ProbioticsasaPreventative

TreatmentforDentalCaries
SarahD,LisaG,LauraM

IntroductiontoProbiotics
Propertiesthathelppromoteimmunity
Probioticsareplacedintomilkandyogurt
Overthecounterprobioticstohelpwithdigestiveproblems
Recentstudieshavebeencompletedshowingtheirbenefitintreatingdental
cariesandperiodontaldisease
ProbioticscanbeusefulindecreasingthelevelofS.mutanspresentintheoral
cavity

OpposingResearch
Themagicofmagicbugsinoralcavity:Probiotics
Statesthatnotalotofevidenceisavailableforprobioticsasapreventativetreatmentfor
caries
Limitednumberofarticles=resultsarentreliable

EarlyinterventionwithprobioticlactobacillusparacaseiF19hasnolongterm
effectoncariesexperience
Longtermstudyshowedthatthelongtermuseofprobioticshadnoeffectondmfs/DMFS
scores

OpposingResearchCONTD
Probiotictreatmentincreasessalivarycountsoflactobacilli:adoubleblind,randomized,
controlledstudy
Conductedadoubleblind,randomized,controlledstudy
35healthyindividuals
Dividedinto3groups
GroupAwasgivencapsuledprobioticsandliquidplacebo,
GroupBwasgivenliquidprobioticsandcapsuleplacebo
GroupCwasgiventheplaceboinbothliquidformandcapsules

Spanof45days
TestedsemiquantitativelywithaCRTbacteriakit

ExaminedthecountsofbothlactobacilliandS.mutans

 Theresultsofthisstudyshowedthatwhencomparedwithplacebo,theoral
administrationofprobiotics,bothincapsulesandinliquidform,significantly
increasessalivarycountsoflactobacilli(p=0.005andp=0.02,respectively).
S.mutanspopulationswerenotsignificantlymodified

OpposingCONTD
AstudydonebyAcharyaetal2015,ComparativeEvaluationof
CommerciallyAvailableFreezeDriedPowderedProbioticsonMutans
StreptococciCount
Arandomized,doubleblind,clinicalstudy
Studyincluded3groups(2treatment&1control)
ResultsconcludedareductioninS.mutans
Resultsdidn'tincludeenoughpopulationtoconcludedrelevant
generalpopulation

tothe

WhyChooseProbiotics?

Effectofprobioticcurdonsalivaryphandstreptococci
mutans:Adoubleblindparallelrandomizedcontrol
trial

StudyconductedbySirvastava,Saha,KumariandMohd(2016)
Probioticcurdshavebeenshowntosignificantlydecreasetheamountof
streptococcusmutanspresentintheoralcavity.
TheprobioticcurdwasalsoabletoincreasetheaveragepHoftheoralcavityby
theendofthe7daytrialperiod.
Aswell,byusingthecurdasthedeliverysystemfortheprobiotics,theprobiotics
canstayintheoralcavityforlongerduetoitssemisolidstate.
Thecurd,beingadiaryproduct,alsocontainscaseinphosphopeptidesthathelp
withtheremineralizationprocessoftoothenamelhelpingpreventdentalcaries.

Acomparativestudyoftheeffectofprobioticson
cariogenicbiofilmmodelforpreventingdentalcaries
AstudyconductedbyLeeandKim(2014),investigatedtheeffectsofvarious
probioticsontheoralbiofilmandtheirinhibitoryaffectonbiofilmformation.
Thestudyshowedthatthelactobacillusstrainofprobioticswasabletoinhibit
bacteriagrowthsignificantlymorethanotherprobiotics,withS.mutanstobe
significantlysusceptible.
ThespecificstrainsL.acidophilus,L.caseiandL.rhamnosuswereableto
decreasetheS.mutanscountwhenpresentinthesalivarybiofilmmodel,with
L.rhamnosusinhibitingthebacteriasignificantlymorethanL.acidophilusand
L.casei.
ThestudyconcludedbystatingthatL.rhamnosuscanbeagoodcandidatefor
probiotictreatmentfordentalcaries.

LactobacillusparacaseiSD1,anovelprobiotic,reduces
mutansstreptococciinhumanvolunteers:A
randomizedplacebocontrolledtrial
InthestudywrittenbyTeanpaisanandPiwat(2014),
theaimofthestudywastodeterminetheeffectsofaspecificlactobacillus
probioticL.paracaseionthegrowthofS.mutans.
ItwasnotabletoincreasethesalivarypHafterthe4weekperiod,theprobiotic
wasabletosignificantlydecreasetheamountofstreptococcimutanspresent
withintheoralcavity.

Salivarymutansstreptococciandlactobacillilevelsafteringestionofthe
probioticbacteriumLactobacillusreuteriATCC55730bystrawsortablets
ConductedbyCaglaret.al,2009
Aimedtodeterminethebestrouteofadministrationofprobiotics
Agroupof120healthyvolunteersbetweentheagesof2124wereselectedfor
thetrial
Thesubjectswerethensplitintofourgroups:

GroupA:probioticwaterandstraw
GroupB:placebostraw
GroupC:probiotictablet
GroupD:placebotablet

 UsingLactobacillusreuteriATCC55730
Concludedthatashorttermdailyingestionoflactobacilliderivedprobiotics
deliveredbypreparedstrawsorlozengesreducedthelevelsofsalivarymutans
streptococciinyoungadults.

ScreeningofProbioticCandidatesinHumanOral
BacteriaforthePreventionofDentalDisease
Aimedtodeterminethespecificbacteriathatcouldbeutilizedfortheprevention
ofcarieswithoutcausingothersystemichealthissues.
Thisstudyincludedcriteriasuchas:
Mustshownoenameldemineralization
MustnotdecreasethepHbelow5.5
Woulddeterminingwhichsurfacesthebacteriaadheredtothebest.

 Thescreeningdetermined4strainsthatcouldbeconsideredascandidatesfor
probioticuseinpreventingcaries.
L.crispatusYIT12319
L.fermentumYIT12320
L.gasseriYIT12321
S.mitisYIT12322
ShowedneitherdemineralizationorpHdecrease
Lowcariogenicpotentialwasduetothefactthatthebacteriadidnotadhereto
thetoothsurface

Prospectsforthedevelopmentofprobioticsand
prebioticsfororalapplications
ConductedbyDevineetal,2009
statesthattherearemanyconsiderationswhenstudyingwhichprobioticswill
workandwhichonesdont
Abilitytocolonize
Adherencetosurfaces
Antagonisticcapabilities
Inhibitionabilities

 Promotetheuseofprobiotics
Showntobeeffectiveinprotectingagainstcaries
EffectiveinreducingS.mutanslevelsinsalivawheningested
HoweverdoesmentionthatsomestrainssuchasLactobacillusspp.orL.
salivariushavebeenlinkedtothedevelopmentofcaries.

Theeffectofaprobioticstrain(Lactobacillusacidophilus)
ontheplaqueformationoforalStreptococci
AstudywrittenbyKermanshahi&Tahmourespourin2011
TheaimdeterminetheeffectoftheprobioticLactobacillusacidophilusonthe
adhesionofselectedstreptococcalstrainsonthesurfaces
Theconclusion:anadhesionreductioncanbeaneffectivewayofdecreasing
cariogenicpotentialoforalstreptococciandthatprobioticbacteriasuchas
Lactobacillusacidophiluscanaffecttheoralecology

ProbioticLactobacillusparacaseieffecton
cariogenicbacterialflora
AstudydonebyChuang,Huang,Lin&OuYang(2010)
TheaimtodecreaseS.mutansusingprobiotictabletintheoralcavityinatwo
weektimeperiod
TheresultsconcludedS.mutansdecreasedslightlyduringthetreatmentphase
andevenmoreofareductionshownduringtheposttreatmentphase

Arandomizedopenlabelclinicaltrialontheeffectsof
lactobacillussalivariuscontainingtabletsoncariesriskfactors
Nishiharaetal2014
TheaimtoreduceS.mutansutilizingL.salivariuscontainingtablets.
ResultsconcludedconcludedareductionincariesriskintheL.salivarius
containingtablets

Conclusion
Fromthesefindingswecanconcludethatcertainprobioticscanbevery
beneficialtosystemichealth,oralhealth,andevencariesprevention.
Selectionofaprobioticmustbedonecarefullyandafterdutifulresearchintothe
specificstrainbeingused.
Withoutcarefulselection,youmayincidentallyincreasetheriskforcaries
ratherthanachievethegoalofcariesprevention
Inadditiontothetypeofbacteriabeingused,theoptimalmodeofdeliverymust
befoundaswell.
Forinstance,somebacteriamightworkbetterasarinsethanatablet.
Inordertocompletelyunderstandandoptimizethebenefitsofprobiotics,
withoutlongtermconsequences,furtherresearchshouldbecompleted.

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