Efficacy of Probiotics Compared to Chlorhexidine Mouthwash in Improving Periodontal Status: A Systematic Review and Meta-Analysis

Abstract

Purpose. To critically evaluate the available literature and conduct a systematic review of recent randomized controlled trials to assess the effectiveness of probiotics compared to chlorhexidine mouthwash in enhancing periodontal health. Methods. Five databases were searched electronically, as well as the gray literature. Using the Cochrane risk-of-bias tool for randomized clinical trials, the risk of bias was examined. The weighted mean difference (WMD) method was used to calculate the effect sizes. Heterogeneity was assessed using I2 and τ2 statistics. The GRADE approach was adopted to assess the certainty of the evidence. To assess the robustness of the findings, sensitivity analysis and publication bias assessment were undertaken. Results. A total of 1850 studies were initially identified. Sixteen clinical trials were eligible for qualitative synthesis, and ten were included in the meta-analysis. In terms of the gingival index, in total, no statistically significant difference was observed between chlorhexidine and probiotics within 4 weeks (WMD −0.03, 95% CI: −0.09∼0.04, P = 0.3885). Similar to GI, no statistically significant difference was observed between chlorhexidine and probiotics regarding the plaque index within 4 weeks (WMD 0.11, 95% CI: −0.05∼0.28, P = 0.1726). No statistically significant difference was observed between chlorhexidine and probiotics in all time intervals regarding oral hygiene index-simplified (WMD −0.01, 95% CI: −0.05∼0.04, P = 0.7508). The robustness of these findings was confirmed by sensitivity analysis and publication bias assessments. Conclusions. Based on the findings, probiotics were an acceptable alternative to conventional chlorhexidine in improving periodontal health. High-quality studies with rigorous methodology should be conducted to assess the optimum doses of probiotics for clinical implications.

Administration of Clinical COVID-19 Mouthwashing Protocol and Potential Modulation of Pediatric Oral Bacterial Prevalence of Selenomonas noxia: A Pilot Study

“…First, the immediate and dramatic reductions observed immediately after the mouth washing protocol do not appear to be sustained over time, as most of the patients who initially tested S. noxia -positive before the protocol were found to harbor this organism once again at the recall appointment. This may suggest that the SARS-CoV-2/COVID-19 protocol may only induce a temporary effect on S. noxia that may be more specifically related to the extension of mouth washing time, an effect which has been demonstrated in other studies to dramatically reduce the prevalence of other pathogenic supra-gingival oral bacteria if practiced regularly [ 32 , 33 , 34 ].…”

Effect of Oxyflower® Gel as an Adjunct in Pericoronitis Treatment: A Randomized, Triple-Blind Clinical Trial

“…Chlorhexidine has been routinely prescribed to control adverse periodontal conditions as it has been established as an efficient agent against oral biofilms [24,25,26]. However, some studies have demonstrated adverse effects associated with the use of this mouthwash [27,28,29,30].…”

Dysbiosis of the Subgingival Microbiome and Relation to Periodontal Disease in Association with Obesity and Overweight

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