Probiotics and oral health

Abstract

The effect of probiotics in the prevention and treatment of several chronic systemic diseases is well documented. Traditionally, probiotics have been associated with gut health, but recently, there has been an increasing interest in their use within the field of dentistry for the management of different oral diseases such as caries, periodontal diseases and halitosis. Although their precise mechanisms of action have not been completely elucidated, they may be related with the host-parasite interactions. Probiotics can compete with pathogens for binding sites and nutrients, produce substances against pathogenic bacteria and modulate the host response. This chapter mainly focuses on Lactobacilli- and Bifidobacteria-based probiotics as these genera are the most widely used in probiotic products. Several randomized clinical trials have been performed in children, evaluating the role of probiotics in caries prevention, although most of them are of short-term duration and restricted to microbiological endpoints. It may be concluded that probiotics decrease mutans streptococci counts, suggesting a positive effect in the prevention of caries. However, there is insufficient evidence supporting that probiotics can prevent dental caries. Few studies have been performed in children on the effects of probiotics on periodontal pathogens and clinical outcomes. The results have shown different outcomes depending on the selected strains and on the evaluated endpoints. As with caries research, data indicate an effect of probiotics on the oral microbiota and a more limited effect on clinical outcomes. Many of the reviewed clinical studies are pilot in nature and with lowresearch quality. Therefore, properly conducted clinical trials, using probiotic strains with in vitro proven periodontal probiotic effects, are needed. Studies investigating halitosis in children are scarce and refer mainly to its etiopathogenesis. The most frequent described causes are: tongue coating, upper respiratory tract conditions, poor oral hygiene or a combination of them. Treatment approaches mainly focused on the improvement of oral hygiene, including tongue cleaning and the regular use of specific mouth rinses. However, its use is only recommended for children older than eight years. Therefore, the use of probiotics may have an important role in the control of halitosis in children. More information is needed on the colonization of probiotic strains in the mouth and their possible effect on and within oral biofilms, especially in children. Due to the increasing global problem with antimicrobial drug resistances, the concept of probiotic therapy is interesting and deserves further research in oral medicine and dentistry in children.