Effect of Probiotic Bacteria on Oral Candida in Frail Elderly

Abstract

The aim of this study was to investigate the effect of a daily intake of probiotic lactobacilli on the prevalence and counts of oral Candida in frail elderly patients living in nursing homes. The study had a double-blind randomized placebo-controlled design with 2 parallel arms. The study group consisted of 215 older adults (range, 60 to 102 y) who were enrolled after informed consent. After baseline examination and randomization, the subjects were given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) or placebo twice daily (morning and evening). The intervention period was 12 wk, and saliva and plaque samples were collected at baseline and follow-up. The primary end point was prevalence of high Candida counts assessed from chairside tests. Secondary end points were levels of dental plaque and gingival inflammation. The groups were balanced at baseline. The attrition rate to follow-up was 19%. There was a statistically significant reduction in the prevalence of high Candida counts in the probiotic group but not in the placebo group, and the difference was statistically significant in both saliva and plaque (P < 0.05). No significant differences between the groups were noted concerning the levels of supragingival plaque or bleeding on probing. Thus, daily use of probiotic lozenges may reduce the prevalence of high oral Candida counts in frail elderly nursing homes residents (ClinicalTrials.gov NCT02391532).

Probiotics as Antifungals in Mucosal Candidiasis

“…Their weakened immune status may favor the recurrence of candidiasis. Two research groups have shown that the daily consumption of lactobacillilaced cheese [15] or lozenges [17] significantly reduces the high yeast counts in saliva and biofilms in the elderly. Because biofilms on oral prosthetic devices act as potent reservoirs of the yeast, the mechanical removal of biofilms associated with the regular use of probiotics that reduce the oral burden of Candida could play a major role in preventing oral candidiasis in denture wearers.…”

Probiotics and oral health: A systematic review

“…Of which, 380 patients were older than 18 years old and 911 were minors. Six studies used only Lactobacilli probiotic strains (19,20,23,27-29), 3 studies Bifidobacteria (24-26), 1 used Streptococci (18), and 2 studies used mixtures of probiotic strains (21,22). Seven RCTs evaluated the influence of bacteriotherapy in the colony forming units (CFU) counts of S. Mutans and dental caries (20-26), 4 in periodontal disease (18,19,28,29) and 1 in the CFU counts of Candidas (27).…”

“…Six studies used only Lactobacilli probiotic strains (19,20,23,27-29), 3 studies Bifidobacteria (24-26), 1 used Streptococci (18), and 2 studies used mixtures of probiotic strains (21,22). Seven RCTs evaluated the influence of bacteriotherapy in the colony forming units (CFU) counts of S. Mutans and dental caries (20-26), 4 in periodontal disease (18,19,28,29) and 1 in the CFU counts of Candidas (27). Four RCTs employed dairy products as a vehicle for the administration of probiotics (20,21,23,24), 6 used oral tablets (18,25-29) and 2 used powder sachets (19,22).…”

“…Of the latter, Jindal G et al (22) used it diluted as a mouthwash. Eight studies had an intervention time equal or greater than 8 weeks (18,19,20,23,25-27,29). The remaining four studies lasted 7 to 18 days (21,22,24,28).…”

Approach to the most prevalent oral disorders among the elderly: an integrative review focusing on primary health care

“…In addition, photodynamic therapy is expensive for consideration as treatment at a populational level. On the other hand, the proposed use of probiotics described by Kraft-Bodi et al 36 could represent an interesting therapeutic strategy in this population, in view of its effect on the reduction of strains of Candida Albicans.…”