Saliva‐based colorimetric test as an index of gingival inflammation in epidemiologic studies

Abstract

There is a pressing need for a reliable, low-cost method of assessing the gingival and periodontal status of large population groups. Existing indexes, despite their value in dental public health, are still too subject to examiner variability for use by uncalibrated examiners. This study describes an evaluation of a quick, inexpensive, extraoral colorimetric test for gingival inflammation, based on a reaction between saliva and the test material. It could probably be applied by non-professional personnel. In this study, the test was applied to a population of elementary schoolchildren, dental hygiene students and faculty, and adult inmates of two correctional institutions. These populations were chosen on the assumption that they would exhibit varying intensities of gingival inflammation. Values obtained from the colorimetric test carried out by one researcher were compared with Gingival Index (GI) scores observed by a different examiner. Results suggest that the colorimetric test may be a valid, reliable means of detecting major differences in the prevalence of gingival inflammation in most adult populations, although having little, if any, useful application among children at the mixed dentition stage.

Effectiveness of the Salivary Occult Blood Test as a Screening Method for Periodontal Status

“…In previous studies, a different type of SOBT showed significant correlation with the gingival index 5,6 and with crevicular fluid flow, 6 and another SOBT showed a significant correlation with the PMA index in adolescents 7,8 but not in adults >40 years old 8 . These studies 5‐8 did not examine the sensitivity or specificity of SOBT or the relationship between SOBT and the presence of deep periodontal pockets. Another SOBT showed a high sensitivity (75.9%) and specificity (90.5%) for >30% BOP in 50 patients at a university dental clinic after stimulation by sulcular toothbrushing for 1 minute; however, when using unstimulated saliva, the sensitivity decreased to 20.7% 9 .…”

“…Salivary occult blood tests (SOBTs) have been evaluated primarily as a screening method for gingivitis 5‐9 . However, a recently developed SOBT was reported to discriminate subjects with a poor periodontal condition, which was defined as bleeding on probing (BOP) in ≥20% of teeth or a probing depth (PD) ≥6 mm plus BOP in ≥1 teeth 10 .…”

Feasibility study of a salivary occult blood test to correlate with periodontal measures as indicators of periodontal inflammation in a population of pregnant women

“…As context for our study, there are published reports of six studies assessing the correlation of various oral occult blood tests with various periodontal measures (10–15). Comparison of our results with those of the published studies is challenging because of the differences amongst the oral occult detection methods, periodontal measures and study populations.…”

“…Comparison of our results with those of the published studies is challenging because of the differences amongst the oral occult detection methods, periodontal measures and study populations. Two studies from 1978 used Gindex (Janar Company, Grand Rapids, MI) colorimetric test of hemoglobin in oral specimens compared with the GI for gingivitis using partial mouth designs (10, 11). The authors concluded that Gindex was useful to discriminate different levels of inflammation in the adult prison inmates with moderate levels of gingival disease, but not useful for the children with mixed dentition or adult hygiene students, in part because of the low disease levels (10).…”

“…Two studies from 1978 used Gindex (Janar Company, Grand Rapids, MI) colorimetric test of hemoglobin in oral specimens compared with the GI for gingivitis using partial mouth designs (10, 11). The authors concluded that Gindex was useful to discriminate different levels of inflammation in the adult prison inmates with moderate levels of gingival disease, but not useful for the children with mixed dentition or adult hygiene students, in part because of the low disease levels (10). A second clinical study found statistically significant correlations of Gindex hemoglobin testing of saliva with GI scores (r=0.79), and also of crevicular fluid with GI scores (r=0.49) (11).…”