For years, probiotics have been used to optimise the microbiome, e.g. in the gut (also referred to as gut flora, or to prevent possible gastro-intestinal diseases. In dentistry, treatment involving probiotics has only recently been considered a significant alternative to conventional therapies, e.g. for gingivitis or gum inflammation, as well as periodontitis or periodontal disease. In a recent publication, Ulrich Schlagenhauf and Yvonne Jockel-Schneider of University Hospital Würzburg pointed out that “there is now a steadily growing number of randomized controlled clinical trials (RCT)” which evaluate the effect of probiotics in the management of dental health and oral hygiene issues.

Among these, two studies had shown that intake of the probiotic Lactobacillus reuteri resulted in “significant and pronounced decrease of gingival inflammation when compared to the placebo-consuming controls”. The mechanism of action can differ considerably. The online portal “Zahnarzt Wirtschaft Praxis” lists, among others, competition for food between different bacterial species. Where good and healthy bacteria find and claim food for themselves, pathogen, i.e. harmful, bacteria lose their basis of existence. Other bacteria neutralise the dangerous acid from cariogenic bacteria which causes the breakdown of teeth enamel. Also, it is considered to be probable that even the intake of probiotics as lozenges or chewing gums “could, through the gut, have a positive influence on the oral dental flora”.

However, it has to be said that use of living (!) probiotics (quite unlike microbiotic agents) always risks to be acid-forming. In the case of a predisposition to or pronounced periodontitis, this may be of advantage overall. Treating bacterial infections in the mouth with antibiotics, however, could frequently prove to be counterproductive. Dr. Raluca Cosgarea, an associate professor at the University of Bonn who recently received a prize for her research, emphasises the resistance harmful bacteria may show: “The more contact they have with a drug, the more likely they will be able to become resistant to it”, a university press release said. In addition, antibiotics destroy the oral bacterial community.

A growing number of studies are proving that thousands of different bacterial species protect us from pathogens, while the number of dangerous bacteria is much lower. It will only stay this way if the microbiome in the gut, in the oral cavity, and in the entire body remains well-balanced. Hence, it is important to nurture useful bacteria in the oral flora, and in this way prevent dental diseases and symptoms like tooth decay, periodontitis or periodontal disease, and halitosis.

Sources:

https://www.frontiersin.org/articles/10.3389/fdmed.2021.708666/full#T1

https://www.zwp-online.info/zwpnews/dental-news/branchenmeldungen/probiotika-wie-bakterien-die-mundgesundheit-starken

https://idw-online.de/de/news798744