Interpreting Bristle Test Results

Comprehensive guide on interpreting Bristle test results.

Interpreting Bristle Test Results
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Comprehensive guide on interpreting Bristle test results.
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The Bristle Oral Health Test provides a complete picture of oral health from a single saliva sample by analyzing all of the good and bad bacteria in the oral microbiome.
Each report contains 7 scores related to health and disease-related conditions. You can read more about what each score means here.
  1. Beneficial Bacteria
  1. Nitric Oxide
  1. Oral Microbiome Diversity
  1. Gum Inflammation
  1. Tooth Decay
  1. Halitosis
  1. Gut Impact

Insights from Test Results


Oral Health Scores

  1. Gum inflammation score: This score measures the level of inflammation in the gums. It indicates the severity of gum disease or periodontal disease. Certain bacteria are known to cause gum inflammation, and this score may help identify the presence and extent of such bacteria in the mouth.
  1. Tooth decay score: This score measures the risk or progression of tooth decay. It takes into account the abundance of specific bacteria that are associated with tooth decay, such as Streptococcus mutans, Streptococcus sobrinus, Bifidobacterium dentium, Scardovia wiggsiae, and others. Higher scores may indicate a higher risk or presence of tooth decay-causing bacteria.
  1. Commensal score: The commensal score evaluates the presence and abundance of bacteria that have a beneficial or symbiotic relationship with the host. These bacteria perform important functions, such as reducing nitrate into nitrite and nitric oxide. A higher commensal score indicates a healthier balance of beneficial bacteria in the oral microbiome.
  1. Halitosis score: This score assesses the presence and severity of bad breath. It measures the abundance of specific bacteria that contribute to halitosis or bad breath. A higher score suggests a higher likelihood of having bad breath-causing bacteria in the mouth.
 

Oral-Systemic & Other Scores

  1. Nitrate reduction score: This score evaluates the ability of bacteria in the mouth to convert nitrate into nitrite and nitric oxide. Nitric oxide is known to have important physiological functions in the body. This score reflects the potential nitrate reduction capacity of the oral microbiome.
  1. Gut inflammation score: This score analyzes microbes that can cause significant gut disruption, either through initiating an inflammatory response or by displacing the normal gut microbes that are important for gut health. The abundance of these microbes are reflected in the gut inflammation score, where higher scores are higher risk for gut inflammation from oral microbiomes.
  1. Diversity score: This score looks at the total microbial diversity of a patient’s sample, taking into account the total number of species in one’s microbiome, and the variance of their abundances. Both extremely low and extremely high diversity can indicate oral microbiome dysbiosis, and a healthy microbiome is somewhere in the middle, generally between 1.5 to 8.5. While diversity alone is not enough to determine the health of a microbiome, it can be an important contributing factor to risk of disease. In general, diversity scores can indicate the stability of a microbiome. Both very high and very low diversity scores are more unstable and likely to change.
 

Contributing Microbes

The Bristle Oral Health Test is the most comprehensive oral microbiome test available. You can read more about the test here.
Our test sequences the whole genome of all microbes in a sample. This method provides us with a few extra layers of information:
  • Broad microbial detection — we can detect bacteria & fungi with our test, instead of only detecting select bacteria.
Why does it matter? This is important because fungi and viruses also play a role in health and disease. Without knowing all of the microbes present, you are missing out on important information and an accurate picture of an individual’s oral health.
Why does it matter? Two species or strains of bacteria can belong to the same genus but have vastly different effects on our health. For example, while most strains of E. coli are harmless, we are all familiar with the strain related to food poisoning. Without knowing which species or strain is present, you can get ambiguous results.
 

Understanding Test Results


Oral Health Report Card

The oral health report card provides a summary of the patient results. This allows you to easily identify areas for improvement. Each result provides a score from 1-10. Scores relate to the condition, with 0 being the lowest and 10 being the highest.
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Health-related scores: a higher score is better
  • A score of “zero” for a health-related condition (such as commensal) indicates the patient has a very low abundance of bacteria that are associated with good oral health. In this case, one goal is to increase the abundance of health-related bacteria and thereby increase the score.
  • A score of “ten” indicates the patient has an extremely high abundance of health-related microbes. In this case, a goal would be maintaining the abundance of health-related bacteria.
 
Disease-related scores: a higher score is worse
  • A score of “zero” for a disease-related condition (such as tooth decay) indicates the patient has a very low abundance of bacteria that are associated with the condition.
  • A score of “ten” indicates the patient has an extremely high abundance of cariogenic microbes. In this case, one goal is to decrease the abundance of health-related bacteria and thereby decrease the overall score.
 

Detailed Results & Data for Each Score

You can click on an individual score in the report card or scroll down to see detailed results. The detailed results section will provide insight into the root-cause of an associated condition and score along with helpful content to interpret and explain the results.
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Detected Microbes

Each score includes a list of detected microbes related to the associated condition.
  1. Species name: Identified microbes include the species name.
  1. Contribution score: Each microbe will include a score from 0-10 indicating how much that particular microbe is driving the overall health or risk score. A higher score indicates that microbe has a greater influence on the resulting score.
  1. Functional tags: Each microbe includes functional details to help guide personalized care decisions.
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Definitions & How Bristle Calculates Scores


Relative Abundance

The relative abundance of a microbe defines how much of the oral microbiome is composed of the related species.
A relative abundance of 0.47 for a microbe indicates that 0.47% of the total oral microbiome is composed of that species. The sum of all relative abundances should equal 100.

Percentile

Relative abundance on its own does not indicate whether a microbe is high or low in relation to the norm. Percentile compares the relative abundance of a given microbe in an individual’s sample against all other samples in our database.
A percentile of 100% indicates that the given microbe is in the highest relative abundance we have detected, while the lowest would be 0%.

Clinical Benchmarks

We partnered with the University of Pacific Dental School to analyze patient oral microbiome samples in the context of physiological symptoms and clinical diagnoses. This provides a “clinical baseline” to understand oral microbiome results in the context of the presence, severity or risk for oral diseases.
Three scores contain comparisons to our clinical data set:
  1. Commensal: this score includes a comparison of your patients’ commensal score to patients who were clinically diagnosed as healthy.
      • If your patient has a score equal to or higher than 6.6 it indicates they have a greater abundance of beneficial bacteria than patients diagnosed as healthy.
  1. Gum inflammation: this score includes a comparison of your patients’ gum inflammation score to patients who were clinically diagnosed as healthy and patients clinically diagnosed with periodontal disease.
      • If your patient has a score equal to or higher than 6.6 it indicates they have a greater abundance of bacteria that drive gum inflammation than patients diagnosed with periodontal disease.
      • If your patient has a score equal to or less than than 3.3 it indicates they have a lower abundance of bacteria that drive gum inflammation than patients diagnosed as healthy.
  1. Tooth decay: this score includes a comparison of your patients’ tooth decay score to patients who were clinically diagnosed as healthy and patients clinically diagnosed with caries.
      • If your patient has a score equal to or higher than 6.6 it indicates they have a greater abundance of cariogenic bacteria than patients clinically diagnosed with caries.
      • If your patient has a score equal to or less than than 3.3 it indicates they have a lower abundance of cariogenic bacteria than patients clinically diagnosed as healthy.
       

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