Probiotics reduce mutans streptococci counts in humans: a systematic review and meta-analysis
Systematically review the available literature regarding the caries-preventive effect of probiotics.
Data, sources and study selection
An electronic search was conducted in three databases (PubMed MEDLINE, ISI Web of Science and Cochrane Library) to identify all suitable studies. The outcomes had to be presented as the effect of probiotics on the incidence of caries or on the levels of mutans streptococci and/or Lactobacillus species. Human studies, written in English, with at least 15 participants, comparing a probiotic product with a placebo/no probiotic were included. Where possible, a meta-analysis was performed to obtain quantitative data.
Since only two articles presented useful data on the caries incidence, we focused on the surrogate endpoints: mutans streptococci and/or Lactobacillus counts. The meta-analysis showed that when the probiotic and control group are compared after treatment, significantly more patients in the probiotic group had low mutans streptococci (<105 CFU/ml) counts and significantly less patients had high (>106 CFU/ml) counts. Regarding the Lactobacillus counts, comparing the probiotic and control group at the end of the probiotic use, no significant differences could be observed, neither in low (<104 CFU/ml) nor in high Lactobacillus (>106 CFU/ml) counts.
Within the limitations of the available data, it may be concluded that probiotics decrease the mutans streptococci counts. This suggests that probiotics could have a positive effect in the prevention of caries.
There is insufficient evidence that probiotics can prevent caries, but they can reduce the mutans streptococci counts.
KeywordsProbiotics Caries Tooth decay Cariogenic bacteria Mutans streptococci Lactobacilli Streptococcus mutans
The study was funded by grants of the Katholieke Universiteit Leuven and the Fund for Scientific Research Flanders.
Conflict of interest
The authors declare that they have no conflict of interest. However, Wim Teughels has received grants from the Katholieke Universiteit Leuven, the Fund for Scientific Research Flanders, BioGaia and Pierre Fabre Médicament for studies in the field of oral probiotics and periodontitis.
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