People often use the term - "real" to differentiate between Cultured pearls, (that they term "real" pearls) and Imitations Pearls.
Natural pearls are in a class of their own. These pearls are completely "natural" and formed without any intervention from man.
Observation of the drill holes of the pearls might be less destructive. Drill holes leave there own clues however, If the pearls are not drilled through the middle of the pearl, one of the best ways of identifying cultured pearls is the test method called the "tooth-test"! The idea is not to scratch the pearl though as this could destroy the pearl. There isn't a market for scratched pearls.