DPH Handout - Chairside Immunoassay Testing

Question 1

most common reason for failure of restorations

Answer 1

recurrent caries

Question 2

when best to tackle dental caries

Answer 2

early pre-cavitation stage

Question 3

methods in focusing on critical risk factors of dental caries

Answer 3

• lifestyle analysis
• saliva testing
• microbial testing

Question 4

comprehensive system for risk assessment and management

Answer 4

STEM (System for Total Environmental Management)

Question 5

according to STEM, the oral environment has ___________, ___________, and ____________ which can be measured, manipulated and monitored over time

Answer 5

physical, ionic, and microbial elements

Question 6

range of diagnostic tests that can be used in practice are for…

Answer 6

• for salivary physical parameters
• for plaque maturity and plaque fermentation
• for major caries pathogen S. mutans

Question 7

salivary physical parameters

Answer 7

• flow rate
• pH
• buffer capacity

Question 8

major caries pathogen

Answer 8

Streptococcus mutans

Question 9

useful for caries risk assessment in individual patients when used in conjunction with other clinical information

Answer 9

salivary levels of S. mutans

Question 10

used for probing a sample of stimulated saliva in direct immunoassays

Answer 10

monoclonal antibodies

Question 11

indicator of host immune response in saliva

Answer 11

salivary antibodies

Question 12

example of current immunoassay technology

Answer 12

GC Saliva Check Mutans test

Question 13

culture-based tests: disadvantages

Answer 13

• low specificity
• record presence of non-disease related bacteria
• require live, viable bacteria, an incubator, and sufficient time
• limited shelf life

Question 14

culture-based test: optimum temperature of bacterial growth

Answer 14

37C

Question 15

culture-based test: sufficient time for bacterial growth

Answer 15

48 hours

Question 16

culture-based test: reason why shelf life is limited

Answer 16

temperature-related decline in used growth media

Question 17

immunoassay tests: advantages

Answer 17

• 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

Question 18

immunoassay tests: reason for almost 100% specificity

Answer 18

use of monoclonal antibodies for capturing specific bacteria

Question 19

immunoassay tests: data provided

Answer 19

semi-quantitative evaluation of S.mutans levels in saliva

Question 20

antibody used in the Saliva Check Mutans test

Answer 20

colloidal gold-labeled anti-S. mutans mouse monoclonal capture antibody

Question 21

formed when the test antibody reacts with another anti-S.mutans antibody

Answer 21

red line in T window

Question 22

formed when the test antibody reacts to anti-S. mutans antibodies which did not react with S. mutans

Answer 22

red line in C window; control red line

Question 23

reason for making patient chew paraffin wax gum for 1 minute

Answer 23

stimulate secretion of saliva

Question 24

can be used when collecting saliva samples from patients with difficulties in expectorating into saliva collection containers

Answer 24

swab

Question 25

factors that can make the Saliva Check Mutans test results inaccurate

Answer 25

1. saliva sample collected within 1 hour of:
   
   • eating
   • drinking
   • toothbrushing
2. use of anti-plaque mouthrinse earlier the same day

Question 26

what patient should not do prior to the Saliva Check Mutans test

Answer 26

for at least 1 hour before the scheduled dental appointment, do not:
- smoke
- eat or drink
- toothbrush
- use a mouthrinse

Question 27

2 reagents used in the test

Answer 27

• alkaline solution of sodium hydroxide
• organic acid

Question 28

purpose of using alkaline solution of sodium hydroxide

Answer 28

• to break down and dissolve viscous components of saliva (particularly glucans)
• to ensure saliva sample flows easily through test device

Question 29

why organic acid reagent is colored yellow

Answer 29

includes a pH indicator

Question 30

purpose of using organic acid reagent

Answer 30

to indicate if sample is neutralized (green)

Question 31

time and temperature needed to allow reaction of sample with reagents to proceed

Answer 31

15 minutes, room temperature

Question 32

indication of thick red-brown line in control (C) window of test device

Answer 32

test is working properly

Question 33

indication of thin red line in test (T) window of test device

Answer 33

• (+) result
• high salivary level of S. mutans
• high caries risk

Question 34

indication of absence of thin red line in test (T) window of test device

Answer 34

• (-) result
• low level