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  • Rob Donnelly

Saliva Testing Provides an Objective Diagnosis for Dental Care

How do we get to the root cause of oral disease? How do we locate and identify bacteria in the mouth that are causing a patient's illness? Saliva testing.


Did you know..?

  • 80% of Americans over the age of 30 have some form of gum disease

  • Untreated periodontal bacteria leads to a 3x greater risk of dying from a stroke and a 2x greater risk of dying of a heart attack

  • Patients with periodontal disease have 8.81x higher chance of death of COVID-19, 3.54x higher chance of ending up in the ICU, and 4.57x higher chance of ending up on a ventilator

  • 95% of Americans who have diabetes also have periodontal disease. Periodontal disease treatment helps with glucose control and reduction of A1c

These scientific facts are sobering and emphasize the need for salivary diagnostics. And this list is not an exhaustive one!

saliva test- direct diagnostics

Just 1ml of saliva delivers highly quantitative results on the five bacteria considered to be the highest risk pathogens for periodontitis, and systemic inflammation: Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), Treponema denticola (Td), Tannerella forsythia (Tf), and Fusobacterium nucleatum (Fn).


When we can identify specific bacteria that are living in the mouth, we can begin to plan the treatment. Saliva testing is a simple and powerful tool used in the oral systemic health care approach. Periodontal disease is a medical condition with a dental solution.


The Oral Systemic approach assesses the patient’s complete health and well-being. This approach reduces and eliminates oral inflammation, some of the most significant root causes of heart disease, stroke, diabetes, and more.


By providing oral systemic care, you have the opportunity to grow your practice and deliver superior results to your patients. What is happening in your mouth is a precursor for the condition of other systems in your body. The mouth is the gateway to the rest of the body.


Periodontal Disease (gum disease) is the presence of significant infection in the tissue and bone surrounding your teeth. 80% of Americans over the age of 30 have some form of gum disease. This disease is triggered by pathogenic bacteria in your mouth that lives in the pockets surrounding your teeth and invades the gum tissue and bone.


Periodontal Disease has been compared to having an open wound in your mouth that never heals. With any other location on the body a long-lasting open wound would be alarming, to say the least. Patients would benefit in understanding that the same situation in the mouth is just as dangerous. Simple daily activities such as chewing, swallowing, and brushing your teeth initiates the travel of bacteria throughout the body. Oral bacteria is even transmissible through sharing food and beverages, and also through kissing.


Biofilms that are created by specific bacteria can build up on the surface of the teeth. They interact with host cells, release inflammatory mediators, resist the effect of drugs, and are unchanged by the immune system. In light of this, further study of the threatening mechanism of periodontal pathogens is greatly needed. Only with this vital information about the root causes of periodontal disease and related systemic diseases can we create effective and efficient treatment plans as well as preventative care tactics.


Traditional dentistry only examines the teeth with probing and viewing with the naked eye. Since pathogenic bacteria is definitely not visible to the naked eye, more sophisticated, yet incredibly easy to use, diagnostics are obviously needed. With traditional dentistry, by the time the visible symptoms are observed (swollen or sensitive gums, bad breath, loose teeth, red, puffy, and/or shiny gums...), the condition is advanced. Plus, it is also possible that none of these symptoms show up and a patient’s oral disease is asymptomatic, even at an advanced stage. This is even more reason to search for issues at the bacterial level. It doesn’t need to develop to this point before we take action! This old, conventional model of care is outdated and ineffective. Direct Diagnostics is on a mission to give clinicians an inexpensive test focused on the five high risk bacteria that is easy to read and comprehend, effortless to order, and results returned in 48 hours.


Saliva testing for periodontal disease is available and effective at identifying the specific bacteria that are at work. To assess your gum and bone health, saliva testing is one strong weapon in your arsenal in the diagnosis of and fight against periodontal disease.


Not only is it the general presence of oral pathogens in the mouth that is important, but the exact identification of the bacteria as well. It is important to identify the specific strains of bacteria that are in your mouth. There are many high-risk oral bacteria that can increase your risk and even cause cardiovascular disease, pregnancy complications, diabetes, Alzheimer's disease, cancer, and more.


When pathogenic bacteria upsets oral harmony

To demonstrate this significance, it’s helpful to discuss the body’s microbiome. Getting a clear picture of a patient’s microbiome and identifying any imbalance and the presence of any high risk pathogenic bacteria is a vital starting point of the oral systemic healing process. Saliva testing can provide this crucial data.


With over 700 bacteria living in the mouth, it’s easy to see that the mouth is ground zero for information and potential risk. Most of these oral bacteria are harmless and some are even beneficial, but certain bacteria lead to tooth decay, gum disease, and a host of other diseases affecting the mouth as well as the entire body. Direct Diagnostics HR5 saliva test will definitively identify any of the major culprits, giving you the information to create effective, precise treatment plans.


Most play a symbiotic role, while others are pathogenic. A healthy body houses many types of beneficial bacteria without incident, and balance is crucial. The human condition is loaded with potential threats to this balance. Inadequate nutrition, stress, prolonged use of antibiotics, substance abuse, and poor sleep are just a few.


50% of heart attacks and strokes are triggered by oral bacteria present in your mouth. This is an alarming statistic! However, we have the scientific data that connects each of these health issues to their corresponding strain of bacteria. This is incredibly powerful information when you consider targeted treatment plans. Given statistics such as this, it can be shocking to realize that salivary diagnostics is not more prevalent in both the dental and medical communities. Let’s take a look at the top bacterial culprits.


What are the High Risk Five?

If you’re not yet familiar, we’d like to introduce you to the High Risk Five (HR5). These menaces to your oral and whole body health are the top five culprits for a vast variety of acute and chronic illness. Scientific research continues to implicate these five bacteria in an expanding horizon of oral and systemic health issues.


Aggregatibacter actinomycetemcomitans (Aa)

This bacteria is a main culprit for rapid alveolar bone loss in both adults and children, severe periodontitis, and dental implant failure. And to go beyond the mouth and bones, this pathogen also increases risk for cardiovascular disease, ischemic stroke, brain abscesses, and heart infections. In addition, it is linked to rheumatoid arthritis, Alzheimer’s Disease, cancer, high blood pressure, and adverse pregnancy outcomes.


Porphyromonas gingivalis (Pg)

Porphyromonas gingivalis is a primary cause of alveolar bone loss, periodontitis and implant failure. Research studies have shown this pathogen also contributes to artery plaque, rheumatoid arthritis, diabetes, cancer, high blood pressure, adverse pregnancy outcomes, Alzheimer's Disease, and other inflammatory diseases.


Treponema denticola (Td)

This pathogen is a major contributor of periodontitis and implant failure (peri-implantitis). It feeds off of stress and has demonstrated its association with diabetes, kidney disease, adverse pregnancy outcomes, artery plaque, high blood pressure, dementia, and Alzheimer's Disease.


Tannerella forsythia (Tf)

Tannerella forsythia is a primary cause of periodontitis and implant failure (peri-implantitis). Other health issues it causes are artery plaque, Alzheimer’s Disease, heart attack, cancer, adverse pregnancy outcomes, diabetes, high blood pressure, atherosclerosis, and kidney disease.


Fusobacterium nucleatum (Fn)

This pathogen tends to facilitate the movement of other oral pathogens into the circulatory system. It is associated with periodontitis, implant failure, preterm birth, pre-eclampsia, low birth weight, artery plaque, atherosclerosis, cancer, and gut dysbiosis. It also adheres to and invades endothelial cells.


This description of the High Risk 5 is a lot to take in and this list is only composed of the five most significant pathogenic oral bacteria. There are many other pathogenic oral bacteria that cause distress throughout the body! The good news is that we have this scientific knowledge and we can do something about it! Salivary diagnostics provides powerful data that is crucial in building a targeted treatment plan.


Our drive to offer salivary diagnostics

The HR5 test was born out of years of research, numerous scientific publications, and decades of clinical experience. Scientific research continues to implicate these five bacteria in an expanding horizon of oral and systemic health issues - acute and chronic. Our unique HR5 test can empower your practice to join the conversation for the evolving field of oral systemic health.


Dr. Tom Nabors is a trailblazer in the field of oral systemic health. For more than four decades, his professional efforts have been focused on the role of oral pathogenic bacteria and their destructive effects. In 2012, Dr. Nabors received the first lifetime achievement award from the American Academy of Oral and Systemic Health (AAOSH). He is the leading authority on salivary diagnostics and the accompanying treatments. Dr. Nabors founded Direct Diagnostics and continues to lead and expand salivary diagnostics and oral pathogen research.



Our HR5 saliva test is the most accurate test available for these bacteria in saliva. Accuracy means we find these harmful pathogens early, which provides the data needed to create efficient and effective treatment plans.


A lower price-point increases accessibility. When patients can afford and take advantage of worthwhile tests, the process of effective treatment can begin. This accessibility also supports therapy adherence. Our goal is to one day have this test covered by medical and dental insurance due to its significant impact on overall health.


Perhaps the most compelling factor is the personalized treatment plan that can be created for each patient in order to manage their pathogen levels. Our mission at Direct Diagnostics is to provide clinicians with an inexpensive test focused on the five high-risk bacteria. Ordering this test is effortless, the results are returned in 48 hours, and they are easy to read and comprehend. Implementation of saliva test results and other diagnostics ensures successful dental treatment plans.


Direct Diagnostics gives you the power of information

Now more than ever, the medical community is geared to find answers through technology. Most patients are unaware that powerful diagnostics such as the saliva test may be available through their dentists. If not, we encourage these patients to ask their dentists about it! Direct Diagnostics is a clinical laboratory and biotechnology company that is advancing the field of molecular testing and driving the evolution of salivary diagnostics.



The founder of Direct Diagnostics, Dr. Tom Nabors is a significant forefather of the oral systemic health care movement. For more than four decades, he has been at the forefront, dedicating his scientific career to advancing the diagnostics and corresponding treatments that implement the oral systemic beliefs and protocols. He is the founder and former Chief Dental Officer of Oral DNA Laboratories, and received the first American Academy for Oral Systemic Health’s lifetime achievement award in 2012. Dr. Nabors continues his groundbreaking research of pathogenic bacteria through his current venture, Direct Diagnostics.


Conventional dentistry consists of examining the patient’s mouth merely by probing and viewing what they can see with the naked eye. Oral systemic healthcare teams use the power of salivary diagnostics to obtain definitive data and create a targeted treatment plan. Utilizing accurate diagnostics elevates your dental practice and offers the most sophisticated services to your patients.


Since scientific evidence has shown that these five high risk bacterial pathogens are the most critical in terms of inflammation, oral cavity damage, and systemic consequences, imagine the power that a simple HR5 test can provide.


The HR5 saliva test is easy to explain and present to patients, which increases its use in the clinic. This test for the High Risk 5 identifies low grade infections long before they display visual symptoms.


Identifying specific bacteria in the mouth is crucial for effectively treating disease in the mouth and the whole body. Here are 10 Reasons to use our HR5 test:​

  • Focused

  • Affordable

  • Accurate

  • Quantitative

  • Patient Friendly

  • Provider Friendly

  • Easy to Read

  • Fast Turnaround

  • User-friendly Software

  • Saliva (just saliva)

And it goes beyond the initial benefit. Saliva testing is not only the starting point of the identification and treatment process, but also provides valuable data throughout the course of treatment. The repeated saliva test supplies proof as to whether or not your treatment plan is effective.


Direct Diagnostics offers many services in addition to the saliva test. We offer tools that conventional medicine does not. Click here to discover the power of salivary diagnostics and to Start Testing.

©2021 by Direct Diagnostics LLC. Direct Diagnostics is certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA), 42 U.S.C. §263a, and meets the requirements to perform high complexity tests. CLIA Registration 45D2190910. 

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