Effect of Lozenges Containing Lactobacillus reuteri on the Severity of Recurrent Aphthous Ulcers: a Pilot Study

  • Anne Marie Lynge PedersenEmail author
  • Kathrine Hansen Bukkehave
  • Eric Paul Bennett
  • Svante Twetman


To investigate the effect of a probiotic supplement on the severity of aphthous lesions in patients with recurrent aphthous stomatitis (RAS) over a 3-month period. A second endpoint was to study the effect on pain related to the lesions. The study employed a double-blind randomized, placebo-controlled design with two parallel arms. Twenty patients with minor and major RAS were consecutively enrolled and randomly assigned to the test or the control group. The intervention consisted of lozenges containing two strains of Lactobacillus reuteri taken twice daily for 90 days. Ulcer Severity Score (USS) consisting of six lesion characteristics (number, size, duration, ulcer-free period, site, and pain) was calculated at baseline and after the intervention. Oral pain related to the lesions was estimated by the patients with a Visual Analogue Pain Scale. An improvement of the USS, as well as oral pain, was evident in both groups after 90 days but the reduction was only statistically significant (p < 0.05) compared with baseline in the test group. There were no significant differences between the groups, neither at baseline nor at follow-up. No side effects were recorded. Daily supplements with L. reuteri reduced the severity of aphthous lesions over a 90-day period but the improvement was not significantly better than placebo. The results encourage further research and provide a basis for power calculations of larger and extended studies. Identifier: NCT02976922


RAS Lactobacillus Probiotics Oral mucosal pain 



We thank the patients for their time and effort in taking part of this project.


We gratefully thank the Danish Dental Association Research Foundation for the financial support and the free-of-charge provision of lozenges from BioGaia AB, Sweden.

Compliance to Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

The protocol was approved by The Research Ethics Committee of the Capital Region of Denmark (protocol no. H-15012527).

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Odontology, Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagen NDenmark

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