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Reference

The sixteen organisms on the Oral Balance Test

The Oral Balance Test detects and quantifies sixteen targets in a saliva sample by qPCR: six organisms associated with periodontal disease, two associated with caries, one fungal, three commensal streptococci, and four narG gene detections that measure nitrate-reduction capacity. Each is reported at its own Detection Level rather than as present or absent. The panel measures the oral microbiome and is intended for adjunctive clinical use alongside a dentist's examination.

Written by OraPathReviewed by Jeff McCormack, PhD, HCLD (ABB) · Laboratory DirectorLast reviewed

The sixteen targets

As reported on the Oral Balance provider report. Each target carries its own Detection Level.

GroupCountTargets
Core periodontal pathogens3P. gingivalis · T. denticola · T. forsythia
Amplifiers2A. actinomycetemcomitans · F. alocis
Bridge1F. nucleatum subsp. animalis
Caries bacteria2S. mutans · S. sobrinus
Fungal1Candida spp.
Commensal bacteria3S. salivarius · S. sanguinis · S. mitis
Nitric-oxide producing4Rothia narG · Neisseria narG · Veillonella narG · Actinomyces narG

Why the groups are not interchangeable

The panel is not a list of sixteen equivalent bacteria with sixteen equivalent meanings. The groups answer different questions, and a Detection Level is read against the group it belongs to.

The six periodontal targets are the organisms most consistently associated with periodontal disease in the published literature. The caries targets are associated with a different disease process. The commensal streptococci and the narG group are the side of the ecology that a healthy mouth has more of, not less.

That is why the report separates disruptive pressure from protective capacity rather than producing a single count. Two patients with identical periodontal Detection Levels can have different protective findings, and the report shows both.

Core, amplifier, bridge

Within the periodontal six, the report distinguishes three roles.

Core pathogensP. gingivalis, T. denticola and T. forsythia — are the organisms most strongly associated with periodontal disease, and are frequently reported together in the literature.

AmplifiersA. actinomycetemcomitans and F. alocis — are associated with more aggressive presentations. A. actinomycetemcomitans is reported against tightened Detection Level bands because it is associated with disease at much lower abundance than the others.

BridgeF. nucleatum subsp. animalis — is so labelled because F. nucleatum is described in the literature as a bridging organism in plaque community structure. The Oral Balance Test targets the animalis subspecies specifically rather than F. nucleatum broadly.

The four narG detections are not species counts

This group is easy to misread. The report lists Rothia, Neisseria, Veillonella and Actinomyces, but what is detected in each case is the narG gene — the nitrate reductase gene — associated with that genus, not the organism as such.

The distinction is the point. Detecting a genus tells you an organism associated with nitrate reduction is present. Detecting narG establishes that the gene which performs the conversion is present, and at what level. That is a measurement of functional capacity rather than an inference from taxonomy.

Why *Candida* is on a bacterial panel

Candida is a yeast, not a bacterium. It is included because it is part of the oral microbial community the panel is describing, and because fungal overgrowth is a finding a clinician may want visibility on when reading a bacterial profile.

It is reported on its own Detection Level bands, separate from the bacterial categories.

What a result does not replace

The Oral Balance Test is a laboratory developed test performed by IMMYLabs under CLIA. It has not been cleared or approved by the FDA. Results are intended to support a clinician's assessment alongside an examination and a patient's history, never to replace one.

  1. Socransky SS, Haffajee AD. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134–144.
  2. Kilian M, et al. The oral microbiome — an update for oral healthcare professionals. Clin Microbiol Infect. 2016;22:657–666.

This page lists what the panel measures. It does not describe what any result means for an individual, and no target on the Oral Balance Test diagnoses or rules out a medical condition. The Oral Balance Test is a laboratory-developed test performed by IMMYLabs (CLIA #37D2236199; COLA #32679), validated under CLIA, 42 U.S.C. § 263a. It has not been cleared or approved by the U.S. Food and Drug Administration. Results are for adjunctive use only and must be interpreted by a qualified healthcare provider alongside clinical findings and patient history.

Laboratory developed test · for adjunctive clinical use · not FDA cleared.