EHS Management

Debunking Common Oral Fluid Testing Misconceptions

By Adam Hall

Oral fluid testing, commonly referred to as saliva testing, is rapidly growing in popularity as a reliable method of drug testing. Ease of use, established testing protocols at laboratories and the ability to collect a sample anytime, anywhere only scratches the surface when it comes to the long list of benefits that come with oral fluid testing. However, oral fluid testing is still relatively new in the drug testing industry, which leads to a few misconceptions about this testing method. By taking a closer look at these misconceptions, we can develop a better understanding of the oral fluid testing process and debunk these common misconceptions.

Oral fluid testing eliminates third-party administrators

Oral fluid collections can be completed nearly anywhere, and in most cases, it is a simple process of shipping the sample off to the laboratory for testing. The simplicity of this may lend itself to the idea that a third-party administrator (TPA) is no longer necessary. Although this process can be handled directly by the employer, it is still a good idea to utilize a TPA. TPAs play an important role in the drug testing process as they act as an agent on behalf of the employer. The TPA works to establish connections between the various vendors needed for a successful drug testing program and can help manage the program with the employer. Everything a TPA provides is applicable to the drug testing process as a whole and is not isolated from one test specimen.

Additionally, offering oral fluid testing may increase a TPA’s business by reaching clients who may not fit into the existing model of urine collections. Perhaps an employer wants to utilize oral fluid testing, but their TPA does not offer this service. Adding oral fluid testing as an alternative option may in turn allow a TPA to maintain current clients seeking different options more suitable to their needs. Keep in mind that oral fluid testing does not force a client to make an all-or-nothing decision. Oral fluid testing can be performed in conjunction with other methods of testing to fully satisfy the client’s needs. When a TPA includes oral fluid testing in their menu of services, they not only create opportunities for increased revenue. They also establish the optic that the TPA fully considers what is best for their customers and has the service depth to meet a wide variety of testing needs.

Lastly, self-collections or in-house collections conducted by the employer are not always ideal. In fact, many employers still choose to utilize a TPA to complete the collection process, which in turn allows the employers to focus more on the administrative side of drug testing, such as onboarding or random program management. TPAs commonly staff on-call technicians to accommodate after-hours testing to support employers when they are not available to perform testing.

Oral fluid testing is not permitted in my state

The misconception that oral fluid testing is not permitted in your state may exist due to long standing federal testing regulations, more specifically regulations pertaining to the Department of Transportation (DOT). However, the DOT has recently approved the use of lab-based oral fluid testing for employees covered by DOT regulations. Although approved, oral fluid testing may not be conducted until there are two HHS-certified laboratories to accommodate testing. Aside from the DOT, oral fluid testing is permitted at a non-federal level in all states and for employers regulated by the Substance Abuse and Mental Health Services Administration (SAMHSA). Certain states may have specific requirements pertaining to oral fluid testing, so it is important to understand all state laws prior to implementing oral fluid testing into a drug testing program.

Oral fluid testing is more expensive than other testing methods

Adding oral fluid testing to your drug testing program reduces overall costs associated with drug testing. The actual testing cost per oral fluid sample tends to be lower than its closest counterpart, urine. Aside from lower testing costs, savings are essentially built into the oral fluid collection process. Oral fluid testing affords employers the option of performing sample collections in-house. Training collectors is a simple process of viewing a few instructional videos and walking through the collection process. While there are still key benefits to using a collection provider, utilizing this option can cut down on travel costs and lost time that may be associated with the collection process. Combined, these factors significantly reduce the cost of a drug testing program that includes oral fluid testing, while simultaneously improving the overall efficiency of the program.

Oral fluid is not an effective testing method

Despite not being around as long as urine testing, oral fluid testing is just as effective and accurate. Similar to urine, once an oral fluid sample is collected, it is bottled up and sealed then processed at the laboratory using comparable testing methods that yield equally reliable results. Depending on the goals of an employer’s drug testing program, oral fluid testing may be a more suitable choice for testing as it has benefits that urine testing does not. For example, it is virtually impossible to cheat an oral fluid test because a collection occurs in plain sight of the collector. Additionally, turnaround times for lab-based oral fluid tests are very competitive with urine testing. These examples, along with many others, bolster the desirability and overall effectiveness of oral fluid testing.

Detecting recent use is not useful for employers

In today’s drug testing climate, recent-use detection is becoming more of a critical need for employers. Specifically in states that allow some form of legal marijuana, recent-use detection is of greater concern for workplace safety than the broader history of use other methods of testing yield. Additionally, recent-use detection is ideal in post-accident scenarios where an employer is ultimately trying to determine if impairment was a possible cause of the accident or incident. For instance, a urine test might show a 3-to-5-day history of use for an individual, but those results may not directly correlate to recent impairment. Oral fluid is a better option because the window of detection period is significantly less for most substances, allowing an employer to make a more informed decision following a drug test outcome.

Oral fluid doesn’t offer drug panel customization

Panel limitations may have been a concern in the early days of oral fluid testing, but this is no longer the case when it comes to lab-based oral fluid testing. In fact, the panel options available for oral fluid testing are very similar when compared to urine testing. Based on the employer’s needs, the TPA and laboratory can work together to establish customized panel options that cater to a specific drug testing program. Often, if needed, the pre-determined panel for a lab-based oral fluid test can be adjusted post-collection in the lab process, although the same does not hold true for a rapid device.

The special training required to administer oral fluid testing is inconvenient

If you are familiar with any collection process, whether that is urine, hair or any other method, you are likely aware that some form of training is necessary to successfully conduct a sample collection. While this is no different for oral fluid collection, the simplicity of the oral fluid collection allows for swift, easy-to-follow training guides. In most cases, a collector can begin conducting a successful oral fluid collection in a matter of minutes. Training typically consists of viewing a short video demonstrating the collection process and how to properly store and seal a sample. This shortened process of training personnel makes oral fluid testing ideal for TPAs and/or collection sites that want to hire staff quickly.

Oral fluid only offers lab-based results, not instant

Despite improved turnaround times for lab-based testing results in recent years, lab-based testing simply cannot compare to instant testing options. Like its urine counterpart, instant oral fluid testing options are available. The sample collection process for an instant test is nearly identical to a lab-based test, but with instant testing the sample is tested on-site, immediately following the collection. Within minutes a result can easily be obtained and passed on to necessary recipients. Panel options are similar to lab-based options, giving employers the ability to meet the needs of their drug testing programs. Instant oral fluid testing is a quick and reliable method of testing and maintains all of the benefits associated with oral fluid collections.


Addressing common misconceptions of oral fluid testing reveals many of the benefits oral fluid testing has to offer. Without a proper understanding of how oral fluid testing works or how this method may benefit your company, it is difficult to make the decision to change or to offer oral fluid to your clients. The bottom line is that oral fluid testing is an effective, reliable means of drug testing that more employers are turning to. Key benefits of oral fluid testing are less time-consuming and invasive collections, increases in recent-use detection and the ability to make rapid hiring decisions.


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