Background and Objective: The potential of probiotics on the prevention and control of periodontitis and other chronic inflammatory conditions has been suggested. Lactobacillus and Bifidobacterium species influence P. gingivalis interaction with gingival epithelial cells (GECs) but may not act in a unique way. In order to select the most appropriate probiotic against P. gingivalis, we aimed to evaluate the effect of several strains on Porphyromonas gingivalis biofilm formation and transcription virulence-associated factors (PgVAFs). Methods: Cell-free pH neutralized supernatants (CFS) and living Lactobacillus spp. and Bifidobacterium spp. were tested against P. gingivalis ATCC 33277 and W83, in mono-and multi-species (with Streptococcus oralis and S. gordonii) biofilms. Relative transcription of P. gingivalis genes (fimA, mfa1, kgp, rgp, ftsH and luxS) was determined in biofilms and under GECs co-infection. Results: Probiotics CFS reduced P. gingivalis ATCC 33277 levels in mono-species biofilms and living probiotics reduced P. gingivalis abundance in multi-species biofilms. L. acidophilus LA5 down-regulated transcription of most PgVAFs in biofilms and GECs. Conclusions: Probiotics affect P. gingivalis biofilm formation by down-regulating overall PgVAFs with the most pronounced effect observed for L. acidophilus LA5.

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Background: Patients with temporomandibular disorder (TMD) often have orofacial pain and may use medication without professional prescription. Self-medication and inappropriate drug intake may cause serious health problems. This cross-sectional study evaluated the self-medication profile of TMD patients, the most used medications and their effect, and the relation between self-medication and socioeconomic factors. Methods: A non-representative sample (n=358) consisted of consecutive adult patients seeking TMD treatment in specialized referral centers for orofacial pain of two universities in São Paulo city, Brazil. A standardized questionnaire was used to collect the study variables before the TMD treatment: self-medication history, TMD pain intensity, sex, age, ethnicity, marital status, schooling and socioeconomic levels. Data were analyzed by descriptive statistics, chi-square test, and logistic regression models at the 0.05 significance level. Results: Almost 60% of 358 TMD patients reported self-medication. Patients with severe TMD were 4.7 times more likely to self-medicate when compared to patients with low TMD intensity (O=5.7; 95% CI=2.4; 13.3; P=0.043), as well as female patients were 30% more likely to self-medicate compared to male patients (OR=2.3; 95% CI=1.1; 5.1; P<0.001). The other independent variables were not associated with self-medication. The frequencies of moderate and severe TMD in women were larger than in those in men (P<0.001). Analgesics and anti-inflammatory drugs were the most used medications. Regarding medication efficacy, 82% of patients reported some improvement after use, but 9% reported side-effect sickness. Conclusion: Self-medication is common among TMD patients attending specialized clinics, and this inappropriate practice is more likely to occur in women and in patients with severe signs and symptoms of TMD.