Written by Greg Arnold, DC, CSCS. Those with chronic periodontitis, who added a probiotic lozenge containing L. reuteri to their scaling and root planing regime, experienced a significant improvement in plaque inhibition due to the anti-inflammatory and antimicrobial effects of the probiotic. 

oral healthPeriodontal disease is a chronic inflammatory disease of the gum and tissues that surround and support the teeth. If left untreated, periodontal disease can lead to tooth loss. There are 2 types of periodontal disease: gingivitis and periodontitis. While gingivitis is the milder form of gum disease since it only affects the gums, periodontitis is more severe because it also damages the bone and connective tissue that support the teeth (1).

While the most popular non-surgical treatment method for periodontitis is a technique called scaling and root planing (1), research suggests that adding probiotics to the treatment regimen in the form of lozenges after brushing may be a benefit. A 2010 study (2) involved 30 subjects (19 men, 11 women) aged 34 to 50 with no significant health problems other than chronic periodontitis. They underwent scaling and root planing on days 0, 21, and 42 on one side of their mouth while the other side went untreated. Each subject was instructed to brush twice daily for a minimum of 2 minutes using fluoridated toothpaste.

On day 21 of the study through day 42, each subject was given lozenges containing 1 x 108 colony-forming units of the probiotic bacteria L. reuteri. They were instructed to suck one lozenge in the morning and one at night after brushing their teeth. In addition to the scaling and root planing on days 0, 21, and 42, each subject underwent a dental examination to assess dental health.

After 42 days, the researchers noted that scaling/root planing + the probiotic produced the greatest improvements, followed by the probiotic alone, then scaling/root planing alone, and then the control group. Specifically:

Probiotic +
Root Planing
ProbioticRoot PlaningNo Root Planing/No Probioticp-value
Plaque Index44.2 % decrease (1.79 to 1)19% decrease (1.79 to 1.45)15.3% decrease (1.77 to 1.5)9.7% decrease (1.77 to 1.6) < 0.01
Gingival Index46% decrease (1.85 to 1)27.1% decrease (1.85 to 1.35)20.3% decrease
(1.88 to 1.5)
9.6% decrease (1.88 to 1.7) < 0.01
Gingival Bleeding Index87.8% decrease (81.6% to 10%)57.2% decrease (81.6% to 35%)37.5% decrease (87.9% to 55%)20.4% decrease (87.9% to 70%) < 0.01
Probing Pocket Depth26.2% decrease (5.08 to 3.75)5.6% decrease (5.08 to 4.80)9.7% decrease
(5.26 to 4.75)
1.7% increase
(5.26 to 5.35)
< 0.01
Clinical Attachment Level28.8% decrease (3.93 to 2.8)7.4% decrease (3.94 to 3.65)8.1% decrease (4.46 to 4.1)5.9% decrease (4.46 to 4.2) < 0.01

For the researchers, “The present randomized controlled trial confirms the plaque inhibition, anti-inflammatory, and antimicrobial effects of L. reuteri” and that “L. reuteri probiotic can be recommended during non-surgical therapy and the maintenance phase of periodontal treatment. Finally, they suggest that “this therapy could serve as a useful adjunct or alternative to periodontal treatment when scaling/root planing might be contraindicated” but that “Further studies are required in this direction.”

Source: Vivekananda MR. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. J Oral Microbiol 2010 Nov 2;2. doi: 10.3402/jom.v2i0.5344

© 2010 K.L. Vandana et al.

Posted July 21, 2016.

Greg Arnold is a Chiropractic Physician practicing in Hauppauge, NY.  You can contact Dr. Arnold directly by emailing him at PitchingDoc@msn.com or visiting his web site at www.PitchingDoc.com.

References:

  1. “Periodontal Disease” posted on the University of Maryland Medical Center website
  2. Vivekananda MR. Effect of the probiotic Lactobacilli reuteri (Prodentis) in the management of periodontal disease: a preliminary randomized clinical trial. J Oral Microbiol 2010 Nov 2;2. doi: 10.3402/jom.v2i0.5344.