Probiotics Support Resilience of the Oral Microbiota during Resolution after Experimental Gingivitis—A Randomized, Double-Blinded, Placebo-Controlled Trial

Abstract

The present study aims to test whether probiotics protect against experimental gingivitis incited by 14 days of oral hygiene neglect and/or subsequently support the restoration of oral homeostasis. Eighty systemically and orally healthy participants refrained from oral hygiene procedures for 14 days, followed by 14 days with regular oral hygiene procedures. Additionally, participants consumed either probiotics (n = 40) or placebo (n = 40) throughout the trial. At baseline, day 14, and day 28, supragingival plaque score and bleeding-on-probing percentage (BOP %) were registered, and supragingival plaque and saliva samples were collected. The supragingival microbiota was characterized using 16S sequencing, and saliva samples were analyzed for levels of pro-inflammatory cytokines and proteases. At day 28, the relative abundance of Lautropia (p = 0.014), Prevotella (p = 0.046), Fusobacterium (p = 0.033), and Selenomonas (p = 0.0078) genera were significantly higher in the placebo group compared to the probiotics group, while the relative abundance of Rothia (p = 0.047) species was associated with the probiotics group. Streptococcus sanguinis was associated with the probiotics group, while Campylobacter gracilis was associated with the placebo group. No difference was observed in salivary cytokines, albumin, or any enzyme activity. The present study suggests that probiotics support the resilience of the oral microbiota in the resolution period after gingivitis.

Exploring the In Vitro Antibacterial Potential of Specific Probiotic Strains against Oral Pathogens

“…The use of probiotics as adjuvant treatment in different diseases seems promising. Several clinical trials reported improvement in halitosis, oral health, and related quality of life in subjects supplemented with different formulation of probiotics [ 65 , 66 , 67 , 68 , 69 ]. Moreover, many beneficial effects have been already demonstrated in the rebalance of the gut microbiota and also systemically [ 70 , 71 , 72 ].…”

Effect of Probiotic Supplements on the Oral Microbiota—A Narrative Review

“…Few RCTs have tested the microbiological effect of probiotics in the treatment of gingivitis ( [73][74][75][76][77], Table 1). In gingivitis, different Lactobacillus species, including L. rhamnosus, L. curvatus, L. plantarum, L. brevis, and L. reuteri, have been delivered as tablets [74][75][76][77] or lozenges [73], either during experimental gingivitis [73,76] or as treatment of established gingivitis [74,75,77].…”

“…Few RCTs have tested the microbiological effect of probiotics in the treatment of gingivitis ( [73][74][75][76][77], Table 1). In gingivitis, different Lactobacillus species, including L. rhamnosus, L. curvatus, L. plantarum, L. brevis, and L. reuteri, have been delivered as tablets [74][75][76][77] or lozenges [73], either during experimental gingivitis [73,76] or as treatment of established gingivitis [74,75,77]. The microbiological effect has been evaluated in supragingival plaque [73,76], saliva [74], subgingival plaque [75], and simultaneously in subgingival plaque and saliva samples [77], using 16S sequencing [73,74], qPCR [75,77], and DNA-DNA checkerboard [76] immediately after probiotic consumption for 28 days to 8 weeks.…”

“…In gingivitis, different Lactobacillus species, including L. rhamnosus, L. curvatus, L. plantarum, L. brevis, and L. reuteri, have been delivered as tablets [74][75][76][77] or lozenges [73], either during experimental gingivitis [73,76] or as treatment of established gingivitis [74,75,77]. The microbiological effect has been evaluated in supragingival plaque [73,76], saliva [74], subgingival plaque [75], and simultaneously in subgingival plaque and saliva samples [77], using 16S sequencing [73,74], qPCR [75,77], and DNA-DNA checkerboard [76] immediately after probiotic consumption for 28 days to 8 weeks. In general, the comparable study designs, the almost similar study cohorts, as well as less heterogenicity in terms of delivery mode and duration of probiotic intake, assisted comparison of data across studies, while the use of different molecular methods together with different microbial samples being analyzed hampered comparison of data.…”

“…Microbiologically, some studies have reported the positive effects of probiotics on the microbial endpoints tested, including microbial resilience to experimental gingivitis in supragingival plaque [73], a significant reduction in subgingival levels of T. forsythia [75], and a significant reduction in P. gingivalis in subgingival plaque together with a significant reduction in total anaerobic counts and Prevotella intermedia in saliva [77]. In one study, no effect was observed on the composition of the salivary microbiota as evaluated by 16S sequencing [74], whereas another study failed to identify any effect on the supragingival microbiota during experimental gingivitis based on DNA-DNA checkerboard analysis [76].…”