Lactic acid bacteria from healthy oral cavity of Thai volunteers: inhibition of oral pathogens

A super sandstorm altered the abundance and composition of airborne bacteria in Beijing

Sandstorm, which injects generous newly emerging microbes into the atmosphere covering cities, adversely affects the air quality in built environments. However, few studies have examined the change of airborne bacteria during severe sandstorm events. In this work, we analyzed the airborne bacteria during one of the strongest sandstorms in East Asia on March 15th, 2021, which affected large areas of China and Mongolia. The characteristics of the sandstorm were compared with those of the subsequent clean and haze days. The composition of the bacterial community of air samples was investigated using quantitative polymerase chain reaction (qPCR) and high-throughput sequencing technology. During the sandstorm, the particulate matter (PM) concentration and bacterial richness were extremely high (PM2.5: 207 µg/m3; PM10: 1630 µg/m3; 5700 amplicon sequence variants/m3). In addition, the sandstorm brought 10 pathogenic bacterial genera to the atmosphere, posing a grave hazard to human health. As the sandstorm subsided, small bioaerosols (0.65-1.1 µm) with a similar bacterial community remained suspended in the atmosphere, bringing possible long-lasting health risks.

Preventive effects of probiotics on dental caries in vitro and in vivo

BACKGROUND

Dental caries is a common disease in the oral cavity, and the microorganisms in the cavity are colonized in the form of dental plaque biofilm. Streptococcus mutans is the main pathogen causing dental caries. Using probiotics to inhibit the growth and colonization of pathogenic bacteria, regulate mucosal immunity and improve oral microecological balance is an effective way to prevent or treat dental caries. The aim of this study was to evaluate the caries-prevention of probiotics in vitro and in rat caries models.

METHODS

The probiotics used in this study are a combination of 4 strains of bacteria. After the fermentation of 4 strains (L. plantarum, L. salivarius, L. rhamnosus, and L. paracasei) was completed, they were mixed in equal volume proportions and used as samples to be tested. The mixture was then assessed the ability to inhibit the growth of S. mutans in vitro and in vivo. SPSS Statistics 22.0 (SPSS, Inc., Chicago, IL, USA) was used for analysis.

RESULTS

In vitro the probiotics mixture could inhibit the growth of S. mutans and was able to remove biofilms formed by S. mutans. In a 42-day in vivo experiment, the probiotics group significantly reduced the level of S. mutans on the tooth surface of rats, reducing more than half the bacterial quantities compared with the caries model group (P < 0.05). The amount of S. mutans in the antagonist group was low and highly significant compared with the caries model group. Moreover, the mixture of 4 strains significantly reduced the caries scores (modified Keyes scoring method) in both the probiotic and antagonist groups (p < 0.05).

CONCLUSIONS

The study showed that the combination of the four strains can reduce the cavity scores, and the four strains can be used as products in oral care products. At the same time, the study also suggests that probiotic therapy can be an effective way to prevent dental caries.

Synergistic Inhibition of Synbiotic Cultures among Lactobacilli and Plant Extracts against Vaginal Discharge Causing Candida albicans

Vulvovaginal candidiasis (VVC) is the most common cause of vaginal discharge among women. The present study aimed to investigate the synergistic anticandidal effect of lactobacillus cultures supplemented with plant extracts. Among 600 isolates of lactic acid bacteria, 41 isolates exhibited inhibitory activity against Candida albicans ATCC10231. Six out of 41 cell-free supernatants demonstrated the most potent antibacterial and anticandidal activities. They also inhibited the clinical isolates of C. albicans, causing VVC and non-C. albicans. The synergistic effect between Lactobacillus crispatus 84/7 and Limosilactobacillus reuteri 89/4 was demonstrated by the lowest fractional inhibitory concentration index (FICI = 0.5). The synbiotic culture of bacterial combination, cultured with Jerusalem artichoke (H. tuberosus) extract, also exhibited the strongest inhibition against the tested C. albicans. Biofilm formation decreased after 12 h of incubation in the selected cell-free supernatants of this synbiotic culture. The anticandidal activity of crude extracts was lost after treatment with proteinase K and trypsin but not with heating conditions, suggesting that it may be a heat-stable substance. In conclusion, the combination of L. crispatus 84/7 and L. reuteri 89/4 with H. tuberosus may be a promising candidate for inhibiting Candida infection and biofilm formation, with the potential use as ingredients in vaginal biotherapeutic products.

Mechanism and application of Lactobacillus in type 2 diabetes-associated periodontitis

Type 2 diabetes mellitus (T2DM) accelerates the progression of periodontitis through diverse pathways. Abnormal immune responses, excessive activation of inflammation, increased levels of advanced glycation end products, and oxidative stress have defined roles in the pathophysiological process of T2DM-associated periodontitis. Furthermore, in the periodontium of diabetic individuals, there are high levels of advanced glycation end-products and glucose. Meanwhile, progress in microbiomics has revealed that dysbacteriosis caused by T2DM also contributes to the progression of periodontitis. Lactobacillus, owing to its fine-tuning function in the local microbiota, has sparked tremendous interest in this field. Accumulating research on Lactobacillus has detailed its beneficial role in both diabetes and oral diseases. In this study, we summarize the newly discovered mechanisms underlying Lactobacillus-mediated improvement of T2DM-associated periodontitis and propose the application of Lactobacillus in the clinic.

Oral Lactobacillus species and their probiotic capabilities in patients with periodontitis and periodontally healthy individuals

OBJECTIVES

This study aimed to identify oral Lactobacillus species and characterize their adhesion properties and antibacterial activity in patients with periodontitis compared with periodontally healthy individuals.

MATERIALS AND METHODS

Three hundred and fifty-four isolates from the saliva, subgingival, and tongue plaque of 59 periodontitis patients and 59 healthy individuals were analyzed. Oral Lactobacillus species were identified through the culture method in the modified MRS medium and confirmed by molecular testing. Moreover, the radial diffusion assay and cell culture methods were used to determine the antibacterial activities of oral strains against oral pathogens and their adhesion activity in vitro.

RESULTS

67.7% of the cases and 75.7% of the control samples were positive for the Lactobacillus species. Lacticaseibacillus paracasei and Limosilactobacillus fermentum were the dominant species in the case group, whereas Lacticaseibacillus casei and Lactiplantibacillus plantarum were dominant in the control group. Lactobacillus crispatus and Lactobacillus gasseri had higher antibacterial effects against oral pathogens. Moreover, Ligilactobacillus salivarius and L. fermentum demonstrated the highest ability to adhere to oral mucosal cells and salivary-coated hydroxyapatite.

CONCLUSION

L. crispatus, L. gasseri, L. fermentum, and L. salivarius can be introduced as probiotic candidates since they demonstrated appropriate adherence to oral mucosal cells and salivary-coated hydroxyapatite and also antibacterial activities. However, further studies should be conducted to assess the safety of probiotic interventions using these strains in patients with periodontal disease.

Evaluating Alterations of the Oral Microbiome and Its Link to Oral Cancer among Betel Quid Chewers: Prospecting Reversal through Probiotic Intervention

Areca nut and slaked lime, with or without tobacco wrapped in Piper betle leaf, prepared as betel quid, is extensively consumed as a masticatory product in many countries across the world. Betel Quid can promote the malignant transformation of oral lesions as well as trigger benign cellular and molecular changes. In the oral cavity, it causes changes at the compositional level in oral microbiota called dysbiosis. This dysbiosis may play an important role in Oral Cancer in betel quid chewers. The abnormal presence and increase of bacteria Fusobacterium nucleatum, Capnocytophaga gingivalis, Prevotella melaninogenica, Peptostreptococcus sp., Porphyromonas gingivalis, and Streptococcus mitis in saliva and/or other oral sites of the cancer patients has attracted frequent attention for its association with oral cancer development. In the present review, the authors have analysed the literature reports to revisit the oncogenic potential of betel quid and oral microbiome alterations, evaluating the potential of oral microbiota both as a driver and biomarker of oral cancer. The authors have also shared a perspective that the restoration of local microbiota can become a potentially therapeutic or prophylactic strategy for the delay or reversal of lip and oral cavity cancers, especially in high-risk population groups.

Evaluation of Probiotic Effects of Lactobacilli on Mutans Streptococci: An In Vitro Study

AIM

The aim of the present study is to evaluate the probiotic effect of Lactobacillus acidophilus and Lactobacillus rhamnosus on clinical isolates of Mutans Streptococci (MS) and antibiotic susceptibility of these strains to commonly used antibiotics in dentistry.

MATERIALS AND METHODS

Plaque samples from permanent first molars were collected and transferred aseptically onto Mitis-Salivarius agar and incubated at 37°C for 24 hours in the presence of 5-10% CO₂. Mutans streptococci colonies were identified biochemically using Hi-Strep identification kit. The inhibitory activity of the clinical strains of MS on Lactobacilli was investigated using agar-overlay interference technique. Positive inhibition was appreciated as a clear zone around the Lactobacilli. Disk diffusion assay was done as described by CLSI M100-S25 for antibiotic susceptibility. The zone of growth inhibition caused by Lactobacilli and antibiotics on MS clinical strains was measured directly using a vernier caliper. Statistical analysis was done using independent t-test.

RESULTS

Mutans streptococci exhibited positive inhibition with both the probiotic strains and L. acidophilus showed more zones of inhibition than L. rhamnosus. Antibiotic susceptibility of clinical strains of MS showed sensitivity to penicillin and vancomycin, however, tetracycline and erythromycin showed very few resistant strains. The highest zone of inhibition was shown by cephalothin followed by penicillin, tetracycline, ciprofloxacin, erythromycin, and vancomycin.

CONCLUSION

L. rhamnosus and L. acidophilus have strong inhibitory effects on clinical strains of MS. Lactobacillus acidophilus showed a higher zone of inhibition. All the clinical strains of MS were sensitive to penicillin and vancomycin. The highest zone of inhibition was shown by cephalothin.

CLINICAL SIGNIFICANCE

Dental caries remains silent epidemic and increasing antibiotic resistance is another major challenge that threatens the world. Newer methods such as whole-bacteria replacement therapy using probiotics for decreasing harmful oral pathogens and reducing the intake of antibiotics must be explored. More researches to promote use of probiotics should be initiated due to its possible preventive and health maintenance benefits providing an end to new cavities and antibiotic resistance.

Characterization of the anti-pathogenic, genomic and phenotypic properties of a Lacticaseibacillus rhamnosus VHProbi M14 isolate

A strain of lactic acid bacteria from cheese was isolated, that showed strong growth inhibitory effects on Streptococcus mutans. The API 50CH system and 16S rDNA sequencing verified that this was a novel strain, and was named Lacticaseibacillus rhamnosus VHProbi M14. The strain inhibited the growth of S. mutans and Fusobacterium nucleatum under mixed culture conditions, coaggregated with S. mutans and F. nucleatum, and reduced the adhesion of S. mutans and F. nucleatum on cultured human primary gingival epithelial (HPGE) cells. The pH, peroxidase and protease sensitivity testing found antibacterial substances of protein- and peptide-like structures in addition to organic acids. The antimicrobial substances were sensitive to hydrolysis with trypsin, papain and pineapple protease and were inactived at temperatures above 100°C. Ammonium sulphate-precipitated proteins from the M14 strain retained the ability to inhibit the growth of S. mutans and F. nucleatum. The M14 strain contained 23 bacteriocin-related genes encoding for metabolites, belonging to class II bacteriocins. The M14 strain also showed inhibitory effects on 8 other pathogenic strains (A. actinomycetemcomitans, C. albicans, E. coli, G. vaginalis, P. acnes, P. gingivalis, S. aureus, S. enteritids), and thus has a broad spectrum of bacterial inhibition. This new isolate has been identified as having potential to be used as a probiotic bacterium in clinical applications.

A comprehensive review of the application of probiotics and postbiotics in oral health

Oral diseases are among the most common diseases around the world that people usually suffer from during their lifetime. Tooth decay is a multifactorial disease, and the composition of oral microbiota is a critical factor in its development. Also, Streptococcus mutans is considered the most important caries-causing species. It is expected that probiotics, as they adjust the intestinal microbiota and reduce the number of pathogenic bacteria in the human intestine, can exert their health-giving effects, especially the anti-pathogenic effect, in the oral cavity, which is part of the human gastrointestinal tract. Therefore, numerous in vitro and in vivo studies have been conducted on the role of probiotics in the prevention of tooth decay. In this review, while investigating the effect of different strains of probiotics Lactobacillus and Bifidobacteria on oral diseases, including dental caries, candida yeast infections, periodontal diseases, and halitosis, we have also discussed postbiotics as novel non-living biological compounds derived from probiotics.

Effect of Different Mouthwashing Regimens on Adhesion of a Universal Adhesive:A Microshear Bond Strength and Scaning Electron Microscopy Evaluation

Objective: To evaluate the effect of probiotic or chlorhexidine-based mouthwashes and coconut oil pulling therapy on microshear bond strength of a universal adhesive, used with two application modes. Method: Ninety-six enamel specimens were prepared using bovine incisors and the surfaces were grounded. Then the specimens were randomly divided into 4groups and each group were subjected to a mouth washing regimen with one of three agents-chlorhexidine mouthwash, probiotic-based mouthwash, coconut oil pulling – or stored in artificial saliva(control) for 7 days(n=24). After the procedure, all groups were divided into 2 subgroups, and a universal adhesive was applied with etch-and-rinse or self-etch mode(n=12). Composite micro-cylinders were bonded to the enamel surfaces and micro-shear-bond strength was measured after 24hours water storage. Failure modes were determined using a stereomicroscope and SEM analysis was also performed. The data were analyzed using Mann-Whitney-U and Kruskal-Wallis tests. Results: No significant differences were observed between the different mouthwash groups, regardless of application modes(p> .05). There were no significant differences in microshear-bond strength, within the same mouthwash groups, between self-etch or etch-and-rinse modes, except for oil pulling group. Etch-and-rinse group showed higher bond strength than self-etch group in specimens subjected to oil pulling(p< .05). Conclusion: Etch-and-rinse mode might be preferable on patients who practice oil pulling.

Probiotics for Oral Candidiasis: Critical Appraisal of the Evidence and a Path Forward

Oropharyngeal Candidiasis (OPC) is a mucosal fungal infection that is prevalent among patients with compromised immunity. The success of probiotics in treating chronic diseases with a microbial etiology component at other mucosal sites (i.e., gastro-intestinal, genitourinary and alveolar mucosae) has inspired research into the use of probiotics in the treatment of OPC. A growing body of research in vitro and in animal models indicates that some probiotic species and strains have inhibitory activities against Candida albicans growth, morphological switching, and biofilm formation. However, recent review and meta-analysis studies reveal a dearth of human randomized, controlled clinical trials on the efficacy of probiotics to treat or prevent OPC, while the majority of these have not based their selection of probiotic strains or the type of administration on sound pre-clinical evidence. In this mini-review, we assess the state of the field, outline some of the difficulties in translating lab results to clinical efficacy, and make recommendations for future research needed in order to move the field forward.

The rationale and potential for using Lactobacillus in the management of periodontitis

Periodontitis refers to a wide range of the inflammatory conditions of supporting dental structures. For some patients with periodontitis, antibacterial agents are needed as an adjuvant to mechanical debridement treatments and oral hygiene maintenance. However, the widespread use of broad-spectrum antibiotics for the prophylaxis and treatment of periodontal infections results in the emergence of resistant pathogens. Therefore, probiotics have become markedly interesting to researchers as a potentially safe alternative to periodontal treatment and maintenance. Probiotics have been used in medicine for decades and extensively applied to the treatment of inflammatory diseases through the modulation of microbial synergy and other mechanisms. A growing amount of evidence has shown that using Lactobacillus strains for oral cavity maintenance could improve periodontal health. In this study, we reviewed studies showing proof of the inhibitory effects of Lactobacillus species on periodontal inflammation. We also explored the rationale and potential for using Lactobacillus species in the management of periodontitis.

Multifunctional Probiotic and Functional Properties of Lactiplantibacillus plantarum LRCC5314, Isolated from Kimchi

In this study, the survival capacity (acid and bile salt tolerance, and adhesion to gut epithelial cells) and probiotic properties (enzyme activity-inhibition and anti-inflammatory activities, inhibition of adipogenesis, and stress hormone level reduction) of Lactiplantibacillus plantarum LRCC5314, isolated from kimchi (Korean traditional fermented cabbage), were investigated. LRCC5314 exhibited very stable survival at ph 2.0 and in 0.2% bile acid with 89.9% adhesion to Caco-2 intestinal epithelial cells after treatment for 2 h. LRCC5314 also inhibited the activities of α-amylase and α-glucosidase, which are involved in elevating postprandial blood glucose levels, by approximately 72.9% and 51.2%, respectively. Treatment of lipopolysaccharide (LPS)-stimulated RAW 264.7 cells with the LRCC5314 lysate decreased the levels of the inflammatory factors nitric oxide, tumor necrosis factor (TNF-α), interleukin (IL)-1β, and interferon-γ by 88.5%, 49.3%, 97.2%, and 99.8%, respectively, relative to those of the cells treated with LPS alone. LRCC5314 also inhibited adipogenesis in differentiating preadipocytes (3T3-L1 cells), showing a 14.7% decrease in lipid droplet levels and a 74.0% decrease in triglyceride levels, as well as distinct reductions in the mRNA expression levels of adiponectin, FAS, PPAR/γ, C/EBPα, TNF-α, and IL-6. Moreover, LRCC5314 reduced the level of cortisol, a hormone with important effect on stress, by approximately 35.6% in H295R cells. L. plantarum LRCC5314 is identified as a new probiotic with excellent in vitro multifunctional properties. Subsequent in vivo studies may further demonstrate its potential as a functional food or pharmabiotic.

The Lactobacillus as a Probiotic: Focusing on Liver Diseases

Over the past decade, scientific evidence for the properties, functions, and beneficial effects of probiotics for humans has continued to accumulate. Interest in the use of probiotics for humans has increased tremendously. Among various microorganisms, probiotics using bacteria have been widely studied and commercialized, and, among them, Lactobacillus is representative. This genus contains about 300 species of bacteria (recently differentiated into 23 genera) and countless strains have been reported. They improved a wide range of diseases including liver disease, gastrointestinal diseases, respiratory diseases, and autoimmune diseases. Here, we intend to discuss in depth the genus Lactobacillus as a representative probiotic for chronic liver diseases.

High Counts and Anthracene Degradation Ability of Streptococcus mutans and Veillonella parvula Isolated From the Oral Cavity of Cigarette Smokers and Non-smokers

The composition and metabolic functions of oral microbiota are affected by many factors including smoking leading to several health problems. Cigarette smoking is associated with changes in oral microbiota composition and function. However, it is not known if the depletion of certain bacterial genera and species is due to specific toxins in cigarette smoke, or indirectly due to competition for colonization with smoking-enriched bacteria. Therefore, the aim of this study was to determine the effect of cigarette smoking on the microbial prevalence and polycyclic aromatic hydrocarbons (PAHs) biodegradation of selected enriched and depleted oral bacteria from oral microbiota of smokers compared to that in non-smokers. Samples of oral rinse from smokers and non-smokers were collected (n = 23, 12 smokers and 11 non-smokers) and screened for oral bacterial strains of Streptococcus mutans, Lactobacillus spp., and Veillonella spp. Comparing counts, S. mutans, V. tobetsuensis, and V. dispar showed higher counts in smokers compared to non-smokers while the Lactobacillus spp. were higher in non-smokers. Lactobacillus fermentum was prevalent in smokers, representing 91.67% of the total Lactobacillus spp. isolates. The biodegradation potential of anthracene; a representative of PAHs of collected isolates, in single and mixed cultures, was assayed with anthracene as the sole source of carbon using 2,6-dichlorophenol indophenol (2,6-DCPIP) as indicator. S. mutans isolates recovered from smokers showed higher degradation of anthracene compared to those recovered from non-smokers. The anaerobic anthracene biodegradation activity of V. parvula isolates from non-smokers was the highest among all isolates of the three recovered genera from the same subject. The anthracene biodegradation potential of Lactobacillus spp. was variable. Combinations of isolated bacteria in co-cultures showed that Lactobacillus spp. interfered with anthracene biodegradation ability along with the viable counts of S. mutans and Veillonella spp. In conclusion, oral dysbiosis due to cigarette smoking was observed not only due to changes in oral bacterial relative abundance but also extended to bacterial functions such as anthracene biodegradation tested in this study. Microbe-microbe interactions changed the anthracene biodegradation potential and growth of the microbial mixture compared to their corresponding single isolates, and these changes differ according to the constituting bacteria.

Thermophilin 110 inhibits growth and biofilm formation of Streptococcus mutans

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S. thermophilus B59671 naturally produces thermophilin 110, a bacteriocin that inhibits the growth of the oral pathogen Streptococcus mutans

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Thermophilin 110 was shown to prevent biofilm formation by S. mutans UA159

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Co-culturing S. thermophilus B59671 with S. mutans UA159 prevented biofilm formation.

Dental caries continues to occur in both children and adults worldwide resulting in significant economic burden, and consumers have expressed interest in natural products that can prevent these recurrent infections. In this study, S. thermophilus B59671, which produces thermophilin 110, was shown to inhibit the growth of S. mutans UA159. A thermophilin concentration ≥ 80 AU ml⁻¹ prevented the growth of S. mutans UA159 in batch culture, while ≥ 160 AU ml⁻¹ was required to prevent biofilm growth. Co-culturing S. thermophilus B59671 and S. mutans UA159 also resulted in impaired biofilm growth. Thermophillin 110 was also shown inhibit additional S. mutans strains and commensal oral streptococci at higher concentrations (640-1280 AU ml⁻¹). These results suggest that thermophilin 110 could be used as a natural antimicrobial in oral care products and support the need for additional studies to assess the probiotic potential of S. thermophilus B59671.

Effect of the local probiotics in the therapy of periodontitis A randomized prospective study

OBJECTIVES

The use of local probiotics in the therapy of periodontitis is reflected in their ability to antagonize periodontopathogens and modulates the immune response of the host to the presence of pathogenic microorganisms. The aim of this study was to investigate the use of local probiotics in the treatment of periodontitis as an adjunctive therapy to scaling and root planning (SRP).

METHODS

The study involved 80 patients diagnosed with periodontitis. All participants underwent SRP therapy. Semi-solid probiotic was then locally applied to the periodontal pocket in randomly selected patients for the test group (40 of them). The other 40 patients were in the control group. Clinical parameters including periodontal pocket depth (PPD), bleeding on probing (BOP) and plaque index (PI) were measured at baseline, and at 7 and 30 days after treatment.

RESULTS

Seven days after the applied therapy in the test and control group, there was a significant decrease in the values or BOP (p < .001), while the values of other parameters did not show a statistically significant difference (p < .05). One month after the therapy in both groups, there was a statistically significant difference in the values of all clinical parameters (p < .001).

CONCLUSIONS

Based on the results of this pilot study, it can be said that, during periodontal treatment, topical application of probiotics in combination with SRP increases the effectiveness of conventional non-surgical therapy of periodontitis.

Developing Lactic Acid Bacteria as an Oral Healthy Food

Lactic acid bacteria have functions in immunoregulation, antagonism, and pathogen inhibition. The purpose of this study was to evaluate the effectiveness of lactic acid bacteria (LAB) in countering oral pathogens and develop related products. After a series of assays to 450 LAB strains, 8 heat-inactivated strains showed a strong inhibitory effect on a caries pathogen, Streptococcus mutans, and 308 heat-inactivated LAB strains showed a strong inhibitory effect on a periodontal pathogen, Porphyromonas gingivalis. The key reasons for inhibiting oral pathogens were bacteriocins produced by LAB and the coaggregation effect of the inactivated cells. We selected Lacticaseibacillus (Lb) paracasei 111 and Lb.paracasei 141, which had the strongest inhibitory effects on the above pathogens, was the main oral health food source. The optimal cultural conditions of Lb. paracasei 111 and Lb. paracasei 141 were studied. An oral tablet with a shelf life of 446 days made of the above strains was developed. A 40 volunteers' clinical study (CSMUH IRB number: CS05065) was conducted with this tablet in the Periodontological Department of the Stomatology Research Center, Affiliated Hospital of Chung Shan Medical University (Taiwan). After 8 weeks of testing, 95% and 78.9% of patients showed an effect on reducing periodontal pathogens and improving probing pocket depth, respectively, in the oral tablet group.

Antagonistic effect of isolated and commercially available probiotics on the growth of Candida albicans on acrylic resin denture surfaces

STATEMENT OF PROBLEM

Biofilms can be retained on dental prostheses leading to the development of infections. The indiscriminate use of antifungal drugs can result in the development of microorganisms that are resistant to these antimicrobial agents. Whether probiotics are a suitable alternative for reducing the prevalence of oral candidiasis is unclear.

PURPOSE

The purpose of this in vitro study was to evaluate the influence of 6 different live strains of probiotics and 2 commercially available probiotic supplements used for inhibiting the growth of Candida albicans biofilm in heat-polymerized acrylic resin denture base material and to determine whether biofilm byproducts modify the surface of specimens.

MATERIAL AND METHODS

Biofilms of C. albicans were formed on acrylic resin specimens in the presence of probiotics and quantified by colony-forming units (CFUs), and the surface roughness (Ra) of the specimens was assessed before and after the formation of biofilms. The CFU and roughness data were analyzed by analysis of variance and the Tukey HSD test (α=.05).

RESULTS

A significant decrease in the number (CFU/mL) of C. albicans cells was found when they were cultured with 4 probiotics: B. lactis (P=.045), B. longum (P<.001), L. casei (P<.001), and L. helveticus (P<.001) and with the commercially available probiotic Prolive (P=.05). The Ra of specimens decreased after exposure to different microbial biofilms (P≤.05) except in 3 experimental groups.

CONCLUSIONS

In general, the tested probiotics had an antagonistic effect on the growth of C. albicans, and the surface of acrylic resin was altered after exposure to biofilm byproducts.

Analysis of relative bacterial activity and lactate dehydrogenase gene expression of caries-associated bacteria in a site-specific natural biofilm: an ex vivo study

Objectives

Detecting bacterial activity is considered a promising approach to monitor shifts from symbiosis to dysbiosis in oral microbiome. The present study aimed at investigating both the relative bacterial activity and the lactate dehydrogenase (ldh) gene expression of caries-associated bacteria in a site-specific natural biofilm.

Material and methods

Sixty subjects (age, mean ± SE: 30.1 ± 1.4) were allocated to two groups: caries-free subjects (CF) or caries-active subjects (CA). CF presented one sound surface (CFS, n = 30). CA presented two donor sites: a cavitated caries lesion (CAC, n = 30) and a sound reference surface (CAS, n = 30). Real-time quantitative PCR (q-PCR) on species or genus level and total bacteria was performed targeting the 16S gene, the 16S rRNA, the ldh gene, and the ldh mRNA (increasing 16S ribosomal RNA copy numbers can function as an indicator of increased energy metabolism). As the 16S rRNA abundance represents the number of ribosomes, while the 16S gene abundance represents the number of genomes, the quotient of the relative abundances functions as a measure for the relative bacterial activity (%).

Results

Both lactobacilli and S. mutans showed the highest relative bacterial activity in CAC ((mean ± SE) 218 ± 60% and 61 ± 16%, respectively) and the lowest values for both sound reference surfaces (69 ± 48%; 8 ± 3%). Significant differences were found between CAC and CAS as well as between CAC and CFS for both lactobacilli and S. mutans (p < 0.05). The ldh gene expression of lactobacilli and S. mutans only showed moderate values in CAC (1.90E+03 ± 2.11E+03; 2.08E+04 ± 4.44E+04 transcripts/μl) and CFS (2.04E+03 ± 2.74E+03; 8.16E+03 ± 6.64E+03 transcripts/μl); consequently no significant differences were detected.

Conclusion and clinical relevance

Caries-associated bacteria (lactobacilli and S. mutans) showed the highest relative bacterial activity in plaque of cavitated lesions, the lowest in sound surfaces, allowing the detection of a significant activity shift in health and disease for caries-active patients. However, no significant differences in ldh gene expression could be determined.

Mitigation of the Toxic Effects of Periodontal Pathogens by Candidate Probiotics in Oral Keratinocytes, and in an Invertebrate Model

The larvae of the wax moth Galleria mellonella and human oral keratinocytes were used to investigate the protective activity of the candidate oral probiotics Lactobacillus rhamnosus GG (LHR), Lactobacillus reuteri (LR), and Streptococcus salivarius K-12 (SS) against the periodontal pathogens Fusobacterium nucleatum (FN), Porphyromonas gingivalis (PG), and Aggregatibacter actinomycetemcomitans (AA). Probiotics were delivered to the larvae (i) concomitantly with the pathogen in the same larval pro-leg; (ii) concomitantly with the pathogen in different pro-legs, and (iii) before inoculation with the pathogen in different pro-legs. Probiotics were delivered as viable cells, cell lysates or cell supernatants to the oral keratinocytes concomitantly with the pathogen. The periodontal pathogens killed at least 50% of larvae within 24 h although PG and FN were significantly more virulent than AA in the order FN > PG > AA and were also significantly lethal to mammalian cells. The candidate probiotics, however, were not lethal to the larvae or human oral keratinocytes at doses up to 10⁷ cells/larvae. Wax worm survival rates increased up to 60% for some probiotic/pathogen combinations compared with control larvae inoculated with pathogens only. SS was the most effective probiotic against FN challenge and LHR the least, in simultaneous administration and pre-treatment, SS and LR were generally the most protective against all pathogens (up to 60% survival). For P. gingivalis, LR > LHR > SS, and for A. actinomycetemcomitans SS > LHR and LR. Administering the candidate probiotics to human oral keratinocytes significantly decreased the toxic effects of the periodontal pathogens. In summary, the periodontal pathogens were variably lethal to G. mellonella and human oral keratinocytes and the candidate probiotics had measurable protective effects, which were greatest when administrated simultaneously with the periodontal pathogens, suggesting protective effects based on bacterial interaction, and providing a basis for mechanistic studies.

Do probiotics promote oral health during orthodontic treatment with fixed appliances? A systematic review

BACKGROUND

Treatment with fixed orthodontic appliances has been associated with significant biofilm accumulation, thus putting patients at a higher risk of oral health deterioration. The use of probiotics has been proposed to be useful in the prevention or treatment of oral pathologies such as caries and diseases of periodontal tissues. Our aim was to investigate the effects of probiotic use on inflammation of the gingival tissues and the decalcification of the enamel in patients being treated with fixed orthodontic appliances.

METHODS

We searched without restrictions 8 databases and performed hand searching until September 2019. We searched for randomized controlled trials (RCTs) evaluating whether individuals with fixed orthodontic appliances benefit from probiotic treatment in terms of the inflammation of the gingivae and decalcification of the enamel. Following the selection of studies and the extraction of pertinent data, we appraised the risk of bias and the confidence in the observed effects based on established methodologies.

RESULTS

From the final qualifying studies, three did not show any statistically significant effect on gingival inflammation after probiotic administration of up to 1 month. Similarly, non-significant differences were noted in another study regarding white spot lesions development (mean administration for 17 months). No adverse effects were reported and the level of evidence was considered moderate.

CONCLUSIONS

Supplementation of orthodontic patients with probiotics did not affect the development of inflammation in the gingivae and decalcification in the enamel. Additional RCTs, with longer intervention and follow-up periods, and involving different combinations of probiotic strains are required.

TRIAL REGISTRATION

PROSPERO (CRD42018118008).

Relationship between Clinical Symptoms and the Microbiota in Advanced Caries

INTRODUCTION

The composition and relative abundance of bacterial species change throughout the development of dental caries; however, how these changes relate to clinical symptoms remains elusive. In this study, we explored the relationship between clinical symptoms and specific microorganisms in advanced dentinal caries.

METHODS

A total of 111 permanent premolars and molars were used to simulate the progression from caries to pulpitis indirectly. Clinical symptoms were evaluated, and teeth were diagnosed according to the diagnostic criteria of the American Association of Endodontics. Samples were collected for 16S ribosomal DNA sequencing. Associations between the microbiota and clinical symptoms/diagnosis and the relationship between alpha diversity and clinical symptoms/diagnosis were evaluated independently by the linear discriminant analysis effect size and Spearman rank correlation analyses.

RESULTS

The 16S ribosomal DNA sequences were assigned to 13,852 operational taxonomic units. The linear discriminant analysis effect size and Spearman correlations unveiled negative associations between the relative abundance of Bacteroidia and Gammaproteobacteria and referred pain, Gammaproteobacteria and the electric pulp test response, and Actinomyces and Propionibacterium and diagnosis (r < 0.0, P < .05). Conversely, the relative abundance of Lactobacillus was positively correlated to referred pain, the cold test, the percussion response, and diagnosis (r > 0, P < .05). Lactobillus reuteri, a probiotic bacterium, was more abundant in teeth with referred pain and teeth diagnosed with symptomatic irreversible pulpitis. The Spearman correlation between alpha diversity and clinical symptoms/diagnosis was not significant (P > .05).

CONCLUSIONS

Clinical symptoms and diagnosis were significantly associated with specific microorganisms in the most advanced layers of dentinal caries.

Metabolomic Status of The Oral Cavity in Chronic Periodontitis

Chronic periodontitis is an inflammatory disease of tooth-supporting tissues associated with Porphyromonas gingivalis. Expansion and invasion of this bacterium into the periodontium is associated with changes in the metabolome of the oral cavity.

MATERIALS AND METHODS

Metabolomics analysis of mouth washout and tongue swab samples based on proton nuclear magnetic resonance (¹H-NMR) method was employed to determine metabolic status of the oral cavity in chronic periodontal disease.

RESULTS

Mouth washout extracts contained a total of 23 metabolites and tongue swab extracts contained 17. Identified metabolites partially overlap with the content of saliva and gingival crevicular fluid. The colonization of the oral cavity of patients with periodontitis by bacteria was manifested in the change in levels of eight metabolites.

CONCLUSION

NMR-based metabolomics analysis is a potentially useful methodological approach for monitoring the pathological processes observed in the oral cavity in the course of periodontitis.

Effect of Probiotics on Oral Candidiasis: A Systematic Review and Meta-Analysis

Oral candidiasis (OC) is an increasing health problem due to the introduction of new drugs, population aging, and increasing prevalence of chronic illness. This study systematically reviews the effects of the oral intake of probiotics, prebiotics, and synbiotics on Candida spp. counts (colony-forming units (CFU)/mL) in oral and palatal samples. A literature search was conducted. Twelve studies, eight randomized clinical trials (RCTs), and four pre-post studies, resulted as eligible for the meta-analysis, which was performed through a Bayesian random-effects model. All studies analyzed probiotics, and none of them analyzed prebiotics or synbiotics. The treatments effects were measured in terms of odds ratio (OR) of OC (CFU/mL >102, 103, or 104). The meta-analytic OR was 0.71 (95% credibility interval (CrI): 0.37, 1.32), indicating a beneficial effect of treatment; the I2 index was 56.3%. Focusing only on RCTs, the OR was larger and more precise at 0.53 (95% CrI: 0.27, 0.93). The effect of treatment appeared to be larger on denture wearers. Our findings indicate that the intake of probiotics can have a beneficial effect on OC and that the effects could vary according to the patients' characteristics. Due to the presence of medium-high-risk studies, the results should be interpreted with caution.

Bacterial survival and adhesion for formulating new oral probiotic foods

Probiotics are defined as live microorganisms, which, when administered in adequate amounts, confer health benefits to the host. Traditionally, probiotic food research has heavily focused on the genera Bifidobacteria and Lactobacilli, along with their benefits for gut health. Recently with the identification of new probiotic strains specifically intended for oral health applications, the development of probiotic foods for oral health benefits has garnered interest, with a renewed focus on identifying new food formats for delivering probiotics. The development of novel oral probiotic foods is highly complex, as the composition of a food matrix dictates: (1) bacterial viability during production and shelf life and (2) how bacteria partition with components within a food matrix and subsequently adhere to oral cavity surfaces. At present, virtually no information is available on oral probiotic strains such as Streptococcus salivarius; specifically, how orally-derived strains survive under different food parameters. Furthermore, limited information exists on the partition behavior of probiotics with food components, governed by physico-chemical interactions and adhesion phenomena. This review aspires to examine this framework by providing a foundation with existing literature related to the common probiotic genera, in order to inform and drive future attempts of designing new oral probiotic food formats.

In vitro evaluation of probiotic strains for lactic acid production

Background

The growing interest on usage of probiotic lactobacilli in maintaining oral health has posed number of questions on its probable side effects. One such consideration could be an increased acid production in dental plaque, in turn leading to dental caries. Thus, the aim of this study was to comparatively evaluate the lactic acid producing ability of L. acidophilus and L. plantarum with and without dental plaque.

Material and Methods

The study consisted of five groups: 3 control groups (Supragingival plaque, L. acidophilus and L. plantarum) and 2 test groups (Supragingival plaque with L. acidophilus and Supragingival plaque with L. plantarum). 26 samples for each group were collected and their baseline spectrophotometric values were recorded. The acid production was initiated by adding 25?l fructose (10%) and stopped by centrifugation for 2 min. The concentration of the lactic acid produced was determined with the aid of COBAS INTEGRA 400 plus.

Results

On comparison of Lactic Acid estimation in mg/dl, the mean values of Plaque group was the highest followed by Plaque +L acidophilus, Plaque +L plantarum, L acidophilus and least in L plantarum. The posthoc analysis shows that the comparison of Group 1 (Plaque) and Group 2 (Plaque +L acidophilus) is statistically Significant results between all the groups except between the Plaque +L acidophilus and Plaque +L plantarum group.

Conclusions

The lactic acid producing ability of pure suspensions of L.acidophilus and L.plantarum and the lactic acid producing efficiency becomes more when they are added to the supragingival plaque. Key words:Probiotic, lactic Acid, plaque.

Dairy Food Consumption is Inversely Associated with the Prevalence of Periodontal Disease in Korean Adults

Dairy food consumption is known to be inversely associated with periodontal disease. However, there are conflicting results depending on the type of dairy foods. The aim of this study was to determine the relationship between individual dairy food consumption and periodontal disease. A total of 9798 Korean adults, aged ≥30 years, who participated in the fifth and sixth Korea National Health and Nutrition Examination Survey were included in this study’s analysis. Dairy food consumption was measured by the semi-quantitative food frequency questionnaire. Periodontal disease was defined as Community Periodontal Index score ≥3 in more than one of six sextants. Frequent intake of dairy foods (≥7 servings/week) was associated with a 24% lower prevalence of periodontal disease compared with never consumers after adjustment for age, gender, income, education, smoking, alcohol consumption, body mass index, diabetes mellitus status, calcium intake, tooth brushing frequency, and use of dental floss (Odds ratio (OR)= 0.76, 95% CI = 0.63–0.91, p for trend = 0.052). Also, frequent intake of milk (≥7 servings/week) was associated with a 26% lower prevalence of periodontal disease after adjustment for potential confounders (OR = 0.74, 95% CI = 0.61–0.89, p for trend = 0.022). Frequent consumption of dairy food including milk may have a beneficial effect on periodontal disease in the Korean adult population.

Lactobacillus salivarius NK02: a Potent Probiotic for Clinical Application in Mouthwash

A specific strain of naturally occurring oral lactobacilli was isolated and identified based on morphological, biochemical, and 16S rRNA gene sequencing. The phylogenetic affiliation of the isolate confirmed that the NK02 strain had close association with the Lactobacillus salivarius. An effective mouthwash was developed for treatment of periodontitis and suppression of the indicator bacterium Aggregatibacter actinomycetemcomitans which is an obvious pathogen of periodontal disease. The mouthwash containing L. salivarius NK02 was tested at a dose level of 10⁸ (colony forming units (CFU) ml^-1), monitoring over a period of 4 weeks. The study was a randomized double-blind placebo control trial, and the patients were treated in two groups of control and test by using scaling and root planing (SRP) + placebo and scaling and root planing (SRP) + probiotic, respectively. It appeared that the probiotic mouthwash was able to inhibit the bacterial growth on both saliva and sub-gingival crevice and exhibited antibacterial activity against A. actinomycetemcomitans. The results also showed that SRP+ probiotic treatment led to a significant decrease of gingival index (GI) and bleeding on probing (BOP) compared with that of SRP + placebo for the probiotic group. The rate of decrease in pocket depth was displayed in the group with SRP + probiotic treatment equal to 1/2 mm, and probing pocket depth (PPD) value was decreased in the probiotic bacteria treatment group that can explain the decrease in inflammation in gingiva. Our findings suggest that probiotic mouthwash is healthy for daily use as an alternative for maintaining dental and periodontal health.

Food Spoilage-Associated Leuconostoc, Lactococcus, and Lactobacillus Species Display Different Survival Strategies in Response to Competition

Psychrotrophic lactic acid bacteria (LAB) are the prevailing spoilage organisms in packaged cold-stored meat products. Species composition and metabolic activities of such LAB spoilage communities are determined by the nature of the meat product, storage conditions, and interspecies interactions. Our knowledge of system level responses of LAB during such interactions is very limited. To expand it, we studied interactions between three common psychrotrophic spoilage LAB (Leuconostoc gelidum, Lactococcus piscium, and Lactobacillus oligofermentans) by comparing their time course transcriptome profiles obtained during their growth in individual, pairwise, and triple cultures. The study revealed how these LAB employed different strategies to cope with the consequences of interspecies competition. The fastest-growing bacterium, Le. gelidum, attempted to enhance its nutrient-scavenging and growth capabilities in the presence of other LAB through upregulation of carbohydrate catabolic pathways, pyruvate fermentation enzymes, and ribosomal proteins, whereas the slower-growing Lc. piscium and Lb. oligofermentans downregulated these functions. These findings may explain the competitive success and predominance of Le. gelidum in a variety of spoiled foods. Peculiarly, interspecies interactions induced overexpression of prophage genes and restriction modification systems (mechanisms of DNA exchange and protection against it) in Lc. piscium and Lb. oligofermentans but not in Le. gelidum Cocultivation induced also overexpression of the numerous putative adhesins in Lb. oligofermentans These adhesins might contribute to the survival of this slowly growing bacterium in actively growing meat spoilage communities.IMPORTANCE Despite the apparent relevance of LAB for biotechnology and human health, interactions between members of LAB communities are not well known. Knowledge of such interactions is crucial for understanding how these communities function and, consequently, whether there is any possibility to develop new strategies to interfere with their growth and to postpone spoilage of packaged and refrigerated foods. With the help of controlled experiments, detailed regulation events can be observed. This study gives an insight into the system level interactions and the different competition-induced survival strategies related to enhanced uptake and catabolism of carbon sources, overexpression of adhesins and putative bacteriocins, and the induction of exchange of genetic material. Even though this experiment dealt with only three LAB strains in vitro, these findings agreed well with the relative abundance patterns typically reported for these species in natural food microbial communities.

The Anti-Periodontitis Effects of Ethanol Extract Prepared Using Lactobacillus paracasei subsp. paracasei NTU 101

Poor oral health and related diseases, including caries, periodontal disease, and oral cancer, are highly prevalent across the world, particularly in the elderly. This study aimed to investigate the anti-periodontitis activity of fermented skim milk produced using the promising probiotic Lactobacillus paracasei subsp. paracasei NTU 101 (NTU101FM). An initial analysis found that an ethanol extract of NTU101FM displayed anti-oxidative activities. Further investigation of pathogen growth inhibition zones, minimum inhibitory concentrations (MICs), and minimum bactericidal concentrations (MBCs) revealed that the NTU101FM ethanol extract also had anti-periodontal pathogen activities. In addition, the NTU101FM ethanol extract significantly decreased the release of pro-inflammatory cytokines induced by lipopolysaccharide (LPS) in RAW 264.7 macrophage cells. Finally, the NTU101FM ethanol extract was found to inhibit receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differentiation by reducing tartrate-resistant acid phosphatase (TRAP) activity and the number of TRAP-positive multinucleated osteoclasts. In summary, our study demonstrated that ethanol extract prepared from NTU101FM has potential use as an anti-periodontitis agent.

Is yogurt intake associated with periodontitis due to calcium?

The purpose of this study is to determine whether the lower intakes of yogurt, milk, and calcium are associated with periodontitis in a nationally representative sample of Korean adults. This study comprised 6,150 adults 19 or more years old who took both periodontal examination and nutrition survey. The frequency of yogurt and milk intake was examined with a food frequency questionnaire. The amount of calcium intake was calculated with dietary intakes data gained from complete one-day 24-hour recall interviews. Periodontitis was assessed using the Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed for the whole sample and subgroups with the strata of age, gender, or smoking, in a complex sampling design. Less intake of yogurt was significantly associated with periodontitis (odds ratio [OR] 0.82, 95% confidential interval [CI] 0.70-0.97), but neither less intake of milk (OR 1.04, 95% CI 0.89-1.20) nor lower intake of calcium (OR 1.04, 95% CI 0.89-1.21) was significantly associated with periodontitis. In the subgroup analysis, no difference in the association of yogurt intake with periodontitis was found according to the strata of age, gender, and smoking. In conclusion, periodonitis was significantly associated with the less intake of yogurt among the Korean adults, but the calcium contained in yogurt is not likely to cause it.

Probiotics: A Promising Role in Dental Health

Probiotics have a role in maintaining oral health through interaction with oral microbiome, thus contributing to healthy microbial equilibrium. The nature and composition of any individual microbiome impacts the general health, being a major contributor to oral health. The emergence of drug resistance and the side effects of available antimicrobials have restricted their use in an array of prophylactic options. Indeed, some new strategies to prevent oral diseases are based on manipulating oral microbiota, which is provided by probiotics. Currently, no sufficient substantial evidence exists to support the use of probiotics to prevent, treat or manage oral cavity diseases. At present, probiotic use did not cause adverse effects or increased risks of caries or periodontal diseases. This implicates no strong evidence against treatment using probiotics. In this review, we try to explore the use of probiotics in prevention, treatment and management of some oral cavity diseases and the possibilities of developing designer probiotics for the next generation of oral and throat complimentary healthcare.

Streptococcus salivarius MS-oral-D6 promotes gingival re-epithelialization in vitro through a secreted serine protease

Gingival re-epithelialization represents an essential phase of oral wound healing in which epithelial integrity is re-establish. We developed an automated high-throughput re-epithelialization kinetic model, using the gingival epithelial cell line Ca9–22. The model was employed to screen 39 lactic acid bacteria, predominantly including oral isolates, for their capacity to accelerate gingival re-epithelialization. This screen identified several strains of Streptococcus salivarius that stimulated re-epithelialization. Further analysis revealed that S. salivarius strain MS-oral-D6 significantly promoted re-epithelialization through a secreted proteinaceous compound and subsequent experiments identified a secreted serine protease as the most likely candidate to be involved in re-epithelialization stimulation. The identification of bacteria or their products that stimulate gingival wound repair may inspire novel strategies for the maintenance of oral health.

Biofilm formation by Candida albicans and Streptococcus mutans in the presence of farnesol: a quantitative evaluation

The aim of this study was to evaluate the effect of the QS molecule farnesol on single and mixed species biofilms formed by Candida albicans and Streptococcus mutans. The anti-biofilm effect of farnesol was assessed through total biomass quantification, counting of colony forming units (CFUs) and evaluation of metabolic activity. Biofilms were also analyzed by scanning electron microscopy (SEM). It was observed that farnesol reduced the formation of single and mixed biofilms, with significant reductions of 37% to 90% and 64% to 96%, respectively, for total biomass and metabolic activity. Regarding cell viability, farnesol treatment promoted significant log reductions in the number of CFUs, ie 1.3-4.2 log10 and 0.67-5.32 log10, respectively, for single and mixed species biofilms. SEM images confirmed these results, showing decreases in the number of cells in all biofilms. In conclusion, these findings highlight the role of farnesol as an alternative agent with the potential to reduce the formation of pathogenic biofilms.

A comparative evaluation of the efficacy of probiotic and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A randomized controlled clinical study

BACKGROUND

The aim of our clinical trial was to assess and compare the antiplaque and anti-inflammatory potential of a probiotic mouthwash with 0.2% chlorhexidine and saline.

MATERIALS AND METHODS

A randomized parallel group study was designed for a period of 4 weeks on 45 systemically healthy subjects between 20 and 30 years having chronic gingivitis. The study population was divided into three groups. Group A - 15 subjects were advised experimental (probiotic) mouthwash. Group B - 15 subjects were advised positive control (chlorhexidine) mouthwash and Group C - 15 subjects into a negative control group (normal saline). Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, all the three groups were instructed to rinse their mouth with 10 ml of their respective mouthrinse, undiluted for 1 min twice daily, 30 min after brushing. Clinical parameters such as plaque index (PI), gingival index (GI), and oral hygiene index simplified (OHI-S) were assessed at baseline, 2 weeks and 4 weeks, respectively.

RESULTS

At day 28, the PI, GI, and OHI-S were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than saline.

CONCLUSION

The probiotic mouthrinses tested was effectively used as an adjunct to mechanical plaque control in the prevention of plaque and gingivitis. Thus, the probiotic mouthrinse has a great therapeutic potential.

Scientific evidence for health effects attributed to the consumption of probiotics and prebiotics: an update for current perspectives and future challenges

Probiotics and prebiotics, mainly commercialised as food ingredients and also as supplements, are considered highly profitable niche markets. However, in recent years, the food industry has suffered from a series of health claim restrictions on probiotics and prebiotics in many parts of the world, including those made by the European Food Safety Authority. Therefore, we reviewed the core benefits of probiotic and prebiotic consumption on health. A number of studies have examined the prevention and/or management of intestinal infections, respiratory tract infections, CVD, osteoporosis, urogenital infections, cavities, periodontal disease and halitosis, allergic reactions, inflammatory bowel disease and irritable bowel syndrome and Helicobacter pylori gastric infections. In fact, a deeper understanding of the mechanisms involved in human microbiota and immune system modulation by probiotics and prebiotics relies on continuous efforts to establish suitable biomarkers of health and diseases risk factors for the design of clinical trials required for health claim approval. In spite of the promising results, the performance of large, long-term, well-planned, well-aligned clinical studies is crucial to provide more reliability and a more solid basis for the outcomes achieved and to support the potential use of probiotics and prebiotics in clinical practice.

Probiotics: can they be used to improve oral health?

The role of probiotic bacteria in improving human health has been an attractive subject for researchers since the beginning of the 20(th) century. They have been used to control gastro-intestinal infections, to promote immunity and to prevent various diseases (allergies, urogenital infections, etc.). However, the use of beneficial bacteria in the field of dentistry has only recently gained interest. Investigation of the effects of probiotic bacteria on oral health has become an important research subject. These studies are still in the early stages, however results show that probiotic bacteria are effective against tooth caries, periodontal disease, oral mucosal lesions and oral malodour. This review provides information on the effects of probiotics--well-known for their effects on general health, and therefore more widely used in healthcare--on oral and dental health, in order to promote their use/prescription by physicians and patients.

Screening of Probiotic Candidates in Human Oral Bacteria for the Prevention of Dental Disease

The oral cavity in healthy subjects has a well-balanced microbiota that consists of more than 700 species. However, a disturbance of this balance, with an increase of harmful microbes and a decrease of beneficial microbes, causes oral disorders such as periodontal disease or dental caries. Nowadays, probiotics are expected to confer oral health benefits by modulating the oral microbiota. This study screened new probiotic candidates with potential oral health benefits and no harmful effects on the oral cavity. We screened 14 lactobacillus strains and 36 streptococcus strains out of 896 oral isolates derived from healthy subjects. These bacteria did not produce volatile sulfur compounds or water-insoluble glucan, had higher antibacterial activity against periodontal bacteria, and had higher adherence activity to oral epithelial cells or salivary-coated hydroxyapatite in vitro. We then evaluated the risk of primary cariogenicity and infective endocarditis of the selected oral isolates. As a result, Lactobacillus crispatus YIT 12319, Lactobacillus fermentum YIT 12320, Lactobacillus gasseri YIT 12321, and Streptococcus mitis YIT 12322 were selected because they showed no cariogenic potential in an artificial mouth system and a lower risk of experimental infective endocarditis in a rat model. These candidates are expected as new probiotics with potential oral health benefits and no adverse effects on general health.

Enhancement of salivary human neutrophil peptide 1-3 levels by probiotic supplementation

Background

Probiotic supplementation can reduce mutans streptococci (MS) numbers. One of its proposed mechanisms is immunomodulation. Salivary human neutrophil peptide 1–3 (HNP1-3) levels have previously been demonstrated to be higher in caries-free than in caries-susceptible children, suggesting their preventive role against caries. We aimed to compare salivary HNP1-3 levels between an intervention group with probiotics and a control group.

Methods

A randomized double-blinded clinical trial was conducted. Sixty schoolchildren were equally allocated to either an intervention or control group. The use of a probiotic strain, Lactobacillus paracasei SD1, has shown to reduce MS numbers in volunteers. In unstimulated whole saliva, HNP1-3 levels were assayed by ELISA, and MS and lactobacilli counts were assayed by colony counting at baseline (T0) and at 3 (T3), 6 (T6), and 12 months (T12). The International Caries Detection and Assessment system was used to assess caries status.

Results

In the intervention group, salivary HNP1-3 levels were significantly greater than those in the control group at T3 and T6 (p < 0.001), whereas MS counts were significantly decreased (p < 0.01). In the intervention group, positive and negative correlations were found between HNP1-3 levels and lactobacilli counts and between MS and lactobacilli counts, respectively. However, there was no significant correlation between enhanced HNP1-3 levels and decreased MS numbers. The caries increment for the pit and fissure surface, but not for the smooth surfaces, was significantly decreased in the intervention group compared with the control group (p = 0.01).

Conclusions

Probiotics can temporarily enhance salivary HNP1-3 levels; however, their action to reduce new pit and fissure caries probably involves microbial interactions.

Trial registration

TCTR20130904001 (registration date: September 04, 2013).

Electronic supplementary material

The online version of this article (doi:10.1186/s12903-015-0003-0) contains supplementary material, which is available to authorized users.

A tolerant lactic acid bacteria, Lactobacillus paracasei, and its immunoregulatory function

The aim of the present investigation was to isolate a probiotic strain from 23 samples of yurts cheese and 21 samples of kumiss (collected from scattered households in Xinjiang and Inner Mongolia), and from eN-Lac Capsules, a health-promoting product. The isolates were subjected to biochemical characterization analysis and were tested for tolerance to low pH, sodium salt, bile salt, pepsin, and trypsin. 16S DNA sequence analysis was conducted to identify the strain. The possible dose-dependent role of strain LP2 in immunomodulation was investigated using the ICR mouse model (from the Institute of Cancer Research). Daily, we conducted clinical observations, a carbon clearance test, a spleen lymphocyte proliferation test, and measurements of body mass and lymphoid organ index. Natural killer cell activity and delayed-type hypersensitivity reaction were determined. The results showed that 3 selected strains (LP2, LP4, and LP9) had high tolerance to low pH, sodium chloride, and bile salt and were not significantly different from Lactobacillus paracasei in terms of morphology, colony, and biochemistry characterizations. A further tolerance test showed that LP2 had the highest survival rate (90%) under the conditions of pH 3.0, 0.3% bile salt, 10 mg/mL pepsin, and 10 mg/mL trypsin for 24 h. The sequence heterogeneities within the 16S rDNA genes molecularly elucidated that the LP2 belongs to the L. paracasei family, on the basis of a homology of 99.6%. A significant enhanced footpad swelling reaction and natural killer cell activity in the middle-dose (10(8) cfu/mL) and the high-dose (10(9) cfu/mL) groups were observed but without obvious dose dependence (P < 0.05). Lymphocyte proliferation was also increased significantly in a dose-dependent manner (P < 0.01) compared with that of the control group, indicating a positive immunoregulatory effect.

A multispecies probiotic reduces oral Candida colonization in denture wearers

PURPOSE

The prevalence of Candida infections has been rising with an increasingly aging population and a larger population of immunocompromised individuals. The use of probiotics may be an alternative approach to antifungal agents in the prevention and treatment of oral candidiasis. This study aimed to evaluate the short-term effect of probiotics in reducing the infection level of oral Candida in candidiasis-asymptomatic elderly denture wearers.

MATERIALS AND METHODS

In a double-blind randomized study, 59 denture wearers harboring Candida spp. in the oral cavity with no clinical symptoms were allocated into two groups: probiotic and placebo. All patients were instructed to clean the denture daily. The probiotic group poured a capsule containing lyophilized Lactobacillus rhamnosus HS111, Lactobacillus acidophillus HS101, and Bifidobacterium bifidum daily on the palatal surface of the maxillary denture, whereas the placebo group was submitted to the same regimen using placebo capsules. Candida spp. infection levels were evaluated in palate mucosa samples obtained before and after a 5-week experimental period.

RESULTS

All patients harbored Candida in the palate mucosa at baseline. Fifty-five individuals completed the experimental period. The detection rate of Candida spp. was 92.0% in the placebo group after the experimental period, whereas it was reduced to 16.7% in the probiotic group. The reduction promoted by the probiotic regimen was independent of baseline characteristics such as Candida infection level and colonizing species, age of denture, and other variables.

CONCLUSION

The probiotic product was effective in reducing the colonization of the oral cavity with Candida in candidiasis-asymptomatic elderly denture wearers, suggesting that this multispecies probiotic could be used to prevent oral candidiasis.

CLINICAL IMPLICATIONS

Colonization of oral surfaces by Candida is considered a risk factor for invasive fungal infections. The use of a product with L. rhamnosus, L. acidophilus, and B. bifidum may represent an alternative treatment for reduction of Candida infections in elderly denture wearers.