Probiotics affect the clinical inflammatory parameters of experimental gingivitis in humans

The effect of a commercial probiotic drink on oral microbiota in healthy complete denture wearers

Background

It is acknowledged that oral and general health status declines with age. The global population of denture wearers is increasing, so is the incidence of denture biofilm-related problems, such as denture-associated stomatitis, aspiration pneumonia and malodour. It has been suggested that consumption of probiotic bacteria may improve oral health. However, the effects of probiotics on the oral microbiota of denture wearers have received little attention.

Methods

The aim of this study was to investigate the effect of consumption of a commercial probiotic product (Yakult) on microbiota of saliva, tongue and denture biofilm in healthy complete denture wearers. Eight healthy complete denture-wearing National Health Service (NHS) patients undertook a 7-week trial comprising three phases: baseline; 4-week consumption of one bottle of Yakult per day, each containing a minimum 6.5×10⁹ viable cells of Lactobacillus casei strain Shirota (LcS); 4-week washout period. The microbial viability and composition of saliva, tongue dorsum coating and denture biofilm were assessed using a range of solid selective and indicator media. Questionnaires were used to explore participants’ denture cleaning habits and impact of wearing dentures on their life quality and well-being [modified oral health impact profile (OHIP-14)] prior to and after the study.

Results

Seven volunteers (1 male, 6 females) completed the trial. LcS temporarily colonised oral cavity and denture surface. There was no significant change in the viability of Streptococcus mutans, acidogenic microorganisms, total anaerobic species and Gram-negative obligate anaerobes between study phases. There was no obvious effect of LcS on occurrence and viability of Candida. Participants presented a good general knowledge of denture hygiene and their responses to OHIP-14 questionnaires improved after completing the study (p=0.16).

Conclusion

It appeared that 4-week consumption of probiotic drink had no overall effect on selected oral parameters in healthy denture wearers despite temporary presence of LcS.

Probiotics as oral health biotherapeutics

INTRODUCTION

Oral health is affected by its resident microorganisms. Three prominent oral disorders are dental caries, gingivitis and periodontitis, with the oral microbiota playing a key role in the initiation/progression of all three. Understanding the microbiota and the diseases they may cause is critical to the development of new therapeutics. This review is focused on probiotics for the prevention and/or treatment of oral diseases.

AREAS COVERED

This review describes the oral ecosystem and its correlation with oral health/disease. The pathogenesis and current prevention/treatment strategies of periodontal diseases (PD) and dental caries (DC) are depicted. An introduction of probiotics is followed by an analysis of their role in PD and DC, and their potential role(s) in oral health. Finally, a discussion ensues on the future research directions and limitations of probiotics for oral health.

EXPERT OPINION

An effective oral probiotic formulation should contribute to the prevention/treatment of microbial diseases of the oral cavity. Understanding the oral microbiota's role in oral disease is important for the development of a therapeutic to prevent/treat dental diseases. However, investigations into clinical efficacy, delivery/dose optimization, mechanism(s) of action and other related parameters are yet to be fully explored. Keeping this in mind, investigations into oral probiotic therapies are proving promising.

A review of the pharmacobiotic regulation of gastrointestinal inflammation by probiotics, commensal bacteria and prebiotics

The idea that microbes induce disease has steered medical research toward the discovery of antibacterial products for the prevention and treatment of microbial infections. The twentieth century saw increasing dependency on antimicrobials as mainline therapy accentuating the notion that bacterial interactions with humans were to be avoided or desirably controlled. The last two decades, though, have seen a refocusing of thinking and research effort directed towards elucidating the critical inter-relationships between the gut microbiome and its host that control health/wellness or disease. This research has redefined the interactions between gut microbes and vertebrates, now recognizing that the microbial active cohort and its mammalian host have shared co-evolutionary metabolic interactions that span millennia. Microbial interactions in the gastrointestinal tract provide the necessary cues for the development of regulated pro- and anti-inflammatory signals that promotes immunological tolerance, metabolic regulation and other factors which may then control local and extra-intestinal inflammation. Pharmacobiotics, using nutritional and functional food additives to regulate the gut microbiome, will be an exciting growth area of therapeutics, developing alongside an increased scientific understanding of gut-microbiome symbiosis in health and disease.