Há lugar para o uso de probióticos na saúde bucal? / Is there a place for probiotics in oral health? Systematic review

RESUMO

Objetivo: revisar os efeitos dos probióticos na profilaxia e tratamento de doenças da cavidade oral. Material e métodos: buscou-se artigos no Medline, Lilacs e SciELO com as estratégias de busca treatment and "oral health" and probiotics; probiotics and "oral health"; probiotics and "oral cavity"; prevention and "oral health" and probiotics; probiotics and "mouth diseases". Critérios de inclusão pesquisas em humanos, em inglês, português e espanhol, e foco nos efeitos dos probióticos na saúde bucal. Critérios de exclusão estudos em animais, ou publicados em outros idiomas, e não relacionados ao benefício dos probióticos na cavidade oral. Resultados: foram incluídos 14 artigos (revisão, ensaio clínico e caso-controle), publicados na Alemanha, Brasil, Cuba, Dinamarca, Índia, Inglaterra e Peru, todos de alta qualidade metodológica. O uso de probióticos parece favorecer o equilíbrio da microflora bucal e reduzir a incidência de cáries, gengivites, halitoses, candidíase oral e periodontites. Apenas dois artigos declararam conflito de interesse, riscos e danos do uso de probióticos. Conclusão: dada a importância dos probióticos e seu potencial promissor, mais estudos isentos de interesses comerciais são necessários para avaliar o custo/efetividade e segurança dos probióticos na profilaxia, e tratamento de doenças bucais antes que profissionais da saúde e governos possam recomendá-los.

ABSTRACT

Objective: review the effects of probiotics in the prevention and treatment of oral cavity diseases. Materials and methods: the Medline, Lilacs, and SciELO databases were screened using the following strategies treatment and "oral health" and probiotics; probiotics and "oral health"; probiotics and "oral cavity"; prevention and "oral health" and probiotics; probiotics and "mouth diseases". Inclusion criteria studies performed in humans in English, Portuguese and Spanish, with focus on probiotics' effects on oral health. Exclusion criteria studies performed in animals, published in different languages, and without direct relationship with the benefi ts of using probiotics for oral health. Results: 14 articles were included (review, clinical trial and case control), published between 2008 and 2013 in Germany, Brazil, Cuba, Denmark, India, England and Peru. Articles included reached high methodological quality. It seems that the use of probiotics enhance balance of the oral microflora, which reduces the incidence of caries, gingivitis, halitosis, periodontitis, and oral candidiasis. Only two articles superficially reported conflict of interests, risks, and damages from probiotics usage. Conclusion: given the importance and potential of probiotics, further studies free of commercial interests are needed to evaluate their cost-effectiveness and safety in the prevention and treatment of oral diseases, before professionals and government programs may recommend their usage.