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Reduction of Streptococcus mutans by probiotic milk: a multicenter randomized controlled trial

Clinical Oral Investigations Aims and scope Submit manuscript



To investigate the effects of probiotics, Lactobacillus paracasei SD1, on the quantities of Streptococcus mutans in saliva and plaque samples of preschool children.


This randomized trial recruited 487 preschool children from eight childcare centers. Participants were assigned to receive a 6-month course of placebo milk daily (group I), probiotic milk either daily (group II) or three days a week (triweekly, group III). The absolute quantities of S. mutans and total lactobacilli in the saliva and plaque samples at baseline (T0), after intervention (T6), and 6 months after discontinuation (T12) were assessed by qPCR.


Of 487 children, 354 completed all follow-up periods. However, only 268 children (3.2 ± 0.8 years old; groups I = 86, II = 89, and III = 93) provided adequate saliva for qPCR. Whereas the quantities of S. mutans were significantly decreased in groups II and III compared to group I in the saliva and plaque samples at T6 and T12, those of total lactobacilli were significantly increased (p < 0.0167). There was no difference in the quantities of S. mutans or total lactobacilli between groups II and III at any period. Significant changes in the quantities of S. mutans and total lactobacilli lasted until T12 compared to T0 (p < 0.0167).


Probiotic administration daily or triweekly reduces S. mutans quantities, whereas it increases total lactobacilli quantities that persists at least 6 months after discontinuation in the saliva and plaque samples of preschool children.

Clinical relevance

Daily or triweekly consumption of L. paracasei SD1 supplemented in milk may help prevent dental caries in preschool children.

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The authors wish to thank Dr. M. Kevin O Carroll, Professor Emeritus of the University of Mississippi School of Dentistry, USA, and Faculty Consultant at Chiang Mai University Faculty of Dentistry, Thailand, for his assistance in the preparation of the manuscript.


This trial was financially supported by the Health Systems Research Institute, Ministry of Public Health, Thailand (#HSRI60-023) to R.T.; by the National Research Council of Thailand (#DEN600045a) to S.P.; by a Postdoctoral Fellowship from Prince of Songkla University, Thailand to N.P.; by the Intramural Endowment Fund, Faculty of Dentistry, Chiang Mai University, Thailand to A.N.; and by the Food Innovation and Packaging Center, Chiang Mai University, and the Thailand Research Fund (#BRG6080001) to S.K.

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Correspondence to Rawee Teanpaisan.

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All procedures involving human participants in this trial were in accordance with the ethical standards of the Ethics Committee, Faculty of Dentistry, Prince of Songkla University (#EC5912-50-L-HR) and the Human Experimentation Committee, Faculty of Dentistry, Chiang Mai University (#10/2018), and with the Declaration of Helsinki (1964) and its later amendments.

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

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Manmontri, C., Nirunsittirat, A., Piwat, S. et al. Reduction of Streptococcus mutans by probiotic milk: a multicenter randomized controlled trial. Clin Oral Invest 24, 2363–2374 (2020).

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