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Background: A previous study revealed Lactobacillus paracasei SD1, a probiotic strain, could reduce mutans streptococci (MS). The aim of this study was to evaluate the long-term effects of L. paracasei SD1 on the colonization of MS, and whether caries lesions developed. Methods: After informed consent, 122 children were recruited and randomly assigned to the probiotic or control groups. The probiotic group received milk-powder containing L. paracasei SD1 and the control group received standard milk-powder once daily for six months. Salivary MS and lactobacilli were enumerated using differential culture at baseline and at three-month intervals for 12 months. The persistence of L. paracasei SD1 was investigated using AP-PCR for DNA-fingerprinting. Oral health was examined at baseline and at the end of the study according to WHO criteria. Results: The long-term consumption could prolong colonization of L. paracasei SD1. Significantly reduced MS counts and increased lactobacilli levels were found among children in the probiotic group. There were less caries lesions in the probiotic group at the end of the study. A significant reduction of the development of new caries lesions (4.5 times) was observed in the high caries risk group but not in the low caries risk group. Conclusions: Results demonstrate that the long-term daily ingestion of the human-derived probiotic L. paracasei SD1 significantly reduces the number of MS and caries risk in the high caries group.

BackgroundProbiotic supplementation can reduce mutans streptococci (MS) numbers. One of its proposed mechanisms is immunomodulation. Salivary human neutrophil peptide 1–3 (HNP1-3) levels have previously been demonstrated to be higher in caries-free than in caries-susceptible children, suggesting their preventive role against caries. We aimed to compare salivary HNP1-3 levels between an intervention group with probiotics and a control group.MethodsA randomized double-blinded clinical trial was conducted. Sixty schoolchildren were equally allocated to either an intervention or control group. The use of a probiotic strain, Lactobacillus paracasei SD1, has shown to reduce MS numbers in volunteers. In unstimulated whole saliva, HNP1-3 levels were assayed by ELISA, and MS and lactobacilli counts were assayed by colony counting at baseline (T0) and at 3 (T3), 6 (T6), and 12 months (T12). The International Caries Detection and Assessment system was used to assess caries status.ResultsIn the intervention group, salivary HNP1-3 levels were significantly greater than those in the control group at T3 and T6 (p < 0.001), whereas MS counts were significantly decreased (p < 0.01). In the intervention group, positive and negative correlations were found between HNP1-3 levels and lactobacilli counts and between MS and lactobacilli counts, respectively. However, there was no significant correlation between enhanced HNP1-3 levels and decreased MS numbers. The caries increment for the pit and fissure surface, but not for the smooth surfaces, was significantly decreased in the intervention group compared with the control group (p = 0.01).ConclusionsProbiotics can temporarily enhance salivary HNP1-3 levels; however, their action to reduce new pit and fissure caries probably involves microbial interactions.Trial registrationTCTR20130904001 (registration date: September 04, 2013).Electronic supplementary materialThe online version of this article (doi:10.1186/s12903-015-0003-0) contains supplementary material, which is available to authorized users.

In this paper we consider the use of mobile dental clinics as a means of improving access to dental care among primary school children in Southern Thailand by reducing the opportunity cost of service use to parents. Parents' willingness to pay (WTP) is measured for three different services provided in a community hospital dental clinic and a school-based mobile clinic. Although the service setting does not affect significantly the WTP for treatment directly, the estimated positive association between WTP and income is modified by setting. The results indicate that the potential for mobile clinics to increase utilization of services among primary school children is associated with parents' income, with the difference in valuation of dental services between the two settings being less among lower income parents than higher income parents. However, even among lower income parents our results indicate that the potential for increasing service utilization among children depends on the improvements in access associated with the mobile clinic not being achieved at the opportunity cost of lower levels of effectiveness.

Objectives: Oral disease is one of the most common health problems among the elderly, which impacts the quality of life. Applying the Health Belief Model (HBM) in oral health promotion is expected to improve the effectiveness of prevention and promotion that restricts oral health problems. The aim of the present study was to determine the effectiveness of an oral health promotion program on oral health behavior and oral status among the elderly in Khiri Mat, Thailand. Materials and Methods: A prospective randomized control trial was carried out among 162 elderly people for 6 months. They were interviewed to gather oral health behaviors and perception information, followed by an oral health examination. The experimental group received oral health education based on the HBM theory and tooth brushing practice in a small group of 4–5 persons, and then they were remotivated to support behavior change at 1 and 3 months. The control group received traditional oral health activity. All the elderly were followed up at 6 months. Data were analyzed using the t -test, Mann–Whitney test, Chi-square, and logistic regression. Results: The elderly in the experimental group had significantly higher oral health perception, lower plaque scores, lower gingival inflammation, and lower clinical attachment loss than those in the control group ( P < 0.05). Conclusion: This oral health promotion program improved oral health perception, behavior, and oral health status of the elderly.