We have been excited to incorporate saliva testing into our array of services at the office. As we are discussing with our patients daily, so much of what goes on in our mouths (whether it is halitosis, gingivitis, decay, etc.) has to do primarily with the presence or absence of specific oral bacteria. There are as many as 700 species of oral bacteria, and just as in the gut, we want a balance of “good” bacteria dominating over “bad”. What easier way to determine what bacteria are in our mouths than sending a tiny vial of our saliva in the mail?
After investigating a few brands and labs including PerioDx, Direct Diagnostics, and even the social media favorite Bristle, we settled on Direct Diagnostics. This company has the most accurate testing (it tests all the way down to 10 bacterial copies) verified by Yale University, and is fast and very affordable too. We found the setup of the Direct Diagnostics testing, results and corresponding treatment protocols that are founded on research to be the most clinically applicable, enabling us to have specific and easy-to-follow recommendations upon receipt of the test results for our patients.
The Direct Diagnostics test detects the presence of the five most pathogenic bacteria in the mouth, in increasing order of virulence: Fn, Tf, Td, Pg, Aa (abbreviated). Each one responds more or less to treatments such as laser gingival treatment, ozone gas, oxidating rinses, antibiotics, etc.. and certain combinations of them also alter our ability to get rid of them. How much better this is for us to be able to increase the efficacy of our approach in the office, rather than just harping on the patient to floss more. Flossing alone certainly will not budge the population of these harmful bacteria… and they are in a high percentage of the U.S. population. 80% of patients over the age of 35 have gum disease!
The most alarming fact is that these five bacteria are causative factors in a multitude of systemic diseases and inflammatory responses, among them cancer, Alzheimers, arterial plaque and heart disease (50% of heart attacks are triggered by oral pathogens), stroke, oxidative stress and diabetes. Even maternal infertility risk is affected by such bacteria as Fn.
We love oral probiotics, and this test also tells us which probiotic is best for a given patient’s bacterial population. The test can also indicate whether sleep disordered breathing may play a role in bacterial dysbiosis, or an underlying infection such as a failing root canal tooth. Also informative is a post-test that can be done 6-12 weeks after implementing treatment to determine how it is affecting the bacteria.
Really there is no person who would not find something of value in their saliva test… it just has not been a very available or popular option in most dental communities. Here’s to changing that!