Your mouth makes a molecule your circulation depends on.
Nitric oxide starts as nitrate in leafy greens and beets — and it takes specific bacteria in your mouth to perform the conversion before your body can finish it. The Oral Balance Test measures whether yours still can, from one saliva sample you collect at home.
$199 · one-time · ships free
Not yet available in AK, CA, CT, HI, MD, MA, NJ, NY, RI.
Four scores, not one number.
The report doesn't hand you a single wellness rating. It separates the load pushing toward inflammation, the defenses holding it back, and one specific functional capacity most people have never had measured — because those three move independently, and which one is off changes what you'd do about it.
Inflammatory load
The organisms associated with periodontal inflammation, each named and levelled. This is the side the systemic research is about, and the side you can put a number on today.
Protective reserve
A healthy mouth isn't one without harmful bacteria — it's one with enough good ones. Protective Capacity is part of why the same bacterial load affects two people differently.
Nitric-oxide capacity
The functional one. We target the narG gene that performs the nitrate conversion, so the score reflects what your microbiome can actually do rather than which species happen to be present. Detailed below.
The same bacteria turn up in more than one conversation.
Evidence is much stronger in some of these areas than others, so each one below says which — the same way the report does.
The common thread is inflammation. Periodontal organisms drive it in the gums, and inflammation is the mechanism researchers point to when they look for effects further away. That is why one saliva measurement is relevant to more than one system — and why it measures bacteria, not any of these conditions.
Heart & blood-vessel health
Several of the organisms on this panel have been repeatedly associated with cardiovascular disease. The leading explanation is inflammation — these organisms and the gum inflammation they drive contributing to the low-grade, body-wide inflammation involved in narrowing of the arteries. The American Heart Association recognises an association between gum disease and heart disease.
Paul 2021 · Sanz 2020 · Genco & Sanz 2020
Blood sugar & metabolic health
This one runs in both directions: poorly controlled blood sugar can worsen gum inflammation, and the inflammation from periodontal bacteria can make blood sugar harder to control. If you have diabetes or prediabetes, it's a connection worth raising with whoever manages it.
Preshaw 2012, Diabetologia
Brain health & memory
Certain oral bacteria — P. gingivalis in particular — have been connected to brain health and the inflammation involved in conditions like Alzheimer's. Active, still-developing research, not a settled conclusion.
Dominy 2019, Sci Adv
Joints & body-wide inflammation
The bacteria that inflame gums may contribute to inflammation elsewhere, and researchers are studying links to inflammatory joint conditions such as rheumatoid arthritis. Evidence here is still emerging.
Hajishengallis 2015, Nat Rev Immunol
Colorectal health
F. nucleatum — the subspecies measured here — has been found enriched in colorectal tumour tissue. This is not a cancer test and says nothing on its own about your colon; the bacterium is common in the mouth. Age-appropriate screening remains the reliable step here.
Zepeda-Rivera 2024, Nature · Castellarin 2012 · Brennan & Garrett 2019
How to read the labels: well-established means the association is strong and repeatedly confirmed in research; supported means the evidence is consistent and growing; emerging means the link is biologically plausible but still under active study.
None of these describe your personal likelihood of developing any condition — only whether the organisms studied in connection with it were found in your sample. The Oral Balance Test measures your oral microbiome; it does not diagnose gum disease, cavities, or any medical condition, and it is not a substitute for medical or dental care.
The nitric oxide pathway starts in your mouth — and it can stall there.
Certain bacteria in your mouth do something most people never learn about: they help turn the nitrate in leafy greens and beets into nitric oxide, a molecule your body uses for healthy blood flow and circulation. The conversion starts in the mouth. Without the right bacteria, the pathway stalls before your body can finish it.
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Dietary nitrate
Leafy greens, beets and similar foods are eaten.
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Concentrated in saliva
Nitrate is absorbed and concentrated back into saliva.
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Oral conversion
Your bacteria convert nitrate to nitrite. This is the step that depends on which organisms you have — and the one we measure.
The step we measure -
Becomes nitric oxide
Nitrite is swallowed and converted further into nitric oxide.
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Blood flow
Nitric oxide is associated in research with healthy blood flow.
What most products assume
That the oral step is working
Nitrate supplements, beet powders, and NO boosters all depend on this conversion happening in your mouth. None of them check whether it does. If your oral bacteria can't perform the step, more nitrate doesn't finish the job.
What we measure
The gene that does the work
We don't just check whether nitrate-reducing species are present — we target the narG gene that performs the conversion. Detecting that gene tells us the capability is actually there, not just that a related organism happens to be present. That's why we can describe this as functional capacity rather than a simple count.
The systemic links here are associations reported in research, not conclusions about any individual. What your score reflects is the oral step of the pathway. The Oral Balance Test measures your oral microbiome; it does not diagnose gum disease, cavities, or any medical condition.
One sample. Four steps.
No appointment, no lab visit, no fasting.
Order your kit
Buy online and we ship a complete saliva collection kit to your door — free.
Collect at home
Follow the simple instructions to give a small saliva sample. About two minutes, no appointment, no swab and no blood.
Mail it back
Seal it in the prepaid return envelope and drop it in the mail. It heads straight to our CLIA-certified lab in Norman, Oklahoma.
Read your results
About a week from the day you mail it — most of that is transit, since your sample is processed within 2 business days of reaching our lab. Your full Balance Report lands in your private OraPath account.
Every organism named, every claim tiered.
No wall of numbers and no unqualified claims. You can read the entire five-page sample report before you order — including the systemic page and the limits it states about itself.
- One headline score, then the reasons An Oral Balance Score out of 100, then the three subscores that produced it — so the summary never hides which side moved.
- A page on systemic associations Heart, blood sugar, brain, joints and colorectal — each labelled by evidence strength and cited, with the ones relevant to your sample first.
- Protective capacity and disruptive pressure Your defense on one side, your bacterial load on the other — the pairing is the part that actually explains your result.
- All sixteen organisms, individually Including the nitrate-reducing group — Rothia, Neisseria, Veillonella and Actinomyces — with a plain-language read on each.
Common questions
I already take a nitric oxide supplement. Why would I test?
Because the supplement can't do the step your mouth does. Nitrate — whether it comes from beet powder or a salad — has to be converted to nitrite by bacteria on your tongue before your body can finish making nitric oxide. If those bacteria aren't there, or aren't carrying the gene that performs the conversion, more nitrate doesn't complete the pathway. This tells you whether the step you're feeding is actually working.
Does mouthwash affect this?
It's a fair question to ask of any antiseptic rinse. Antiseptic mouthwashes don't pick favorites — they knock back the helpful bacteria right alongside the rest, which is one reason the “nuke everything” approach can backfire. Your report shows where your nitrate-reducing group actually stands, which is a more useful basis for a decision than a general rule.
Is this a diagnosis?
No. The Balance Test measures bacteria in your saliva. It doesn't diagnose gum disease, cavities, or any medical condition, and it isn't a substitute for a dental exam. The systemic connections described here are associations reported in research, not conclusions about you specifically. Your results are meant to be reviewed by a professional alongside an examination and your history — bring your report to your next appointment and go through it together.
Can I retest to see whether anything changed?
Yes — that's where the test earns its keep. Most people tracking an intervention retest at 60 to 90 days, then settle into roughly every six months once things are stable. Each Detection Level step is about twice as much bacteria as the one below it, so the comparison is readable rather than a matter of interpretation.
How long until I get results?
Your report is ready within 2 business days of your sample reaching our lab — about a week from the day you mail it, once transit both ways is counted. You'll get it in your private OraPath account.
How accurate is an at-home saliva test?
It's the same validated test dental practices order — run in our own CLIA-certified, COLA-accredited lab on the sample you collect. Saliva collection is simple and hard to get wrong, and the lab work is identical to an in-office order. The Oral Balance Test is a validated Laboratory-Developed Test; it has not been cleared or approved by the FDA.
Which states do you ship to?
We ship the at-home Balance Test to most US states, but not yet to AK, CA, CT, HI, MD, MA, NJ, NY, RI. Those states apply extra requirements to at-home lab testing, and we've held them back from this first launch rather than cut corners. We're working through them.
If you're in one of those states and want the test, ask your dental practice — they can order OraPath panels for you directly.
Also from OraPath
Ora-Protek daily oral probiotic
A daily dissolvable lozenge with 16 clinically studied probiotic strains, including BLIS K12 and M18. Ships to all fifty states — including the states the test can't reach yet. Multi-bottle pricing from $25.00 per bottle.
Find out whether your pathway still works.
One saliva sample, collected at home, measures the oral step the whole pathway depends on — plus your protective reserve and the bacterial load working against it.
Results in your private OraPath account · not a diagnosis — meant to be reviewed with your dentist alongside an exam.