Objectives: This study aimed to evaluate the feasibility salivary Lactate dehydrogenase (sLDH) as a potential screening biomarker for oral squamous cell carcinoma (OSCC).

Materials and Methods: This cross-sectional, comparative observational pilot study was conducted in the Department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital, Bangladesh. A total of 60 participants were enrolled, comprising 30 histopathologically confirmed OSCC patients and 30 age- and sex-matched healthy controls. Unstimulated whole saliva samples were collected in the morning to minimize diurnal variation. Samples were obtained in sterile containers, transported to the laboratory within 15 minutes, centrifuged, and analyzed spectrophotometrically for LDH concentration. Demographic data, clinical  information were also recorded. Statistical analyses were performed using independent t-tests, and a p-value of <0.05 was considered significant.

Results: The mean sLDH concentration was significantly higher in OSCC patients (1449.17 U/L; SD ± 774.8) compared to healthy controls (408.7 U/L; SD ± 401.6). The difference was statistically significant (p = 0.00001).

Conclusions: Salivary LDH levels were significantly increased in OSCC patients compared with healthy individuals, supporting its potential as a simple, non-invasive, and cost-effective adjunctive screening tool. Within comprehensive head and neck oncology programs, sLDH estimation may serve as an initial stratifier to prioritize patients for definitive diagnostic evaluation. Larger, multicentric studies are recommended to validate these findings and establish diagnostic thresholds for clinical application.