Probiotics for Caries Prevention and Control

Abstract

Modulation of the microbiota for restoring and maintaining health is a growing issue in medical science. A search for relevant clinical trials on the use of probiotic bacteria as a potential and clinically applicable anti-caries measure was performed. According to predetermined criteria, papers were selected and key data on study design, sample size, intervention, duration, and results were extracted. Two animal and 19 human studies were retrieved. Most studies were short-term and restricted to microbiological endpoints, and only 3 human studies reported a caries endpoint. A high degree of heterogeneity among the included investigations hampered the analysis. Significant reductions of mutans streptococci in saliva or plaque following daily intake of probiotic lactobacilli or bifidobacteria were reported in 12 out of 19 papers, whereas 3 reported an increase of lactobacilli. Three caries trials in preschool children and the elderly demonstrated prevented fractions of between 21% and 75% following regular intakes of milk supplemented with L. rhamnosus. No adverse effects or potential risks were reported. The currently available literature does not exclude the possibility that probiotic bacteria can interfere with the oral biofilm, but any clinical recommendation would be premature. Large-scale clinical studies with orally derived specific anti-caries candidates are still lacking.

<b><i>Lactobacillus reuteri</i></b> Influences Regrowth of Mutans Streptococci after Full-Mouth Disinfection: A Double-Blind, Randomised Controlled Trial

“…Probiotics have traditionally been associated with gut health; however, over the last decades an increasing number of potential applications for oral health have been suggested [for reviews, see Twetman and Stecksén-Blicks, 2008;Twetman and Keller, 2012]. The mode of action is attributed to three main avenues: probiotic bacteria can prevent or inhibit the proliferation of pathogens, suppress production of virulence factors by pathogens, and…”

“…Studies have clearly shown that selected probiotic strains and clinical isolates can inhibit the growth of mutans streptococci (MS) in vitro [Simark-Mattsson et al, 2007;Hasslöf et al, 2010;Keller et al, 2011;Söderling et al, 2011]. In vivo, a short-term reduction in MS counts has been observed with Lactobacillus reuteri [Caglar et al, 2006] and L. rhamnosus [Glavina et al, 2012]; however, any clinical recommendation for an oral health purpose is not yet justified [Haukioja, 2010;Twetman and Keller, 2012].…”

Molecule Targeting Glucosyltransferase Inhibits Streptococcus mutans Biofilm Formation and Virulence

“…In addition, numerous small molecules, including tt-farnesol (12), chitosan, 7-epiclusianone (13), and apigenin (14), have been characterized and have been shown to have antibiofilm activity. Other potential anticariogenic methods include sugar substitutes (15), probiotic strains (16), and arginine (17). However, few of these treatments have been proven to confer selectivity against S. mutans biofilms.…”

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

“…There are a number of reviews of the effect of probiotic bacteria on the oral microbiota and how this may affect dental caries and periodontal disease [Stamatova & Meurman, 2009;Bonifait L et al, 2009;Twetman & Keller, 2012;Twetman, 2012]. 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].…”