Frequently Asked Questions

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Common questions about the Bristle test, logistics, etc.

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General Information for Provider Partners

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Bristle Testing Which bacterial species are detected?Does Bristle test for HPV and other viruses?What method does Bristle use for testing?What research supports your test?Ordering & Payment Can the test be used for children under the age of 18?Is the Bristle test reimbursed by dental or medical insurance?Can patients use their HSA/FSA to pay for the test?Sample Collection & Results Does the collection kit have an expiration date?What is the clear liquid that is in the collection tube?After the sample is collected, does it need to be refrigerated or shipped back in any particular way?What is the turnaround time on receiving results?Why is the turnaround time longer than other salivary tests?Data & Privacy How is patient personal information and data protected?Does Bristle sell any patient data to third-parties?Does Bristle analyze and store human DNA?Is Bristle CLIA compliant?

Still have questions? Please email providersupport@bristlehealth.com.

Bristle Testing

Which bacterial species are detected?

The Bristle test analyzes all 700+ unique bacterial species found in the oral cavity, both beneficial and pathogenic. On average, an individual tested will have ~75 – 150 unique species of bacteria detected in their saliva.

Each report includes a full breakdown of the bacteria detected including both the identity (names) as well as the relative abundance levels (quantity) of each species that was detected.

Does Bristle test for HPV and other viruses?

We do not currently report on HPV or other viruses. While the sequencing technology we use does enable us to detect viruses, there are a few technical challenges that must be solved to prevent over-reporting false negatives. Viruses are significantly smaller than bacteria and we want to ensure we can accurately detect and quantify them.

Over time we do anticipate being able to include HPV detection in our test results but we do not currently have a projected timeline.

What method does Bristle use for testing?

Bristle uses shotgun metagenomic sequencing, a form of next-generation sequencing (NGS), to analyze saliva samples. With this technology, Bristle completes whole-genome sequencing on all microbial DNA found in a sample, which enables detection of all bacterial species present rather than a predetermined subset.

You can read more about different sequencing technologies and how they compare in this guide.

What research supports your test?

The Bristle test and supporting database was created in collaboration with the University of the Pacific Dugoni School of Dentistry via a joint research study. You can read more about the development, validation, and accuracy of the Bristle test in this white paper.

Ordering & Payment

Can the test be used for children under the age of 18?

We have done some pilot testing with children and have found that their oral microbiomes shift quite significantly, especially depending on the patient's age. Our test can be used to identify and quantify the microbes that are found in a child's saliva (e.g., levels of S. mutans), but our report including the high-level condition scores & recommendations are currently geared towards adults. This is because our current database, in part built from our research study with the University of the Pacific Dental School, is comprised of adult samples (18+ years old).

There are certainly instances where it may be helpful to use a Bristle test with children to understand the makeup of their oral microbiome and see if there may be microbial drivers for certain conditions/diseases the patient may be exhibiting. Our test has and can be used with children under the age of 18 with parental consent, but given the above we do not currently market it.

Is the Bristle test reimbursed by dental or medical insurance?

There are a number of applicable CDT codes that exist, but most insurers do not provide reimbursement for salivary testing at this time.

Can patients use their HSA/FSA to pay for the test?

Bristle tests are eligible for reimbursement by most FSA and HSA plans. Since every plan is different, we advise that you check with your plan to confirm that the Bristle test is eligible.

Sample Collection & Results

Does the collection kit have an expiration date?

Your Oral Health Test kit can be used up to 6 months after it is delivered. Our sample collection kit stabilizes your saliva sample so that it can be properly tested after a period of time. We recommend shipping your saliva sample back to our lab within two weeks of collection to ensure the quality of your sample and accuracy of your results.

What is the clear liquid that is in the collection tube?

This is called a "buffer" solution and helps preserve your sample after you send it back to us for analysis. We provide you with two collection tubes in each kit in case you spill the first one. Our buffer is non-toxic but we do not recommend consuming it.

After the sample is collected, does it need to be refrigerated or shipped back in any particular way?

No! Since there is a buffer solution in each collection tube that stabilizes the sample, there is no refrigeration or other requirements for shipping back the sample to Bristle’s laboratory.

What is the turnaround time on receiving results?

Our standard turnaround time is 2-3 weeks from when the sample is returned in the mail, to when you will be able to access the patient report in your dashboard.

Why is the turnaround time longer than other salivary tests?

The technology and process we use to analyze the entire microbiome (sequencing) takes 8 days to complete. Our lab begins the sequencing process every Monday, so if a sample is received late on Monday and doesn’t make it into queue, it can take up to 15 days for it to complete the full sequencing process. The average shipping time to return the sample is 3-5 business days, which is why we say the turnaround time can be 2-3 weeks in total.

Data & Privacy

How is patient personal information and data protected?

We fiercely protect your privacy every step of the way — we will never share your personal data without your consent. Even with consent, we will only ever share your data to advance oral health research or at your request. Bristle implements several physical and technical security measures to ensure confidentiality, integrity, security, and availability of Bristle and user data by employing industry standard safeguards such as de-identification, pseudonymization, encryption, and data segmentation. You control how your data is used, stored, and shared. For more information, see our full privacy policy here.

Does Bristle sell any patient data to third-parties?

We will never sell your data. Our mission is to empower our users to better understand their oral health to lead healthier and happier lives. We give you choices to control how your personal information is used, stored, or shared. You can request your data and sample be removed from your account by contacting support@bristlehealth.com. Want to learn more? Check out our terms of service here.

Does Bristle analyze and store human DNA?

Regarding Bristle saliva samples, inevitably there is human DNA that is captured during laboratory processing. However, each saliva sample goes through a process known as "host depletion" where we attempt to remove as much human DNA as possible so that we can get the most signal from the microbiome.

After sequencing, we use bioinformatic methods to remove all human DNA from analysis and store only data related to bacteria, viruses, and fungi from a given sample. We would be unable to share patient information related to human DNA from our samples as we don’t use or store that data.

Is Bristle CLIA compliant?

Yes — Bristle tests are analyzed in a U.S. laboratory that is certified by CLIA standards. A CLIA certified lab must meet strict quality standards and ensure both the accuracy and validity of your results.