Salivary Levels of Hemoglobin for Screening Periodontal Disease: A Systematic Review

Table 1

Selected articles.

Author(s) and year published	Title of journal	Journal	Number of subjects	Results
Burt et al. 1978 [5]	Saliva-based colorimetric test as an index of gingival inflammation in epidemiologic studies	Community Dentistry and Oral Epidemiology	253	Colorimetric test may be a valid, reliable means of detecting major differences in the prevalence of gingival inflammation in most adult populations, although having little, if any, useful application among children at the mixed dentition stage.
Abbott and Caffesse 1978 [6]	The reliability of a colorimetric test in determining gingival inflammation	Journal of Periodontology	81	The G index chemical analysis may be a useful diagnostic aid for detecting the presence or absence of gingival inflammation in dental practice.
Kopczyk et al. 1995 [7]	The feasibility and reliability of using a home screening test to detect gingival inflammation	Journal of Periodontology	50	The test should be used as a home screening tool rather than a diagnostic aid. Patients who test positive for occult blood should seek advice from a dental professional.
Nomura et al. 2006 [8]	Screening of periodontitis with salivary enzyme tests	Journal of Oral Science	187	LDH level had the highest sensitivity and specificity (sensitivity, 0.66; specificity 0.67).
Kugahara et al. 2008 [9]	Screening for periodontitis in pregnant women with salivary enzymes	Journal of Obstetrics and Gynaecology Research	221	Combining LDH, ALP, and occult blood showed the highest diagnostic performance, with a sensitivity value of 0.90, specificity value of 0.62, positive predictive value of 0.18, and negative predictive value of 0.98.
Ohshima et al. 2009 [10]	Comparison of periodontal health status and oral health behavior between Japanese and Chinese dental students	Journal of Oral Science	92	Pain in gum, swollen gum, and bleeding gum had statistically significant corelation with the result of Perioscreen.
Shimazaki et al. 2011 [11]	Effectiveness of the salivary occult blood test as a screening method for periodontal status	Journal of Periodontology	1998	The sensitivity and specificity of the salivary occult blood test in screening for poor periodontal status were 0.72 and 0.52, respectively. In a multivariate logistic regression analysis, the results were significantly associated with the proportion of teeth with BOP and the proportion of teeth with PD ≥ 4 mm, independent of age, sex, use of antihypertensive medication, use of antidiabetic medication or insulin therapy, and the number of decayed or filled teeth.
Pham et al. 2011 [12]	Periodontal disease and related factors among Vietnamese dental patients	Oral Health & Preventive Dentistry	243	The perioscreen test showed moderate sensitivity (0.752) and specificity (0.746) to periodontal disease. The binary logistic regression analyses indicated that older subjects (OR = 2.5), or those who did not frequently visit a dentist (OR = 4.1), brushed their teeth only once a day (OR = 2.5), did not use dental floss (OR = 2.9), were past smokers (OR = 3.1), current smokers (OR = 4.1), or had positive BANA test results (OR = 12.0) were more likely to have periodontal disease.
Nomura et al. 2012 [13]	Screening for periodontal diseases using salivary lactate dehydrogenase, hemoglobin level, and statistical modeling	Journal of Dental Sciences	101	By the statistical modeling, sensitivity and specificity were improved for the screening of periodontal disease by the salivary levels of hemoglobin and LD.
Nomura et al. 2012 [14]	Salivary biomarkers for predicting the progression of chronic periodontitis	Archives of Oral Biology	85	Salivary ALT level and the P. gingivalis ratio may be potential indicators for the progression of periodontitis. Such a salivary test could be a useful diagnostic tool for predicting periodontal disease progression.
Nam et al. 2015 [15]	Validity of screening methods for periodontitis using salivary hemoglobin level and self-report questionnaires in people with disabilities	Journal of Periodontology	195	The salivary hemoglobin level, self-report questionnaire, and the combined method demonstrated screening potential that could predict the population prevalence of CPI 3 or CPI 4.
Reed et al. 2015 [16]	Feasibility study of a salivary occult blood test to correlate with periodontal measures as indicators of periodontal inflammation in a population of pregnant women	Journal of Oral Science	23	Pearson correlation coefficient with the percent of sites with BOP was statistically significant (0.301, value 0.0469), and with BOP as the sum of sites with bleeding on probing was 0.280, value 0.0647.
Nomura et al. 2016 [17]	A new screening method for periodontitis: an alternative to the community periodontal index	BMC Oral Health	92	The sensitivity and specificity for hemoglobin levels were, respectively, 0.722 and 0.711, for lactate dehydrogenase levels. Combining these two tests, when samples tested positive for both hemoglobin and lactate dehydrogenase, the positive predictive value was 91.7%.
Maeng et al. 2016 [18]	Diagnostic accuracy of a combination of salivary hemoglobin levels, self-report questionnaires, and age in periodontitis screening	Journal of Periodontal & Implant Science	202	The combination of salivary hemoglobin levels and self-report questionnaires was shown to be a valuable screening method for detecting periodontitis.