Severity of Candida‐associated denture stomatitis is improved in institutionalized elders who consume Lactobacillus rhamnosus SP1

Abstract

Background: This study aimed to determine the effect of the consumption of a probiotic on the clinical characteristics of Candida-associated denture stomatitis (DS) and to determine the impact of a protocol of self-care measures in oral/prosthetic hygiene in institutionalized elders that wear removable prostheses (RP). The current treatment for DS is the systemic use of antifungals, as well as the replacement of these devices together with oral/prosthetic hygiene instructions. Methods: This study was a randomized, controlled and triple-blind trial. Thirty-six elders presenting DS of different severity and who carried RP consumed milk with/without the probiotic L. rhamnosus SP1. The prevalence and severity of DS and prevalence of Candida were determined and all participants/caregivers were trained in oral/prosthetic hygiene. Results: In both groups a decrease in the prevalence of DS was observed (P < 0.05) but only the group that consumed probiotic throughout the trial had a significant reduction in the severity of DS and reduced Candida counts (P < 0.05). Educational instruction in oral/prosthetic hygiene was relevant for the participants, regarding the prevalence of this lesion. Conclusions: The frequent consumption of Lactobacillus rhamnosus SP1 and the establishment of a protocol of oral/ prosthetic hygiene drastically reduced the severity of DS in institutionalized elders who wore RP.Abbreviations and acronyms: DS = denture stomatitis; LEE = long-term establishments for the elderly; RP = removable prostheses.

Lactobacillus rhamnosus strains of oral and vaginal origin show strong antifungal activity in vitro

“…Oral candidosis is a result of bacterial-fungal dysbiosis appearing when the microbial homeostasis is disrupted due to antibiotic treatment, local or systemic immune disturbances, smoking, hyposalivation, use of dentures, and poor oral hygiene [32]. To our knowledge, only one randomized clinical trial (RCT) has investigated the antifungal effect of a single strain of L. rhamnosus in the oral cavity [22]. When added to milk, L. rhamnosus SP1 provided a significant reduction in the severity of denture stomatitis and significantly reduced Candida counts in the probiotic group after 6 months' intervention [22].…”

“…To our knowledge, only one randomized clinical trial (RCT) has investigated the antifungal effect of a single strain of L. rhamnosus in the oral cavity [ 22 ]. When added to milk, L. rhamnosus SP1 provided a significant reduction in the severity of denture stomatitis and significantly reduced Candida counts in the probiotic group after 6 months’ intervention [ 22 ]. Four RCT’s [ 19–21 , 33 ] have shown decreased Candida counts after intervention with different L. rhamnosus strains; however, in these trials the strains were combined with non- L. rhamnosus probiotic species, and the antifungal effect can therefore not completely be ascribed to one probiotic strain.…”

“…Several clinical trials have confirmed that regular probiotic administration can decrease the Candida cell counts in samples from the oral cavity, in particular among elderly individuals prone to infections [8,[19][20][21][22] and be a possible supplement to conventional antimycotic treatment [23,24]. However, the genera of probiotics used in the trials are wide-spread, and the choice of an appropriate type of probiotic for this specific target is challenging.…”

Probiotic Streptococcus salivarius Reduces Symptoms of Denture Stomatitis and Oral Colonization by Candida albicans

“…Previous studies have already shown that the assumption of some, but not all [22], probiotic preparations can reduce symptoms of DS [19][20][21], and Candida colonization levels in healthy denture wearers [19,20] and in subjects affected by DS [21]. However, common probiotic strains of the genus Lactobacillus have few chances to exert prolonged protective activity since they are not adapted to be oral colonizers.…”

“…In recent years the administration of specific probiotic preparations was investigated as a means to contrast oral colonization by Candida spp. in denture wearers both in the presence and in the absence of DS, although with contrasting results [19][20][21][22].…”