Written by Halima Phelps, DC, ND. Oral administration of the probiotic Streptococcus salivarius M18 ((SsM18) reduced the reoccurrence of black stains on the teeth of study participants.
Probiotics have gained popularity in the Western world due to forthcoming research in their role as an aid in digestive and intestinal health. Perhaps less-known is their role in oral health as well. 1 Bacteria in the mouth has been seen as a negative factor for years by the general population, but what is not always understood is that all microbes are not created equally. Different microbes have different properties: some are beneficial, some pathogenic, and some opportunistic. The use of probiotics in oral health is undergoing research due to the capacity of probiotics to increase oral microbial diversity, thereby directly and indirectly decreasing the negative impacts of harmful microbes and harmful buccal conditions based simply upon their presence and/or inherent microbial properties. 2 In this study, Streptococcus salivarius M18 (SsM18) is examined for its potential to reduce the presence of black stains (BSs) on children’s teeth. This particular strain has previously been studied for its ability to directly decrease the development of dental caries, as well. 2 BSs are a heterogeneous mixture of substances, among which are microbes, and SsM18 has been shown to possess inhibitory bacteriocin and enzymatic properties which may help to combat the potential formation of BSs on dentition. 1,2 SSM18 also possess an inherent property of reducing oral acidity. 2 The ability to promote oral health in childhood would provide a significant feat as, according to Di Pierro et al, “Dental caries is the most common chronic disease of childhood.” 2
In this study 3, 58 children with BSs initially present on their dentition, between the ages of 4-10, participated in a randomized controlled study. At the initiation of the study, they obtained a preliminary professional fluoridated cleaning and tooth polishing, then were divided into two groups A (n=29) and B (n=29). Both groups were initially provided with a toothbrush and fluoride-based toothpaste and proper dental hygiene education. There was no significant clinical or demographic variation between the cohorts (p<0.05). The children were also instructed not to consume tannin-containing drinks for a period of 6 months. Group A, the treatment group, was given SsM18 tablets to consume without chewing once daily and Group B was untreated. Both were re-assessed at 3 and 6 months via simplified oral hygiene index (OHI-s) and the presence or absence of BSs. Four children were omitted during the study, due to antibiotic use, reducing the groups (Group A, n=28; Group B, n=26). At the initial visit (T0), and at 3 months (T1), OHI-s were insignificant (p=0.3 & p=0.4, respectively), but at 6 months (T2), there was a significant difference (p=0.02). For BSs, a significant difference was present at T1 (p=0.02), but not at T2 (p=0.1). At T1 6/28 children had BSs present in Group A and 13/26 children had BSs in Group B; and at T2 9/28 children had BSs in Group A and 14/26 in Group B.
The results of this study exemplified a reduction in BSs using SsM18, which is especially significant in childhood. The findings of this study support the use of oral probiotics, specifically SsM18, as a natural means in childhood to prevent the presence of BSs and potentially dental caries.2 Having a more natural approach to treating childhood dental caries could be ideal, since one conventional treatment to the condition is the utilization of antibiotics which can disturb normal gastrointestinal flora and potentially lead to other systemic consequences. 2 Future considerations should include evaluations of other probiotic strains to also determine their potential in the prevention of the presence of BSs. Also, future studies could vary the age groups to examine the ability of SsM18 and other probiotic strains to aid in the oral health of the adult population as well. These findings support a plausible affordable and attainable natural alternative across financial demographics to support public health measures in the area of dentistry. Additionally, educating the general public on the differences between beneficial and pathogenic bacteria may also be a necessary component to ensure client compliance with future use of probiotics for oral health as a public health measure.
Source: Bardellini E, Amadori F, Gobbi E, Ferri A, Conti G, Majorana A. Does Streptococcus Salivarius Strain M18 Assumption Make Black Stains Disappear in Children? Oral Health Prev Dent. 2020;18(2):161-164. doi:10.3290/j.ohpd.a43359
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Posted September 9, 2020.
References:
- Burton JP, Wescombe PA, Macklaim JM, et al. Persistence of the oral probiotic Streptococcus salivarius M18 is dose dependent and megaplasmid transfer can augment their bacteriocin production and adhesion characteristics. PLoS One. 2013;8(6):e65991.
- Di Pierro F, Zanvit A, Nobili P, Risso P, Fornaini C. Cariogram outcome after 90 days of oral treatment with Streptococcus salivarius M18 in children at high risk for dental caries: results of a randomized, controlled study. Clinical, cosmetic and investigational dentistry. 2015;7:107-113.
- Bardellini E, Amadori F, Gobbi E, Ferri A, Conti G, Majorana A. Does Streptococcus Salivarius Strain M18 Assumption Make Black Stains Disappear in Children? Oral Health Prev Dent. 2020;18(2):161-164. doi:10.3290/j.ohpd.a43359
