The Power of Saliva Testing in Preventive Dental Care

Saliva testing, also known as salivary testing, has become an incredibly valuable tool in preventive dental care. This article will cover why we saliva test in our office, the steps you can expect to take when you take a saliva test, understanding what your results mean, and – in the event that your results reveal harmful bacteria – the powerful impact that targeted treatment can have on your health outcomes.

Silent Invaders: The hidden dangers of oral bacteria lurking in your mouth

There are millions of bacteria in your mouth. While some of these bacteria are beneficial, there are also some that are harmful and have the potential to embed themselves deep within the tissues of your gums and ultimately spread throughout your body.

“Even if you're not feeling anything right now - you feel healthy, you feel fine - a lot of times you can be harboring these bacteria, and they're just waiting for the most opportune time to cause destruction.” - Rylie, Registered Dental Hygienist, Alpers Family and Cosmetic Dentistry, Scottsdale, AZ

A common misconception is that symptoms like bleeding and inflammation in the mouth are contained and remain only in the mouth – when in reality, they may serve as red flags for systemic issues. For example, harmful bacteria that cause gum disease can also affect the heart – putting you at higher risk for heart disease and heart attacks1, as well as the brain, putting you at higher risk for stroke1, Alzheimer's and dementia.2 In addition, several studies have pointed to the connection between harmful bacteria in the mouth and rheumatoid arthritis.3 For those who are diabetic, gum disease can cause your blood sugar to rise and make it harder to control your diabetes.4

“People with gum disease are nearly twice as likely to suffer from heart disease.” - The American Academy for Oral and Systemic Health

Brushing and flossing are key for at-home oral care, but for many of these harmful bacteria, these techniques are not enough to eliminate them. In order to ensure your body is able to kill off the bacteria, before they become a problem in high populations, it’s important to first identify which specific bacteria you need to fight. Enter, saliva testing!

The Role of the Saliva Test: Identifying and targeting harmful pathogens

At Alpers Family and Cosmetic Dentistry, our saliva test is a simple, non-invasive test that allows us to identify and measure the top five bacterial pathogens that are considered the most critical and put you at the highest risk for infection, inflammation, oral cavity damage, and systemic consequences.

The top five most harmful bacterial pathogens
Each of the top five harmful bacterial pathogens are linked to systemic health conditions

If any of these five bacterial pathogens – Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), and Fusobacterium nucleatum (Fn) – are present in your mouth, and if no action is taken, they have the potential to enter your bloodstream and put you at risk for developing these harmful health conditions.

However, the specific saliva test we do in our office is proven to be accurate and ensures that you are screened for these damaging bacteria. So when you choose to take our saliva test, you’re taking the first step on the path to eliminating these bacteria!

Hygienist holding saliva test tube and packaging it to send to the lab
Left: You will collect enough saliva to fill to the red line of the test tube. Right: Your hygienist will package the sample and send it off to the lab.

Easy and Effortless: Steps for saliva testing

The saliva testing process is performed in our office during your routine preventive dental cleaning, and our dental hygienists are there to guide you each step of the way.

Step 1 - Your hygienist will hand you a small test tube. You will spit into the tube, holding it close to your mouth, until the saliva reaches the red line. It’s really that easy! If you are having a hard time producing the right amount of saliva, your hygienist will give you chewing gum to activate your saliva glands. This gum does not affect the test results.

Step 2 - You will hand the test tube back to the hygienist, who will send it off to a specialized lab. The lab usually takes about a week to send us your results.

Step 3 - You will get an email from your dental hygienist, who will share the results with you. The email will contain a graph and explain the specific types of bacteria that are present, if any, and your hygienist will give you a customized plan on how to target and eliminate or reduce these bacteria.

Spit Science: Understanding your results

The graph contained in your email will show your bacteria levels for the top five bacterial pathogens. You will see the bacteria represented on the bottom of the graph, ranging from least destructive (right side) to most destructive (left side). If more than one of these bacteria are identified in your saliva sample, your hygienist will likely recommend targeting the most destructive bacteria first, and then working your way toward the right side of the graph.

 

Saliva test results example given to dental patient
You will receive an email with your saliva test results. The email will contain a graph showing any bacteria levels you may have. In this example, the hygienist may recommend targeting Pg first, since that bacteria is more destructive. Once that bacteria is reduced or eliminated, Tf would be targeted next.

Remember, if your result shows that these damaging bacteria reside in your mouth, it’s not necessarily a direct correlation to the effort you take with your oral home care. While brushing and flossing are effective in fighting plaque and gum disease, the truth is that you can take care of your smile and have what appears to be a healthy mouth, but still carry these harmful bacteria.

The good news is, your hygienist will review the results of your test and, if the bacteria are present in your mouth, formulate an action plan to fight them.

Fight Back Against Bacteria: Tailored action plans from your hygienist

If any harmful bacteria are flagged in the saliva test result, your hygienist will partner with you to create an action plan that will target them. At our Scottsdale office, it is a priority to provide the patient with a treatment plan that is tailored to their specific needs and health circumstances, so our dental hygienists do not apply "one size fits all" recommendations - if you are a patient in our office, your recommendations are tailored to you and what will optimize YOUR health! In addition, factors such as your health history, lifestyle and goals will be taken into account so that the plan is feasible for you.

Recommendations may include steps you can take at home – such as taking a supplement or oral probiotic that’s tailored to target the particular bacteria – as well as treatment you can do in the dental office – such as your using the diode laser during your routine cleaning appointments. Usually our patients are pleasantly surprised at how easy the recommendations are!

Retesting and Tracking Your Progress

Your dental hygienist may suggest performing another saliva test at a future hygiene appointment. This allows you to see if the bacteria that were previously present have been reduced or eliminated. If you had multiple bacteria present at the time of your first saliva test, and you reduced or eliminated the first bacteria, your hygienist may say that it’s time to target the next one. 

Once you have eliminated all of the bacteria, your hygienist will give you tips for keeping the levels down. The goal is to get you to a state where you are so healthy that if you come across these bacteria, your mouth can fight them off on its own without additional help. By this time, you have effectively fought off the bacteria and have taken significant steps to reduce your risk for systemic health issues.

Conclusion

Saliva testing is a valuable tool that can provide insights into the types of harmful bacteria affecting your oral health, which in turn flags your risk for conditions that can negatively impact your total health. When you choose to take a saliva test, you’re taking charge of your health. Our registered dental hygienists in our Scottsdale dental office are there to walk you through each step, providing you with a clear action plan so that you can enjoy a healthier smile and be your best self.

Ask about saliva testing at your next appointment, or visit our preventive page to learn more about other ways you can fight harmful bacteria.

Sources:

1. Harvard Health Publishing. "Gum Disease and the Connection to Heart Disease." Harvard Health. Accessed 25 July 2024.

2. Beydoun M, et al. Clinical and Bacterial Markers of Periodontitis and their Association with Incidental All-Cause and Alzheimer's Disease Dementia in a Large National Survey. Journal of Alzheimer's Disease. 2020;75(1):157-172. doi: 10.3233/JAD-200064.

3. Kriauciunas A, et al. The Influence of Porphyromonas Gingivalis Bacterium Causing Periodontal Disease on the Pathogenesis of Rheumatoid Arthritis: Systematic Review of Literature. National Library of Medicine. 2019;11(5):e4775. doi: 10.7759/cureus.4775.

4. Cedars-Sinai. "Diabetes and Gum (Periodontal) Disease." Cedars-Sinai Health Library. Accessed 25 July 2024.

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