Probiotics are emerging as a promising concept when it comes to maintaining oral health, Maria Papavergos explains.
With a growing appetite from the general public to adopt simple strategies to nurture their health, probiotics for oral care deserve a place in our professional toolkit.
A better balance
Probiotic bacteria are defined as viable microorganisms, which, when administered in adequate amounts, confer a health benefit to the host.
When it comes to the mouth, probiotics show potential to rebalance the oral microbiome. They improve microbial-host dysbiosis and reduce the risk of dental disease.
These beneficial bacteria can alter the ecology of our mouths. They crowd out and control levels of specific oral pathogens.
The oral microbiome is in delicate balance. It is susceptible to environmental changes, which can tip the balance towards dental disease.
We know dental caries and periodontal diseases are multifactorial. But with several preventative strategies, we can help reduce risk of these prevalent diseases.
Alongside mechanical removal of dental plaque, an undisputed initiator of dental disease, we can help create a supportive oral environment through adjunctive measures. From nutrition to lifestyle choices.
This is where dental probiotics come into play.
Obliteration of all mouth microbes is fast becoming an outdated oral hygiene approach. The benefits of highly abundant health-associated oral species are becoming widely recognised.
Some of these supportive species include those belonging to the lactobacillus genus as well as nitrate-reducing bacteria.
Nitrate-reducing bacteria convert dietary nitrate, concentrated by the salivary glands, into nitrite. Salivary nitrite may limit the growth of cariogenic bacteria, as a result of the production of antimicrobial nitric oxide in an acidic environment.
Lactobacillus strains also demonstrate probiotic action, with proposed mechanisms of action including disruption of the plaque biofilm formation, inhibition of pathogenic bacteria through production of antimicrobial compounds, along with indirect interaction with the immune system, modulating the host immune response.
Dental probiotics show potential to modify the oral microbiota. They act as a therapeutic tool for both prevention and adjunctive treatment of dental diseases.
Emerging research supports probiotics in a preventative role. Research shows improvement in gingival health due to their anti-inflammatory action. As well as an increase in health-associated species.
There is some evidence to suggest a reduction in levels of cariogenic bacteria, including streptococcus mutans. This helps to reduce patients’ risk of dental decay.
Probiotics may also manage oral malodour, suppressing the production of volatile sulphur compounds produced by certain bacteria, that contribute to smelly breath.
Dental probiotics have also shown promising results as an adjunct to clinical periodontal treatment.
Studies reveal strain L.reuteri to be effective in reducing levels of specific periodontal pathogens, displaying an antimicrobial action.
Further evidence supports reduction in levels of inflammatory mediators. It demonstrates a consequential anti-inflammatory effect and improved periodontal outcomes.
From a dietary perspective, fermented foods, especially milk products like live yoghurt and kefir, containing lactobacillus should be encouraged.
Also foods high in dietary nitrate, such as beetroot and green leafy vegetables, that feed nitrate-reducing bacteria are beneficial to oral and overall health.
From an oral hygiene perspective, oral care products containing probiotics are being pioneered in toothpastes, mouthwashes as well as lozenges.
This is an exciting step towards nurturing the oral microbiome, for both patient and profession. A step we should be ready to embrace.