Generic placeholder image

Current Pharmaceutical Biotechnology

Editor-in-Chief

ISSN (Print): 1389-2010
ISSN (Online): 1873-4316

Systematic Review Article

Clinical Efficacy of Probiotics on Oral Health: A Systematic Review of Clinical Trials

Author(s): Tahereh Navidifar, Marzie Mahdizade Ari, Asma Alipourkermani, Roghayeh Afifirad, Parisa Asadollahi, Ali Veisi, Roya Ghanavati* and Atieh Darbandi*

Volume 24, Issue 15, 2023

Published on: 11 May, 2023

Page: [1916 - 1927] Pages: 12

DOI: 10.2174/1389201024666230405135457

Price: $65

Abstract

Introduction:: Periodontal diseases and dental caries are the two most common dental diseases caused by the dental plaque.

Objective: The aim of the present study was to review the clinical efficacy of probiotics for oral health in randomized controlled trials.

Methods: An electronic search was conducted in December 2021 in Embase, Medline, The Cochrane Library, ProQuest, and Google Scholar using the following keywords: “mouthwash” and “probiotics”. The titles and abstracts of 3,775 articles were screened and 24 publications that fulfilled the inclusion criteria were included.

Results: A total of 24 clinical trials were reviewed, including 1612 participants receiving either probiotics or mouth treatments. The results of this review indicated that individuals receiving probiotic products have a significant reduction (65% reduction; p < 0.05) in the count of Streptococcus mutants in their mouths. It was also found that probiotic products were more effective or equal in effect compared to chlorhexidine in reducing oral pathogens, gingival index, and plaque index scores. On the other hand, the consumption of xylitol mouthwash was shown to cause an improvement in salivary parameters. Considering their safety and effectiveness, the use of probiotic products, such as kefir and mouthwashes, has been recommended against cariogenic bacteria and periodontal diseases.

Conclusion: Probiotics are considered a safe alternative to conventional therapies, such as chlorhexidine and fluoride. Co-administration of chlorhexidine, fluoride, and probiotics seems to be a perfect package.

Keywords: Probiotics, Streptococcus mutans, oral health, mouthwash, clinical trials, diseases.

Graphical Abstract
[1]
Kinane, D.F.; Stathopoulou, P.G.; Papapanou, P.N. Periodontal diseases. Nat. Rev. Dis, 2017, 3(1), 1-14.
[2]
Prasad, M.; Patthi, B.; Singla, A.; Gupta, R.; Jankiram, C.; Kumar, J.K.; Vashishtha, V.; Malhi, R. The clinical effectiveness of postbrushing rinsing in reducing plaque and gingivitis: A systematic review. J. Clin. Diagn. Res., 2016, 10(5), ZE01-ZE07.
[http://dx.doi.org/10.7860/JCDR/2016/16960.7708] [PMID: 27437376]
[3]
Van der Weijden, F.A.; Van der Sluijs, E.; Ciancio, S.G.; Slot, D.E. Can chemical mouthwash agents achieve plaque/gingivitis control? Dent. Clin. North Am., 2015, 59(4), 799-829.
[http://dx.doi.org/10.1016/j.cden.2015.06.002] [PMID: 26427569]
[4]
Brookes, Z.L.S.; Bescos, R.; Belfield, L.A.; Ali, K.; Roberts, A. Current uses of chlorhexidine for management of oral disease: A narrative review. J. Dent., 2020, 103, 103497.
[http://dx.doi.org/10.1016/j.jdent.2020.103497] [PMID: 33075450]
[5]
McCoy, L.C.; Wehler, C.J.; Rich, S.E.; Garcia, R.I.; Miller, D.R.; Jones, J.A. Adverse events associated with chlorhexidine use. J. Am. Dent. Assoc., 2008, 139(2), 178-183.
[http://dx.doi.org/10.14219/jada.archive.2008.0134] [PMID: 18245686]
[6]
Hill, C.; Guarner, F.; Reid, G.; Gibson, G.R.; Merenstein, D.J.; Pot, B.; Morelli, L.; Canani, R.B.; Flint, H.J.; Salminen, S.; Calder, P.C.; Sanders, M.E. The international scientific association for probiotics and prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat. Rev. Gastroenterol. Hepatol., 2014, 11(8), 506-514.
[http://dx.doi.org/10.1038/nrgastro.2014.66] [PMID: 24912386]
[7]
Kechagia, M.; Basoulis, D.; Konstantopoulou, S.; Dimitriadi, D.; Gyftopoulou, K.; Skarmoutsou, N.; Fakiri, E.M. Health benefits of probiotics: A review. ISRN Nutr., 2013, 2013(7), 481651.
[PMID: 24959545]
[8]
Seminario-Amez, M.; López-López, J.; Estrugo-Devesa, A.; Ayuso-Montero, R.; Jané-Salas, E. Probiotics and oral health: A systematic review. Med. Oral Patol. Oral Cir. Bucal, 2017, 22(3), e282-e288.
[http://dx.doi.org/10.4317/medoral.21494] [PMID: 28390121]
[9]
Mahasneh, S.; Mahasneh, A. Probiotics: A promising role in dental health. Dent. J., 2017, 5(4), 26.
[http://dx.doi.org/10.3390/dj5040026] [PMID: 29563432]
[10]
Zhang, G.; Lu, M.; Liu, R.; Tian, Y.; Vu, V.H.; Li, Y.; Liu, B.; Kushmaro, A.; Li, Y.; Sun, Q. Inhibition of Streptococcus mutans biofilm formation and virulence by Lactobacillus plantarum K41 isolated from traditional sichuan pickles. Front. Microbiol., 2020, 11, 774.
[http://dx.doi.org/10.3389/fmicb.2020.00774] [PMID: 32425911]
[11]
Pahumunto, N.; Piwat, S.; Chanvitan, S.; Ongwande, W.; Uraipan, S.; Teanpaisan, R. Fermented milk containing a potential probiotic Lactobacillus rhamnosus SD11 with maltitol reduces Streptococcus mutans: A double-blind, randomized, controlled study. J. Dent. Sci., 2020, 15(4), 403-410.
[http://dx.doi.org/10.1016/j.jds.2020.03.003] [PMID: 33505609]
[12]
Meurman, J.H.; Stamatova, I.V. Probiotics: Evidence of oral health implications. Folia Med., 2018, 60(1), 21-29.
[http://dx.doi.org/10.1515/folmed-2017-0080] [PMID: 29668457]
[13]
Elgamily, H; Mosallam, O; El-Sayed, H; Mosallam, R. Antibacterial effectiveness of probiotic-based experimental mouthwash against cariogenic pathogen: An in vitro study. Euro. J. Dent., 2018, 12(1), 7-14.
[14]
Moher, D.; Liberati, A.; Tetzlaff, J.; Altman, D.G.; Group, P. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med., 2009, 6(7), e1000097.
[http://dx.doi.org/10.1371/journal.pmed.1000097] [PMID: 19621072]
[15]
Aminabadi, N.A.; Erfanparast, L.; Ebrahimi, A.; Oskouei, S.G. Effect of chlorhexidine pretreatment on the stability of salivary lactobacilli probiotic in six- to twelve-year-old children: A randomized controlled trial. Caries Res., 2011, 45(2), 148-154.
[http://dx.doi.org/10.1159/000325741] [PMID: 21454978]
[16]
Sefidgar, S.A.A.; Moghadamnia, A.A.; Ghadimi, R.; Shirkhani, L.; Gharekhani, S.; Shirkhani, L. Comparative study of Kefir yogurtdrink and sodium fluoride mouth rinse on salivary mutans streptococci. J. Contemp. Dent. Pract., 2014, 15(2), 214-217.
[http://dx.doi.org/10.5005/jp-journals-10024-1517] [PMID: 25095846]
[17]
Jose, J.E.; Padmanabhan, S.; Chitharanjan, A.B. Systemic consumption of probiotic curd and use of probiotic toothpaste to reduce Streptococcus mutans in plaque around orthodontic brackets. Am. J. Orthod. Dentofacial Orthop., 2013, 144(1), 67-72.
[http://dx.doi.org/10.1016/j.ajodo.2013.02.023] [PMID: 23810047]
[18]
Keller, M.K.; Hasslöf, P.; Dahlén, G.; Stecksén-Blicks, C.; Twetman, S. Probiotic supplements (Lactobacillus reuteri DSM 17938 and ATCC PTA 5289) do not affect regrowth of mutans streptococci after full-mouth disinfection with chlorhexidine: A randomized controlled multicenter trial. Caries Res., 2012, 46(2), 140-146.
[http://dx.doi.org/10.1159/000337098] [PMID: 22472585]
[19]
Patil, R.; Dastoor, P.; Unde, M. Comparative evaluation of antimicrobial effectiveness of probiotic milk and fluoride mouthrinse on salivary Streptococcus mutans counts and plaque scores in children – An in vivo experimental study. J. Indian Soc. Pedod. Prev. Dent., 2019, 37(4), 378-382.
[http://dx.doi.org/10.4103/JISPPD.JISPPD_45_19] [PMID: 31710013]
[20]
Romani Vestman, N.; Hasslöf, P.; Keller, M.K.; Granström, E.; Roos, S.; Twetman, S.; Stecksén-Blicks, C. Lactobacillus reuteri influences regrowth of mutans streptococci after full-mouth disinfection: A double-blind, randomised controlled trial. Caries Res., 2013, 47(4), 338-345.
[http://dx.doi.org/10.1159/000347233] [PMID: 23486236]
[21]
Shah, S.S.; Nambiar, S.; Kamath, D.; Suman, E.; Unnikrishnan, B.; Desai, A.; Mahajan, S.; Dhawan, K.K. Comparative evaluation of plaque inhibitory and antimicrobial efficacy of probiotic and chlorhexidine oral rinses in orthodontic patients: A randomized clinical trial. Int. J. Dent., 2019, 2019, 1-6.
[http://dx.doi.org/10.1155/2019/1964158] [PMID: 30930947]
[22]
Jothika, M.; Vanajassun, P.P.; Someshwar, B. Effectiveness of probiotic, chlorhexidine and fluoride mouthwash against Streptococcus mutans - Randomized, single-blind, in vivo study. J. Int. Soc. Prev. Community Dent., 2015, 5(7)(Suppl. 1), 44.
[http://dx.doi.org/10.4103/2231-0762.156153] [PMID: 25984467]
[23]
Antony, B.; Goyal, N.; Shamanna, P.U.; Varughese, S.T.; Abraham, R.; Emmatty, R.; Paul, P. Effects of amine fluoride and probiotic mouthwash on levels of Porphyromonas gingivalis in orthodontic patients: A randomized controlled trial. J. Indian Soc. Periodontol., 2019, 23(4), 339-344.
[http://dx.doi.org/10.4103/jisp.jisp_551_18] [PMID: 31367131]
[24]
Sajedinejad, N.; Paknejad, M.; Houshmand, B.; Sharafi, H.; Jelodar, R.; Shahbani Zahiri, H.; Noghabi, K.A. Lactobacillus salivarius NK02: A potent probiotic for clinical application in mouthwash. Probiotics Antimicrob. Proteins, 2018, 10(3), 485-495.
[http://dx.doi.org/10.1007/s12602-017-9296-4] [PMID: 28631250]
[25]
Klarin, B.; Molin, G.; Jeppsson, B.; Larsson, A. Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: A randomised controlled open pilot study. Crit. Care, 2008, 12(6), R136.
[http://dx.doi.org/10.1186/cc7109] [PMID: 18990201]
[26]
Annigeri, R.G.; Mangala, G.; Thimmasetty, J.; Sharma, N.; Kanjani, V.; Sravya, G. Evaluation of tulasi extract mouthwash in the management of oral candidiasis. J. Adv. Clinic. Res. Insights, 2018, 5(2), 30-34.
[27]
Söderling, E.; Isokangas, P.; Pienihäkkinen, K.; Tenovuo, J. Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. J. Dent. Res., 2000, 79(3), 882-887.
[http://dx.doi.org/10.1177/00220345000790031601] [PMID: 10765964]
[28]
Khoramian Tusi, S.; Jafari, A.; Marashi, S.M.A.; Faramarzi Niknam, S.; Farid, M.; Ansari, M. The effect of antimicrobial activity of Teucrium polium on oral Streptococcus mutans: A randomized cross-over clinical trial study. BMC Oral Health, 2020, 20(1), 130.
[http://dx.doi.org/10.1186/s12903-020-01116-4] [PMID: 32357889]
[29]
Deshmukh, M.A.; Dodamani, A.S.; Karibasappa, G.; Khairnar, M.R.; Naik, R.G.; Jadhav, H.C. Comparative evaluation of the efficacy of probiotic, herbal and chlorhexidine mouthwash on gingival health: A randomized clinical trial. J. Clin. Diagn. Res., 2017, 11(3), ZC13-ZC16.
[http://dx.doi.org/10.7860/JCDR/2017/23891.9462] [PMID: 28511500]
[30]
Manjunathappa, T.H.; Jojo, J.; Kenganora, M.; Kumar, M.N. Effect of tulsi extract and probiotic mouthrinse on plaque and gingivitis among school children–A randomized controlled trial. J. Datta Meghe Inst. Med. Sci., 2020, 15(1), 82.
[31]
Kandaswamy, S.K.; Sharath, A.; Priya, P.R.G. Comparison of the effectiveness of probiotic, chlorhexidine-based mouthwashes, and oil pulling therapy on plaque accumulation and gingival inflammation in 10-to 12-year-old schoolchildren: A randomized controlled trial. Int. J. Clin. Pediatr. Dent., 2018, 11(2), 66-70.
[http://dx.doi.org/10.5005/jp-journals-10005-1487] [PMID: 29991855]
[32]
Yadav, A.; Mitra, D.; Prithyani, S.; John, L.; Rodrigues, S.; Shah, R. The antiplaque efficacy of lantibiotic Nisin extract mouthrinse. J. Indian Soc. Periodontol., 2019, 23(1), 31-34.
[http://dx.doi.org/10.4103/jisp.jisp_326_18] [PMID: 30692740]
[33]
Shah, R.K. Probiotic, chlorhexidine and flouride mouthrinses in children: AS hort-term clinical study. Int J Dent Med Res., 2014, 1(2), 21.
[34]
Pancu, G; Andrian, S; Topoliceanu, C; Tofan, N; Nica, I; Ghiorghe, CA The influence of xylitol on some salivary parameters involved in saliva remineralisation capacity. J. Chem., 2017, 1, 4.
[35]
Manikandan, S.; Behera, S.; Karthikeyan, R.; Niranjana, A.; Bharathan, R.; Mohammed, O.B. Effect of green tea extract mouthrinse and probiotic mouthrinse on salivary pH in a group of schoolchildren: An in vivo study. J. Pharm. Bioallied Sci., 2020, 12(5)(Suppl. 1), 404.
[http://dx.doi.org/10.4103/jpbs.JPBS_119_20] [PMID: 33149495]
[36]
Penala, S.; Kalakonda, B.; Pathakota, K.; Jayakumar, A.; Koppolu, P.; Lakshmi, B.; Pandey, R.; Mishra, A. Efficacy of local use of probiotics as an adjunct to scaling and root planing in chronic periodontitis and halitosis: A randomized controlled trial. J. Res. Pharm. Pract., 2016, 5(2), 86-93.
[http://dx.doi.org/10.4103/2279-042X.179568] [PMID: 27162801]
[37]
Jamali, Z.; Aminabadi, N.A.; Samiei, M.; Sighari Deljavan, A.; Shokravi, M.; Shirazi, S. Impact of chlorhexidine pretreatment followed by probiotic Streptococcus salivarius strain K12 on halitosis in children: A randomised controlled clinical trial. Oral Health Prev. Dent., 2016, 14(4), 305-313.
[PMID: 27508274]
[38]
Patil, R.; Dastoor, P.; Unde, M.; Patil, R.U.; Dastoor, P.P.; Unde, M.P. Comparative evaluation of antimicrobial effectiveness of probiotic milk and fluoride mouthrinse on salivary counts and plaque scores in children-An experimental study. J. Indian Soc. Pedod. Prev. Dent., 2019, 37(4), 378.
[http://dx.doi.org/10.4103/JISPPD.JISPPD_45_19] [PMID: 31710013]
[39]
Sundas, S.; Rao, A. Comparative evaluation of chlorhexidine and sodium fluoride mouthwashes on streptococcus mutans. J. Nepal Dent. Assoc., 2011, 12, 17-21.
[40]
Wiedemann, I.; Breukink, E.; van Kraaij, C.; Kuipers, O.P.; Bierbaum, G.; de Kruijff, B.; Sahl, H.G. Specific binding of nisin to the peptidoglycan precursor lipid II combines pore formation and inhibition of cell wall biosynthesis for potent antibiotic activity. J. Biol. Chem., 2001, 276(3), 1772-1779.
[http://dx.doi.org/10.1074/jbc.M006770200] [PMID: 11038353]
[41]
Xu, X.; Zhou, X.D.; Wu, C.D. The tea catechin epigallocatechin gallate suppresses cariogenic virulence factors of Streptococcus mutans. Antimicrob. Agents Chemother., 2011, 55(3), 1229-1236.
[http://dx.doi.org/10.1128/AAC.01016-10] [PMID: 21149622]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy