Dear Editor:In response to comment [1] on our published article [2], we would like to point out that cancer has indeed different pathways involving oxidative stress, hormonal factors, inflammation, and others. As such, cancer is considered a multi pathway disease, involving various diagnostic markers. In this way, salivary biomarkers may be multiple (8-hydroxy-2-deoxyguanosine, malondialdehyde (MDA), vitamin C, and vitamin E) but at the same time also present some further challenges to act as diagnostic biomarkers of oral pre-cancer and cancer.Variations in salivary MDA level are caused by different collection time, different storage time, time from collection to analysis or collection to storage, and analysis methods. In the present study, a standardized method of collection was followed, i.e., drooling method with minimum time for storage and standardized analysis parameters, in order to enable reproducing results. At the same time, and in combination with other biomarkers, salivary MDA as an oxidative biomarker may be considered a reliable biomarker for oral pre-cancer and cancer [3][4][5]. Considering both aforementioned factors, it can be stated that salivary MDA may be a reliable biomarker if standardized methods of collection, storage, and analysis are followed [3][4][5].