Retrospective Review of Oral Probiotic Therapy.

Purpose: There have been many in vitro studies reporting on the efficacy of probiotic bacteria in inhibiting pathogens, and there have been published studies reporting on the inhibitor effects of probiotic bacteria on the salivary levels of bacterial pathogens. However, there have not been but a few studies on the clinical benefits of oral probiotic therapy. Study design: Dental records of 60 patients that were enrolled in an Institutional Review Board approved study were reviewed as to current caries activity status with measurement of the Decayed Missing Filled Teeth index and by Caries Management By Risk Assessment (CAMBRA) determination. The current oral health status was compared to the prior-to-study enrollment status and then analyzed in respect to published national norms. The data (without any identifiers) had a statistical analysis by a blinded biostatistician. The data was subjected to statistical analysis (Statsgraphic) before and after the probiotic therapy. Results: Of the 53 subjects available for follow up, only 4 had remained caries active with a grand total of 27 carious lesions being detected and subsequently restored in this group. Of the original total of 60 patients with 292 initial carious lesions, after probiotic therapy and dental restoration, 78 total restorations were placed in the subject group over the following three years. Approximately half of these restorations were required in teeth that had initially presented with smaller lesions and had been placed in a "watch" category. Two of the patients that developed further carious lesions had been randomly assigned to the probiotic PerioBalance, while the other two caries active patients were assigned EvoraKids probiotic. Of the original group of caries active patients, 24 did not present with any further carious involvement. Another 25 could be categorized as caries static, as the restorations required were substantially less than before probiotic therapy had been begun. The F-ratio, which in this case equals 51.3313, is a ratio of the between-group estimate to the within-group estimate. Since the P-value of the F-test is less than 0.05, there is a statistically significant difference between the means of the 4 variables at the 95.0% confidence level. Conclusion: The tested probiotic supplements had a statistically significant effect on the caries experience of the enrolled subjects.

Effectiveness of CRT at measuring the salivary level of bacteria in caries prone children with probiotic therapy.

AIM: This IRB approved clinical trial was to determine the effect of "over the counter" probiotic supplements on the Caries Risk Test- CRT- (Ivoclar) results of the oral microflora in high caries risk children. STUDY DESIGN: Sixty subjects 6 to 12 years old with a caries risk assessment (CAMBRA) of moderate to high (caries prone) were evaluated by an analysis of the difference in the salivary levels of pathogenic bacteria (mutans streptococci and Lactobacilli). The subjects were randomly selected by randomizing software and assigned to two diferent Groups. Group A used PerioBalance (Lactobacilli reuteri-CFU of 200 million) lozenges for 28 days. Group B used the EvoraKids (Streptococcus uberis KJ2, Streptococcus oralis KJ3, Streptococcus rattus JH1 45, > or = 100 million) probiotics chewable tablets for 30 days. Salivary samples were collected then incubated for 48 hours for colony counting and ranking. Follow up testing with the CRT was performed after 60 days at a follow up visit. RESULTS: There was a statistically significant diference in the CRT results between the pre and post use of the probiotics. PerioBalance; SM results t= -6. 78, p< .0001, Lactobacilli results t= -5.762, p< .0001, EvoraKids SMresults t= -7.33, p< .0001, Lactobacilli results t= -2.952, p= .0068. CONCLUSIONS: The CRT values obtained with caries prone children may be significantly affected by probiotic use. Based on this study's results the following conclusions can be made: Both EvoraKids and PerioBalance affected the CRT results by significantly decreasing the number of S. mutans and lactobacilli present in the salivary samples.