Title No Evidence to Show that Oral Probiotics Reduce the Number of Common Periodontal Pathogens
Clinical Question In humans, what effects do oral probiotics exert on periodontal disease as assessed via bacterial numbers compared with a placebo or alternative treatments?
Clinical Bottom Line Based on a systematic review and meta-analysis including 100 patients in three studies, the use of oral probiotics did not result in a reduction in the number of periodontal pathogens.
Best Evidence  
PubMed ID Author / Year Patient Group Study type
(level of evidence)
26965080Gruner/2016100 adolescent/adult patients in three included studies Meta-Analysis
Key resultsPooled estimates did not show any significant differences between probiotics and the control groups for all three common periodontal pathogens analyzed. [Aggregatibacter actinomycementcomitans: SMD -0.33 (95% CI: -1.32, 0.66), p=0.08; Porphyromonas gingivalis: SMD -0.29 (95% CI: -0.77, 0.19), p=0.36; Prevotella intermedia: SMD -0.48 (95% CI: -1.49, 0.53), p=<0.05].
Evidence Search "periodontal pathogens"[All Fields] AND ("probiotics"[MeSH Terms] OR "probiotics"[All Fields])
Comments on
The Evidence
Validity: Heterogeneity varied between outcomes, and publication bias was not assessed due to the limited number of studies. Only one of the three studies had a low risk of bias. Overall, the findings were inconsistent and the evidence supporting the use of probiotics was graded as very low. Perspective: This study analyzed not only bacterial number measurements as a surrogate for periodontal disease, but also other parameters to determine periodontal tissue inflammation including: plaque and gingival indexes, bleeding on probing (BOP), probing pocket depths (PPD), and clinical attachment loss. This review found that probiotic therapy resulted in reduction of scores in gingival indexes, BOP, and PPD. The authors believe these results are due to the effects of probiotics on host response rather than on the quantity of periodontal pathogens.
Applicability Based on this systematic review, there is presently inadequate evidence to support the use of probiotics to prevent or treat gingivitis or periodontitis. However, a growing number of studies have found that probiotic therapy can reduce gingival inflammation. Further studies are necessary to fully determine the significance of probiotics and gingival health.
Specialty (General Dentistry) (Periodontics)
Keywords Probiotics, periodontal pathogens
ID# 3177
Date of submission 03/25/2017
E-mail reddyd@livemail.uthscsa.edu
Author Danelle Reddy
Co-author(s) e-mail
Faculty mentor Joseph A. Bartoloni, DMD, MPH
Faculty mentor e-mail bartoloni@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
None available
Comments and Evidence-Based Updates on the CAT
None available