InquiryEffects on periodontal and caries status
Section snippets
Background
Probiotics are live microorganisms that can confer a health benefit when given in adequate amounts. Some benefits are provided by a range of bacteria, most commonly lactobacilli, streptococci, and bifidobacteria. Oral diseases such as caries, gingivitis, and periodontitis may benefit from probiotic administration, shifting the bacterial biofilm composition and activity and altering host responses. Often alterations in surrogate markers such as bacterial numbers have been used to indicate the
Methods
A search was conducted through the Medline, Embase, and Central databases. Fifty studies (3247 participants) met the criteria for inclusion. Most involved children and used lactobacilli (LB, 45 studies), bifidobacteria, or other bacteria. Most assessed bacterial numbers in probiotic and control groups directly after treatment or after a follow-up period.
Results
A significant increase in the chance of reducing Streptococcus mutans (SM) or LB were noted after probiotic therapy. Reduced SM counts were confirmed, but those for LB were not.
No reduction in periodontal pathogens exceeding those seen with placebo was noted. However, probiotics reduced bleeding on probing (BOP) and gingival index significantly, along with probing pocket depths (PDs). Plaque index did not show any significant reduction related to probiotic therapy, nor did caries incidence or
Discussion
Probiotics, especially bifidobacteria, were able to significantly reduce SM numbers, but increased the numbers of LB (but most of the probiotics were LB). Bacterial numbers have traditionally been used to act as a surrogate for caries. Although all of the studies reported nonsignificant beneficial effects on caries measures, the studies supporting this finding were prone to publication bias and carried limited validity. No evidence was sufficient to make a strong recommendation for or against
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Gruner D, Paris S, Schwendicke F: Probiotics for managing caries and periodontitis: Systematic review and meta-analysis. J Dent 48:16-25, 2016
Reprints available from F Schwendicke, Dept of Operative and Preventive Dentistry, Charité – Universitätsmedizin Berlin, Germany, Aßmannshauser Str 4-6, 14197 Berlin, Germany; e-mail: [email protected]