Total Salivary Protein and Its Relationship to Periodontal Health in an Adult Kenyan Population

Abstract

Introduction: Periodontal disease is highly prevalentand is one of the highest contributors to global oral health burden.Diagnosis of active periodontal disease provides a challenge for clinicians because the traditional periodontal diagnostic parameters are not very easyto use and they mostly only measure disease history. Advances in oral and periodontal disease diagnostic research is moving towards more objective measures such as biomarkers which can identify and quantify the presence of disease. Saliva is a mirror of oral and systemic health and a valuable source for biomarkerswhich are specific for the unique and physiological aspects of periodontal diseases. Changes in quality and quantity of salivary proteins occur in different physiologic and pathologic states therefore measuring these may act as biomarkers for the periodontal phenotype. The aim of this study is to analyze total salivary protein as a potential diagnostic biomarker for detecting inflammation of the periodontal tissues using simple biochemical methods. Study objective: To determine the total protein content of saliva in a Kenyan adult population and investigate its relationship with periodontal health status. Study population and sample size: one hundred and sixty-one study participants were selected from a pool of people attending University of Nairobi Dental Hospital. Study area: The study was carried out at the University of Nairobi Dental Hospital (UNDH).The subjects were recruited from the OralDiagnosis and Periodontology clinics. Study design: This was a hospital based descriptive cross-sectional study. Materials and Methodology:one hundred and sixty-one participants were selected from a pool of individuals attending the University of Nairobi Dental Hospital during the period of study via systematic random sampling. Saliva was collected from each participant using the spit method followed by a periodontal examination. Total salivary protein was quantified using bicinchoninic acid assay. Results: A total of 161 participants were recruited. The male to female ration was 0.85. The age of the participants ranged between 18 – 80 with a mean of 38.34 years (+ 13.44 SD) and a median of 37.00. The total salivary protein ranged between 0.11mg/ml to 12.17mg/ml (mean = 2.03mg/ml + 1.97 SD and a median =1.38). Males had a statistically higher salivary protein levels (mean = 2.39+2.16SD) than females (mean = 1.72+1.75SD), t (140.220) = 2.156, p = 0. 033.Generally, the mean levels were higher in patients with periodontitis with statistically significant association between salivary protein levels and mild periodontitis levels (r = 0.594*, p = 0.020). However, onlya moderate, positive and non-statistically significant association was found between salivary protein levels and severe periodontitis levels (r = 0.359, p = 0.278). Conclusion:The findings of this study suggests that total salivary proteinlevels could serve as biomarkers of inflammation in the periodontium. Recommendation Total salivary protein should be considered as a potential adjunctive diagnostic tool for evaluating inflammatory periodontal diseases. However, there is need for more salivary proteomic studies with larger sample sizes and evaluation of individual proteins and their specific role in periodontal diseases and randomized controlled trials in Kenyans to fully exploit the potential of these biomarker