Probiotics in dentistry Flashcards
Define probiotics, and detail how it works in the human microbiome
Definition:
• Probiotics: Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host
• Probiotics include bacteria, fungi, viruses and archea
How they work:
• In humans a state of symbiosis with microbiome is desired, as this promotes health
• When dysbiosis occurs within our microbiome, it causes health problems and disease
• Thus, probiotics work by restoring a disturbed bacterial community to a state of homeostasis
List the three strains of probiotic bacteria
- Lactobacillus
- Bifidobacterium
- Streptococcus
List and describe the two forms of probiotics
- Foods:
Foods
• Yoghurt
• Cheese
Fermented foods:
• Pickles
• Kimchi
• Sauerkraut
- Formulations
• Powder
• Capsule
List the health effects of dysbiosis in the gut microbiome (4)
- Antibiotic-associated diarrhea
- Inflammatory bowel disease
- Helicobacter pylori infection
- Paediatric allergy (eczema)
Describe the 6 ways probiotics work
· The probiotics might stick together with bad bacteria and inactive their pathogenic activity
· Production of antimicrobial substances against oral pathogens
· They stimulate the immune system so they can combat the pathogens
· Alteration of environmental conditions of the mouth (to symbiosis)
· Binding to dental surfaces and prevent colonisation by dysbiotic microbes
· Reduction of the inflammatory response
Describe the use of probiotics in caries prevention
- Caries is caused by shift in oral microbiome due to carbohydrate consumption
- Aim of probiotics is to restore to homeostasis with probiotic
Comment on the efficacy of probiotic use in caries prevention
- 3 RCT studies on Lactobacillus rhamnosus showed
* 2 RCT studies on different strains showed no difference on caries
Describe the use of probiotics in periodontal disease prevention
- Periodontal disease is caused by a dysbiosis between the oral biofilm and immune system
- Aim of probiotic is to antagonise pathogens and restore immune response
Comment on the efficacy of probiotic use in periodontal disease prevention
4 bacterial strains RCT show DECREASE in
- Plaque
- Inflammatory markers (MMP, IFN) in saliva
- Pocket depths
- Periodontal pathogens
Describe the use of probiotics in halitosis management by mentioning:
- The cause of halitosis
- How probiotics would work
- Which strains are examined
- Might be caused by underlying periodontal disease, hence dysbiosis
- Probiotics: treat oral and gut-origin halitosis by restoring symbiosis
Strain examined are varied:
• E. coli
• S. Salivarius
Comment on the efficacy of probiotic use in halitosis management
• Very few clinical studies
Describe the use of probiotics in candida infection prevention
(mention the strain and outcome)
- Strain: L. rhamnosus strains GG and LC705 and Propionibacterium freudenreichii ssp. shermanii JS in cheese
- Group: Elderly, 16 weeks
- Outcome: Decreased C. albicans counts, no difference in mucosal lesions
Comment on the efficacy of probiotic use in candida infection prevention (mention the strain and outcome)
- Strain: Lactobacillus rhamnosus LC 705 in cheese
- Group: 18-35 years, 3 weeks
- Outcome: No significant change in counts of C. albicans
Highlight the limitations of the evidence for the use of probiotics in oral health
(4)
· Lack of consistent evidence
· Lack of long-term, follow-up studies
· Not a one size fits all probiotic for all diseases
(specific strains have specific effects)
· Strains vary in effect for different oral health conditions
Give an example of a probiotic strain
· 100 caries active children
· 3 months RCT through the provision of streptococcus salivarius
· The intervention group showed a reduction in plaque, reduction in S. mutans with colonised children
