Efficacy of probiotics against dental caries in children: a systematic review and meta-analysis

Probiotics‐containing beverages and dental caries: A systematic review and meta‐analysis

“…These findings are consistent with the quantitatively summarized evidence concerning the effect of probiotics on dental caries in children [13][14][15]. However, these previously published systematic reviews included data from the sample analyzed in the study of Rodriguez et al [26] and from a subsample analysis considering the effects of probiotics on caries occurrence and immunological modulation [31].…”

“…The risk of bias analysis of the studies included in the present meta-analysis revealed some concerns regarding attrition bias and/or reporting bias, which is congruent with the risk of bias analysis of Twetman and Jørgensen [13], but different from the risk of bias analyses of Shi et al [14] and of Meng et al [15], in which most studies were considered at low risk of bias. It is also important to emphasize that the certainty of the scientific evidence from the consumption of probiotics-containing beverages on dental caries increment and prevalence were considered as "low" and "moderate", respectively.…”

“…Despite the inconsistent and small effect size observed in the present and in the previously published systematic reviews [13][14][15], and considering that dental caries is a noncommunicable disease with relatively slow progression rates, it is outstanding to observe an effect on caries development at a clinical level within less than 1 year of intervention and follow-up. This observation suggests that the included studies were conducted under high-risk contexts for caries development, except for one study included in the descriptive analysis that managed, perhaps through supervised brushing with fluoride toothpaste (1450 ppm), to control the disease, and could not demonstrate an effect on caries prevalence or caries increment from the consumption of milk supplemented or not with probiotics [28].…”

“…This data duplication potentially overinflated the observed effects. In the meta-analysis of Shi et al [14], probiotic consumption was associated with lower development of carious lesions, considering both non-cavitated lesions (SMD −0.15 [95 % CI −0.28 to −0.02]; p < 0.05), as well as cavitated lesions (SMD −0.29 [95 % CI −0.55 to −0.04]; p < 0.05), than seen in the control groups. It is noteworthy that if the study of Sandoval et al [31] had not been considered, their meta-analysis would only include data from the studies of Piwat et al [25] and Rodriguez et al [27].…”

“…Previously published systematic reviews with metaanalyses demonstrated that frequent consumption of probiotics-containing products (e.g., lozenges, yogurt) promotes a reduction in the counts of Streptococcus mutans in dental plaque and in saliva [10][11][12], a result that has been claimed as a health-related benefit in terms of potentially reducing the risk of dental caries development. More recently, small clinical effects of probiotics on reducing the development of early childhood caries were revealed by summarized quantitative data [13][14][15]. Data from randomized clinical trials also suggest that probiotics influence caries development, especially with supplemented milk or reconstituted milk powder.…”