The efficacy of probiotics in management of recurrent aphthous stomatitis: a systematic review and meta-analysis

Abstract

There is currently a lack of effective drugs to cure recurrent aphthous stomatitis. This study aimed to evaluate the efficacy of probiotics alone or as an adjunct in recurrent aphthous stomatitis (RAS) patients. Seven randomized controlled trials (RCTs) were included, of which three were included in quantitative analysis. Of five studies evaluating the efficacy of probiotics alone compared with placebo or Oracure gel, two reported no significant difference in relieving oral pain, while probiotics exhibited a higher capacity for decreasing oral pain in the other three. A significant decrease in ulcer severity was found in one, while no significant difference was found in the other four. The remaining two studies demonstrated that probiotics, as an adjunct to steroids or anaesthetic antiseptic gel, significantly reduced the ulcer severity and oral pain. The meta-analysis showed a significant decrease in oral pain (− 1.72, P = 0.0001) with probiotics compared with placebo. In conclusion, probiotics alone were capable of relieving oral pain but not effective in reducing ulcer severity. A combination of probiotics and steroids or anaesthetic antiseptic gel was more effective than steroids or anaesthetic antiseptic gel alone in RAS patients. Probiotics are promising for the treatment of recurrent aphthous stomatitis.

Recurrent aphthous stomatitis: A comprehensive review and recommendations on therapeutic options

“…A meta‐analysis of three of the studies showed that taking oral probiotics through local application or lozenges resulted in a significant decrease in oral pain compared to placebo. While probiotics alone were unable to reduce ulcer severity, probiotics as an adjunct to steroids or anesthetic antiseptic gel proved beneficial 17 …”

Current Progress and Future Perspectives on the Use of Bacillus clausii

“…Recurrent aphthous stomatitis is a frequently-occurring disease of the oral mucosa [97]. It is characterized by round or elliptical ulcers in the oral cavity, which can cause severe pain and affect chewing and swallowing, thus reducing the patient's quality of life [97].…”

“…Recurrent aphthous stomatitis is a frequently-occurring disease of the oral mucosa [97]. It is characterized by round or elliptical ulcers in the oral cavity, which can cause severe pain and affect chewing and swallowing, thus reducing the patient's quality of life [97]. Equally, a disruption to the oral microbiota, caused by the use of immunosuppressive drugs or broad-spectrum antimicrobials, can allow the overgrowth of normal commensals such as Candida albicans, leading to oral candidiasis [98].…”

“…This may be due to the formation of a biofilm in the oral cavity, which prevents the growth of other microorganisms and protects the oral mucosa [86]. Recent meta-analyses and systematic reviews have found a beneficial effect of probiotics in reducing oral pain from recurrent aphthous stomatitis [97] and reduced oral Candida spp. counts [98].…”

Efficacy of Topical Intervention for Recurrent Aphthous Stomatitis: A Network Meta-Analysis

“…However, the quality of daily life is severely affected by localized mucosal defects resulting in poor palatability, pain due to chemical-mechanical irritation and recurrent episodes [31]. To date, several authors have conducted traditional meta-analyses of local interventions for RAS [32][33][34]. Their focus has been on whether the interventions studied have a positive effect compared to an ineffective placebo.…”