Effectiveness of a Salivary Testing System to Screen for Periodontal Disease: A Cross-Sectional Study from the NOSE Study

<b>Background:</b> This study aimed to evaluate the effectiveness of a saliva-based screening method for periodontal disease among community-dwelling older adults in Japan. <b>Methods</b>: A total of 372 study participants (mean age: 73.1 years) with 20 or more remaining teeth were included in the study. Of the six parameters assessed by the Salivary Multi Test (SMT), this study focused on the three parameters related to periodontal disease: occult blood, leukocytes, and proteins. Periodontal tissue examinations were performed based on the Community Periodontal Index (CPI) using partial mouth recording. To evaluate screening accuracy, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for each of the three markers: occult blood, leukocytes, and proteins. Receiver operating characteristic (ROC) analysis was performed for each SMT item, and area under the curve (AUC) was calculated. Logistic regression analysis was used to calculate the odds ratios for combinations of SMT markers, with the presence of periodontal pockets and gingival inflammation as the respective outcome variables. <b>Results</b>: Among the individual markers, occult blood showed the highest diagnostic performance for detecting both periodontal pockets and gingival inflammation. The combination of elevated occult blood and leukocyte levels yielded the highest odds ratios for both periodontal pockets and gingival inflammation. <b>Conclusions</b>: While several SMT markers showed associations with periodontal conditions, their utility for screening in older Japanese adults remains to be further validated. Combining markers may help improve diagnostic performance, but additional studies are warranted.