Sir,In the study of Singh et al.,[1] salivary tumor necrosis factor-alpha (TNF-alpha) showed significant variation among the groups and co-related with the systemic and smoking status, which are, although not in the ambit of the study of Singh et al., known to result greater periodontal tissue destruction.[23] This inference suggested TNF-alpha as a marker of severity of periodontal destruction. Furthermore, Singh et al. underlined the respective influence of both the confounders upon Salivary TNF-alpha levels suggesting a role of TNF-alpha in pathogenic influence of these conditions upon existing periodontitis.Ultimate use of salivary TNF-alpha as biomarker would require not only the baseline salivary TNF-alpha levels across racially varied populations, but also an estimation of the influence of these socially prevalent confounders. It will also be useful to establish an independent influence of systemic confounders like diabetics and to smoke on salivary TNF-alpha to understand undiluted role of these conditions in periodontitis subjects in both health and disease.