Support for the Benefits of Using Oral Probiotics for Gum Disease, Tooth Decay, Halitosis and other Health Benefits
Its principal findings were that: under the given conditions, the probiotic therapy resulted in additional clinical beneﬁts in moderate and deep pockets and in lower P. gingivalis numbers. Further the study stated these practical implications: The use of this probiotic supplement during 3 months as an adjunct to scaling and root planing can be considered a valuable treatment option.
Aim: The aim of this randomized placebo-controlled clinical trial was to evaluate the effects of Lactobacillus reuteri-containing probiotic lozenges as an adjunct to scaling and root planing (SRP).
Material and Methods: Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15)group. The lozenges were used two times a day for 12 weeks.
Results: At week 12, all clinical parameters were signiﬁcantly reduced in both groups, while there was signiﬁcantly more pocket depth reduction (p < 0.05) and attachment gain (p < 0.05) in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.
Conclusions: The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
Abstract Objectives: A double-blind, randomised, placebo-controlled clinical trial was performed to validate the hypothesis that the use of lozenges containing Lactobacillus brevis CD2 (Inersan®, CD Investments srl) may reduce plaque pH, salivary mutans streptococci (ms) and bleeding on probing, during a 6-week period, in a sample of high caries risk schoolchildren.
Methods: A total of 191 children (aged 6–8 years), presenting two to three carious lesions and a salivary ms concentration of ≥105 CFU/ml, were enrolled and divided into two groups, an L. brevis CD2 lozenge group and a no L. brevis lozenge group, and examined at baseline (t0), after 3 weeks (t1), after 6 weeks of lozenge use (t2) and 2 weeks after the cessation of lozenge use (t3). Plaque pH was assessed using the microtouch technique following a sucrose challenge. The area under the curve (AUC5.7 and AUC6.2) was recorded. Salivary ms were counted, and bleeding on probing was assessed.
Results: At t0, the plaque-pH and ms concentration values were similar in both groups. Mean areas (AUC5.7 and AUC6.2) were significantly greater in the control group at t1, t2 and t3. L. brevis CD2 lozenges significantly reduced salivary ms concentrations and bleeding. The subjects from the test group showed a statistically significant decrease (p = 0.01) in salivary ms concentration. At t2, a statistically significantly lower bleeding value was recorded in the test group compared with the control group (p = 0.02).
Conclusions: Six weeks’ use of lozenges containing L. brevis CD2 had a beneficial effect on some important variables related to oral health, including a reduction in plaque acidogenicity, salivary ms and bleeding on probing. (Trial Registration Number NCT01601145 08/21/2012)
The studies conclusions were: that the use of probiotic strains for caries prevention showed promising results even if only few studies have demonstrated clear clinical outcomes. Therefore, the scientific evidence is still poor. A continuous regular almost daily intake is probably required; this maybe a compliance aspect to be considered. However, for all products effective in caries prevention (i.e., fluoride and chlorhexidine) a frequent intake is required, so a possible way of administration could be to insert probiotic in other daily preventive products like toothpaste.
For some decades now, bacteria known as probiotics have been added to various foods because of their beneficial effects for human health.
The mechanism of action of probiotics is related to their ability to compete with pathogenic microorganisms for adhesion sites, to antagonize these pathogens or to modulate the host’s immune response.
The potential application of probiotics for oral health has recently attracted the attention of several teams of researchers. Although only a few clinical studies have been conducted so far, the results to date suggest that probiotics could be useful in preventing and treating oral infections, including dental caries, periodontal disease and halitosis. This article summarizes the currently available data on the potential benefits of probiotics for oral health.
Objective: (1) To investigate the effect of probiotic bacterium Lactobacillus paracasei SD1 on the level of salivary mutans streptococci and lactobacilli, and (2) the oral persistence of L. paracasei SD1 in orthodontically treated nonsyndromic cleft lip and palate patients.
Design: Double-blinded, randomized, placebo-controlled study.
Participants: A total of 30 orthodontically treated nonsyndromic cleft lip and palate patients (aged 19.22 ± 3.66 years): 15 in the intervention group (A) and 15 in the control group (B).
Interventions: Milk with or without L. paracasei SD1. Average daily consumption of milk in both groups was 50 mL for 4 weeks.
Main Outcome Measures: Salivary mutans streptococci and lactobacilli were enumerated using a quantitative differential culture at baseline and once a week after the end of the administration period for 4 weeks. The persistence of L. paracasei SD1 was traced using arbitrarily primed polymerase chain reaction of the DNA fingerprinting.
Results: A statistically significant reduction in mutans streptococci counts occurred in group A, in contrast to group B (P < .001). A significant increase of lactobacilli numbers was found in group A (P < .001), and L. paracasei SD1 could be detected up to 4 weeks following cessation of dosing.
Conclusions: The probiotic milk powder containing L. paracasei SD1 could reduce mutans streptococci counts and was apparently able to colonize the oral cavity of the orthodontically treated cleft lip and palate patients. However, the potentially beneficial influence of the probiotic milk on the complex oral microflora justifies further studies with a larger group of volunteers.
A randomized, placebo-controlled, double blind study was performed over 2 weeks. Fifty-nine patients with moderate to severe gingivitis were included and given one of two different Lactobacillus reuteri formulations (LR-1 or LR-2) at a dose of 2×10(8) CFU per day, or a corresponding placebo.
At baseline (day 0) gingival index and plaque index were measured on two surfaces and saliva for lactobacilli determination was collected. The patients were instructed how to brush and floss efficiently and study treatment was started. The patients returned on day 14 for final assessment of gingivitis and plaque and slaiva was collected. 20 patients were randomized to LR-1, 21 patients to LR-2 and 18 to placebo.
Gingival index fell significantly in all 3 groups. LR-1 but not LR-2 improved more than placebo.
Plaque index fell significantly in LR-1 and in LR-2 between day 0 and day 14 but there was no significant change in the placebo group. At day 14, 65% of the patients in the LR-1 were colonized with Lactobacillus reuteri and 95% in the LR-2 group.
Lactobacillus reuteri was efficacious in reducing both gingivitis and plaque in patients with moderate to severe gingivitis.
Matsumoto A, Takemoto T.
A study in several parts beginning with the effect of different probiotics on the growth of Streptococcus mutans (a bacterium correlated with the risk of caries). A laboratory screening of probiotic bacteria isolated from 18 different fermented dairy products available in Japan showed that L. reuteri was the only strain that inhibited the growth of S. mutans.
A further laboratory study verified that L. reuteri had no harmful effect on dental enamel. A clinical study was also performed in which 40 subjects with healthy mouths took part. Half of them ingested 95 g daily of yoghurt containing L. reuteri with their lunch, while half ingested the same quantity of a placebo yoghurt.
After 2 weeks the groups changed the study product and the subjects thus served as their own controls. Both groups showed a significant decrease in the number of S. mutans in the saliva during the 2-week period when ingesting L. reuteri. The group which started with L. reuteri yoghurt, also showed a significantly inhibiting effect on S. mutans in the two subsequent weeks when ingesting the placebo yoghurt.
Conclusion: The daily ingestion of yoghurt containing L. reuteri for a period of two weeks significantly reduced the number of Streptococcus mutans in the saliva of healthy subjects. This effect was consistent also for at least two weeks after ending the intake of the probiotic yoghurt. L. reuteri was the only bacterium in a laboratory screening test
To catalog what is known about the safety of interventions containing Lactobacillus, Bifidobacterium, Saccharomyces, Streptococcus, Enterococcus, and/or Bacillus strains used as probiotic agents in research to reduce the risk of, prevent, or treat disease.
We searched 12 electronic databases, references of included studies, and pertinent reviews for studies addressing the safety of probiotics from database inception to August 2010 without language restriction.
We identified intervention studies on probiotics that reported the presence or absence of adverse health outcomes in human participants, without restriction by study design, participant type, or clinical field. We investigated the quantity, quality, and nature of adverse events.
The search identified 11,977 publications, of which 622 studies were included in the review. In 235 studies, only nonspecific safety statements were made (“well tolerated”); the remaining 387 studies reported the presence or absence of specific adverse events. Interventions and adverse events were poorly documented.
A number of case studies described fungemia and some bacteremia potentially associated with administered probiotic organisms. Controlled trials did not monitor routinely for such infections and primarily reported on gastrointestinal adverse events. Based on reported adverse events, randomized controlled trials (RCTs) showed no statistically significantly increased relative risk (RR) of the overall number of experienced adverse events (RR 1.00; 95% confidence interval [CI]: 0.93, 1.07, p=0.999); gastrointestinal; infections; or other adverse events, including serious adverse events (RR 1.06; 95% CI: 0.97, 1.16; p=0.201), associated with short-term probiotic use compared to control group participants; long-term effects are largely unknown. Existing studies primarily examined Lactobacillus alone or in combination with other genera, often Bifidobacterium.
Few studies directly compared the safety among different intervention or participant characteristics. Indirect comparisons indicated that effects of delivery vehicles (e.g., yogurt, dairy) should be investigated further. Case studies suggested that participants with compromised health are most likely to experience adverse events associated with probiotics. However, RCTs in medium-risk and critically ill participants did not report a statistically significantly increased risk of adverse events compared to control group participants.
There is a lack of assessment and systematic reporting of adverse events in probiotic intervention studies, and interventions are poorly documented. The available evidence in RCTs does not indicate an increased risk; however, rare adverse events are difficult to assess, and despite the substantial number of publications, the current literature is not well equipped to answer questions on the safety of probiotic interventions with confidence.
ABSTRACT: Probiotics or health-beneficial bacteria have only recently been introduced in dentistry and oral medicine after years of successful use in mainly gastro-intestinal disorders. The concept of bacteriotherapy and use of health-beneficial micro-organisms to heal diseases or support immune function was first introduced in the beginning of the 20th century. Later the concept lead to the development of modern dairy industry and even today most probiotic strains are lactobacilli or bifidobacteria used in milk fermentation.
The mechanisms of probiotic action are mainly unknown but the inter-microbial species interactions are supposed to play a key role in this together with their immuno-stimulatory effects. The introduction of probiotic bacteria in the mouth calls for ascertainment of their particular safety. Since acid production from sugar is detrimental to teeth, care must be taken not to select strains with high fermentation capacity.
The first randomized controlled trials have nevertheless shown that probiotics may control dental caries in children due to their inhibitory action against cariogenic streptococci. Less evidence exists on their role in periodontal disease or oral yeast infections. Furthermore the best vehicles for oral probiotic applications need to be assessed.
So far mainly dairy products have been investigated but other means such as probiotics in chewing gums or lozenges have also been studied. From the clinical practitioner’s point of view direct recommendations for the use of probiotics cannot yet be given.
Material and Methods: Thirty chronic periodontitis patients were recruited and monitored clinically and microbiologically at baseline, 3, 6, 9 and 12 weeks after therapy. All patients received one-stage full-mouth disinfection and randomly assigned over a test (SRP + probiotic, n = 15) or control (SRP + placebo, n = 15) group. The lozenges were used two times a day for 12 weeks.
Results: At week 12, all clinical parameters were significantly reduced in both groups, while there was significantly more pocket depth reduction and attachment gain in moderate and deep pockets; more Porphyromonas gingivalis reduction was observed in the SRP + probiotic group.
Conclusions: The results indicate that oral administration of L. reuteri lozenges could be a useful adjunct to SRP in chronic periodontitis.
Recent evidence from international research suggests, however, that the most effective strategy for beating back bad breath may be more about nurturing helpful bacteria in the mouth than about destroying the offending germs and their by-products. Instead of singling out ostensible culprits, microbiologists are now shifting their focus to entire communities of microbes on the tongue, gum and teeth to figure out why some people have a sweeter-smelling oral village than others.