DPH Handout - Chairside Immunoassay Testing Flashcards
most common reason for failure of restorations
recurrent caries
when best to tackle dental caries
early pre-cavitation stage
methods in focusing on critical risk factors of dental caries
- lifestyle analysis
- saliva testing
- microbial testing
comprehensive system for risk assessment and management
STEM (System for Total Environmental Management)
according to STEM, the oral environment has ___________, ___________, and ____________ which can be measured, manipulated and monitored over time
physical, ionic, and microbial elements
range of diagnostic tests that can be used in practice are for…
- for salivary physical parameters
- for plaque maturity and plaque fermentation
- for major caries pathogen S. mutans
salivary physical parameters
- flow rate
- pH
- buffer capacity
major caries pathogen
Streptococcus mutans
useful for caries risk assessment in individual patients when used in conjunction with other clinical information
salivary levels of S. mutans
used for probing a sample of stimulated saliva in direct immunoassays
monoclonal antibodies
indicator of host immune response in saliva
salivary antibodies
example of current immunoassay technology
GC Saliva Check Mutans test
culture-based tests: disadvantages
- low specificity
- record presence of non-disease related bacteria
- require live, viable bacteria, an incubator, and sufficient time
- limited shelf life
culture-based test: optimum temperature of bacterial growth
37C
culture-based test: sufficient time for bacterial growth
48 hours
culture-based test: reason why shelf life is limited
temperature-related decline in used growth media
immunoassay tests: advantages
- almost 100% specificity
- results in 15 minutes
- no need for specialized equipment
- no need to cultivate bacteria; does not rely on bacteria growth
- no risk for contamination by other bacteria
- avoids lack of selectivity
immunoassay tests: reason for almost 100% specificity
use of monoclonal antibodies for capturing specific bacteria
immunoassay tests: data provided
semi-quantitative evaluation of S.mutans levels in saliva
antibody used in the Saliva Check Mutans test
colloidal gold-labeled anti-S. mutans mouse monoclonal capture antibody
formed when the test antibody reacts with another anti-S.mutans antibody
red line in T window
formed when the test antibody reacts to anti-S. mutans antibodies which did not react with S. mutans
red line in C window; control red line
reason for making patient chew paraffin wax gum for 1 minute
stimulate secretion of saliva
can be used when collecting saliva samples from patients with difficulties in expectorating into saliva collection containers
swab
factors that can make the Saliva Check Mutans test results inaccurate
- saliva sample collected within 1 hour of:
- eating
- drinking
- toothbrushing
- use of anti-plaque mouthrinse earlier the same day
what patient should not do prior to the Saliva Check Mutans test
for at least 1 hour before the scheduled dental appointment, do not:
- smoke
- eat or drink
- toothbrush
- use a mouthrinse
2 reagents used in the test
- alkaline solution of sodium hydroxide
- organic acid
purpose of using alkaline solution of sodium hydroxide
- to break down and dissolve viscous components of saliva (particularly glucans)
- to ensure saliva sample flows easily through test device
why organic acid reagent is colored yellow
includes a pH indicator
purpose of using organic acid reagent
to indicate if sample is neutralized (green)
time and temperature needed to allow reaction of sample with reagents to proceed
15 minutes, room temperature
indication of thick red-brown line in control (C) window of test device
test is working properly
indication of thin red line in test (T) window of test device
- (+) result
- high salivary level of S. mutans
- high caries risk
indication of absence of thin red line in test (T) window of test device
- (-) result
- low level
