Probiotics Prove Effective as Adjunctive Treatment for Gum Disease

by | Jan 22, 2016 | 2013, Oral Health, Probiotics

Written by Greg Arnold, DC, CSCS. A probiotic lozenge reduced the risk of gum disease by 40% over those in a control group.

Statistics from the Centers for Disease Control and Prevention state that 47.2% of American adults (64.7 million) have mild, moderate or severe periodontitis, also known as gum disease. For American adults over the age of 65, the prevalence increased to 70.1% (1). Periodontitis has been labeled “an important public health problem in the United States” by the American Association for Dental Research (2).

The primary cause of periodontitis is the presence of pathogenic bacteria along with the absence of “beneficial bacteria” (3, 4, 5). The most popular approach to periodontitis is a procedure called “scaling and root planing” and oral hygiene instructions (6) which initially eliminate many of the pathogenic bacteria. But because of the absence of the “good bacteria”, periodontitis can quickly recur as the pathogenic bacteria return and re-colonize the mouth (7). As a result, ways to prevent the return of pathogenic bacteria to the mouth after scaling and root planing is of primary importance.

Now a newdouble-blind placebo controlled study (8) suggests a probiotic bacteria called L. reuteri may help. In the study, 30 patients between the ages of 39 and 50 with “moderate to severe” periodontitis (classifications based on previous research (9)) underwent either scaling and root planing while taking a placebo lozenge twice per day for 12 weeks or scaling and root planing combined with taking a probiotic lozenge of L. Reuteri twice per day for 12 weeks. Each L. Reuteri lozenge contained 1 x 108 colony-forming units. Each patient sucked on the lozenge once in the morning and once at night after brushing their teeth. Before the study began (when scaling and root planing treatment was performed) and at week 3, 6, 9, and 12, saliva samples were obtained from each patient to measure for the presence of periodontitis.

After 12 weeks, those in the probiotics group saw the number of “deep pockets” (space around the teeth where bacteria live) in their mouths to decrease by 39.7% (7.27 to 4.39 ) compared to a 31.4% decrease in the placebo group (7.21 to 4.95, p < 0.001). When looking at the % of sites in the mouth where periodontitis that stretched for at least 5 millimeters, those in the probiotics group saw a 85.3% decrease (40.21% to 5.92%) compared to a 75.7% decrease in the placebo group (44.85% to 10.90%, p < 0.001). What’s more, 66.7% of the control group (10 patients) were “high risk” for periodontal disease progression after 3 months compared to only 26.7% of those in the probiotic group (4 patients). As a result, “[probiotic supplementation] resulted in significantly more patients falling in the low category in terms of risk for disease progression” according to measures used in previous research (10).

For the researchers, “oral administration of L. reuteri lozenges could be a useful adjunct to scaling and root planning in chronic periodontitis.”

Source: Teughels, Wim, et al. “Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo‐controlled study.” Journal of clinical periodontology 40.11 (2013): 1025-1035.

© The Authors. Journal of Clinical Periontology. Creative Commons Attribution – Non Commercial License

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Posted March 4, 2014.

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. “Prevalence of Periodontitis” posted on the American Dental Association Research Website
  2. Eke PI.  Prevalence of Periodontitis in Adults in the United States: 2009 and 2010.  Jou Dent Res 2012; 91(10): 914-920
  3. Slots, J. & Rams, T. E.  New views on periodontal microbiota in special patient categories. Journal of Clinical Periodontology 1991; 18: 411–420.
  4. Socransky, S. S. & Haffajee, A. D.  The bacterial etiology of destructive periodontal disease: current concepts. Journal of Periodontology 1992; 63: 322–331
  5. Wolff, L., Dahlen, G. & Aeppli, D.  Bacteria as risk markers for periodontitis. Journal of Periodontology 1994; 65: 498–510
  6. Haffajee, A. D., Teles, R. P. & Socransky, S. S.  The effect of periodontal therapy on the composition of the subgingival microbiota Periodontology 2006; 42:219–258
  7. Teughels, W., Newman, M. G., Coucke, W., Haffajee, A. D., van der Mei, H. C., Haake, S. K., Schepers, E., Cassiman, J. J., Van Eldere, J., van Steenberghe, D. & Quirynen, M.  Guiding periodontal pocket recolonization: a proof of concept. Journal of Dental Research 2007; 86, 1078–1082
  8. Teughels W.  Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo-controlled study.  J Clin Periodontol 2013 Nov;40(11):1025-35. doi: 10.1111/jcpe.12155. Epub 2013 Sep 15
  9. Van der Velden U. Purpose and problems of periodontal disease classification. Periodontology 2005;39:13–21
  10. Lang NP.  Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health and Preventive Dentistry 2003; 1: 7–16