Understanding Salivary Testing: What Can It Really Tell You About Your Oral Health?

In this video, a dentist explains the concept of a healthy oral biofilm and discusses the limitations of salivary testing. The dentist emphasizes the importance of promoting healthy bacteria in the mouth rather than trying to eliminate all bacteria through regular cleanings and treatments. The video explains that testing saliva can determine the presence of cavity-forming bacteria, such as streptococcus mutans, as well as bacteria associated with gum disease. However, the video cautions that salivary testing cannot determine the overall health of the mouth’s biofilm, which plays a crucial role in protecting teeth and gums. The dentist recommends maintaining good oral care habits to support a healthy biofilm and sharing healthy bacteria with others through regular interaction. Overall, the video highlights the need for a balanced understanding of bacterial presence in the mouth and the importance of a healthy oral biofilm.

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Key Insights:

  • The concept of promoting healthy bacteria in the mouth is a new approach to dentistry, as opposed to killing bacteria and scraping teeth every six months.
  • Salivary testing can be a fun way to test the bacteria in your mouth and determine if you have a high population of cavity-forming bacteria.
  • There are tests available for measuring streptococcus mutants, which are known to cause cavities.
  • A complete mouth care system can lower the levels of streptococcus mutants and promote the growth of healthy bacteria in the mouth.
  • Salivary testing can also detect the presence of periodontal bacteria, which can cause gum disease and potentially affect overall systemic health.
  • Sharing bacteria through interactions such as kissing and sharing food is normal, but maintaining a healthy mouth is essential.
  • Measuring saliva cannot determine the overall health of the mouth, as the most important bacteria are found in the biofilm that coats the teeth.
  • The composition of the biofilm is difficult to change, even with antiseptic mouthwashes or regular dental cleanings.
  • Modulating the biofilm’s composition involves reducing sugar intake, controlling mouth acidity, and using appropriate oral care products.
  • Regular dental cleanings may not be necessary if a person maintains a healthy biofilm.


I haven’t had a dental cleaning in 45 years. I haven’t had a cavity. I don’t have gum disease. Dentists have probably examined my gums and looked for pockets and deposits in my carotid arteries. They’ve measured my A1C and CRP levels for inflammation. I don’t floss and I don’t have regular cleanings. Why is that? It’s because my biofilm is healthy. Biofilm acts as a protective barrier for my teeth, preventing infection. This concept is relatively new, but it’s crucial to understand.

For about 15 years, we have known that the mouth harbors a diverse population of healthy bacteria. This is why my approach to Dentistry differs from traditional methods. Instead of focusing on killing bacteria and scraping teeth every six months, I promote the growth of healthy bacteria and allow saliva, which nourishes the teeth and oral microbes, adequate time to do its job.

Salivary testing has gained popularity as people want to understand the bacteria in their mouths without visiting a dentist. These tests can provide information about the presence of cavity-forming bacteria, such as Streptococcus mutans. These bacteria are sticky and adhere to teeth, feeding on sugars in our diet. By testing saliva, we can determine if there is a high population of these bacteria, indicating a potential risk for cavities.

There have been tests for Streptococcus mutans for a long time, and my recommended mouth care system has been effective in lowering the levels of these bacteria. Testing saliva can also reveal the presence of bacteria associated with gum disease. While we cannot directly measure the bacteria beneath the gums, we can assess their proliferation based on their presence in saliva. This is important because these bacteria can enter the bloodstream through gum pockets and potentially affect various parts of the body, including the heart, lungs, and digestive system.

It’s crucial to maintain good oral care, especially during pregnancy when saliva becomes more acidic, favoring the growth of plaque-forming bacteria. Following a proper mouth care regimen can suppress the proliferation of periodontal bacteria and ultimately heal periodontal pockets.

While salivary testing is useful for identifying problem-causing bacteria, it cannot determine if the mouth is healthy overall. The composition of a healthy mouth’s bacteria is not well-defined. We know that certain bacteria in the mouth use nitrates to produce nitric oxide, indicating oral health. However, there is no gold standard for the bacteria present in a healthy mouth.

It’s important to distinguish between planktonic bacteria, which float in saliva, and the bacteria in the biofilm that coats the surfaces of the teeth. Planktonic bacteria are affected by external factors like drinking water, but the biofilm’s composition is much more resilient. Genomic testing has shown that a significant portion of the biofilm developed during childhood and has familial patterns.

Maintaining a balanced mouth, limiting sugar intake, controlling mouth acidity, and using appropriate oral care products can help modulate the biofilm on teeth. Routine dental cleanings may not be as necessary as commonly believed, as long as the biofilm remains healthy. Understanding the difference between planktonic bacteria and the durable biofilm is crucial in evaluating studies and products aimed at mouth health.

Our understanding of the bacteria present in a healthy mouth is still evolving. It’s essential not to be swayed by misleading information and to recognize the vital role of biofilm in protecting teeth and gums.