Salivary Biomarkers in Periodontal Disease: Revolutionizing Early Detection and Precision Dentistry.

Abstract

This review explores the transformative potential of salivary biomarkers in revolutionizing periodontal disease diagnostics and management through a non-invasive real-time analysis. A comprehensive literature search was performed using databases such as PubMed, Scopus, and Google Scholar, from inception to March 2025 employing keywords such as "salivary biomarkers," "periodontal disease," "biosensor," "precision dentistry," and "pro-inflammatory cytokines." Saliva, rich in inflammatory cytokines (e.g., interleukin-1β, interleukin-6, tumor necrosis factor-α), enzymatic markers (e.g., matrix metalloproteinase-8, matrix metalloproteinase-9), microbial DNA, oxidative stress indicators, and emerging biomarkers such as exosomes and microRNAs, offers a dynamic medium for early disease detection, risk stratification, and therapeutic monitoring. Technological advancements, including biosensors, lab-on-a-chip systems, and artificial intelligence-driven analytics, enable precise point-of-care applications that align with precision dentistry paradigms. These innovations facilitate personalized interventions by identifying subclinical inflammation, tracking disease progression, and tailoring treatments to individual molecular profiles. However, challenges such as biomarker variability, standardization of collection protocols, cost, and regulatory hurdles impede clinical translation. Future directions emphasize interdisciplinary collaboration, expanded biomarker panels, and rigorous clinical trials to validate diagnostic accuracy and scalability. By bridging gaps between laboratory research and clinical practice, salivary diagnostics promise to shift periodontal disease management from reactive to proactive care, enhancing patient outcomes and reducing systemic disease risks. This review underscores saliva's pivotal role in advancing oral health diagnostics while advocating for optimized methodologies to realize its full potential in precision dentistry.