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

HR5 Salivary Testing for More Personalized, Targeted Gum Disease Treatment

Jan 24, 2024 | Gum Disease / Periodontal Health

When you stop to think about just how close the teeth and gums are to the brain, it seems almost obvious that conditions in the mouth can and do affect that most vital of vital organs. The presence of “silver” mercury amalgam fillings is perhaps only the most obvious example of mouth/brain health, since mercury is constantly being released from those restorations and mercury is especially toxic to the brain.

Oral infections can damage the brain, too. This was the case in the death last fall of former Tampa Bay wide receiver Mike Williams. According to the Tampa Bay Times, Williams’ official cause of death was “bacterial sepsis with cerebral abscesses and necrotizing lobar pneumonia due to multiple dental caries and retained tooth roots.”

Then there’s the robust body of literature that has linked gum disease with cognitive decline. What’s more, new research has finally demonstrated a causal link between gum health and brain health.

So yes, maintaining healthy gums is a pretty big deal. Not only has gum disease been linked to brain health; it’s also linked with heart disease, stroke, diabetes, rheumatoid arthritis, chronic kidney disease, and even some cancers.

Yet to diagnose periodontal (gum) disease and develop treatment plans, many dentists continue to rely overwhelmingly on technology invented nearly 90 years ago: the periodontal probe. Unfortunately, a probe can only measure the amount of damage that’s been done by infection in the gingival tissues. It can tell you nothing about the specific pathogens that set the immune process into chronic damage mode, spurring inflammation.

“Because every infection is different,” says Dr. Tom Nabors, Chief of Oral Systemic Medicine at Direct Diagnostics, “it makes zero scientific sense to treat every patient as if they have the same infection.”

We agree – which is exactly why Dr. Grabiak orders a special salivary test for all Denver Dental patients: the HR5 High Risk Pathogen Test. It’s the first step in early detection and prevention.

sample HR5 salivary test results for oral pathogensThis simple screening tool tests a small sample of saliva for five specific bacteria that are especially active in the gum disease process: Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Treponema denticola, Tannerella forsythia, and Fusobacterium nucleatum.

All these are also directly associated with alveolar bone loss – which, if untreated, leads to tooth loss – and contributors to the kinds of systemic inflammatory conditions listed above.

The HR5 test utilizes the latest in qPCR technology, an extremely sensitive laboratory technique that can detect even tiny amounts of specific DNA sequences, allowing us to accurately identify the causal bacteria in infections. It’s the most accurate test of its kind currently available. Testing at the Yale School of Public Health determined its accuracy to be 100%.

So at your very first appointment with us, we’ll take a saliva sample – 1 milliliter is all that’s needed for the test – to send to our lab for analysis. The results come back quickly and complete Dr. Grabiak’s assessment of your current level of periodontal health. Those findings will guide him in creating a personalized treatment plan for you so you can attain the highest level of periodontal health possible.

Strong, healthy teeth need strong, healthy tissues to support them – both the soft gingival tissues and the hard bone that forms the tooth sockets. By taking a personalized approach to your dental care, we’re much more able to help you achieve both, since we can target your unique mouth/body health situation and needs.

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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