Probiotics and oral health: A systematic review.

Medicina oral, patologia oral y cirugia bucal. 2017;22(3):e282-e288
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Plain language summary

Oral cavity has its own microbiome. When the balance of the microbes living in the oral cavity is altered, e.g. due to poor oral hygiene, diet or the use of antimicrobial drugs, periodontal disease and dental caries can develop. Probiotics may provide a new approach for the prevention and management of these oral diseases. This review paper examined 12 published randomised clinical trials, 2 meta-analyses and 1 systematic review that assessed the effect of probiotics in the treatment and/or prevention of an infectious oral disease. Based on the reviewed studies, the authors concluded that the use of probiotics could be beneficial for the maintenance of oral health, due to its ability to decrease colony forming unit counts of oral pathogens. However, more clinical trials with longer-term follow-ups are needed to confirm the efficacy of probiotic therapy, identify specific probiotic strains and determine the correct dose, treatment time and delivery form required for each disease.

Abstract

BACKGROUND Probiotics are microorganisms, mainly bacteria, which benefit the host's health. Many studies support the role of probiotics as a contributor to gastrointestinal health, and nowadays many authors are trying to prove its influence in oral health maintenance. OBJECTIVES To review the published literature with the purpose of knowing the importance of using probiotics as a preventive and therapeutic method for oral infectious diseases management. MATERIAL AND METHODS An electronic search in PubMed database with the keywords "oral health AND probiotics AND dentistry" was conducted. The inclusion criteria were: randomized clinical trials (RCTs) that assess the action of any probiotic strain in the treatment and / or prevention of an infectious oral disease, RCTs that assess the action of any probiotic strain on counting colony forming units (CFU) of oral pathogens, systematic reviews and meta-analysis. The Jadad scale was used to assess the high quality of RCTs. RESULTS Fifteen articles were considered for this review. Of which, 12 were RCTs of good / high quality (Jadad scale), two meta-analysis and one systematic review. CONCLUSIONS The literature reviewed suggests probiotics usage could be beneficial for the maintenance of oral health, due to its ability to decrease the colony forming units (CFU) counts of the oral pathogens. However, randomized clinical trials with long-term follow-up periods are needed to confirm their efficacy in reducing the prevalence/incidence of oral infectious diseases. Furthermore, the recognition of specific strains with probiotic activity for each infectious oral disease is required, in order to determine exact dose, treatment time and ideal vehicles.

Lifestyle medicine

Fundamental Clinical Imbalances : Digestive, absorptive and microbiological
Patient Centred Factors : Mediators/Cariogenic bacteria
Environmental Inputs : Diet ; Xenobiotics ; Microorganisms
Personal Lifestyle Factors : Not applicable
Functional Laboratory Testing : Not applicable
Bioactive Substances : Probiotics

Methodological quality

Allocation concealment : Not applicable
Publication Type : Journal Article ; Review ; Systematic Review

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