FAQ
What is MyPerioPath?
It is a molecular based test for the detection of eleven bacterial species known to be associated with periodontal disease.
What is MyPerioID PST?
It is a molecular test for the detection of mutations in the inflammatory marker IL-1. Research has shown that such mutations or “positive” test results indicate increased periodontal breakdown and disease progression.
Why test using MyPerioPath & MyPerioID PST?
Research confirms that periodontal diseases are inflammatory infections. This is one of the most common and chronic diseases worldwide. Pathogenic bacteria must be present in order for the body to begin its defense against the bacteria—inflammation. By knowing the bacterial make-up of the periodontal infection (MyPerioPath) as well as the patient’s genetic susceptibility (MyPerioID) you are making treatment decisions based the true cause not just the clinical signs and symptoms. This information helps to validate initial clinical diagnosis, support therapeutic decisions and help design the patient’s treatment recommendations. Periodontal health may have a direct impact on overall health and has been linked to heart disease, stroke and other systemic conditions. Identifying the patient’s risk factors by bacterial and genetic susceptibility testing provides a way to help monitor and maximize success in periodontal therapy.
What does MyPerioPath tell me?
MyPerioPath will tell you if bacteria known to cause periodontal disease are present in the patient's mouth. If they are, MyPerioPath will also tell you in what quantity and indicate whether antimicrobial treatment is suggested to help eliminate them.
When do I test?
Both tests can be a part of a comprehensive periodontal diagnosis assessment to identify the bacterial cause (MyPerioPath) of active periodontal infections as well as the genetic susceptibility (MyPerioID PST). MyPerioPath can be incorporated as a preventive yearly screening to monitor the success and stability of past periodontal treatment.
How will MyPerioPath change treatment?
Knowing the bacteria present is the basis for treating any infection. Knowing the type and quantity of bacteria present can help create treatment that is case specific, instead of the "one size fits all" approach. Are antibiotics required? Are local antimicrobials needed? Does my patient need a home irrigator? Knowing the infection you are treating can help answer these types of questions.
How will MyPerioID PST change treatment?
In a genetically susceptible individual a small amount of bacteria can be a bigger problem. Periodontal therapy may need to be more aggressive based on the type/virulence of the infection and the genetic susceptibility of the individual. Such modifications may include: Scaling and root planing vs. “prophy”, longer (or more frequent) appointments for treatment, and adjunctive antimicrobials (such as locally delivered or systemic antibiotics). Closer supervision and more retreatment may be needed in genetically compromised patients with deeper pockets to achieve periodontal stability.
Who benefits from the test?
These tests can help identify persons that are genetically at a higher risk for periodontal disease (MyPerioID) as well as the bacteria type and virulence that are present (MyPerioPath). Less bacteria and even less aggressive bacteria can be more of a problem for individuals that are genetically compromised. MyPerioPath can also be used as a preventive screening to provide a base line reading so that periodontal health maybe monitored over time.
What is periodontal disease?
Periodontal disease is an infection of the tissues of supporting structures of the teeth. It can be an infection of the soft tissues (gingivitis) and/or an infection of the soft tissues and the bone (periodontitis). Significant medical and dental literature over the past decade supports the increased risks for other medical conditions when periodontal disease continues without appropriate diagnosis and treatment.
How is periodontal disease presently being diagnosed?
Traditional diagnosis for periodontal diseases includes visual examination, probe depths and x-rays. This is called “clinical signs and symptoms.” However, since periodontal infections are bacterial, traditional diagnosis cannot determine the most important aspect of the disease: the bacteria that cause the disease. Bacterial infections are microscopic; thus laboratory testing adds a significant benefit to traditional diagnostics. According to the American Dental Association (2006), "Having a standard diagnostic procedure and treatment recommendations are critical steps toward improving a patient's overall oral and systemic Health. Despite the prevalence of periodontal disease among adults, it is still under diagnosed and under treated, putting patients at risk for systemic disease.”
How is periodontal disease being treated today?
Today, treatment of periodontal disease is mostly determined by clinical signs. Thus, even though different disease forms exist, treatment revolves around mechanical therapy. This may include non-surgical procedures called debridement or SRP and in some cases, surgical procedures. The use of antimicrobials such as locally applied, sustained release, host response, and systemic antibiotics may also be used. However, an accurate diagnosis of which pathogens are present should precede the use of antibiotics.
Does mechanical therapy cure periodontal disease? How can the current treatment model be improved?
Traditional therapy is a fundamental element of the treatment process, because it is necessary to disrupt the biofilm that contains the disease-causing pathogens. However, mechanical therapy does not cure periodontal disease. Improvement in diagnostics such as DNA-PCR testing greatly improves the change for healing because knowing the bacterial load provides information that improves treatment success.
What are the goals of your testing and treatment model?
Earlier and more accurate diagnosis, targeted treatment, and the return of oral health.
Does the infection really go away with your testing and treatment model?
When treating disease, there is no guarantee that a successful end result always occurs. However, microbial testing provides important details about the bacterial make-up of the infection. This allows for individualized treatment with the intended outcome of sustainable oral health for the patient (improvement in clinical signs and symptoms and pathogen concentrations). However, infection-free does not necessarily mean pathogen-free; pathogens may still be present with no clinical significance because they are either present in small concentrations or the patient's genetic make-up keeps the pathogens from causing harm to oral health. It is possible, however, for the infection to recur (like any other infection e.g. strep throat) if the patient comes in contact with pathogens in sufficient quantity.
Does testing lead to un-necessary antibiotic usage?
We believe testing will lead to more precise and responsible utilization of antibiotics. As stated in a 2005 article in the Journal Periodontology 2000, "… prescription of antibiotics in periodontal patients should be based on defined clinical and microbiological parameters rather than on an empiric approach to prescription."
Why does my patient need an antibiotic?
Research has shown that for certain bacteria scaling and root planing alone is generally ineffective. These bacteria reside not only in the sulcus, but in the actual tissues! When faced with tissue-invasive pathogens, local antimicrobials and possible systemic antibiotics can help eliminate these infections.
Is there an antibiotic for each different pathogenic process?
Bacterial testing gives details of the oral micro-flora and bacterial load. Recommendations are based on the type and quantity of pathogens in the mouth, the medical history, history of previous treatment, and if the infection is a refractory disease. Depending on the infection, antibiotics are employed singularly or in combination. Antibiotic use is adjunctive and must always coincide with biofilm breakup & removal.
Is OralDNA Labs, Inc. regulated by an outside agency?
Yes, multiple agencies: Federal Government Agency (CLIA), State of TN, College of American Pathologists (CAP), and a variety of states from which we accept specimens.
How do I talk to my patients about the importance of testing?
Inform them that they may have an active bacterial infection that can become serious and result in not only tooth loss but other possible systemic diseases. Testing is the only way to identify the specific destructive pathogens and create a targeted treatment plan.
How do I explain the possible need for a systemic antibiotic to my patients?
Antibiotics are indicated for specific pathogens that cannot be controlled by debridement alone. Studies show that the risk of future tooth loss is substantially higher for patients with long term, uncontrolled periodontitis. Systemic antibiotics may be an important adjunct to resolving some periodontal infections.
Why should I label the collection tube prior to collecting the sample?
This reduces the likelihood of sample mix-up. OralDNA must reject specimens that arrive with no barcode label as positive sample ID cannot be verified.
Can a Rush be placed on testing?
Normal turn-around time (TAT) is approximately four (4) days from receipt in the laboratory. Please call our client services and we will make every attempt to work with your time frame.
Do mouthwashes or lozenges affect results?
Over the counter rinses do not appear to alter test results. However, prescriptions rinses such as chlorhexidine can affect the results.
Does touching the inside cap of the collection tube with an ungloved hand affect the specimen?
Yes, it contaminates the sample and may affect the test results. Please take care to follow the Client Contamination Reduction protocol to avoid contamination and possibly altering test results.
Why is medical history important?
With certain medical conditions, consultation with the patient’s physician may be beneficial prior to periodontal treatment.
What does “Immunosuppressed” on the health history include?
Examples include HIV, Chemotherapy, and Crohn's Disease. Immunosuppressed individuals are more likely to have unresolved periodontal issues.
How do I know if my Credit Card and/or e-check is on file?
This will be established at initial setup through your account executive.
Why do you need collection date & time?
This is necessary for compliance with state and federal regulatory agencies.
How do I choose an appropriate ADA classification?
ADA classification is based on pocket depth. The deepest pocket determines the overall classification. The number of pockets determines the type of infection (localized vs. generalized).
What is GCF?
GCF is an acronym for Gingival Crevicular Fluid.
Can you provide our office with an example time-line of appointments and what to do at each appointment?
We have sample protocol guidelines that an office can use to tailor their specific patient treatment.
Where can I find research on systemic links and periodontal disease?
Our website has a link to many articles that can help.
Are tours permitted at your lab facility?
Yes, by appointment. Please contact your account executive.
What will you do with my PST test sample and PST test result?
We will retain your test sample for up to sixty days following testing and will destroy the sample after that time unless your state law requires us to hold the sample for a longer time. We will retain an electronic copy of your test results, solely for the convenience of you and your dentist, for seven years following your test.
Can health insurers or employers use my test results to block my eligibility for insurance or employment?
First, OralDNA Labs will only provide your tests results to you and your dentist and not to your insurer, or to your employer or potential employer. Second, the Genetic Information Nondiscrimination Act of 2008 (“GINA”) is a federal law that prevents health insurers from using such “genetic information” to deny coverage or charge a higher rate or premium to an otherwise healthy individual found to have a potential genetic condition or genetic predisposition towards a disease or disorder. GINA also makes it illegal for employers to use an employee's genetic information when making hiring, firing, placement, or promotion decisions.
Will you keep my PST information and test results confidential?
OralDNA Labs will not, without your explicit consent, reveal your Patient Information, your Genetic Data, or your Phenotype Information to a third party (other than your dentist who is requesting this test) except as required to provide services you have requested or as required by law. If you would like additional information, we will be happy to forward you a letter that describes our policy related to genetic samples and test results.
Does OralDNA Labs handle genetic counseling questions?
Yes. We are equipped to handle all questions in our Client Services department. We also offer genetic counseling through our affiliation with InterLekin Genetics.
How does MyPerioID PST® relate to MyPerioPath ?
Taken together, the results of these two tests can serve to modify recommendations in the treatment modalities or in the maintenance appointment intervals of a particular patient. With the genetically susceptible individual, a small amount of bacteria can be a bigger problem. Periodontal therapy may need to be more aggressive based on the type/virulence of the infection and the genetic susceptibility of the individual. Such modifications may include: debridement vs. “prophy”, longer (or more frequent) appointments for treatment, adjunctive antimicrobials (such as locally delivered or systemic antibiotics), as well as the use of home irrigation solutions. Closer supervision and more aggressive treatment may be needed.
How does MyPerioID PST® change treatment recommendations?
This test gives insight into the person’s inflammatory response to specific pathogenic bacteria, thus creating a scientific basis for therapy protocols and re-care ("personalized medicine"). A genetic mutation in the individual’s inflammatory response would suggest a more aggressive therapy protocol than otherwise would be called for (more aggressive medication utilized and more maintenance appointments scheduled).
When should MyPerioID PST®be ordered?
MyPerioID PST® is a one-time test that can be performed at the first appointment or at any point during the treatment phase to assess a patient's perio-genetic profile. Knowing this important risk factor will help determine a more accurate diagnosis and prognosis.
