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Oral DNA Testing

What is Oral DNA Testing?

Recent studies and tests have shown a strong link between gum disease and other conditions such as heart disease, diabetes, stroke, Alzheimer’s, and some forms of cancer. In our practice we take this very seriously. We employ oral DNA testing to determine any genetic predisposition our patients may have toward inflammatory gum infections. Oral DNA testing allows us to determine not only if a patient is susceptible to gum disease but also the types of bacteria in the mouth so the patient can be treated more effectively. These tests are quick, painless, and non-invasive and will enable us to create a treatment program specifically for you.

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One of the most significant advances in dental medicine, a simple DNA test, can now determine the specific type and quantity of disease-causing bacteria in your mouth! This gentle oral rinse procedure is performed by swishing a small amount of sterile saline throughout the mouth and can be done in about 30 seconds. The sample is then sent to OralDNA Labs, Inc. for processing. The lab report that we get back will identify the bacteria associated with the gum infection and allow us to develop a far more powerful and effective treatment plan. Through this state-of-the-art technology, we are now able treat the cause of the infection and not just the symptoms.

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At our office, we use clinical laboratory services from OralDNA Labs® to ensure we are giving our patients the best oral health information possible. OralDNA Labs® is a specialty diagnostics company designed to provide reliable, definitive and cost effective clinical tests that guide oral health professionals in detecting and prognosing disease at an earlier, more treatable stage.

Oral DNA Saliva Testing

If you would like, Arlington Smile Center can apply DNA saliva testing to ascertain your risk of periodontal disease and the presence of specific periopathogenic bacteria. With this information, we can help you better eliminate inflammation in your mouth and the spread of bacteria and inflammation throughout your body. Because chronic gum disease is a contributor to cardiovascular disease, diabetes, arthritis, inflammatory bowel disease, kidney and liver disease, obesity, head and neck cancer, neuroinflammatory diseases, preterm birth, and more, health-conscious patients are delighted with the availability of this relatively low-cost diagnostic service.

On January 28, 2019 a study was published in the journal Science Advances, uncovering a potential link between P. gingivalis, the bacteria associated with periodontal disease (commonly known as gum disease) and Alzheimer’s. Researchers analyzed brain tissue, spinal fluid, and saliva from Alzheimer’s patients – both living and deceased – and found evidence of P. gingivalis. Gingipains, the toxic enzyme secreted by P. gingivalis, were found in 96 percent of the 53 brain tissue samples examined, with higher levels detected in those with the pathology and symptoms of Alzheimer’s disease.

Dr. Roca is passionate about Oral DNA saliva testing.

With this easy testing, she can now:

  • Identify the specific bacterial cause of a patient’s oral infection.
  • Determine if a patient has a genetic susceptibility to periodontal disease.
  • Evaluate the risk for developing oral infection.
  • Evaluate the risk for causing or exacerbating certain systemic diseases.
  • More effectively treat those who have advanced or chronic gum disease.
  • More effectively monitor and track the progress of a patient’s oral health.
  • Intentionally refer patients to appropriate physicians.
  • Educate and motivate patients about their specific circumstances.
  • Create a healthy foundation for dental restoration of their smile.
  • Help patients achieve and enjoy optimal health.
  • Predict your risk of dental decay.

“My patients with diabetes, heart disease, metabolic disease, and arthritis have had improved lab results for their conditions after DNA saliva testing and targeted treatment for disease-correlated bacteria in their mouths. Because they have been prone to inflammation of their gum tissue and sometimes suffered from periodontal disease, they are delighted to achieve control over the infectious bacteria in their mouths. Now, they enjoy much improved oral and overall health. Many have had smile makeovers to restore their teeth and gum tissue. Their renewed confidence and healthy, beautiful appearance make them – and me – smile!” —Lupita M Roca, DDS

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Reduce your risk for many systemic diseases with oral DNA saliva testing.

The Centers for Disease Control and Prevention estimate that over half of all U.S. citizens have gum disease. Left untreated, these individuals are at high risk of advanced periodontitis, tooth loss, and inflammation throughout their bodies. Scientific evidence has made clear that the bacteria in your mouth enter your bloodstream and are carried to all the organs of your body where certain oral bacteria can increase your risk of many systemic diseases.

With oral DNA testing, Dr. Roca can determine the specific type and amount of disease-causing bacteria in your mouth. She also can provide you with the advice, treatment, and medical referrals you might need to lower your risk of chronic periodontal disease and other inflammatory diseases of your whole body, including heart disease, stroke, diabetes, rheumatoid arthritis, metabolic disease, and even Alzheimer’s disease.

Dr. Roca partners with OralDNA Labs for saliva diagnostics. Your saliva is collected by swishing a small amount of sterile saline solution in the mouth and spitting it in a funnel. Your saliva specimen is then sent to the lab. When the lab report is returned, it will list the specific bacteria present that are associated with gum infection. This allows Dr. Roca to develop an effective treatment plan. With bacteria-specific antibiotics, the bacterial risk of disease progression will be reduced. In most cases, her targeted treatment will greatly help stop the periodontal infection from continuing.

Another test can tell if you have an exaggerated immune response to oral bacteria due to family genetics that will put you at greater risk of developing gum infections. Even with good oral hygiene at home, patients with this susceptibility benefit from more frequent teeth cleaning appointments and checkups. Tests also can be done to learn if the human papillomavirus (HPV), herpes simplex virus (HSV), chlamydia trachomatis, or neisseria gonorrhea are present in the mouth or throat. Specific types of the HPV virus can be identified that have separate risk factors for oral and throat cancers. Early detection and monitoring will enable optimal treatment. Patients of Dr. Roca should not be embarrassed to request testing and medical referral.

Who should have Oral DNA saliva testing?

Everyone is a candidate for oral bacteria testing and may benefit from it. Please speak up if you have interest in the testing. Each time you come to our office, we will inquire about any changes in your health and medications. And, we will be looking for signs of periodontal inflammation. Common signs include:

  • Red, swollen or tender gums that may bleed when you brush your teeth.
  • Gum tissue that is receding or pulled away from your teeth.
  • Pockets between the teeth and gums.
  • Recurring or chronic bad breath or bad taste.

Depending on your circumstances, you may have a heightened reason for saliva testing. Dr. Roca recommends saliva testing for patients with gingivitis, periodontitis, and/or one or more known or suspected inflammatory diseases. However, due to cost constraints she understands not everyone wants or can afford to have this testing done, so she is very understanding and only mentions it once, then allows you to think about it.

We need to prevent the fires and control the smoke…
We need to take a more proactive role in our health…

Conditions Oral DNA Testing Can Look For

Diabetes

Diabetes results when the body cannot produce insulin (type 1) or the body’s tissues become resistant to insulin (type 2). The inflammation of the beta cells within the pancreas, which produce insulin, are the basis for both types of diabetes. Recent studies have proven that elevated amounts of oral bacteria, usually also causing gum disease, can raise blood sugar and cause inflammation of the beta cells. [Kumar M, Mishra L, Mohanty R, Nayak R. “Diabetes and gum disease: the diabolic duo”. Diabetes Metab Syndr 2014;8:255-8]

Heart Disease

A heart attack is triggered by the blockage of one of the arteries that supply the heart muscle with oxygen-rich blood. Occlusion of the coronary arteries is now known to be caused not only by deposition of bad cholesterol, but by the migration and entrapment of oral bacteria, such as Porphyromonas gingivalis, or Pg. In a recent review article by Drs. Brad Bale and Amy Doneen, they describe how oral bacteria can no longer be viewed as associated with heart attacks, but as a cause. [Bale, BF, Doneen, A L, Vigerust, DJ. High-risk periodontal pathogens contribute to the pathogenesis of atherosclerosis Postgrad Med J. 2017 Apr;93(1098):215-220.]

Stroke

Infection of the gums is caused by a variety of bacteria. The inflammation that results from gum infection can also lead to the spread of those bacteria elsewhere in the body. Large blood vessels in the heart and in the neck are one of the places these oral bacteria can land. These bacteria cause local inflammation and the risk of forming unwanted blood clots. A stroke is caused when blood clots, arising from these areas of diseased blood vessels, break loose and migrate to the brain, where they cut off the blood supply to that area of the brain. In this way, oral bacteria are involved in strokes. [Dorfer, CE, Becher, H, Ziegler, CM, Kaiser, C, Lutz, R, Jorss, D, Lichy, C, Buggle, F, Bultmann, S, Preusch, M, Grau, AJ. The association of gingivitis and periodontitis with ischemic stroke J Clin Periodontol. 2004 May;31(5):396-401.]

Bad Breath

One cause of bad breath or halitosis is bacteria that produce sulphur-containing chemicals, a by-product of the chemical’s metabolism process. Many of the bacteria causing gum disease have this capability. Lowering the levels of bacteria such as Treponema denticola (Td) and Porphyromonas gingivalis (Pg) and Prevotella intermedia (Pi) will lessen the causes of bad breath. [Kapoor, U; Sharma, G; Juneja, M; Nagpal, A (2016). “Halitosis: Current concepts on etiology, diagnosis and management.” . European journal of dentistry. 10 (2): 292-300]

Rheumatoid Arthritis

Rheumatoid arthritis is a chronic condition of the immune system. The inflammation that spurs this form of joint disease is caused by autoimmunity, or the body reacting against itself. Heightened levels of total body inflammation worsen rheumatoid arthritis, and the cause of that inflammation is in part due to oral bacteria. In a recent study, persons with mouth infections involving Porphyromonas gingivalis (Pg) and Fusobacterium nucleatum (Fn) have a significantly increased risk of developing rheumatoid disease. [Johansson L, Sherina N, Kharlamova N, et al. Concentration of antibodies against Porphyromonas gingivalis is increased before the onset of symptoms of rheumatoid arthritis. Arthritis Res Ther 2016;18:201]

Pregnancy Complications

Fusobacterium nucleatum (Fn) is associated with risk to infect the mother’s blood and the placenta. Presence of Fn can cause premature delivery of the baby, lower birth weight, and, at the same time, problems for the mother such as high blood pressure and kidney failure. [Han YK. Fusobacterium: A commensal turned pathogen. Curr Opinion Microbiol 2015, 23: 141-147.]

Tooth Loss

Tooth loss is a consequence of advanced gum disease. The problem begins with infection that resides in the space between the teeth and gums (periodontium). As the infection worsens, the body responds with needed but sometimes destructive inflammation due to selected type of bacteria. Over time, the ligament that attaches a tooth to the underlying jaw bones is loosened and may even dissolve, which results in the loosening of that tooth. Managing the gum infection, first by testing for the specific bacteria involved, and then having your dentist tailoring the specific treatment, will prevent tooth loss. [Baumer, A, Pretzl, B, Cosgarea, R, Kim, TS, Reitmeir, P, Eickholz, P, Dannewitz, B. Tooth loss in aggressive periodontitis after active periodontal therapy: patient-related and tooth-related prognostic factors J Clin Periodontol. 2011 Jul;38(7):644-51.]

Dental Decay

Dental decay is also called dental caries, or cavities. The decay starts at the tooth enamel. An opening in the enamel – either a pit or crevice – can be further dissolved by the acid produced by certain bacteria in the mouth, most importantly Streptococcus mutans. Higher levels of this bacteria create more risk of new or worsening cavities. Lowering the amount of Streptococcus mutans in the mouth, mostly through good tooth brushing and reduced consumption of sugary foods, will help prevent cavities. [Hardie JM (May 1982). “The microbiology of dental caries”. Dent Update. 9 (4):199-200, 202-4, 206-8.]

Oral Cancer

The Oral Cancer Foundation states that HPV is the leading cause of oropharyngeal cancers. In fact 65% of oral cancers are linked to HPV.

Here is a list of the current tests available from Oral DNA Lab

MyPerioPath™ – Early Warning of Oral Pathogens
MyPerioPath is our most widely used test for the detection of oral pathogens that cause gum disease and threaten oral & systemic health. MyPerioPath provides early warning of oral pathogens to enable the personalization of periodontal treatment. The pathogens tested for in MyPerioPath can help determine if a patient is at increased risk of cardiovascular disease, diabetes, stroke, and birth complications. MyPerioPath test identifies the following type(s) of oral bacteria:

  • (Aa) Aggregatibacter actinomycetemcomitans
  • (Pg) Porphyromonas gingivalis
  • (Tf) Tannerella forsythia
  • (Td) Treponema denticola
  • (En) Eubacterium nodatum
  • (Fn) Fusobacterium nucleatum/periodonticum
  • (Pi) Prevotella intermedia
  • (Cr) Campylobacter rectus
  • (Pm) Peptostreptococcus (Micromonas) micros
  • (Ec) Eikenella cordoned
  • (Cs) Capnocytophaga species (gingavalis, ochracea, sputigena)

Order a second MyPerioPath after therapy or annually, and receive a complimentary MyPerioProgress report outlining bacterial changes! This valuable tool allows you to measure success and track progress for a more personalized therapy.

MyPerioID™ IL-6 – Determine Increased Genetic Risk for Periodontal Infections
The MyPerioID IL-6 (Interleukin-6) test identifies individual genetic susceptibility to periodontal disease. With this information, clinicians are able to establish which patients are at increased risk for more severe periodontal infections due to an exaggerated immune response, allowing personalized therapy and treatment.

OraRisk™ Caries – Determine Bacterial Risk for the Development of Cavities
OraRisk Caries is a simple saliva screening test that identifies three types of harmful bacteria known to cause cavities: Streptococcus mutans, Streptococcus sobrinus & Lactobacillus casei. Did you know that 90 percent of US adults have had a cavity and 1 in 4 have untreated cavities?

OraRisk™ HPV Complete Genotyping – Determine Increased Risk for HPV-Related Oral Cancers
Human papillomavirus (HPV) is one of the most common virus groups in the world (and is a manifestation of the HPV virus in the mouth and is primarily found in the oropharyngeal complex). Specific types of oral HPV are now considered to be separate and serious risk factors for developing oral cancers. Early detection and identification of the presence or absence of oral HPV is important, as early oral HPV infections do not typically cause any clinical signs or symptoms. OraRisk HPV Complete Genotyping enables the clinician to establish increased risk for oral cancer and determine appropriate referral and monitoring conditions. OraRisk HPV Complete Genotyping identifies a total of 51 types of oral HPV:

  • High Risk Genotypes: 16, 18, 26, 30, 31, 33, 34, 35, 39, 45, 51, 52, 53, 56, 58, 59, 64, 66, 67, 68, 69, 70, 73, 82
  • Low Risk Genotypes: 2a, 6, 11, 32, 40, 42, 43, 44, 54, 55, 57, 61, 62, 71, 72, 74, 77, 81, 83, 84, 89
  • Unknown Risk Genotypes: 41, 49, 60, 75, 76, 80, 85

Celsus One™ – Evaluate Gene Markers Related to Inflammatory Response
Celsus One helps understand how genetics impact health. Celsus One evaluates eight gene markers related to inflammatory response:

  • Interleukin 1 composite genotype
  • Interleukin 6
  • Interleukin 17 A
  • Beta-defensin 1
  • CD14
  • Tumor necrosis factor alpha
  • Toll-like receptor 4 composite genotype
  • Matrix metalloproteinase 3

OraRisk™ Candida – Identify Infections Caused by Species of the Yeast Candida
OraRisk Candida identifies all common species of the yeast candida, which is known to cause oral thrush in patients with a normal or compromised immune system. Candida species identification is key to treatment choice, as some types of candida are resistant to standard antifungal treatments.

DNA DrugMap™ – Evaluate Gene Markers to Personalize Prescription and Dosing Decisions
Drug metabolism varies by individual and can be critical to health and well-being. Now there is a simple way to test for this. DNA DrugMap helps personalize prescription and dosing decisions based on individual genetics.

OraRisk™ CT/NG – Identify Chlamydia Trachomatis(CT) and or Neisseria Gonorrhea(NG) in the Oropharynx
OraRisk CT/NG is the most sensitive way to test for one of the emerging STDs, chlamydia trachomatis (CT) and or neisseria gonorrhea (NG) of the oropharynx. These conditions may be asymptomatic or involve only mild pharyngitis, yet the consequences of an unchecked infection may be severe and are transmissible to partners and others who share intimate contact. OraRisk CT/NG provides highly sensitive detection of either or both chlamydia trachomatis or neisseria gonorrhea, and the report will include interpretative comments with specific recommendations for treatment.

OraRisk™ HSV – Identify Herpes Simplex Virus Type 1 and 2 in the Oropharynx
OraRisk HSV test is an accurate, sensitive, and easy way to diagnose herpes simplex virus outbreaks involving the oropharynx. HSV infections are very common, yet can often be mistaken for other causes of oral vesicles, ulcers, and other forms of painful oral and pharyngeal lesions. OraRisk HSV will identify HSV1 or HSV2 by detecting “shed virus” specific to active infections or outbreaks.

Call us now at (703) 237-7622 to schedule your visit and ask us about oral DNA testing as part of your care plan.