Probiotics and Periodontal Diseases

Abstract

Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Probiotics have been used to directly modify the resident oral microbiome and proposed to modulate immune responses. In dentistry, probiotics have been employed as useful adjuncts for the reduction of caries development, suppressing oral Candida infection and controlling halitosis. Plaque-induced gingivitis is a gingival inflammation caused by the adherent bacterial biofilm around teeth. Gingivitis and periodontitis are considered to be a continuum of the same inflammatory process, although many gingivitis lesions do not progress to periodontitis. Periodontitis is an inflammatory process that affects the attachment structures of teeth. It constitutes a second cause of tooth loss worldwide. Conventional treatment modalities of periodontal disease include non-surgical and/or surgical management, with an emphasis on mechanical debridement. However, mechanical debridement as a sole therapy is not always effective to improve clinical parameters. A growing number of studies support probiotic therapy to prevent or treat gingivitis and periodontitis. Oral administration of probiotics is an effective adjunct in reducing pathogenic bacteria and improving clinical signs of disease. Probiotics may serve as adjunct or replacement therapy substitute antibiotics in managing human periodontal infections in future.

Nutrition as a Key Modifiable Factor for Periodontitis and Main Chronic Diseases

“…In a review, Matsubara et al analyzed 12 RCTs and concluded that oral administration of Lactobacillus reuteri (DSM17938, ATCC 55,730 + ATCC PTA5289, 1 × 10 8 CFU), Lactobacillus salivarius (WB21, 6.7 × 10 8 CFU) and Lactobacillus brevis (CD2, 0.2 × 10 8 CFU) had a positive impact on the clinical signs of PD and reduced the levels of major periodontal pathogens; however, the benefits were maintained only with continuous probiotic administration [ 74 ]. Morales et al raised the same conclusions for the same strains and also concluded on the Lactobacillus plantarum (L137) in supportive periodontal therapy [ 75 ]. Several mechanism could explain the action of probiotics: (i) production of lactic acid that inhibits the proliferation of periodontal bacteria by penetrating the membrane of bacteria and acidifying the cytoplasm, (ii) production of hydrogen peroxide that inhibits the growth of pathogenic bacteria, (iii) modification of proteins at the level of the site of attachment, (iv) production of inhibitory substances such as bacteriocins, (v) production of vitamins or other substances [ 75 ].…”

“…Morales et al raised the same conclusions for the same strains and also concluded on the Lactobacillus plantarum (L137) in supportive periodontal therapy [ 75 ]. Several mechanism could explain the action of probiotics: (i) production of lactic acid that inhibits the proliferation of periodontal bacteria by penetrating the membrane of bacteria and acidifying the cytoplasm, (ii) production of hydrogen peroxide that inhibits the growth of pathogenic bacteria, (iii) modification of proteins at the level of the site of attachment, (iv) production of inhibitory substances such as bacteriocins, (v) production of vitamins or other substances [ 75 ].…”