PROBIOTICS A BOOST TO ORAL HEATH?
More research needed in order to establish a definitive connection
Two cavities. The last words Sasha, a mother of three children, wanted to hear at the dentist’s office as her son Spencer was getting a checkup.
Spencer, who recently turned four, has now collected five cavities over the course of his young life. These cavities occurred despite Sasha’s diligent efforts to brush and floss Spencer’s teeth twice a day, and minimize how much snacking he does. With dental care being so expensive in Calgary, Sasha feels frustrated and hopeless. Is there any way to reduce the number of cavities Spencer gets in his lifetime?
A cavity develops when a tooth decays, or breaks down. It is a relatively large hole in the tooth that can grow larger over time. Cavities develop because of microbeinfested plaques made up of harmful bacteria that stick to the tooth and cause it to decay. It is one of the many diseases that can compromise your oral health. Others include dental infections and sores, gum diseases such as gingivitis, and any other condition that may limit an individual’s ability to bite, chew, smile or speak.
Oral health is a very important part of overall health, and a smile is also often referred to as a window to the soul. Missing, stained or damaged teeth can affect employment and mental health, and toothaches and dental infections can be extremely painful.
The mouth is home to 250 to 300 different types of bacteria at any given time. Though we usually think of bacteria as a cause of diseases, the human body is full of both “good” and “bad” bacteria. While the good bacteria in the mouth are important to help with digestion, stimulating saliva production and fighting bad breath, the bad bacteria can lead to cavities and gum disease; strep mutans is a particularly villainous species. Many have suggested that one of the factors contributing to oral health is the careful balance between the helpful and non-helpful guests in your mouth.
Probiotics have been a recent hot topic in the media for their role in improving digestive health in the human body. However, the perceived benefits of these healthpromoting bacteria are not so new. The 1908 Nobel Prize for Medicine went to Dr. Elie Metchnikoff, who claimed that Bulgarians lived longer than other Europeans because they ate lots of fermented products like yogurt, which contained helpful bacteria such as lactobacilli and acidophilus.
Probiotics have been shown to be beneficial in certain conditions such as irritable bowel syndrome, inflammatory bowel disease, and antibiotic-triggered diarrhea. Probiotics work well for these conditions because they replace some of the harmful bacteria in your digestive tract, which is home to hundreds of species of bacteria.
Probiotics can be taken as supplements, or through diets that help promote the good bacteria in your system. Examples of probiotic-containing foods include yogurt, kefir and, little-known to most, sauerkraut and kimchi. What most people don’t often hear about is the potential role probiotics may play in improving oral health. When there are more harmful bacteria than helpful bacteria in the oral cavity, symptoms of inflammation set in, leading to dental pain and infection and bleeding and sensitive gums.
This all sounds great, but just like Sasha, you may wonder if any of this is true. A recent systematic review has sought to answer that question. Published last summer in a Spanish journal of oral health, researchers in Barcelona collected all the published research evidence they could find on the connection between probiotics and oral health. Their review identified 12 randomized trials where subjects were given either some form of probiotics, or a placebo. Next, after a period of two months, researchers looked for the amount of the unfriendly bacteria (strep mutans) growing in subjects’ mouths. They also looked at how likely gums were to bleed as a result of poking with a metal dental probe, a sign of gum inflammation. Only a few studies followed patients long enough to look at cavities and gingivitis.
In these columns, we try to focus on research that is sound and convincing enough to allow someone to seriously consider following the study conclusions and recommendations. However, the same cannot be said for this topic. Although there were a few studies that showed positive results and thus a benefit in oral health to taking supplements of probiotics, others failed to show improvement.
In a nutshell, the use of probiotics to improve oral health is intriguing, maybe even promising, but certainly not proven to be beneficial at this time. Two things are clear, however: probiotics are almost certainly safe and better research is urgently needed. Especially lacking are studies that follow study subjects for extended periods of time to determine if probiotics have a lasting effect on things that matter to patients, such as cavities and dental pain; bacterial colony counts won’t cut it.
Most important to keep in mind is that diseases of teeth and gums are caused by a complex interplay of many factors unrelated to probiotic intake. Brushing and flossing, following a healthy diet, and visiting the dentist regularly are all part of ongoing oral care for healthy teeth and gums. April is oral health month, a time to think about how much you are doing to look after your teeth and gums.
Many have suggested that one of the factors contributing to oral health is the careful balance between the helpful and nonhelpful guests in your mouth.