Home  |  About JAPTR |  Editorial board  |  Search |  Ahead of print  |  Current issue  |  Archives |  Submit article  |  Instructions  |  Subscribe  |  Advertise  |  Contacts  |Login 
Users Online: 256   Home Print this page Email this page Small font sizeDefault font sizeIncrease font size

 Table of Contents  
Year : 2015  |  Volume : 6  |  Issue : 2  |  Page : 43-47  

The magic of magic bugs in oral cavity: Probiotics

1 Department of Oral Medicine and Radiology, Century International Institute of Dental Science and Research Centre, Kasaragod, Kerala, India
2 Department of Restorative Sciences, Faculty, Al-Farabi College of Dentistry, Riyadh, Saudi Arabia

Date of Web Publication2-Apr-2015

Correspondence Address:
Dilshad Umar
Fathimas, Jains Compound, Attavar, Mangalore, Karnataka
Saudi Arabia
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-4040.154526

Rights and Permissions

The aim of this review is to present an update about the current status of probiotics in the field of dentistry. Oral infections are the most common forms of infections. It is necessary to understand the role of the ecology and microbiology of the oral cavity in better understanding of the pathogenesis of various oral diseases. The concept of bacteriotherapy has been an emerging field in dentistry. The use of health-beneficial micro-organisms to heal diseases or support immune function was first introduced in the beginning of the 20 th century. Probiotics are dietary supplements containing potentially beneficial bacteria or yeasts and it has been found to be beneficial to the host health. In medicine, probiotics are used mainly in support therapy for gastro-intestinal diseases. In recent years, probiotics have been used as a treatment to promote oral health. This approach has shown promising results in the oral cavity with respect to control of chronic diseases such as dental caries, periodontitis, and recurring problems such as halitosis and candidal infections. Despite the immense potential of probiotics, data are still deficient on the probiotic action in the oral cavity, which further mandates randomized trials before any concrete clinical recommendations can be arrived.

Keywords: Magic bugs, oral health, probiotics

How to cite this article:
Anusha RL, Umar D, Basheer B, Baroudi K. The magic of magic bugs in oral cavity: Probiotics. J Adv Pharm Technol Res 2015;6:43-7

How to cite this URL:
Anusha RL, Umar D, Basheer B, Baroudi K. The magic of magic bugs in oral cavity: Probiotics. J Adv Pharm Technol Res [serial online] 2015 [cited 2023 Mar 27];6:43-7. Available from: https://www.japtr.org/text.asp?2015/6/2/43/154526

  Introduction Top

The mouth dominates a varied, exuberant and heterogenous microbial community. This notably varying microflora inhabits the various surfaces of the normal mouth. Oral bacteria have evolved mechanisms to sense their environment and bypass or reorganize in the host. Bacteria subjugate the ecological niche divulged by both the tooth surface and gingival epithelium. However, an immensely efficient innate host defense system constantly monitors the bacterial colonization and prevents bacterial invasion of local tissues. A defective steadiness exists between dental plaque bacteria and the innate host defense system. [1]

However, due to increased use of antibiotics, this equilibrium of oral ecology has been altered since three decades. Thus, the perception of bacteriotherapy and use of health-beneficial micro-organisms to heal diseases or support immune function was introduced in the early 20 th century. Looking back through history, however, one forgotten concept of using bacteria beneficial to health has been resurrected and has now come under intensive research using modern study designs and methods. The term "probiotic" was derived from the Greek word meaning "for life". [2] Probiotics or health-beneficial bacteria have only recently been introduced in dentistry and oral medicine after years of successful use in mainly gastro-intestinal disorders.

Ellie Metchnikoff postulated that consumption of Bulgarian yoghurt promotes good health in 1907. A probiotics product was expended as a drug for the treatment of scour among pigs in 1950. Lilley and Stillwell in 1965 introduced the term "probiotics." In 1974, Mann and Spoering determined that the fermented yogurt reduced blood serum cholesterol. Hull in 1984 diagnosed the first probiotic species, the Lactobacillus acidophilus. In 1991, Holcombh discovered Bifidobacterium bifidum. In 1994 World Health Organization (WHO) described the probiotics as next most important in immune defense system following resistance to antibiotics. These occurrences steered to a new methodology of probiotics in medicine as well as in dentistry [Table 1]. [3],[4],[5]
Table 1: Brief history of probiotics

Click here to view

The oral cavity with a well-maintained balance of species and species interactions may be a potential source for health promoting probiotic bacteria hence we called it as magic bugs. Several health-promoting effects of probiotics are well recognized, but their influence on oral health is blemished. The aim of this comprehensive review is to present an update about the current status of probiotics in the field of dentistry.

  Definition Top

  • The term Probiotic, meaning "for life," is derived from the Greek language
  • A live microbial food supplement, which beneficially affects the host animal by improving its microbial balance (Fuller in 1989) [6]
  • According to the currently adopted definition, by WHO/Food and Agriculture Organization (2002), probiotics are: "Live micro-organisms, which when administered in adequate amounts confer a health-benefit on the host"
  • International Life Science Institute Europe suggests a definition according to which a probiotic is "a live microbial food ingredient that, when consumed in ample volume, exerts health-benefits on the consumer". [7]

  Prebiotics and synbiotics Top

Prebiotics are generally defined as not digestible food ingredients that beneficially affect the host by selectively stimulating the growth and⁄or activity of one or a limited number of bacterial species already established in the colon, and thus in effect improve host health. [8]

These prebiotics includes inulin, fructooligosaccharides, galacto oligosaccharides and lactulose. The concept of prebiotics essentially has the same aim as probiotics, which is to ameliorate host health via modulation of the intestinal flora, albeit by a distinctive mechanism. Yet there are some cases in which probiotics may be beneficial for the probiotic, specifically with favor to Bifidobacteria is recognized as the symbiotic concept. Synbiotics are outlined as concoctions of probiotics and prebiotics that beneficially affect the host by improving the survival and implantation of live microbial dietary supplements in the gastro-intestinal tract of the host. [9] Sometimes, prebiotics and probiotics are combined in the same product and characterized as synbiotics. The various micro-organisms used as probiotics are summarized in [Table 2].
Table 2: Micro-organisms used as probiotics

Click here to view

  Mechanism of action Top

Some of the hypothetical mechanism of probiotics action in the oral cavity includes: [13],[14],[15]

Direct interaction in dental plaque

  • Enmeshing in securing of oral micro-organisms to proteins
  • Agility on plaque evolution and on its complex ecosystem by competing and intervening with bacterial attachments
  • Engaging in metabolism of substrate and yielding of chemicals that inhibit oral bacteria.

Indirect probiotic actions featured are

  • Modulating systemic immune function
  • Effect on local immunity
  • Eventuality on nonimmunologic defense mechanisms
  • Regulation of mucosal permeability
  • Probiotics function as antioxidants and also produce antioxidants
  • Hamper plaque induction by neutralizing the free electrons.

The mechanisms of probiotic action in the oral cavity could be analogous to those described for the intestine. Conceivable means through which probiotics might affect oral health are summarized in [Figure 1].
Figure 1: Hypothetical mechanism of action of probiotics in oral cavity

Click here to view

Features of a good probiotic

  • It should be a strain, which is capable of exerting a beneficial effect on the host animal, e.g., elevated growth or hindrance to disease
  • It should be nonvirulent and nonpathogenic [10],[11],[12]
  • Preferred to be present as viable cells in large numbers
  • It should be capable of surviving and metabolizing in the gut environment, e.g., endurance to low pH and carbon-based acids, and should be able to maintain genetic stability in oral microflora
  • It should be stable and adept of permanently viable for periods under storage and field conditions. [16]

Probiotic delivery system

They are provided in four basic forms: [17]

  • Beverage or food (fruit juice)
  • Prebiotic fibers
  • Milk-based products
  • Dried cell packages such as powder, capsule, gelatin tablets.

  Probiotics and dental caries Top

The impact of oral administration of probiotics on dental caries has been studied in several experiments utilizing different test strains [Table 3]. Considering the emerging and growing body of evidence about the role of probiotics on caries pathogens, nonetheless, it has been recommended that the operative approach in caries treatment might be challenged by probiotic implementation with subsequent less invasive intervention in clinical dentistry. [20] Conversely, further studies are definitely mandatory before this goal could be achieved.
Table 3: Summary of various studies done on probiotics and dental caries

Click here to view

  Probiotics and periodontal diseases Top

Orally administered probiotics could be beneficial in the treatment of chronic Periodontitis [Table 4]. The presence of periodontal pathogens could be regulated by means of antagonistic interactions. Probiotic strains comprised in periodontal dressings at optimal concentration of 108 CFU/ml have been shown to diminish the number of most frequently isolated periodontal pathogens: Bacteroides sp., Actinomyces sp. and Staphylococcus intermedius, and also Candida albicans. [24]
Table 4: Summary of various studies done on probiotics and periodontal disease

Click here to view

  Probiotics and yeast Top

Various studies are being carried out to find out the correlation of use of probiotics in the reduction of yeast, which are summarized in [Table 5]. However, authors had no explanation. It could be hypothesized that extending research on oral pathology, such as yeast infections, with respect to probiotics, and scrutinizing the molecular means of probiotic activity, might further broaden the field of their potential applications. [27]
Table 5: Summary of various studies done on probiotics and yeast

Click here to view

  Probiotic and imbalanced oral ecosystem Top

Halitosis the oral malodor is the condition normally ascribed to the disturbed commensal micro flora equilibrium. Inhibitory effect on the production of volatile sulfur compounds (VSC) by Fusobacterium nucleatum after ingestion of Weissella cibaria was noticed in a study done by Kang et al. in 2006 both in vitro and in vivo. The possible mechanism in VSC reduction is hydrogen peroxide engendered by W. cibaria that dissuades the procreation of F. nucleatum. [28] Although various probiotic products are marketed for both mouth and gut associated halitosis, their efficacy demands more clinical studies.

  Safety issues Top

The issue of safety is of special concern during the past few years due to the increased probiotic supplementation of different food products. From the safety argument of view, the recognized probiotic microbes must not be pathogenic, should never have any growth exhilarating effects on bacteria instigating diarrhea, and should not possess and capability to relocate antibiotic resistance genes. The probiotics should satisfactorily be adept to maintain genetic stability in the oral microflora. [29]

  Conclusion Top

The oral cavity with a well-maintained balance of species and species interactions may be a potential source for health promoting probiotic bacteria hence we called it as magic bugs. Several health-promoting effects of probiotics are well recognized, but their influence on oral health is blemished. There is limited evidence supporting some uses of probiotics. Extensive scientific acquaintance is required about probiotics, embracing their safety and suitable use. Effects unearthed from one genera or strain of probiotics do not necessarily hold accurate for others, or equal for distinctive preparations of the same species or strain. The full potential of probiotics can be realized when their benefits can be established scientifically. Genetic modification of probiotic strains to suit the oral conditions is indispensable. Systematic studies and randomized control trials are therefore needed to find out the best probiotic strains and means of administration in different oral health conditions.

  References Top

Anthony R. Molecular Oral Microbiology. Norfolk, UK: Caister Academic Press; 2008.  Back to cited text no. 1
Reid G, Jass J, Sebulsky MT, McCormick JK. Potential uses of probiotics in clinical practice. Clin Microbiol Rev 2003;16:658-72.  Back to cited text no. 2
Patil MB, Reddy N. Bacteriotherapy and probiotics in dentistry. KSDJ 2006;2:98-102.  Back to cited text no. 3
Boden EK, Snapper SB. Regulatory T cells in inflammatory bowel disease. Curr Opin Gastroenterol 2008;24:733-41.  Back to cited text no. 4
Manisha N, Ashar, Prajapathi JB. Role of probiotic cultures and fermented milk in combating blood cholestrol. Indian J Microb 2001;41:75-86.  Back to cited text no. 5
Fuller A. Probiotics in man and animals. J Appl Bacteriol 1989;66:365-78.  Back to cited text no. 6
Bhardwaj A, Bhardwaj SV. Role of probiotics in dental caries and periodontal disease. Arch Clin Exp Surg 2012;1:45-9.  Back to cited text no. 7
Gibson GR, Roberfroid MB. Dietary modulation of the human colonic microbiota: Introducing the concept of prebiotics. J Nutr 1995;125:1401-12.  Back to cited text no. 8
Agarwal E, Bajaj P, Guruprasad CN, Naik S, Pradeep AR. Probiotics: A novel step towards oral health. AOSR 2011;1:108-15.  Back to cited text no. 9
Senok AC, Ismaeel AY, Botta GA. Probiotics: Facts and myths. Clin Microbiol Infect 2005;11:958-66.  Back to cited text no. 10
Santosa S, Farnworth E, Jones PJ. Probiotics and their potential health claims. Nutr Rev 2006;64:265-74.  Back to cited text no. 11
Doron S, Gorbach SL. Probiotics: Their role in the treatment and prevention of disease. Expert Rev Anti Infect Ther 2006;4:261-75.  Back to cited text no. 12
Meurman JH. Probiotics: Do they have a role in oral medicine and dentistry? Eur J Oral Sci 2005;113:188-96.  Back to cited text no. 13
Huovinen P. Bacteriotherapy: The time has come. BMJ 2001;323:353-4.  Back to cited text no. 14
Salminen MK, Tynkkynen S, Rautelin H, Saxelin M, Vaara M, Ruutu P, et al. Lactobacillus bacteremia during a rapid increase in probiotic use of Lactobacillus rhamnosus GG in Finland. Clin Infect Dis 2002;35:1155-60.  Back to cited text no. 15
Oyetayo VO, Oyetayo FL. Potential of probiotics as biotherapeutic agents targeting the innate immune system. Afr J Biotechnol 2005;4:123-7.  Back to cited text no. 16
Caglar E, Kargul B, Tanboga I. Bacteriotherapy and probiotics role on oral health. Oral Dis 2005;11:131-7.  Back to cited text no. 17
Meurman JH, Antila H, Korhonen A, Salminen S. Effect of Lactobacillus rhamnosus strain GG (ATCC 53103) on the growth of Streptococcus sobrinus in vitro. Eur J Oral Sci 1995;103:253-8.  Back to cited text no. 18
Montalto M, Vastola M, Marigo L, Covino M, Graziosetto R, Curigliano V, et al. Probiotic treatment increases salivary counts of lactobacilli: A double-blind, randomized, controlled study. Digestion 2004;69:53-6.  Back to cited text no. 19
Anderson MH, Shi W. A probiotic approach to caries management. Pediatr Dent 2006;28:151-3; discussion 192.  Back to cited text no. 20
Grudianov AI, Dmitrieva NA, Fomenko EV. Use of probiotics Bifidumbacterin and Acilact in tablets in therapy of periodontal inflammations. Stomatologiia (Mosk) 2002;81:39-43.  Back to cited text no. 21
Krasse P, Carlsson B, Dahl C, Paulsson A, Nilsson A, Sinkiewicz G. Decreased gum bleeding and reduced gingivitis by the probiotic Lactobacillus reuteri. Swed Dent J 2006;30:55-60.  Back to cited text no. 22
Kõll-Klais P, Mändar R, Leibur E, Marcoöe H, Hammarström L, Mikelsaar M. Oral lactobacilli in chronic periodontitis and periodontal health: Species composition and antimicrobial activity. Oral Microbiol Immunol 2005;20:354-61.  Back to cited text no. 23
Volozhin AI, Il′in VK, Maksimovskii IuM, Sidorenko AB, Istranov LP, Tsarev VN, et al. Development and use of periodontal dressing of collagen and Lactobacillus casei 37 cell suspension in combined treatment of periodontal disease of inflammatory origin (a microbiological study). Stomatologiia (Mosk) 2004;83:6-8.  Back to cited text no. 24
Hatakka K, Ahola AJ, Yli-Knuuttila H, Richardson M, Poussa T, Meurman JH, et al. Probiotics reduce the prevalence of oral Candida in the elderly - A randomized controlled trial. J Dent Res 2007;86:125-30.  Back to cited text no. 25
Ahola AJ, Yli-Knuuttila H, Suomalainen T, Poussa T, Ahlström A, Meurman JH, et al. Short-term consumption of probiotic-containing cheese and its effect on dental caries risk factors. Arch Oral Biol 2002;47:799-804.  Back to cited text no. 26
Meurman JH, Stamatova I. Probiotics: Contributions to oral health. Oral Dis 2007;13:443-51.  Back to cited text no. 27
Kang MS, Chung J, Kim SM, Yang KH, Oh JS. Effect of Weissella cibaria isolates on the formation of Streptococcus mutans biofilm. Caries Res 2006;40:418-25.  Back to cited text no. 28
Grajek W, Olejnik A, Sip A. Probiotics, prebiotics and antioxidants as functional foods. Acta Biochim Pol 2005;52:665-71.  Back to cited text no. 29


  [Figure 1]

  [Table 1], [Table 2], [Table 3], [Table 4], [Table 5]

This article has been cited by
1 Microencapsulation of Probiotic Streptococcus salivarius LAB813
Priyadarshani Choudhary, Heinz-Bernhard Kraatz, Céline M. Lévesque, Siew-Ging Gong
ACS Omega. 2023;
[Pubmed] | [DOI]
2 Bacterial extracellular polymeric substances as potential saliva substitute
Piotr Kardas, Monika Astasov-Frauenhoffer, Olivier Braissant, Michael M Bornstein, Tuomas Waltimo
FEMS Microbiology Letters. 2022; 369(1)
[Pubmed] | [DOI]
3 Effect of conditioning and 3-year aging on the bond strength and interfacial morphology of glass-ionomer cement bonded to dentin
Ahmed Zubaer, Rime Shamme Akter, Al Azad Salahuddin, Rahman Mir Ayubur, Sano Hidehiko, Hoshika Shuhei
Journal of Dental Sciences. 2022;
[Pubmed] | [DOI]
4 Effect of Lactobacillus reuteri on Gingival Inflammation and Composition of the Oral Microbiota in Patients Undergoing Treatment with Fixed Orthodontic Appliances: Study Protocol of a Randomized Control Trial
Kevimy Agossa, Marie Dubar, Grégoire Lemaire, Alessandra Blaizot, Céline Catteau, Emmanuël Bocquet, Laurent Nawrocki, Emile Boyer, Vincent Meuric, Florence Siepmann
Pathogens. 2022; 11(2): 112
[Pubmed] | [DOI]
5 Gemella haemolysans inhibits the growth of the periodontal pathogen Porphyromonas gingivalis
Tomohiro Miyoshi,Shogo Oge,Satoshi Nakata,Yuji Ueno,Hidehiko Ukita,Reiko Kousaka,Yuki Miura,Nobuo Yoshinari,Akihiro Yoshida
Scientific Reports. 2021; 11(1)
[Pubmed] | [DOI]
6 Tapioca Starch Modulates Cellular Events in Oral Probiotic Streptococcus salivarius Strains
Rafig Gurbanov,Hazel Karadag,Sevinç Karaçam,Gizem Samgane
Probiotics and Antimicrobial Proteins. 2020;
[Pubmed] | [DOI]
7 Lactobacillus brevis CD2 attenuates traumatic oral lesions induced by fixed orthodontic appliance: A randomized phase 2 trial
Nathália Louize Nunes Vieira Silva,Alvaro Della Bona,Moisés Cardoso,Sidia Maria Callegari-Jacques,Fernando Fornari
Orthodontics & Craniofacial Research. 2020;
[Pubmed] | [DOI]
8 Synbiotics in caries prevention: A scoping review
Mohammed Nadeem Bijle,Manikandan Ekambaram,Edward C. M. Lo,Cynthia Kar Yung Yiu,Jens Kreth
PLOS ONE. 2020; 15(8): e0237547
[Pubmed] | [DOI]
9 The Effect of Lactobacillus salivarius SGL03 on Clinical and Microbiological Parameters in Periodontal Patients
Polish Journal of Microbiology. 2020; 69(4): 441
[Pubmed] | [DOI]
10 Streptococcus thermophilus Attenuates Inflammation in Septic Mice Mediated by Gut Microbiota
Fu Han,Gaofeng Wu,Yijie Zhang,Haotian Zheng,Shichao Han,Xiaoqiang Li,Weixia Cai,Jiaqi Liu,Wanfu Zhang,Xiaowei Zhang,Dahai Hu
Frontiers in Microbiology. 2020; 11
[Pubmed] | [DOI]
11 Association between semi-solid yogurt intake and periodontitis in Korean adults
Hyo-Jin Lee,Seon-Jip Kim,Young-Seok Park,Jeongmin Ko,Hyun-Jae Cho
Journal of Periodontal & Implant Science. 2019; 49(4): 206
[Pubmed] | [DOI]
12 Effect of bovine milk fermented with Lactobacillus rhamnosus L8020 on periodontal disease in individuals with intellectual disability: a randomized clinical trial
ODA Yuki,Chiaki FURUTANI,Yuika MIZOTA,Atsuko WAKITA,Sumiyo MIMURA,Takuya KIHARA,Masaru OHARA,Yoshiyuki OKADA,Mitsugi OKADA,Hiroki NIKAWA
Journal of Applied Oral Science. 2019; 27
[Pubmed] | [DOI]
13 Severity of Candida -associated denture stomatitis is improved in institutionalized elders who consume Lactobacillus rhamnosus SP 1
X Lee,C Vergara,CP Lozano
Australian Dental Journal. 2019;
[Pubmed] | [DOI]
14 An introduction of the role of probiotics in human infections and autoimmune diseases
Helioswilton Sales-Campos,Siomar Castro Soares,Carlo José Freire Oliveira
Critical Reviews in Microbiology. 2019; : 1
[Pubmed] | [DOI]
15 Efficacy of probiotics: clinical and microbial parameters of halitosis
Athina C Georgiou,Marja L Laine,Dong M Deng,Bernd W Brandt,Cor van Loveren,Xanthippi Dereka
Journal of Breath Research. 2018; 12(4): 046010
[Pubmed] | [DOI]
16 Role of prebiotics and probiotics in oral health
Richard Frank Tester,Farage H. Al-Ghazzewi
Nutrition & Food Science. 2018; 48(1): 16
[Pubmed] | [DOI]
17 Genome Sequence of Weissella cibaria M2, a Potential Probiotic Strain Isolated from the Feces of a Giant Panda
Xin Du,Fuying Dai,Fang Yao,Mingzheng Tan,Qu Pan,Irene L. G. Newton
Microbiology Resource Announcements. 2018; 7(11)
[Pubmed] | [DOI]
18 Complete Genome Sequences of Weissella cibaria Strains CMU, CMS1, CMS2, and CMS3 Isolated from Infant Saliva in South Korea
Mi-Sun Kang,Ji-Eun Yeu,Jong-Suk Oh,Boo-Ahn Shin,Jin-Hee Kim
Genome Announcements. 2017; 5(40): e01103-17
[Pubmed] | [DOI]
19 Probiotics: A Promising Role in Dental Health
Sari Mahasneh,Adel Mahasneh
Dentistry Journal. 2017; 5(4): 26
[Pubmed] | [DOI]
20 Investigation of the Potential Benefits and Risks of Probiotics and Prebiotics and their Synergy in Fermented Foods
Alemayehu Getahun,Anteneh Tesfaye,Diriba Muleta
Singapore Journal of Chemical Biology. 2016; 6(1): 1
[Pubmed] | [DOI]
21 Interactions between Lactobacillus rhamnosus GG and oral micro-organisms in an in vitro biofilm model
Qingru Jiang,Iva Stamatova,Veera Kainulainen,Riitta Korpela,Jukka H. Meurman
BMC Microbiology. 2016; 16(1)
[Pubmed] | [DOI]
22 Oral candidiasis following steroid therapy for oral lichen planus
DR Marable,LM Bowers,TL Stout,CM Stewart,KM Berg,V Sankar,SS DeRossi,JR Thoppay,MT Brennan
Oral Diseases. 2016; 22(2): 140
[Pubmed] | [DOI]
23 Enterosalivary nitrate metabolism and the microbiome: Intersection of microbial metabolism, nitric oxide and diet in cardiac and pulmonary vascular health
Carl D. Koch,Mark T. Gladwin,Bruce A. Freeman,Jon O. Lundberg,Eddie Weitzberg,Alison Morris
Free Radical Biology and Medicine. 2016;
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article
   Prebiotics and s...
  Mechanism of action
   Probiotics and d...
   Probiotics and p...
  Probiotics and yeast
   Probiotic and im...
  Safety issues
   Article Figures
   Article Tables

 Article Access Statistics
    PDF Downloaded1012    
    Comments [Add]    
    Cited by others 23    

Recommend this journal