Oral testing is trending this year among both patients and dental practitioners. Having been introduced to salivary testing through platforms like 23andMe and Ancestry.com, dental patients are understanding firsthand how oral tests can uncover mysteries within their bodies. With the rise of new salivary, plaque, and cellular tests in the dental industry, dental practitioners have more questions than ever about which ones to offer their patients.
Melissa K. Turner, RDH.
Because of this, I spent the last year trying out and researching oral tests to uncover the similarities and differences within the offerings. What I found may surprise you! Take a look at the top 10 things you need to know about oral testing:
It's not just about saliva.
At the beginning of my research, I commonly lumped all oral tests under the phrase "salivary tests." I quickly learned the phrase "oral test" was a more appropriate umbrella term. While many tests in dentistry do indeed test saliva, it is common for them to also analyze plaque, biofilm, cells, breath, and saliva. In the future, perhaps we'll even test snot!
Most oral health tests do not examine human DNA.
Another assumption while beginning my research is that any test that discussed DNA or RNA was testing human cells. The truth is that the majority of oral health tests evaluate microbial cells -- DNA, RNA, and bio components of bacteria, fungi, viruses, and yeast, even if "DNA" is in the name. Keep in mind there are a few oral tests that do indeed examine human DNA. These tests are to be taken once in a lifetime and will have the same results whether or not you test the person as an infant or an adult. Human genetics tests will uncover predispositions and familial patterns.
Most oral tests do not diagnose.
Unlike our medical colleagues who can diagnose conditions from routine blood tests, most oral tests do not diagnose oral diseases. Instead, these tests analyze the components of the mouth and offer results that are predictive in nature: screening for symptoms, predicting disease, or helping uncover what the patient is "at risk" for.
Not all tests are sent to a lab.
Thanks to innovative technology and artificial intelligence, many companies are working toward ways to provide results without needing to send the sample to the lab. Point-of-care or near-patient tests are completed chairside in the clinical operatory or at the patient's home. At this point, these are typically limited to screening or predictive tests and use an additional screening device or even an app on a cell phone.
Patients will pay.
The age-old question of "Will insurance cover this?" is sometimes more important to the dental practitioner than the patient. While there are several Code on Dental Procedures and Nomenclature (CDT) codes that should be submitted when completing a test or reviewing the results with the patient, keep in mind that CDT codes are procedural codes and don't necessitate reimbursement. Even if insurance doesn't typically reimburse for an oral test, be sure to always give the patient the choice -- you may be surprised how many patients will willingly pay out of pocket for it!
Show, don't tell.
Speaking of reviewing the test results, oral tests are a simple way to provide patient education, increase treatment plan acceptance, and engage the patient in their journey to health. Results should be reviewed with the patient immediately and can be completed through an email, a virtual appointment, or within the dental practice. In a world where the internet inundates patients with information, the idea of showing the disease to the patient -- instead of telling them about it -- is a more effective method of education. Also (and surprisingly), if a patient reviews their oral health status from a computer, app, or report, they will typically be more easily convinced of their oral health status than if dental professionals try to explain it to them.
The results will provide an overload of information.
After taking many tests this year, I now have a wealth of information about the inner workings of my mouth. However, it didn't take me long to begin asking the question, "Now what?" Now that I know my salivary pH and buffering capacity are within normal limits, what does that mean? Now that I know my salivary proteins (matrix metalloproteinase-8 and nitric oxide) are in poor status, what exactly do I need to do to fix this? No matter what test you use, the difficult thing is understanding the results enough to create personalized oral health recommendations other than the typical brushing and flossing.
Most tests aren't one and done.
Keep in mind that unless you're taking a test that examines human DNA, most tests provide a snapshot evaluation of the oral cavity in one moment in time. Taking the same test repeatedly on an annual basis or at each preventive appointment allows you to track your patient's condition, providing insights and patterns that may otherwise be overlooked.
Automatically include tests as part of your regular clinical protocol.
One of the most frequently asked questions I receive when providing oral testing education is, "Where do I fit testing into the clinical appointment?" The answer lies in how our medical colleagues use blood and urine tests within their clinical day -- they make them part of every appointment. For example, include a human DNA oral test in every new patient appointment. Also, include general wellness tests as part of the routine preventive appointment and disease-specific tests as part of your infection management protocol.
Encourage at-home tests.
Even if you are unable to complete oral testing in the office, encourage your patients to take oral tests at home. Have them bring in the results to discuss them with you. You may be surprised at how involved your patients will become in their health journey!
In the future, oral testing will continue to spike in interest in our patients, and new products will be released within the dental profession. As licensed care providers, it is our duty to stay up to date on the latest ways to evaluate the oral biome and provide our patients with valuable information, uncovering the mysteries of not just their oral health but their systemic health as well.
Melissa K. Turner is the senior executive consultant and chief hygiene officer at Cellerant Consulting Group. She leads the Cellerant Best of Class Hygiene Awards. She is a founding board member of the American Mobile & Teledentistry Alliance and co-founder of the Denobi Awards and the National Mobile & Teledentistry Conference. Turner's newest launches include Smile Proud, an advocacy organization built to support current and future LGBTQIA dental professionals, as well as "I, Woman," a podcast for women founders, executives, and entrepreneurs. Turner can be reached at www.MelissaKTurner.com.
The comments and observations expressed herein do not necessarily reflect the opinions of DrBicuspid.com, nor should they be construed as an endorsement or admonishment of any particular idea, vendor, or organization.
