What is the role of probiotics in the prevention and treatment of caries?

The essence of caries is an oral ecological imbalance disease, which needs ecological prevention and control. In addition to reducing the intake of sugary foods, the application of fluoride, pit and fissure sealing, the use of antibacterial agents and other conventional caries prevention and control methods, finding a safe and adjustable oral microecological balance of caries prevention has become a new trend in the prevention and treatment of dental caries.

As a new type of caries prevention and treatment, probiotic therapy has gradually attracted the attention of scholars, and this article reviews the related research on probiotics and caries prevention and treatment in recent years.

1. Probiotics

Probiotics are defined as a class of bacteria that are beneficial to the human body and maintain the balance of oral and gastrointestinal flora. Probiotic therapy, also known as live bacteria therapy or bacterial replacement therapy, refers to the treatment method of replacing pathogenic bacteria with non-pathogenic bacteria, which has become a potential new method for the prevention and treatment of infectious diseases, and is widely used to regulate the intestinal ecological balance.

It has been used for a long time in the prevention and treatment of intestinal diseases and has a good effect on regulating intestinal flora. Acidobillus and Bifidobacterium are the most commonly used probiotics.

In recent years, a large number of studies have found that some strains of Acidobacter and Bifidobacterium have probiotic properties in the oral cavity, such as Lactobacillus rhamnosus GG, Lactobacillus casei, Lactobacillus reuteri, Bacillus plantarum, Bacillus breve CD2, Bifidobacterium BB12, etc., which can reduce the number of Streptococcus mutans in saliva, regulate the pH of plaque, and reduce the incidence of caries.

The mechanism of action may include: immunomodulatory function, affecting the oral microecology, producing bacteriocin, influencing and changing the composition of oral microorganisms, producing bacteriostatic substances, and competitively eliminating and preventing the attachment of oral pathogenic bacteria.

2. Colonization of probiotics in the oral cavity

Probiotics can play a role in the intestine based on the inhibition of intestinal pathogenic bacteria and regulation of intestinal flora after temporary colonization and colonization, and the same is true for the probiotic effect in the Japanese cavity. If probiotics colonize the oral cavity, participate in the formation of plaque biofilm, and inhibit pathogenic bacteria, they may play a good role in oral probiotics.

It can also be seen that although probiotics have a certain "residual effect" after short-term use, they cannot be colonized in the oral cavity for a long time. Before a baby is born, the digestive tract is sterile, and after birth, the colonization of bacteria begins when the newborn is exposed to a bacterial environment and diet.

Bacteria that colonize early may persist once they survive and promote the growth of other bacteria. There is a "window of infection" for infection and colonization in the oral cavity of children. - Some scholars believe that early colonization of probiotics may be the basis for long-term chemical benefits.

However, it should be noted that in some experiments on probiotic colonization, saliva is mainly selected as the test sample, which may underestimate the actual colonization of probiotics in plaque, so further understanding of probiotic colonization in the oral cavity depends on the detection of probiotic membrane.

In addition, although many researchers support that early intake of probiotics can promote permanent colonization, the timing and timing of early intake are inconclusive, which also requires further research.

3. The relationship between probiotics and children's disease

Although the long-term colonization of probiotics in the oral cavity is still inconclusive, short-term intake can indeed play a certain role in oral probiotics. In recent years, probiotic products have attracted the attention of pediatric dentists, and have been recommended for the prevention and treatment of children's disease for many times, and the effect has been reported in the relevant research on the prevention and treatment of children's disease.

The application of probiotics in the field of caries prevention and treatment in children has mostly focused on the effects of short-term consumption of products containing different probiotics on the number of S. mutans in saliva, plaque biofilm, and saliva buffering capacity.

1. Effect of probiotics on the number of S. mutans in children's saliva

For a long time in caries research, S. mutans is recognized as a cariogenic bacteria, it produces acid and is acid-resistant, and is involved in the occurrence and development of caries.

Volunteers aged 12-14 years were randomly divided into probiotic ice cream group, probiotic-free ice cream group (control), probiotic curd group, and probiotic-free curd group (control).

Among the different types of probiotics, Lactobacillus rhamnosus GG could quickly and significantly reduce the number of S. mutans in saliva, showing good oral probiotics.

2. Effect of probiotics on oral plaque biofilm in children

Probiotics can reduce the number of S. mutans in children's saliva, which indicates to a certain extent that they have the effect of inhibiting the growth of cariogenic bacteria, and the initiating factor of caries is dental plaque, which is not caused by a single pathogen, but by the imbalance of plaque microecology.

With the deepening of research, researchers began to pay attention to the effect of probiotics on plaque biofilms. It was found that Lactobacillus breve CD2 can not only reduce the prosthetic mutans in saliva, but also increase the pH in the plaque and reduce the acid production of bacteria in the plaque, but the specific mechanism of action has not been further studied.

It was found that LGG had stronger antibacterial activity than Lactobacillus acidophilus and Lactobacillus brevis, and LGG could inhibit the formation of cariogenic biofilms, which may be by: (1) reducing the dextran required by S. mutans or S. mutans in the initial stage of plaque formation, thereby inhibiting the formation of cariogenic biofilms;

(2) interfere with the growth of other bacteria involved in the formation of biofilms, and (3) Lactobacillus rhamnosus LGG does not colonize biofilms in this process.

3. Effect of probiotics on saliva buffering energy in children

Saliva buffering capacity is the ability of saliva to neutralize a certain amount of acid or base to keep the oral environment stable within the appropriate pH range. Salivary buffering capacity is an important endogenous anti-caries factor for the host, and a decrease in salivary buffering capacity will lead to an increased risk of caries.

Thus, alterations in salivary buffering capacity are also commonly detected in caries-related studies. In vivo experiments showed that saliva buffering capacity was significantly increased in saliva samples from 25 children aged 6-10 years after taking yogurt containing Lactobacillus rhamnosus for 30 days.

4. Research on probiotics and adult mycoses

The relevant research on the application of probiotics in the field of adult caries prevention and treatment mostly focuses on the different effects of lactobacillus and bifidobacterium on oral microecology and the discussion of oral probiotic strains. Acidobacter presentiflorum has been used as an intestinal probiotic for decades and has attracted attention for its ability to block a variety of pathogenic bacteria.

However, because it is often found in dentin and is thought to be related to the progression of related diseases, the probiotic effect of lactobacilli in the oral cavity is still controversial, and different species of acidobacilli have different effects on the oral microecology.

A growing body of research suggests that some species of lactobacilli may play a positive role in regulating the balance of the oral microbiota through their interaction with other microorganisms.

Through different experiments, researchers have found that Lactobacillus salivarius, Lactobacillus rhamnosus, Lactobacillus paracasei, Lactobacillus brevis, Lactobacillus reuteri, Porus plantarum and Lactobacillus bulgaricus can reduce the incidence of caries, reduce the number of S. mutans in saliva or plaque, regulate the pH of plaque, etc., and have certain oral probiotics.

By simulating oral hard tissue in vitro, the probiotic properties of Lactobacillus plantarum HO-69 in the oral cavity were studied, and it was found that the non-acid antibacterial substances produced by Bacterium plantarum HO-69 had broad-spectrum antibacterial activity, especially for S. mutans.

A total of 50 subjects were selected to use toothpaste containing Lactobacillus casei for 4 weeks, and saliva samples before and after use were compared, and the results showed that the number of Streptococcus mutans and Lactobacillus mutans in the oral cavity was significantly reduced after 4 weeks of probiotic toothpaste.

A large number of studies have made stomatologists re-understand the different roles of different types of lactobacilli in the oral ecological balance, but how to use lactobacilli with oral probiotic effects to serve the prevention and treatment of caries needs more in-depth research.

Bifidobacteria are widely used in intestinal diseases as a safe probiotic. However, there are fewer studies on bifidobacteria and caries in adults. Its probiotic mechanism is competitive attachment to the tooth surface or competition for nutrients, pH transition, buffer energy, and antibacterial effect under immune stimulation.

However, at the same time, it has a certain acid-producing and acid-resistant properties, and it is not clear whether it plays a cariogenic or caries-inducing effect if it is placed under cariogenic conditions. The bacteriocins produced by bifidobacteria have a strong bacteriostatic effect, especially against Gram-positive bacteria.

The study found that short-term consumption of yogurt containing Bifidobacterium BB-12 in adults significantly reduced the amount of saliva, while the number of lactic acid rods and chisels did not change significantly, indicating that some strains of Bifidobacterium have oral probiotics.

5. Probiotic intake routes

Probiotics are mainly added to food in four ways: (1) in concentrated form, such as fruit juice, (2) as prebiotics to promote the role of probiotics, (3) in dairy products, such as milk, yogurt, cheese, and (4) in the form of freeze-dried powder as a daily dietary supplement, such as probiotic tablets, chewing gum, etc.

Studies have shown that dairy products with probiotics are a better way to consume probiotics. Because the carrier contains the basic nutrients needed for children's growth and development, such as natural casein, hook, pathogen, etc., it can reduce the colonization of pathogenic bacteria and is considered to be caries-proof;

It is recommended that children aged 0-5 years with high caries risk consume yogurt containing probiotics every day to reduce high levels of bacteria in the oral cavity, so as to achieve the purpose of preventing caries, but there are no clear recommendations and relevant studies on the intake of yogurt containing probiotics.

From the side, it shows that whether probiotics are added or not, yogurt itself is beneficial for reducing the total number of bacteria in the plaque. Ice cream and curd are loved by children as a fun probiotic product, and the advent of probiotic toothpaste is also a convenient way to intervene.

Because early intake may promote the permanent colonization of probiotics, the ideal route of intake in children still needs to be further explored.

6. The safety of probiotics for oral amine

Lactic acid and bifidobacterium have good effects and high safety when used in intestinal diseases. Because it metabolizes acid-producing and is involved in the formation of biofilms, it theoretically increases the risk of caries.

However, a large number of studies have shown that bacteria with certain oral probiotics in Lactobacillus and Bifidobacterium, such as Bifidobacterium paracasei SDK Bifidobacterium BB-12, Bacterium acidophilus, Lactobacillus reuteri, etc., have not been found to have any adverse reactions while reducing the incidence of myeloid disease, and can be recommended as safe strains to promote oral health.

In order to make probiotics more safe to be applied to the oral cavity, some researchers have proposed to replace live bacteria with inactivated probiotics. The use of inactivated probiotics has the following advantages: it can standardize the number of bacteria, have a long shelf life, can safely use "pathogenic bacteria", overcome its dozenogenic effect, and exert a probiotic effect.

VII. Conclusion

A large number of studies have confirmed the oral probiotics of probiotics, but the use of probiotics in the prevention and treatment of caries still needs to solve many problems.

For example: (1) how to choose the best oral probiotics, the best dosage and intake route; (2) probiotics are not easy to colonize in the oral cavity for a long time, and short-term intake will not have a long-term effect, so long-term continuous supplementation and intake are required, so there are problems such as how to choose the total time of long-term intake and what is the best way to supplement every day;

(3) The long-term continuous supplementation of probiotics, the compliance and consciousness of patients, and the level of compliance will inevitably affect the therapeutic effect of probiotics;(4) The research on the early colonization of probiotics in the oral cavity and the safety of probiotics in young children need to be further explored.

That's all for this article, thank you for reading it carefully, and if you have any questions, please feel free to leave me a message in the comment area.