Frequently Asked Question

1) Who we are?

Lab srl is a company founded by dentist for dentists. See also here.

2) What’s the aim of parodonatal bacterial test?

Periodontal bacterial test sets the level of patient’ oral hygiene and identifies the presence of aggressive bacteria for the periodontum. These are key elements to plan any dental treatment.

3) Why perform the test?

Since 30% of adult population is affected by periodontal disease, then 30% of children are potential candidate to develop it. Identify these individuals let dentist to perform prevention protocols.

4) The diagnosis of parodontal disease is made by the clinician. Why use also a laboratory test?

A quantity test is able to identify subclinical situations (i.e. without clinical signs but with pathogenic bacteria) and to implement / verify the effectiveness of therapies also in “healthy” patients. In periodontal disease the bacterial test measures the extent of the problem in an objective way.

5) Why pay laboratory test if the goal of therapy is to maintain a high level of oral hygiene?

Because the test is like a "thermometer", that allows dentist to check the efficacy of therapy (such as scaling, curettage, surgery, laser, antibiotics, gels and mouthwashes).

6) Can I performe prosthetic rehabilitation, implantology, orthodontics if the bacterial test is positive?

Although the oral cavity is not sterile, the execution of complex treatments must take place when bacterial load is low. If the test is positive, oral cavity should be cleaned. Afterwards dentist has to repeat the test, and if it is negative he will proceed safely. This will be useful to demonstrate how the medical procedure or surgery has been performed without negligence or imprudence.

7) Is the test useful in legal quarrels?

The test is an objective exam (such as x-rays) and it make a photo of the case in a sensitive and specific way. If implantologist performs surgery in conditions of controlled bacterial charge but then the home care of the patient is insufficient, this can be documented.

8) Who performs the sampling?

Dentists or hygienists usually perform test since they have skills and instruments to sample under the best conditions (absence of contamination, proper lighting and instrumentation). Also family doctor, paediatrician, or of any other medical doctor can use LAB test.

9) Can the patient perform the sampling by himdelf?

It’s better that dentist or hygienist perform test. However, it is possible that patient perform sampling by himself.

10) If there is a family history of periodontitis and some relatives have lost teeth, it is possible to know if other relatives are at risk?

Yes, the genetic LAB test screen some genes related to an higher risk of periodontal disease.

11) There are other tests on the market with higher cost. Are they better?

No. The cost of LAB test is low because is based on high technology that has high performance and low cost.

12) Why other tests (like pregnancy tests) have a lower cost?

Because they are self-testing (made by the patient himself), not certified and with a single answer YES / NO (not quantity). They evaluated a single marker and are based on antigen-antibody reaction while LAB tests are based on the extraction and amplification of DNA in a specialized laboratory.

13) Why dentist or hygienist should charge the patient for an additional cost?

It is not an additional cost but an “added value”. In fact the patient perceives that doctor check the effectiveness of therapy.

14) What is the best test for orthodontic patients?

Genetic test should be done in all young patients without signs of periodontal disease. Micro-biological test should be done in adults or young patients with pour oral hygiene.

15) Why do tests in diabetics, smokers, immunosuppressed patients or subjects treated with bisphosphonates or with heart valve?

These people have a higher risk to bacterial colonization, lower defences and greater difficulty in healing. The LAB test allows to define the bacterial load in order to reduce it before any treatments.

16) Is test difficult to be performed or painful?

Test sampling is simple and painless. A sterile paper tip is placed in sulcus between gingival and tooth. Crevicular fluid is adsorbed on it. The procedure is repeated with at least one additional paper tip in the same tooth area (if there is pus or bleeding) , or in all 4 quadrants if dentist wants to have a mean value of periodontal pathogens. Paper tips are then placed (without touching them) into a tube and this is inserted in a plastic small bag together with a label filled with doctor and patient’s data.

17) How to send the kit to LAB srl?

After having placed plastic tube with paper tips and filled label in a the small plastic bag, doctor can post everything to LAB srl headquarter. Payment proof should be enclosed. Test report will be send by e-mail.

18) How read/understand LAB reports
19) Why LAB report have few explanations ? More detailed writings might be useful to understand results?

It would be easy to write a long description but Lab report is similar to blood test. In fact:

A – The report must be based only on investigated variables (i.e. genetic haplotypes) and not on patient’s clinical habits (i.e. smoke) or signs. Only clinician can combine lab test and clinical parameters (such as smoking, diabetes, pregnancy) to get the final patients risk assessment.

B – The laboratory reports SHOULD NOT and CAN NOT give therapeutic guidelines; Therapy is provided by doctor/dentist.

20) How assess lab quality?

Scientific research published in international journals is a way to check the company’ reliability. In the “scientific publications section” there are several reports produced by LAB team.

21) It could be important to investigate a larger number of bacteria?

There are about 25,000 different species of bacteria in oral cavity. It is technologically possible to analyze most of them but this is extremely expensive and not useful from clinical point of view. The objective of LAB srl is to provide a useful and chip test. The selected bacterial profile is based on bacterial species which are sufficient to make an appropriate molecular diagnosis (to the today knowledge).

22) Does a screen of wider number of genetic markers important?

Up-today, only few genes are internationally accepted to be related to chronic periodontal disease. These are those used in our report.

23) Should the sampling be performed in a single or in multiple sites?

Single sampling is useful in case of peri-implantitis or if a single tooth has an abscess. Four quadrants sampling is useful to get a general view of bacterial status. The first sampling is indicated in acute inflammation, the second in chronic disease.

24) Antibiogram (laboratory testing based on coltures) or PCR test?

Antibiogram is useful to detect the sensitivity of an isolated bacterial strain to different antibiotics but 1) some anaerobic bacteria are difficult to be selected and therefore there is the risk of “losing” some microbial species, 2) It takes times, 3) It is expensive, 4) there are dental therapies based on physical instrument (such as laser) and in this case antibiogram is not useful.