Probiotic supplements promote oral health in schoolboys
Short-term daily consumption or probiotic lozenges containing Lactobacillus rhamnosus GG (LGG) and Bifidobacterium lactis BB-12 confers benefits for gingival health, as well as reduces the plaque carriage of periodontal pathogens, in adolescent males, a study has shown.
“These data indicate that probiotics could be a simple adjunct to standard oral care for promoting the oral health, particularly in adolescents when their attention to oral care may not be a priority,” the investigators said.
In the study, 101 schoolboys aged 13–15 years were randomized to receive 1 g probiotic lozenges (n=52) containing a mixture of LGG (4.4×108) and BB-12 (4.8×108) or placebo lozenges (n=49), administered twice daily for 4 weeks. Plaque index (PI) and gingival index (GI), as well as levels of four periodontal reference bacteria (Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum) in saliva and plaque samples were assessed at baseline and at 4 weeks after the intervention.
At week 4, probiotics produced a greater decrease in GI compared with placebo (p=0.012), whereas no significant between-group difference was observed in PI, with both probiotics and placebo yielding reductions (p=0.819). [Benef Microbes 2018;9:593-602]
Meanwhile, levels of A. actinomycetemcomitans and F. nucleatum in saliva and plaque (p<0.05) and P. gingivalis in plaque (p<0.05) substantially dropped in the probiotic group. Total salivary and bacterial counts (p<0.001) also decreased significantly with probiotics. No significant changes were seen in the placebo group.
“The use of probiotic bacteria to promote oral health represents a relatively new area of research,” according to the investigators, adding that the current trial is the first of its kind to evaluate the impact of probiotic combination of LGG and BB-12 on the periodontal health among adolescents.
The observed beneficial effect of probiotics on oral health in adolescence may have important clinical implications, especially because many adolescents have gingivitis, the first stage of periodontal disease, and not see oral health as a priority issue, the investigators continued. [Pediatr Rev 2017;38:61-68]
Periodontal diseases such as periodontitis and gingivitis are commonly associated with A. actinomycetemcomitans, P. gingivalis, P. intermedia, F. nucleatum, T. forsythia, T. denticola and C. rectus. A dysbiotic oral microbiota plays an active role in the pathogenesis by promoting chronic dysregulated inflammation, which in turn sustains the dysbiotic microbial ecology. [Nat Rev Microbiol 2012;10:717-725; Virulence 2015;6:223-228]
Therefore, a probiotic that could modify the oral microbial ecology may prove useful in the management of periodontitis, with the potential to offer twofold benefits: first, to combat dysbiosis by competitive inhibition of periodontal pathogens, thereby reducing the overall immunogenicity of the oral microbiota; and second, to modulate active disease-associated immune/inflammatory pathways to reduce the destructive inflammation of periodontitis. [Curr Oral Health Rep 2017;4:309-318; Expert Opin Biol Ther 2012;12:1207-1220]
“[However], since the study population were male adolescents, aged 13-15 years, the generalizability of the results is limited. Further clinical trials are necessary to evaluate the efficacy of such probiotic combinations over a more extended period and in different age groups in order to corroborate our findings,” the investigators said.