Detecting non-communicable diseases early using prediction tools and saliva biomarkers

Periodontitis and dental caries affect 3.7 billion adults globally and account for more years lived with disability than any other human disease. Severe periodontitis alone affects 1.1 billion people worldwide and is linked to premature mortality, diabetes, cardiovascular disease, rheumatoid arthritis and inflammatory bowel disease.

Despite this, early detection remains poor because only around 50% of adults regularly attend dental professionals, whereas most engage with GPs and pharmacists. The WHO, NICE and FDI have all highlighted the need for integrated oral and general healthcare pathways. We therefore aimed to develop saliva-based diagnostics and prediction tools that would enable early detection of periodontitis and related non-communicable diseases (NCDs) in non-dental settings. 

Our work identified saliva biomarker signatures that distinguish oral health, gingivitis and periodontitis, leading to 66 granted patents globally, including 15 granted during 2025–2026 across Europe, Asia-Pacific and America. These discoveries transformed industrial R&D strategies at Philips, Haleon and Unilever, who invested in the development of saliva-based diagnostic technologies and care pathways.

We also developed a two-step prediction model for identifying pre-diabetes and type 2 diabetes in dental practices, supported by a £1.2 million Haleon grant. In a pilot study of 805 patients, we identified 3% previously undiagnosed diabetes and 10% undiagnosed pre-diabetes. Validation is now underway in 10,000 people across the UK, with 4,020 participants tested in 2025–2026. 

The impact is substantial. Country-level economic modelling estimates preventing periodontitis could save €7.8–€38 billion per decade, while effective periodontal management could reduce diabetes care costs globally by US$162.8 billion. Our findings informed NICE guidance and NHS England commissioning standards promoting saliva diagnostics and integrated referral pathways between dental and medical services.