treat. Dr Yudelman explains how saliva can reveal clues about dry mouth, acidity, buffering capacity, bacteria, bad breath, gum disease risk, and even implant risk.
He also takes a balanced view, explaining where these tests can be useful, where they may still be too expensive for the average patient, and why the basics, such as flossing, hydration, professional cleaning, diet, and regular dental care, still matter most.
10 Questions
1. Why on earth would a dentist want to test my saliva?
Saliva protects the teeth by neutralising acids, washing away bacteria, and delivering minerals such as calcium and phosphate. Testing saliva can help assess flow rate, acidity, buffering capacity, dryness, and potentially bacterial risk. Dr Yudelman explains that while saliva testing can be valuable, he does not currently use it routinely at OptiSmile because, in many cases, clinical signs already reveal the key risks.
2. Can a DNA test tell us if we are genetically more prone to gum disease, and if so, how?
Some people have a stronger inflammatory response to plaque than others. DNA testing can identify genetic variations, such as the IL-1 marker, that may suggest a higher risk of severe gum disease. However, genes are only part of the story. Oral hygiene, smoking, diabetes, professional cleaning, and daily habits still play a major role.
3. Can saliva testing identify the specific bacteria causing bad breath?
Yes, saliva and plaque testing can identify anaerobic bacteria associated with bad breath, especially bacteria on the tongue or in gum pockets. Dr Yudelman explains that this may help guide treatment, but for most patients, the practical basics remain essential: flossing, healthy gums, tongue scraping, professional cleaning, and appropriate antimicrobial products when needed.
4. What is the IL-1 genetic marker and how does it affect implant risk?
The IL-1 marker relates to how strongly the immune system responds to bacterial challenge. In patients with a history of gum disease, this may suggest a higher risk of inflammation and bone loss around dental implants. In such cases, Dr Yudelman may refer patients to a periodontist for more specialised assessment and maintenance planning.
5. How do we test for the acidity or buffering capacity of saliva?
Saliva can be collected in two ways: resting saliva, where the patient simply spits into a container, and stimulated saliva, where the patient chews wax before spitting into a cup. The saliva can then be tested for acidity and buffering capacity. Low buffering capacity means saliva is less able to neutralise acid, increasing the risk of tooth erosion and cavities.
6. Can saliva testing help us choose the right antibiotic for an infection?
In specific periodontal cases, specialists can test fluid from gum pockets, known as crevicular fluid, to identify bacteria and guide antibiotic choice. This is not usually a general saliva test for everyday dental infections, but it may be valuable in selected gum disease cases where targeted treatment is needed.
7. Is this testing expensive, and is it worth it for the average patient?
Dr Yudelman explains that saliva and DNA testing can be expensive, especially when paid for privately in rands. For the average patient, it may not always be necessary. However, in selected cases, such as unusual gum disease, implant risk, or persistent bacterial problems, targeted testing may be worthwhile if it changes the treatment plan.
8. How does this all fit into personalised medicine in dentistry?
Personalised dentistry means using more information to tailor prevention and treatment to the individual patient. Saliva testing, DNA markers, bacterial testing, AI-assisted x-ray analysis, and digital diagnostics may all help motivate patients and guide more specific care. Dr Yudelman believes these tools will become more common as they become faster, cheaper, and easier to use.
9. Can saliva testing detect diseases like diabetes or even cancer?
There is research into saliva-based detection for systemic diseases such as diabetes and cancer, but Dr Yudelman stresses that this is not yet routine dental practice. He mentions future possibilities such as small sensors that could monitor glucose from saliva, but explains that this episode is more future-looking than a guide to what patients should expect at the dentist tomorrow.
10. How do you perform the test? Is it just spitting in a tube?
Most saliva tests are non-invasive. Patients may chew a piece of wax and spit into a small cup or tube. DNA testing may involve saliva or a cheek swab. There are no needles, no finger-pricks, and no major discomfort. The sample is then analysed depending on the type of information being tested.
Key Takeaways
Saliva is not just spit. It is one of the body's most important protective systems for the mouth. Good saliva flow helps neutralise acid, protect enamel, control bacteria, support remineralisation, and reduce the risk of decay, erosion, dry mouth problems, bad breath, and gum disease.
Saliva and DNA testing may become more common in dentistry as the technology becomes quicker and more affordable. These tests may help identify patients at higher risk of gum disease, implant inflammation, dry mouth complications, acid erosion, bad breath, or bacterial imbalance.
However, Dr Yudelman's message is practical and balanced. Testing may be useful in selected cases, but it does not replace the fundamentals: flossing, tongue cleaning, regular professional cleaning, hydration, a sensible diet, managing dry mouth, avoiding smoking and vaping, and seeing a dentist before small problems become expensive ones.
Further Resources
1. The Oral Microbiome and Your Health [https://optismile.co.za/blog/the-oral-microbiome-your-health/] - A highly relevant companion episode on oral bacteria, dysbiosis, gum disease, and links between oral health and general health.
2. Dry Mouth Dilemmas: Causes, Consequences and Relief Strategies [https://optismile.co.za/blog/dry-mouth-dilemmas-causes-consequences-relief-strategies/] - Useful for listeners who want to understand how reduced saliva flow increases the risk of cavities, infections, sensitivity, and dry mouth complications.
3. Medicines and Mouth Health: What You Need to Know [https://optismile.co.za/blog/medicines-your-mouth/] - Explains how common medicines can reduce saliva flow, contribute to dry mouth, and increase the risk of cavities and gum problems.
4. Dental Implants at OptiSmile Cape Town [https://optismile.co.za/dental-solutions/dental-implants/] - Relevant to the discussion about implant risk, gum health, inflammation, and long-term implant maintenance.
5. OptiSmile Dental Solutions [https://optismile.co.za/dental-solutions/] - A useful starting point for patients exploring dental check-ups, teeth cleaning, implants, cosmetic dentistry, and preventive dental care at OptiSmile.
Disclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.
