Laboratory diagnostic tests are performed in the dental field in cases of suspicion and provide information about the current state of oral health.
Early cancer detection
Conspicuously altered areas of the oral mucosa can be sampled using a simple brush biopsy (form of abrasion cytology dar; cells are obtained from all mucosal layers down to the basal cell layer (lowest cell layer)) cells. It is used to exclude or diagnose cancer of the oral mucosa at an early stage. If the result is positive, an excisional biopsy (complete removal of the tumor) follows.
Salivary diagnostics
Saliva, with its cleansing effect and ability to buffer acids, has a decisive influence on maintaining the mineralization balance in the mouth and thus on caries activity. Thus, the determination of the saliva flow rate provides information on whether a sufficient amount of fluid is produced, while a buffer capacity determination allows conclusions to be drawn on the patient’s caries risk.
At the same time, saliva is a habitat for a large number of microorganisms, which form a balanced ecosystem in the healthy mouth. Pathogenic cariogenic (caries-causing) germs can only be detected in increased numbers when there is a shift in the balance, which is triggered by excessive sugar consumption and poor oral hygiene. Saliva tests for Streptococcus mutans and lactobacilli provide information on this. Since cariogenic germs produce lactate (lactic acid), the determination of the lactate formation potential provides information about their metabolic activity.
The Candida albicans fungus is part of the oral flora in 70% of all healthy patients. The pathological increase only occurs when there are changes in the body’s own defenses. The saliva test for Candida albicans must take this aspect into account.
Marker germs for periodontitis
With the help of a so-called DNA probe test, periodontopathogenic germs (those that damage the periodontium) can be detected in the gingival pockets so that targeted therapy can be initiated to eliminate them.
Genetic risk factors
Patients whose genome (genetic makeup) has a positive IL-1 genotype are at increased risk for developing periodontitis (gingivitis) with more severe inflammatory reactions. The interleukin-1 gene test, for which sulcus fluid (fluid from the gingival pockets) must be taken, allows statements to be made about the severity and course of the disease and contributes to the development of a long-term therapy concept.
The most important laboratory diagnostic services are presented below.