Administration of <b><i>Bifidobacterium</i></b><b><i>animalis</i></b> subsp. <b><i>lactis</i></b> BB-12 in Early Childhood: A Post-Trial Effect on Caries Occurrence at Four Years of Age

Abstract

Probiotic bifidobacteria are widely used in the prevention of childhood diseases. These bacteria are also associated with caries occurrence. The present secondary analysis in a low-caries population evaluated the effect of early administration of Bifidobacterium animalis subsp. lactis BB-12 (BB-12) on caries occurrence and identified markers of dental decay in early childhood. In the original randomized, double-blind, placebo-controlled study (NCT00638677, http://www.clinicaltrials.gov), infants (n = 106) received BB-12, xylitol or sorbitol tablets from the age of 1-2 months to 2 years with a slow-release pacifier or a spoon (daily dose of BB-12 10¹⁰ colony-forming units, polyol 200-600 mg). The present data were collected using clinical examinations and questionnaires at the age of 4 years. The occurrence of dental caries was assessed using the International Caries Detection and Assessment System. Oral hygiene status and mutans streptococci (MS) levels were also determined. No differences were detected between the study groups in the occurrence of enamel caries (p = 0.268) or obvious dentinal caries (p = 0.201). The occurrence of caries was associated with daily consumption of sweet drinks (p = 0.028), visible plaque observed (p = 0.002) and MS detected in the dental plaque (p = 0.002). Administration of BB-12 in infancy does not seem to increase or decrease the occurrence of caries by 4 years of age in a low-caries population.

Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?

“…A similar inference was also reached by a qualitative systematic review of probiotic caries studies, concluding that clinical recommendations would be premature without more comprehensive RCTs showing an actual reduction in individual caries experience [Twetman and Keller, 2012]. Relatively few RCTs of oral probiotics have used clinical dental caries indicators to prove the efficacy of probiotics in preventing or treating dental caries [Näse et al, 2001;Stecksén-Blicks et al, 2009;Burton et al, 2013;Taipale et al, 2013]. A comprehensive systematic review utilizing evidence from these RCTs concluded that current evidence is insufficient for recommending probiotics in controlling dental caries [Gruner et al, 2016].…”

Oral Administration of <b><i>Lactobacillus reuteri</i></b> during the First Year of Life Reduces Caries Prevalence in the Primary Dentition at 9 Years of Age

“…In a study in adults with established root caries, Petersson et al [2011] found partial reversal of the lesions after daily intake, for 15 months, of milk supplemented with probiotic bacteria. In contrast, the study by Taipale et al [2013] found no difference in caries prevalence in 4-year-old children who during the first year of life had been treated with probiotic bacteria, compared to those who received xylitol or sorbitol administered in the same way. Neither, Hasslöf et al [2013] found any effect on caries at 9 years of age after supplementation of L. paracasei (LF19) in cereals for the first 4-13 months of life.…”

“…Several studies have shown positive effects of probiotic lactobacilli: reduction in the number of mutans streptococci, dental plaque and gingival inflammation [Nikawa et al, 2004;Krasse et al, 2006;Calgar et al, 2008;Marttinen et al, 2012]. To date, however, only five studies have been published with caries as the endpoint [Näse et al, 2002;Stecksén-Blicks et al, 2009;Petersson et al, 2011;Hasslöf et al, 2013;Taipale et al, 2013], three of which report lower caries increment after exposure to probiotic bacteria compared to control groups. In the study by Näse et al [2002], preschool children were exposed to milk with L. rhamnosus five days a week over seven months at 1-6 years of age.…”

Inhibition of <b><i>Streptococcus mutan</i></b>s Growth and Biofilm Formation by Probiotics in vitro

“…Finally, we modeled a repetitive uptake of probiotics. In a clinical setting, this was deemed necessary given the poor retention of certain probiotic strains [Taipale et al, 2012[Taipale et al, , 2013 but might decrease the possible efficacy of any probiotic therapy, as it requires patient compliance.…”

“…However, both in vitro and clinical studies yielded ambiguous results with regard to the benefits or risks associated with caries prevention via probiotics. While a number of studies reported reduced numbers of cariogenic bacteria after probiotic therapy [Laleman et al, 2014;Gruner et al, 2016], others did not confirm such effects Marttinen et al, 2012;Taipale et al, 2012Taipale et al, , 2013. Furthermore, the beneficial effects of probiotics on carious lesions have been reported [Näse et al, 2001], but not always confirmed Hasslöf et al, 2013].…”