Probiotics Could Also Benefit Oral Health

Recent research findings published in Pharmaceuticals suggest that probiotic microorganisms, typically used for gut health, could also benefit dental health. According to the literature review, probiotics are associated with reduced cariogenic pathogens and protection against periodontal diseases, although the exact mechanism is unknown.

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The oral mucosa is believed to have the second-largest number of host microbes after the colon, according to the study authors. Researchers have previously established that a diverse and healthy microbiota thrives in the oral cavity, with many commensal microorganisms beneficial in preventing or treating oral diseases. In fact, physiological microbiota are well known to safeguard the oral cavity against infection.

Probiotics have been proposed as an effective treatment for some oral health concerns, such as candidiasis, based on studies finding that probiotics can inhibit the growthof Candida biofilms in vitro. Similarly, researchers have observed positive effects with probiotics following antibiotics or chemotherapy treatments, with one study suggesting that Lactobacillus brevis CD2 lozenges reduced the incidence of oral mucositis caused by grade 3 and 4 anticancer therapy.

In one study of probiotic use for dental caries and associated microbes, investigators found a trend toward a decrease in the number of streptococci in saliva, and several studies suggested that consuming probiotic products with lactobacilli or probiotic bifidobacteria could decrease the quantity of Streptococcus mutans in saliva. However, the study authors noted that the study populations were small and the studies were short, suggesting stronger evidence is needed.

With regard to periodontal disease, research has established that Lactobacillus reuteri probiotic is an effective option for gingivitis and periodontal disease. One study evaluated this and found improvements in all parameters, including bleeding on probing, gingivitis, plaque index, attachment level, and pocket depth.

Additionally, probiotic use has been evaluated for its effectiveness in halitosis. Specifically, Weissella cibaria was researched for this use and outcomes in subjective halitosis, subjective oral health status, depression, self-esteem, and oral health-related quality of life were measured. At baseline and 8 weeks later, participants who received placebo vs the probiotic displayed statistically significant variations in subjective halitosis and quality-of-life scores.

Finally, one study of the use of multispecies probiotics for peri-implant mucositis found that the therapy provided additional clinical and immunological benefits when used in addition to mechanical debridement. However, the authors acknowledged that it was a short assessment period and recommended further research.

Although the studies evaluated in this review warrant further research, the authors noted that a number of therapeutic advances of probiotic bacteria have been well established. Pharmacists can play a key role in helping patients select OTC probiotic products and counsel patients on when to visit their primary care provider or dentist.

Reference

Inchingolo F, Inchingolo AM, Malcangi G, et al. The benefits of probiotics on oral health: systematic review of the literature. Pharmaceuticals. 2023;16(9):1313. doi:10.3390/ph16091313