Clinical effects of probiotics containing Bacillus species on gingivitis: a pilot randomized controlled trial

Abstract

Teughels W. Clinical effects of probiotics containing Bacillus species on gingivitis: a pilot randomized controlled trial. J Periodont Res 2017; 52: 497-504.Background and Objective: Lactobacillus spp. and bifidobacteria are the most frequently used probiotics in oral health research. However, although probiotic effects have been suggested for other genera, such as bacilli, no trials are available to describe the effect of bacilli probiotics on gingivitis in humans. The aim of the present study was to evaluate the clinical effects of a bacilli-containing toothpaste, a mouthrinse and a toothbrush cleaner versus a placebo in patients with generalized gingivitis.Material and Methods: In this double-blind placebo-controlled randomized clinical trial, nonsmoking, systemically healthy patients with generalized gingivitis were included. They used a placebo or an experimental probiotic Bacillus subtilis-, Bacillus megaterium-and Bacillus pumulus-containing toothpaste, mouthrinse and toothbrush cleaner for 8 wk. Primary outcome measures of interest were plaque and gingivitis index, and the secondary outcome measures were pocket probing depth and bleeding on probing.Results: Twenty male and 20 female patients were randomized over the two groups. All participants could be included in the final analysis. Although plaque and gingivitis indices were significantly reduced after 8 wk, no intergroup differences could be found at any time point. Also, for the secondary outcome measure, intragroup but no intergroup differences could be detected. No harm or unintended effects were reported by the patients after using the study products.Conclusions: This study did not show any statistically significant differences between a placebo and a bacilli-containing toothpaste, mouthrinse and toothbrush cleaner on gingivitis parameters.

Probiotics, including nisin‐based probiotics, improve clinical and microbial outcomes relevant to oral and systemic diseases

“…Several studies have examined the use of probiotics as monotherapy to treat gingivitis and experimental gingivitis . However, these studies have produced mixed results.…”

“…However, these studies have produced mixed results. Some found that probiotics ( Lactobacillus casei Shirota milk drink , L. reuteri tablet; Bacillus subtilis, Bacillus megaterium , and Bacillus pumulus toothpaste, mouthwash, and toothbrush‐cleaning solution, respectively) did not improve or impact clinical parameters, including plaque and gingival indices, periodontal pocket depth, and bleeding on probing . By contrast, other studies did reveal improvements in bleeding on probing, plaque and gingival indices, and gingival crevicular fluid volume with monotherapy probiotics ( L. reuteri LR‐1 and LR‐2 chewing gum; L. brevis lozenges; L. casei Shirota milk drink, Bifidobacterium animalis sp.…”

“…Additional factors that may impact clinical, microbiological, or host response outcomes in gingivitis, periodontitis, and healthy subjects are the specific probiotic strains, concentrations, or doses that are being delivered in monotherapy (Table ). Doses have ranged from 10 6 to 10 9 and probiotic strains have included various Streptococcus , Lactobacillus , Bacillus , and Bifidobacterium strains . While a systematic review found that 10 6 and 10 9 colony forming units per day can be used to prevent antibiotic‐associated diarrhea, there are no guidelines on the concentration or probiotic strain that should be used for optimal effects in dentistry …”

Clinical efficacy of probiotics in the treatment of gingivitis: A systematic review and meta‐analysis

“…Recent studies have reported the use of probiotics in inhibiting gingival inflammation . Probiotics are ‘living microorganisms which, when administered in adequate amounts, confer a health benefit for the host’ .…”

“…Recent research indicates that different probiotics including Bifidobacterium animalis, Lactobacillus reuteri ( L. reuteri ) and Bacillus species have been assessed for their clinical efficacy in gingivitis . These studies have reported that probiotics were effective in reducing bleeding, gingival indices and plaque.…”