Monitoring Salivary Sialic Acid and Sialidase Activity to Assess Oral Health Status: Results of a Single Site Double-Blind Study

Featured Application Sialic acid is a critical membrane constituent required to maintain mucosal integrity. This investigation describes the biochemical quantitation of salivary sialic acid as a rapid measure of oral health that corresponds with the clinical status of the patient. The test can be utilized widely including in remote facilities with limited resources. A rapid, low-cost, visual test for sialic acid using commonly available reagents complements the biochemical assessment. The test can be applied for screening large populations, monitoring oral health status, amenable to digital health and can advance patient engagement to manage their oral health.Objective: Sialic acid [SA] represents a critical mucosal membrane component maintaining mucosal integrity. This investigation stratified adult subjects based on clinical parameters of periodontal health to examine salivary sialic acid [SA] as a health measure and develop a corresponding rapid visual chair-side assay. Methods: Adults [n = 90] were enrolled and clinically stratified into healthy [n = 30], gingivitis [n = 29] or periodontitis [n = 31] groups. Saliva from subjects was evaluated for SA using the Ninhydrin method. A novel rapid SA spot test was developed utilizing filter paper discs soaked in a sialidase substrate. Substrate-laden disks were incubated at room temperature with saliva produced a blue color with increasing color intensities due to higher sialidase activity. Subjects were recalled weekly for clinical and salivary assessments. Results: Average baseline salivary SA in healthy, gingivitis and periodontal disease groups were 64, 95 and 102 mu g/mL, respectively with significant differences (<0.05). Differences in SA concentrations among control and test groups were maintained throughout the study. Similarly, the differences in the color intensities in the rapid visual chair side spot test were also observed during the entire study period. Conclusions: Increasing levels of salivary SA were observed from healthy to periodontal disease with these differences remaining consistent over the study. These results corresponded with the chair-side visual assay, which is suitable for patient education or monitoring.