The American Dental Association advises against this practice. Have a cold, sore throat or other virus? There are also several types of mouthguards — those that protect your teeth, mouth and jaw during sports, and help keep you from grinding your teeth at night. Whatever type you use, mouthguards, which are porous, should never be shared. A study, reported in General Dentistry , found that mouthguards harbor bacteria, yeasts and molds.
This can expose your mucous membranes to infection. Benninger, it can also spread this new, challenging infectious disease. Did you know your mouth harbors hundreds of different microorganisms? Find out which ones can cause trouble when you accidentally share saliva.
Learn more about vaccine availability. Advertising Policy. You have successfully subscribed to our newsletter. Providers may need to refer mothers for lactation support to learn how to maintain milk production and how to supplement with donor human milk or formula while temporarily not breastfeeding.
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Hepatitis B or C Infections. Minus Related Pages. Mothers with Hepatitis B or C infections can breastfeed their infants. Top of Page. Learn More. Connect with Nutrition, Physical Activity, and Obesity. To receive email updates about this topic, enter your email address. Email Address. What's this? Studies reported in the literature typically involved the use of whole saliva or another oral fluid obtained by means of an adsorbent collector.
Many of the tests on the market involve the use of oral mucosal transudate OMT obtained by swabbing the buccal mucosa and tongue. This sample is rich in antibodies and contains surface pathogens. Thus, OMT provides a richer source of antibodies, including those directed against bacterial and viral pathogens, and it is relatively more concentrated in oral surface pathogens and antigens derived from those pathogens.
We should note that investigators in many research studies performed analyses on whole saliva clarified by centrifugation, and these results may differ from those for fluid collected with an oral swab. Investigators have detected a large number of viruses in oral samples by using an antigen, an antibody or nucleic acid targets.
Reports in the literature 4 , 5 , 7 - 33 focus on the diagnosis of viral infections that require immediate therapeutic intervention and those that pose a threat to blood transfusion safety blood donor screening.
In this review, we included only HSV in the large group of herpesviruses; it resembles HIV in that it is a sexually transmitted virus for which there are therapeutic options to decrease the viral load but no cure, as the virus can become latent and reappear when drug therapy is discontinued.
Thus, currently available treatments reduce the chance of transmission, but a latent infection remains. The literature regarding salivary-based antibody tests for detection of viral infections is extensive. For diagnosis of severe and high-mortality infections such as Ebola or rabies, antibody assays are less useful because the infected patient may not survive long enough to go through seroconversion. Researchers have not demonstrated the presence of antibodies to Ebola and rabies in saliva, but they have isolated the virus from various bodily fluids including saliva, which supports the concept that a salivary antigen or nucleic acid diagnostic test could be developed for these viruses.
Diagnosis of bacterial and viral pathogens is based increasingly on a combination assay that measures both antibody and antigen or antibody and nucleic acid. Two decades ago, nucleic acid—based detection often involved use of hybridization such as Southern blot or dot blot analysis. However, we have observed that investigators in more recent studies used one of the nucleic acid amplification technologies.
Because most of these technologies require concentration and purification of the nucleic acid targets, they are applicable to any biological matrix, including oral samples. Several automated, laboratory-based commercial systems are available to perform these assays, not only for diagnosis of the disease but also for monitoring the effect of antiviral drugs on the viral load for example, Cobas Amplicor, Roche Molecular Diagnostics, Pleasanton, Calif.
Nucleic acid—based diagnosis is attractive because it allows for simultaneous detection of multiple targets that is, multiplexing ; a current research focus is the development of amplification technologies that minimize the need for nucleic acid purification.
The first definitive proof of the presence of HIV antibodies in saliva demonstrated the potential of oral fluid for screening purposes and saliva-based antibody assays for almost any known pathogen, including those in the veterinary sector. In this review, we focus on HIV, hepatitis C virus HCV and HPV because these three major viruses are responsible for a series of worldwide epidemics that have had an enormous effect on morbidity and mortality.
The infection of immune system cells eventually leads to the loss of cell-mediated immunity. If the infection is left untreated, opportunistic infections and cancers develop, which eventually lead to death. HIV infection is detected easily with an antibody-based screening test after seroconversion; however, early infections are difficult to recognize because they are accompanied only by mild flulike symptoms, and an antigen or nucleic acid assay is required in the weeks before seroconversion.
Diagnosis according to a reactive antibody assay requires a confirmatory test with either a Western blot via blood or saliva or a polymerase chain reaction PCR via blood. Well-managed drug therapy is required to keep viral propagation at close to undetectable levels. Currently, no cure exists for HIV infection, and once it is integrated into the human genome, it remains and can replicate unless suppressed by medication.
Although some investigators have reported the isolation of infective viral particles from oral samples and demonstrated the presence of viral particles in epithelial cells of the buccal mucosa, 39 - 41 the chance of transmitting HIV through saliva remains extremely low.
In general, these tests involve the use of nitrocellulose lateral flow strips that contain two capture zones: a control line that detects the presence of all antibodies in the sample and a test line that specifically reacts with HIV-1 or, ideally, with both HIV-1 and HIV A reactive result needs to be confirmed with a second test.
Although many oral tests are on the market, the U. The clinician collects oral fluid with a swab and places it directly into a developing solution in the device; after 20 minutes, he or she can visualize the resulting lines.
Results from multiple studies demonstrated that the sensitivity and specificity of these oral tests are comparable to those of tests for antibody detection that involve the use of plasma or finger-stick blood. Several investigators have conducted studies pertaining to the development and application of technologies used to detect HIV antibodies, HIV-derived antigen and nucleic acids in oral samples. As is seen for other infectious diseases, salivary antibody diagnostics for HIV are as effective as blood-based diagnostics.
However, because of differences in concentration and stability, other pathogen-specific targets antigen, nucleic acid are not always detectable in saliva. For example, the fourth-generation immuno-assays detect p24 antigen and antibodies against HIV, allowing earlier detection of HIV infection with blood-based samples. Similarly, detection of viral RNA in saliva is more difficult than is detection in a blood sample owing to decreased viral load. Researchers have reported higher loads of HIV in saliva than in serum in some patients, 61 and these patients are referred to as hypersecretors.
Detection of HIV RNA in saliva is possible because current technologies include concentration and purification steps to attain the required sensitivity. The common hepatitis viruses are named with the letters A through E.
Blood safety procedures for donor blood for transfusion-transmissible infectious diseases include various tests for HBV screening for the presence of antibody and antigen and HCV screening for the presence of antibody and nucleic acid targets.
No vaccine currently is available for HCV. Chronic infection causes liver cirrhosis, which may lead to liver failure, cancer or extremely dilated sub-mucosal veins in the stomach and esophagus.
Acute infections generally are accompanied by mild symptoms and are not recognized easily. The first step in screening is to test for the presence of antibodies; if the test result is positive, then a confirmatory test is required. Typically, the confirmatory test, as for HIV, is a Western immunoblot assay combined with a nucleic acid—based viral load assay. Although an Internet search reveals several such tests, none of these saliva-based tests, to date, has received FDA approval.
OraSure Technologies markets an FDA-approved test for HCV that uses finger-stick blood; in addition, the company has a salivary test that is used widely in Europe but has not been approved for sale in the United States. About 70 percent of cervical cancers are attributed to HPV types 16 and 18 and are part of a national prevention and screening program that includes use of an anti-HPV vaccine. Most HPV infections are self-cleared but antibodies to the virus remain; thus, antibody tests to screen for HPV infection are not considered useful.
Since , there has been a striking increase in oropharyngeal squamous cell carcinoma OSCC , and approximately 60 percent of these tumors are associated with HPV. Gillison and colleagues 68 conducted a large study of the prevalence of oral HPV infection in the United States in They reported that oral HPV infection in men and women aged 14 through 69 years was 6.
An intriguing HPV genome sequencing report by Andrews and colleagues 69 pertaining to two couples who developed HPV-associated tonsillar carcinoma revealed the identical HPV 16 in the partners of both couples, which suggests the potentially infectious nature of this cancer. Kits containing a salivary collector are placed in transport media and sent to a central laboratory for analysis. Investigators in the laboratory use a variety of primers to detect as many HPV types as possible.
Early diagnosis is critical for survival of patients with OSCC, and, thus, it is likely that use of salivary HPV analyses will continue to increase. Although several salivary tests are available for the detection of viral infections, and many others are being developed, the use of these tests by dental professionals has been limited.
Although investigators have reported dentists' and patients' acceptance of oral tests for the diagnosis of systemic diseases, 72 , 73 the use of available salivary tests in dental settings is modest. Such issues as scope of the profession, time required for testing and third-party reimbursements have been advanced as obstacles, and these issues need to be addressed. The CDC has been active in expanding the number of sites at which health care professionals can carry out HIV testing.
Strauss and colleagues 74 reported that in , Thus, by conducting salivary HIV tests in a dental setting, practitioners would be able to identify infections in a cohort that might not otherwise be detected.
We hope that other salivary tests for example, HCV, HPV and influenza can be added and that the program can be extended to include community health centers and, ultimately, dental offices. As soon as specific guidelines and approaches for infectious disease screening in the dental setting are defined and the new rapid salivary tests for example, HCV are approved by the FDA, testing during dental visits seems an appropriate and cost-efficient way to screen patients for infection.
None of the authors reported any disclosures. Paul L. William R. National Center for Biotechnology Information , U. J Am Dent Assoc. Author manuscript; available in PMC Dec Corstjens , PhD, Assistant professor , Dr.
Abrams , PhD, Research professor , and Dr. Daniel Malamud , PhD, Professor. Daniel Malamud. Author information Copyright and License information Disclaimer. Address reprint requests to Dr.
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