Plain language summary
Caries are caused by cariogenic microorganisms in plaque biofilms that ferment dietary carbohydrates to produce acids, resulting in the loss of minerals from the hard tissue of teeth and the formation of cavities. This study's aim was to evaluate the potential of probiotics in preventing caries in preschool children. This study was a systematic review and meta-analysis of seventeen studies with a total of 3781 preschool children (divided into an experimental group (n = 2047) and a control group (n = 1734)). Results showed that probiotics could effectively prevent dental caries, of which Lactobacillus rhamnosus was more effective than other bacteria in preventing dental caries. Probiotics reduced the high concentration of Streptococcus mutans in saliva but could not reduce the number of lactic acid bacteria in saliva and dental plaques. Authors concluded that since there is still a lack of relevant research on the dose, route of administration, and frequency of probiotic use, further randomised controlled studies are needed to standardise the use of probiotics and achieve more beneficial effects before they are generally used in clinical practice.
Abstract
This paper systematically evaluate the effects of probiotics on preventing caries in preschool children. The present systematic review was conducted following the Transparent Reporting of Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recorded in the International prospective register of systematic reviews (PROSPERO) database (registration no: CRD42022325286). Literature were screened from PubMed, Embase, Web of Sciences, China National Knowledge Infrastructure (CNKI), Wanfang and other databases from inception to April 2022 to identify randomized controlled trials on the clinical efficacies of probiotics in preventing dental caries in preschool children and extract relevant data. The meta-analysis was performed using the RevMan5.4 software and the Stata16. Cochrane handbook was used to assess the risk of bias. The Grading of Recommendations Assessment, Development and Evaluation (GRADEprofiler 3.6) was used to determine the evidence quality. A total of 17 randomized controlled trials were eligible, of which two trials had certain levels of bias and 15 had a low risk of bias. Evidence quality assessment showed that the included trials were of medium quality. The meta-analysis results showed that Lactobacillus rhamnosus was associated with a reduced incidence (p = 0.005) and progression (p < 0.001) of caries in preschool children. Probiotics could reduce the number of high-level Streptococcus mutans in saliva (p < 0.00001) but could not reduce the number of Streptococcus mutans in dental plaque nor the amount of Lactobacillus in the saliva and dental plaque. Current evidence shows that probiotics could prevent caries in preschool children, but Lactobacillus rhamnosus was more effective in preventing caries than others. Although probiotics could reduce high levels of Streptococcus mutans in saliva, they could not reduce the amount of Lactobacillus in saliva and dental plaque.
Methodological quality
Jadad score
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Not applicable
Allocation concealment
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Not applicable
