Probiotics for oral health: do they deliver what they promise?

Abstract

Probiotics have demonstrated oral health benefits by influencing the microbiome and the host. Although promising, their current use is potentially constrained by several restrictions. One such limiting factor lies in the prevailing preparation of a probiotic product. To commercialize the probiotic, a shelf stable product is achieved by temporarily inactivating the live probiotic through drying or freeze drying. Even though a lyophilized probiotic can be kept dormant for an extended period of time, their viability can be severely compromised, making their designation as probiotics questionable. Additionally, does the application of an inactive probiotic directly into the oral cavity make sense? While the dormancy may allow for survival on its way towards the gut, does it affect their capacity for oral colonisation? To evaluate this, 21 probiotic product for oral health were analysed for the number of viable (probiotic), culturable (CFU) and dead (postbiotic) cells, to verify whether the commercial products indeed contain what they proclaim. After isolating and uniformly lyophilizing three common probiotic species in a simple yet effective lyoprotective medium, the adhesion to saliva covered hydroxyapatite discs of lyophilized probiotics was compared to fresh or reactivated lyophilized probiotics. Unfortunately, many of the examined products failed to contain the claimed amounts of viable cells, but also the strains used were inadequately characterized and lacked clinical evidence for that unknown strain, questioning their label of a ‘probiotic’. Additionally, lyophilized probiotics demonstrated low adhesive capacity compared to their counterparts, prompting the question of why fresh or reactivated probiotics are not currently used.

Investigating the antimicrobial and anti-inflammatory effects of Lactobacillus and Bifidobacterium spp. on cariogenic and periodontitis pathogens

“…This supports the idea that probiotics originated from fecal samples are the same as to those found in the mouth (Rohani et al, 2015). In order to establish long-term colonization of probiotics in the oral cavity, a strong and permanent adherence is required to colonization, however, probiotics remain for a short period in the oral cavity, and most of them establish a reversible adherence with cells that can be easily detached (Van Holm et al, 2023).…”

Lactiplantibacillus plantarum Induces Apoptosis in Melanoma and Breast Cancer Cells

“…As an example, in vitro and in vivo studies of L. reuterii against B16F10 melanoma cells were conducted using 10 7 CFU bacterial suspension; the authors indicated that a minimal concentration of 10 6 CFU/mL viable bacteria is necessary for probiotic activity [ 13 ]. In addition, concentrations of 10 8 –10 9 CFU/dose or higher are found in commercial products advertised with probiotic effects [ 25 ]. Molska and Regula reported that, although the optimal concentration of probiotics that should be recommended for cancer treatment or prevention is not yet clearly established, it cannot be low if a successful impact on the host organism is to be expected; the authors mentioned that 10 10 –10 11 CFU/day of Lactobacillus spp.…”

Multikingdom oral microbiome interactions in early-onset cryptogenic ischemic stroke

“…Moreover, the probiotic supplementation status of patients is unknown. Probiotics have demonstrated oral health benefits by influencing the microbiome and host [ 69 ]. Finally, we identified some members of the oral microbiota that could be used as indicators of disease status.…”