Sir,Singh et al. reported an observation on “salivary tumor necrosis factor-α (TNF-α) and periodontal destruction.[1]” Singh et al. concluded “diabetes status increased TNF-α significantly in comparison to smoking in chronic periodontitispatients.[1]” In the present report the consideration is on the confounding factors, such as other concomitant pathology or risks (such as smoking), which might affect salivary TNF-α. In a previous report by Yousefimanesh et al., it was reported “this biomarker cannot seem to be a good index to evaluate or predict periodontal disease.[2]” In addition, it is also questionable about the diagnostic property of the salivary TNF-α for differentiate of severity of destruction. Finally, it will be more useful if a comparative study with other markers (such as salivary cotinine[3] or immunoglobulin[4]) to compare efficacy and cost-effectiveness.