Probiotics show oral health benefits: BioGaia study

Probiotic-containing lozenges may reduce levels of three different pathogens in patients with chronic periodontitis, suggests a new study that also supports benefits for inflamed gums.

Three weeks of sucking on Lactobacillus reuteri prodentis-containing lozenges, in combination with scaling and root plaining (SRP) – the standard treatment for gum disease (periodontitis) – were associated with significant reductions in the severity of periodontitis, according to findings published in a supplement to the Journal of Oral Microbiology.

In addition, the preliminary randomized clinical trial also found that the levels of three different pathogens in patients with chronic periodontitis were significantly reduced following the probiotic intervention.

“The present randomized controlled trial confirms the plaque inhibition, anti-inflammatory, and antimicrobial effects of L. reuteri Prodentis,” wrote researchers, led by K.L. Vandana from the Department of Periodontics, College of Dental Sciences in Karnataka, India.

Oral health potential

Oral health is being tipped to be a big area for probiotics, but mainly in gum formulations. Euromonitor stated in a recent comment article: “Probiotics are in line to become the next blockbuster functional ingredients in gum and mints”.

This is not the first time that the oral health benefits of the BioGaia strain have been reported: A study with 42 subjects with moderate gingivitis published in the journal Acta Odontologica Scandinavica showed benefits of L. reuteri prodentis against gingervitis, otherwise known as bleeding or inflamed gums.

Danish researchers used BioGaia’s proprietary probiotic strain and found its interaction with the immune system could boost oral health.

Furthermore, a pilot study using Yakult’s probiotic milk drink found that a daily dose of probiotics may reduce inflammation and bleeding in the mouth linked to gingivitis and periodontitis.

Results published in the Journal of Clinical Periodontology (2009, Vol. 36, pp. 850-856) indicated that the Lactobacillus casei strain Shirota may improve oral health based on its influence of the immune system.

New data

Periodontitis is a common, chronic inflammatory disease that is characterized by gum tissue separation from the tooth – forming a periodontal pocket that can lead to bone and tooth loss.

Traditional therapies for periodontitis focus on targeting the initial bacterial infection, however more recent therapeutic strategies have aimed to target the response to the infection, which is thought to play an important role in the pathogenesis of periodontitis.

The Indian researchers recruited 30 people with chronic periodontitis, but considered otherwise healthy. All of the participants were treated with SRP in one half of their mouth, whereas the teeth in the other half were left untreated. After three weeks, the participants were randomly assigned to receive either the L. reuteri Prodentis lozenges (1x108 CFU DSM 17938 plus 1x108 CFU ATCC PTA 5289 (prodentis)) or placebo lozenges twice a day for a further 21 days.

Results showed significant reductions in the severity of periodontitis, as measured by probing pocket depth (PPD) and clinical attachment level (CAL).

The combination of probiotic plus SRP was also found to be superior for reducing gingivitis and plaque.

The researchers also noted that the probiotic lozenges, either alone or combined with SRP, significantly reduced levels of pathogenic bacteria, including Aggregibacter actinomycetemcomitans, Porphyromonas gingivalis and Prevotella intermedia by up to 90 percent, compared with the other treatments.

“Further randomized controlled clinical trials over longer periods are required to build up stronger evidence for probiotic application of L. reuteri Prodentis supporting a periodontal treatment protocol,” they concluded.

Source: Journal of Oral Microbiology

Published online ahead of print, doi: 10.3402/jom.v2i0.5344

“Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial”

Authors: M.R. Vivekananda, K.L. Vandana, K.G. Bhat

The full study can be accessed here.