The flagship report
The Oral Ecosystem.
The Balance Test reads sixteen organisms across both sides of the oral ecosystem - the bacteria driving disease and the bacteria protecting against it - and resolves them into scores you can read at a glance and track over time.
Chairside salivary diagnostics
The Oral Ecosystem.
A validated salivary qPCR assay of sixteen organisms - core periodontal pathogens and amplifiers, cariogenic and fungal taxa, weighed against nitrate-reducing and commensal capacity - resolved into the Oral Balance Score and four supporting scores, including a narG-targeted nitric oxide readout and a pattern-based Periodontal Risk Score. Order through the provider portal for chairside use alongside probing and recall.
Why a balance, not a list
Oral health isn't the absence of bad bacteria. It's an equilibrium.
A pathogen panel tells you what's present. It can't tell you whether the mouth has the protective capacity to hold those organisms in check — the commensal gatekeepers and the nitrate-reducing bacteria that keep a community stable.
The Balance Test measures both sides of that ledger. It quantifies the disruptive pressure from periodontal, caries, and fungal organisms, and the protective capacity of the beneficial community — then expresses the relationship between them as a single readout, with the supporting scores beneath it so you can see exactly what's driving the number.
Sixteen organisms, two sides
The protective community on one side. The disruptive on the other.
Every organism on the panel is doing one of two things: helping hold the ecosystem in balance, or pushing it toward dysbiosis. Reading both is what makes a balance possible.
Beneficial bacteria that stabilize the community, exclude pathogens, and supply functional capacity the rest of the body draws on.
Organisms that push the community toward inflammation, demineralization, and cross-kingdom dysbiosis.
The score architecture
One headline number. Four scores that explain it.
The Oral Balance Score integrates the whole picture into a single 0–100 readout. The four scores beneath it show why the number landed where it did — so a provider can move from "where does this patient stand" to "what's driving it" without leaving the page.
Oral Balance Score
A single 0–100 measure of overall microbiome balance — protective capacity weighed against disruptive pressure, with pattern penalties applied where organism combinations represent more risk than their individual levels suggest. Higher is better.
Protective Capacity Score
Higher is betterThe combined strength of the beneficial community — resilience, recovery, and competitive exclusion. Weighted toward functional capacity: 70% nitric oxide system, 30% commensal abundance.
Disruptive Pressure Score
Lower is betterOverall harmful bacterial pressure across the three disease axes, with the single largest contributor surfaced as the "top disruptor" so the priority is obvious at a glance.
Nitric Oxide System Score
Higher is betterThe functional capacity of the nitrate-reducing community — measured at the gene that performs the conversion, not just by which organisms are present. This is the score that ties oral findings to whole-body relevance.
Periodontal Risk Score
1–5 · pattern-basedA pattern-first classification of the six periodontal organisms — driven by which pathogens appear together, not by any single threshold. Reported with the named pattern that produced it. (Detailed below.)
What the protective side actually does
The nitric oxide pathway — measured at the gene.
The beneficial community isn't just "good bacteria" in the abstract. A specific group of them performs a job: converting dietary nitrate into nitrite, the first step in producing nitric oxide — a molecule that supports circulation, immune balance, and tissue healing.
Most tests that include these organisms detect them at the species level — telling you the organism is there, but not whether it's doing the work. The Balance Test targets narG, the gene that codes for nitrate reductase. Detecting it confirms the organism is present and functionally capable of the conversion. That distinction is the difference between counting bacteria and measuring capacity.
Inside the Periodontal Risk Score
Six organisms. The pattern they form is the score.
The Perio Risk Score reads only the six periodontal organisms on the panel — three core pathogens and three amplifiers. It isn't a threshold ("organism X above level Y"); it's a classification of which organisms appear together, because periodontal disease is driven by community structure, not isolated abundance.
From quiet to severe — the pattern ladder
As these six organisms accumulate and combine, the score climbs through five named patterns. Each rung is a recognizable signature, not just a higher count.
From data to decision
The report doesn't stop at scores. It surfaces the next step.
Every Balance Test runs an algorithm that evaluates the full result against a library of thirteen possible recommendations, then surfaces the four highest-priority items for that specific patient — sorted Critical, High, Moderate, Routine. The provider sees what matters most without sorting through everything that doesn't.
Illustrative selection. The algorithm returns the four highest-priority items for each specimen from the full library.
An honest caveat
A balance, read alongside the chair.
A salivary sample reflects the whole mouth, not a single site — which is exactly what makes it useful for reading overall ecological balance, but also why it isn't a substitute for site-specific probing and radiographs.
The scores are most powerful read alongside clinical findings — pocket depths, bleeding, attachment levels, bone — and patient history. The Balance Test is a Laboratory-Developed Test intended for adjunctive use: it adds the microbial and functional dimension to a clinical picture the provider is already assembling. It doesn't replace it.
See it in a real report
Five scores. One conversation your patient can follow.
The Balance Test is available to dental practices and, at home, directly to patients - same lab, same methodology, same report.
The science behind this page
Grounded in published literature.
- Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL Jr. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25(2):134–144.
- Hajishengallis G. Periodontitis: from microbial immune subversion to systemic inflammation. Nat Rev Immunol. 2015;15:30–44.
- Darveau RP, Hajishengallis G, Curtis MA. Porphyromonas gingivalis as a potential community activist for disease. J Dent Res. 2012;91(9):816–820.
- Lundberg JO, Weitzberg E, Gladwin MT. The nitrate–nitrite–nitric oxide pathway in physiology and therapeutics. Nat Rev Drug Discov. 2008;7:156–167.
- Hyde ER, et al. Metagenomic analysis of nitrate-reducing bacteria in the oral cavity. PLoS One. 2014.
- Kreth J, Merritt J, Qi F. Bacterial and host interactions of oral streptococci. DNA Cell Biol. 2009.