Probiotic lozenge fights periodontitis

Periodontitis is a complicated bacterial infection in the gums generally caused by a dysbiosis in the oral microbiome. It results is an immune response which inflames the gums, and after a long time causes pockets to develop in the gums that can be further infected by harmful bacteria. The usual treatment for this problem is the physical removal, or scraping away of the accumulated bacteria in these sensitive pockets. A team of researchers in Istanbul, Turkey did a study published by the Journal of Clinical Periodontology in which they tested the effects of a probiotic lozenge, Prodentis®, on the periodontitis condition.

Forty participants with periodontitis were involved in this double-blind study and randomly placed into a placebo group or a group that would consume a probiotic lozenge twice a day for three weeks, after brushing their teeth in the morning and at night. The probiotic used in this experiment was Lactobacillus reuteri, which is a bacterium we have discussed on the blog previously because of its probiotic characterization and because it commonly resides in the gut.

Samples were taken from the participants at day 21, 90, 180, and 360 to test for bleeding on probing (BoP), plaque (PI), gingival indices (GI), and probing depth (PD). The researchers found a significant reduction in probing depth on day 360 in the patients receiving the probiotic, compared to those receiving the placebo. Also, significantly fewer patients were at high risk for periodontitis disease at day 360 if they received the probiotic. As for the presence of L. reuteri in the mouth of participants taking the probiotic, on day 21 the bacteria was detected in six patients and on day 90 it was detected in eleven. No L. reuteri was detected in patients on days 180 and 360, making the levels not statistically different from the baseline sample before the start of the trial.

So what do the results of this study tell us? The participants receiving the Prodentis® probiotic lozenge had improved clinical and microbiological states compared to the placebo group. No long-term statement about L. reuteri colonization capabilities can be said however, because the microorganism was not detected in the probiotic group at days 180 and 360. At the very least, it seems the probiotic slowed the recolonization of harmful bacteria for up to six months before the levels returned to those pre-treatment, which is a promising step toward a more long-term treatment of periodontitis. 

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