Dentists can play a key role in medical-dental integration with the use of salivary diagnostics, according to one exec in the field.
Daniel Weinstein is the CEO and co-founder of Lura Health, a startup company developing a wearable salivary diagnostic device.
Mr. Weinstein recently spoke with Becker's to discuss his company's technology and what the future holds for salivary diagnostics as interest in the dental industry grows.
Editor's note: Responses were lightly edited for clarity and length.
Question: How is Lura Health advancing salivary diagnostics?
Daniel Weinstein: Our company is making the first wearable for saliva diagnostics. The premise is that if you look at blood monitoring as a gold standard of the past, all blood monitoring used to be ex vivo, so take a draw and send it off to a lab, and then point-of-care systems where you could do it chairside or tableside. If you look at the biggest transformation in the space, it was the adoption of continuous blood monitoring systems. Instead of taking readings outside of the body, these are embedded or implanted sensors that are worn on or inside the body that theoretically perform the same level of tests except on a continuous basis, so there's the opportunity for real-time data.
The reason these continuous monitors have been really changing the field to the tune of companies going public is because for a lot of conditions, continuous data is really the only way to meaningfully monitor the disease. For example, if you're monitoring your DNA, your genome's not changing. It's static. You can take a reading now and in six months, a year or two years, it'll say the same thing. However, if you look at markers like hormones, which constantly fluctuate and are actually tied to circadian rhythms, those are changing constantly. Glucose is another great example. If you're trying to track diabetes for preventive care, it used to all be finger prick tests and now you'd be hard pressed to find a Type 1 diabetic without a continuous monitoring system. And there are many more as well, so that's why it transformed blood [testing], and we're doing the same thing for saliva. Instead of having the patient drool into a tube and send it to a lab, we're making a sensor small enough to go on the side of one tooth or be integrated into any dental device. Once it's worn in the mouth, it continuously samples saliva in the user and then transmits information via Bluetooth to a patient's smartphone and syncs with a healthcare provider.
Q: What are some of the challenges that come with this type of technology?
DW: The biggest challenge so far has just been the engineering complexity. You're fitting a computer on the side of a tooth, so everything that goes along with that. You're not just shrinking a computer down to a tooth, you're putting it in an environment that's constantly exposed to fluids that sometimes has high corrosive forces, enzymes, it has temperature fluctuations, it has durability and mechanical forces based on the teeth and grinding. It's really one of the most difficult frontiers to digitize. The first patent around a wearable or a sensor in the mouth to track saliva was filed in the 70s. So it's been recognized for a while, but computers in the 70s were the size of a room. Anybody will tell you a big piece of patent protection is reduction to practice. Can I actually make this, and does this patent describe how this is going to actually be produced? Until now, it hasn't been possible. Now, based on Moore's law of computing and all this innovation around new microbatteries, new microcontrollers and new code bases, this is really the first time in history that this potential has a possibility of being realized.
Q: How has interest in salivary diagnostics evolved over the years?
DW: When we started the company in 2017, it was known that saliva was useful, and I think the first tests that everybody really knew about were genetic testing. Then it evolved to drugs of abuse testing, so testing for more forensics. COVID-19 hit and there started being FDA approvals for COVID-19 within saliva instead of a prick or a nasal swab or something like that. Now, it's completely taken off. You have companies spinning off left and right that are making new use cases for saliva testing. It really seems like it's going to be the thing that catalyzes and accelerates dentistry's true integration with real health monitoring. I really believe, and I think almost every other thought leader believes this as well, that the thing dentists really have going for them to catalyze this integration with healthcare is the fact that they have access to one of the most valuable fluids in health monitoring.
Q: How do you hope to see salivary diagnostic technology continue to evolve in the field?
DW: For saliva, I don't really have to hope because every week it seems like there's an announcement of a new company or a new indicator as a lab test. I think that's great. There are so many applications for when lab tests are useful. A great one is oral microbiome sequencing. There's hemoglobin A1C testing that's being done. We don't view that as we want to change that. We view it as, if you need a one-time test, use saliva instead of blood if the accuracy is there. But there's a subset of conditions that you can never monitor properly by one-time tests ... we're really excited to see saliva play more of a role in spot checks at a single point in time. There's a massive black hole of datasets between those readings and we want Lura Health to fill that.