ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title In Children at High Caries Risk, Strategies Utilizing Probiotics Are More Effective in Preventing Tooth Decay Than Therapies That Do Not Utilize Probiotics
Clinical Question For caries management in pediatric patients, are strategies utilizing probiotics more effective than therapies that do not utilize probiotics in arresting or preventing the tooth decay process?
Clinical Bottom Line Probiotics were shown to provide improved prevention of caries when compared to interventions that did not include probiotics. The reviewed studies showed a significant decrease in tooth decay and S. mutans in patients receiving probiotics.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 23892501Teanpaisan/201440 Young AdultsRandomized Controlled Trial
Key resultsA statistically significant reduction (P<0.05) of salivary S. mutans bacteria was detected following the 4-week consumption within Group A (probiotic) when compared to the baseline while Group B (placebo) did not show a reduction in S. mutans. The persistence of L. paracasei SD1 could be detected in 15 of the 20 subjects in group A after receiving the milk containing probiotic, but none were present in Group B. The probiotic group (Group A) displayed a significant decrease in bacteria that causes caries and tooth decay.
#2) 26747421Rodriguez/2016261 Children Aged 2-3 years Randomized Controlled Trial
Key resultsAt the end of this study, results from the examinations showed caries prevalence in 54.4% of the probiotic group and in 65.8% of the control group. Probiotic intake showed a statistically significant (P = 0.006) result, indicating that individuals from the probiotic group had a lower probability of tooth decay from caries. Although there was a high drop-out rate, the children that were able to complete the study and received probiotics had a greater decrease in tooth decay processes than those who did not receive probiotics.
Evidence Search Probiotics and caries; probiotics and streptococcus mutans
Comments on
The Evidence
Validity: The Rodriguez study did have a few factors that could have affected the overall results of the study. The overall dropout rate of 21% is a factor that could have affected the results of the trial. This study did, however, have a long trial period that may have contributed to its dropout rate, but a long trial period is necessary for this type of study to truly produce valid results on how the oral cavity responds to probiotics. The groups, however, were randomized, which did reduce bias throughout the study. The Teanpaisan study was conductec over a short amount of time, and I believe a longer trial period could give more valid results. Three test subjects from Group B did not complete the study and stopped reporting to the physician; this could skew results by producing uneven groups. The groups were randomized, minimizing any potential bias. Perspective: Although I received different conclusions on within each article, overall I believe that probiotics are beneficial in caries prevention and also can contribute to the arrest of caries. The articles overall stated that probiotics are a good method to help arrest carries and prevent further carious lesions.
Applicability This subject is applicable to general practice, especially in communities where caries is an epidemic. It is a valid option for children who are susceptible to carious lesions.
Specialty/Discipline (Public Health) (General Dentistry) (Pediatric Dentistry)
Keywords Probiotics, Caries, S. Mutans, Prevention
ID# 3231
Date of submission: 04/21/2017spacer
E-mail ejesieme@livemail.uthscsa.edu
Author Ezinwanne Ejesieme
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Bennett T. Amaechi, BDS, MS, PhD
Faculty mentor/Co-author e-mail amaechi@uthscsa.edu
Basic Science Rationale
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