Prevention of Recurrent Childhood Caries with Probiotic Supplements: A Randomized Controlled Trial with a 12-Month Follow-Up

Abstract

The aim of this study was to evaluate the effect of drops containing probiotic bacteria on the recurrence of dental caries in preschool children. The study employed a randomized, placebo-controlled, double-blinded design with two parallel arms. 38 preschool children were enrolled after comprehensive restorative treatment under general anesthesia or conscious sedation (baseline), and they were followed up after 6 and 12 months. Parents of children in the test group were instructed to give 5 daily drops containing two strains of Limosilactobacillus reuteri (DSM 17938 and ATCC PTA 5289) at bedtime. The placebo drops were identically composed but lacked bacteria. The duration of the intervention was 12 months. The primary endpoint was recurrence of new caries lesions on subject level (yes/no), and secondary endpoints were presence of dental plaque and gingivitis. We found high rate of recurrent moderate and extensive lesions after 12 months (67%) but there were no significant differences between the groups. We observed no beneficial effects on dental plaque or gingival inflammation. The findings were however uncertain and inconclusive due to lack of power, a consequence of the COVID-19 pandemic. ClinTrials.gov Identifier: (NCT04929340), June 18, 2021; retrospectively registered.

The Benefits of Probiotics on Oral Health: Systematic Review of the Literature

“…The studies discussed in this collection shed light on the potential advantages of probiotics in enhancing oral health across different contexts. Duraisamy et al (2021) conducted a randomized controlled trial with children, demonstrating that daily probiotic consumption led to a significant reduction in S. mutans levels in saliva [ 30 ]. Sarmento et al (2019) explored the use of probiotic-fortified cheese and its potential to influence the oral microbiota in children [ 31 ].…”

“…Kang et al (2020) found that probiotics improved periodontal health in adults, with reduced bleeding and altered oral bacteria levels [ 38 ]. Finally, Hasslof et al (2022) investigated probiotic drops’ potential to prevent dental caries recurrence in preschoolers, with no significant differences observed between the test and control groups [ 30 ]. These studies collectively underscore the promising role of probiotics in promoting oral health, although their effectiveness may vary, and long-term impacts require further exploration.…”

“…The trend toward a decrease in the number of streptococci in saliva appears to be independent of the product or strain used; however, this effect was not observed in all studies [ 30 ].…”

“…Parents of kids in the test group were told to put five drops of two strains of Limosilactobacillus reuteri in their children’s mouths at bedtime each day. As a result, they saw that there were no notable variations between the groups [ 30 ].…”

Contribuições científicas em odontologia: pesquisas, práticas e novos paradigmas

“…Estes artigos selecionados estão dispostos na Tabela 1. Dos 15 artigos incluídos nessa revisão, apenas 3 não apresentaram resultados detectando a alimentação próbiótica como importante na redução da incidência da cárie dentária ou da diminuição de formação de colônias de Streptococcus mutans ou de Lactobacillus acidophilus(TAIPALE et al, 2013;HASSLÖF et al, 2013;HASSLÖF et al, 2022).Os artigos estudados envolveram um total de 2806 indivíduos. Os veículos para o oferecimento do alimento probiótico foram: o leite em 7 casos(NÄSE et al, 2001; SJOSTROM;TWETMAN, 2009;RODRÍGUEZ et al, 2016; VILLAVICENCIO et al, 2018;PAHUMUNTO et al, 2018;PIWAT et al, 2020;SANDOVAL et al, 2021), gotas (TEHRANI et al, 2016HASSLÖF et al, 2022), pastilhas(ALAMOUDI et al, 2018;STASZCZYK et al, 2022), suco(POHJAVUORI et al, 2010), chupeta (TAIPALE et al, 2013, comprimidos mastigáveis(HEDAYATI HAJIKAND et al, 2015) e dieta com cereais(HASSLÖF et al, 2013).…”