Littleton, CO dentist Dr. Guy Grabiak and team celebrate case study award for long-term healthy results with their patient.

Modified Lymphocyte Transformation Test (MELISA)

Modified Lymphocyte Transformation Test (MELISA)

What is this service?

The most frequently allergenic metals are nickel, gold, palladium, cadmium, various mercury compounds, cobalt and chromium. Occasionally, other metals can induce positive responses in MELISA, e.g. beryllium, titanium tin, platinum and copper. These types of metals can be found in dental restorations such as dental fillings, crowns, implants, and orthodontic braces. Other types of exposure can come from orthopedic devices, cardiac and vascular devices, or environmental subjections.

Metal allergies are not typically the first thing that comes to mind when discussing chronic diseases like joint and muscle pain, inflammation, cognitive impairment, depression, headaches, fibromyalgia, skin rashes, and chronic fatigue. However, exposure to metals such as those in certain dental restorations can lead to health problems in susceptible individuals. MELISA is a scientifically proven and clinically validated blood test that detects type-IV allergy to multiple metals, such as mercury, gold, palladium and titanium. It is used worldwide by healthcare professionals to help determine whether patients are hypersensitive to metals commonly used in dental restorations or medical implants. Dr. Grabiak can incorporate MELISA testing to aid the diagnosis of metal hypersensitivity.

What is the procedure?

MELISA Test (Memory Lymphocyte Immunostimulation Assay), evaluates white blood cells (lymphocytes) from whole blood that are isolated and tested against allergens chosen according to the patient’s medical, dental and occupational history. The blood is incubated for five days and the lymphocyte reaction is measured by two separate technologies: one based on the uptake of a radioisotope by dividing lymphocytes; the other on an evaluation by microscopy. The level of reactivity is measured as a Stimulation Index (SI). A value over 3 indicates a positive reaction to a given allergen. Finally, a report is produced.

The MELISA test is not invasive. The prick of a needle in your arm is minimal risk when compared with many of the other tests that are used by clinicians today. A MELISA laboratory needs 20-40 ml of blood depending on the number of metals to be tested. The blood will be drawn into special tubes containing sodium citrate (an anticoagulant). For best results the patient should not be taking any immuno-suppressive medication as this may affect the test results. Examples of such medication are steroids, allergy medicine, anti-inflammatory medicine, painkillers etc. Medical clearance with the individuals prescribing physician may be indicated prior to the cessation of any medications.

What are the benefits?

The MELISA organization was founded to promote research into metal hypersensitivity and its implications in contributing to the development of chronic diseases such as multiple sclerosis and chronic fatigue syndrome. The information gleaned from a single blood sample can be used to create an individualized treatment plan for metal hypersensitivity. Dr. Grabiak frequently recommends MELISA testing when treating patients who have a chronic illness.

Current research has shown that individuals who suffer from metal sensitivity might suffer from chronic fatigue syndrome, joint and muscle pain, cognitive impairment, fibromyalgia, or other autoimmune diseases. In a statement on May 15, 2019 the FDA affirmed, “a growing body of evidence suggests that a small number of patients may have biological responses to certain types of materials in implantable or insertable devices. For example, they develop inflammatory reactions and tissue changes causing pain and other symptoms that may interfere with their quality of life.” Dr. Grabiak and the Denver Dentistry team believe exposure to offending allergens and metals should be minimized or, if possible, avoided altogether. If a patient is allergic to a metal found in dental fillings or dental implants, it is important to consult Dr. Guy Grabiak DMD, FAGD who is experienced in the field of metal-free dentistry. The importance of being protected during removal of mercury fillings (SMART certified office), cannot be overstated.

The foundation of providing safe and personalized holistic care begins by getting to know you and your goals for your oral health and overall health, both short term and long term. Dr. Grabiak will then learn about your family’s dental and medical history, along with your dental and medical history. Afterwards, we begin your exam by taking a sample of your saliva (Sillha), checking for seven different biomarkers. That same day, we will send you home with a report showing how you scored in those different biomarker categories.

The head and neck examination is often overlooked by busy clinicians but it is as crucial as an element of the oral cancer examination. Dr. Grabiak begins his exam outside of the mouth by starting with a soft tissue check of the neck and the jaw. A thorough head and neck examination is essential for detecting early skin cancers, any overdeveloped jaw muscles that may be contributing towards bruxism, and enlarged lymph nodes that may indicate an active virus or infection.

After the extraoral exam, Dr. Grabiak begins his extensive intraoral exam. During Dr. Grabiak’s exam he is evaluating the teeth, uvula, mucosal tissues, tongue, floor of the mouth, hard and soft palate, and the oropharynx. Part of this exam includes taking high-definition photos of the mouth, all at different angles so you can see exactly what he is seeing. Our hygienist will then come in and complete a comprehensive periodontal assessment. In some cases, Dr. Grabiak and your hygienist may recommend additional testing to get to the root cause of the evidence of symptoms they are seeing in your mouth. This entire process takes roughly an hour. In some cases, depending on what Dr. Grabiak and your hygienist had found during their exam we will invite you back for a follow-up appointment called review of findings.

In preparation for the review of findings, Dr. Grabiak and your hygienist will take the time to evaluate all of the data that was collected from your examination and testing to determine your specific needs. At your review of findings appointment Dr. Grabiak will sit down with you one on one to review the data that was collected from your appointment, along with any recommendations. This allows you the time to ask Dr. Grabiak any questions that you may have about your treatment recommendations and expectations from treatment.

Jeromy Mulkey

Jeromy Mulkey

Operations Manager

Jeromy received his Bachelors of Science in Finance from New Mexico State University in Las Cruces, New Mexico. He moved to Colorado in 2015 from Hannibal, New York (a small town outside of Syracuse) and that is when his career in the dental field began. Jeromy started in corporate dental as a patient coordinator and quickly progressed to office manager and then running multiple specialty practices over the next 5 years. Holistic dentistry was an exciting new challenge and Jeromy couldn't be happier with his family at Denver Dentistry. Holistic dentistry was a breath of fresh air and gave a new excitement and passion for learning of all the new sciences and technologies the Denver Dentistry team has integrated into their practice. Jeromy currently lives in Sheridan and enjoys living close to the mountains. In his free time he enjoys spending time with family, snowboarding, playing soccer and basketball, camping, and hiking. Jeromy is passionate about delivering excellent customer service and assisting the team in bringing more smiles to satisfied patients.
Chelsea White

Jazmin Contreras

Dental Hygiene Assistant

In 2020 Jazmin graduated from Colorado Mesa University at the top of her class with a degree in Kinesiology. From a young age Jazmin knew she had a passion and interest in the medical field which led her to gain various experiences in the medical field. However, when she first came to Denver Dentistry, she fell in love with dentistry and knew this was her passion. Dr. Grabiak and his team offered a unique holistic approach to the field; something Jazmin has always been highly interested in. She quickly realized this is where she was meant to be and Denver Dentistry instantly felt like home. In her free time she and her fiance enjoy traveling and participating in outdoor activities like hiking, camping, and kayaking.
Chelsea White

Chelsea White


Chelsea is a born and raised Florida girl and has now been a Colorado resident for 5 years. She has loved dentistry for a long time, and couldn’t see herself in any other profession. Knowing her career path, she went to school at Central Florida Institute to become a dental assistant with an extended program. Graduated in 2012 as a Dental Assistant and as an EDDA, she looks forward to esthetics and happiness with patients. As someone who has been in the field for almost 10 years, she strives to work as a team to meet all expectations with the patient. In her free time she loves to hike, and explore the beautiful places Colorado has to offer.

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