Oral cavities are swarming with microbes—some beneficial and some harmful. In the latter group is the notorious salivary mutans streptococcus (S. mutans). This bacterium causes dental caries or cavities.
With healthy diets, regular check-ups, cleanings, flossing and fluoride treatments, we try to safeguard our teeth.
Probiotics may offer additional protection.
Probiotics and dental caries
Probiotics are linked with decreased colony forming units (CFUs) of cariogenic pathogens such as S. mutans. Many studies concluded that the use of probiotics can reduce S. Mutans CFU counts during the time they are used.
Probiotics modulate the inflammatory response (humoral and cellular) and produce substances such as lactic acid, hydrogen peroxide and bacteriocins (antimicrobial agents produced by lactic acid bacteria.
Probiotics and periodontal disease
Imbalance between the saprophytic (microorganism that lives on dead or decaying organic matter) and pathogenic flora of the oral cavity can result in periodontal disease. Debridement usually consists of surgical or nonsurgical and in some cases systemic administration of antimicrobials is required.
Probiotic bacteria may attach to the oral tissues more strongly than pathogens, competing for adhesion surfaces and in the process creating a new biofilm.
A look at the studies
An analysis of random controlled studies by researchers in Barcelona, Spain explored the use of probiotics as a preventive and therapeutic method for oral infectious diseases management.
Fifteen articles were considered of which 12 were RCTs of good or high quality, two meta-analyses and one systematic review.
Seminario-Amez, M et al. “Probiotics and oral health: A systematic review.” Medicina oral, patologia oral y cirugia bucal vol. 22,3 e282-e288. 1 May. 2017, doi:10.4317/medoral.21494 This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
According to the literature reviewed, probiotics provides a decrease in CFU counts of cariogenic pathogens.
Regarding periodontal disease, the studies included in this review reported a clinical improvement of bleeding on probing, probing depth and gingival index, but no significant difference in CFU counts of periodontal pathogens.
The authors contend “…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.”
Mouthwash, toothpaste, lozenges and chewing gum are all being explored as vehicles for delivery for probiotics. Diet too is important. Eat lots of prebiotic and probiotic-rich foods.