Probiotics aid oral health: When the goal is to reduce antibiotics

by Susan Clark, RDH

An antibiotic was originally thought of as a substance produced by one microorganism that selectively inhibits the growth of another. Currently, the term antibiotic is applied to any medication that kills bacteria or inhibits their growth, regardless of whether that medication is produced by a microorganism or not.(1)

Sometimes the term antibiotic is used to refer to any substance used against microbes, synonymous with antimicrobial, leading to the widespread, but incorrect belief that antibiotics can be used against viruses. Antibacterials are used in soaps and disinfectants, while antibiotics are used as medicine and have no effect on viral infections such as the common cold or influenza.(2) As a result of this misconception, the overuse of antibiotics in medicine has led to a slew of so-called superbugs, leading to antibiotic resistance.

The Centers for Disease Control and Prevention es­timate that up to 50% of antibiotics are unnecessary or inappropriately prescribed.(3)From 1996 to 2013, dental prescribing increased by 62.2%, and its proportionate contribution increased from 6.7% to 11.3% of all antibiotic prescriptions. The rate of prescribing increased most for dental patients aged 60 years or older, in regard to:

• Unnecessary prescriptions for periapical abscesses and irreversible pulpitis
• Increased prescribing associated with dental implants and their complications
• Slow adoption of guidelines calling for less perioperative antibiotic coverage for patients with valvular heart disease and prosthetic joints
• Emphasis on cosmetic practices reducing the surgical skill set of average dentists
• Underinsured practices driving antibiotics to be a substitute for surgery
• The aging population
• The fact that there are now more dental providers per capita(4)

It is advisable that antibiotic prescribing should be reviewed regularly to make sure that they are compliant with the most recent evidenced-based guidelines.

In addition, with all antibiotics, it is important to take probiotics along with them in order to replenish the good bacteria that may have been killed off during the treatment with antibiotics.(1)

The word probiotic comes from the Greek words “pro” (promoting) and “biotic” life, as opposed to “anti” (against) and “destructive” (kill micro-organisms). Probiotic bacteria must be kept alive. They may be killed by heat, stomach acid, or simply die with time.

The best source of probiotics is from yogurt with live active cultures. Other sources include soft cheese such as Gouda (and milk with acidolfilus added to it), soy, miso, sauerkraut, sour dough bread, tempeh, kimchi, kefir, and even pickles. They are also added to some high-end dark chocolates and available as supplements.

Oral Probiotics

Oral probiotics are designed to boost the level of your oral health naturally and effectively, working to build a strong and healthy foundation for your mouth, gums, and teeth. They are designed to repopulate the mouth with good microorganisms. Oral probiotics:

• have properties that reduce inflammation to reduce gingivitis, and periodontal disease by recolonizing with healthy bacteria to fight this bacterial overgrowth.
• kills off foul sulfurous gases produced by bacterial colonies, mostly found in the back of the tongue to rid your mouth of that foul smell.
• boost your immune system and hinder pathogens from binding to your body's tissues by allowing the good bacteria fend off illness
• contain powerful elements to assist in the remineralization of your teeth
• helps to balance the pH in your mouth to restore natural and healthy saliva flow in your mouth therefore reducing dry mouth.(8)

A (2006) study in the Swedish Dental Journal reported that “Lactobacillus Reuteri may also be capable of promoting dental health, as it has been proven to kill Streptococcus mutans, a bacterium responsible for tooth decay. A screen of several probiotic bacteria found L. reuteri was the only species of those tested able to block S. mutans. Before testing in humans was begun, another study showed L. reuteri had no harmful effects on teeth. Clinical trials have since proven those people whose mouths are colonized with L. reuteri (via dietary supplementation) have significantly less of the harmful S. mutans. Since these studies have been short-term, it is not yet known whether L. reuteri prevents tooth decay. However, since it is able to reduce the numbers of an important decay-causing bacterium, this would be expected.”(10)

Gingivitis also may be ameliorated by consumption of L. reuteri. Patients afflicted with severe gingivitis showed decreased gum bleeding, plaque formation, and other gingivitis-associated symptoms compared with placebo after chewing gum containing L. reuteri.(10)

S. salivarius is primarily found in the mouth, competing with these bad bacteria and is thought to have a positive impact on microbial balance as well.

Researchers have discovered that probiotics create a film in the mouth that acts as a protective sheath for oral tissues and prevent diseases connected with gums and teeth. The space used by bad bacteria is occupied by probiotics, which thus restricts the multiplication of these bacteria. Consequently, the bad bacteria are replaced by good bacteria, which prevent contributions to oral health problems.

From cavities to bad breath and periodontitis, all of your oral problems have their roots with undesirable bacteria building up in your oral cavity. By introducing good bacteria in the mouth through probiotic supplements, the amount of harmful bacteria is significantly reduced, which improves the health of the mouth environment.(8)

Probiotic products are considered an element of healthy life. Oral administration of probiotics is a safe and effective and may reduce the need for antibiotics. There's no recommended daily dose of probiotics, but research suggests aiming for 1 billion to 10 billion live bacteria cultures (measured in Colony Forming Units, or CFUs). Since bacteria counts are rarely found on food labels, focus instead on eating a serving of a probiotic-rich food every day.

Susan Clark, RDH, is a retired dental hygienist with 32 years of clinical experience. She is a certified orofacial myologist, key opinion leader, public speaker, and a self-published author of "Exploring Dental Hygiene: Finding the Hidden Rewards." She served two terms as president of the San Diego County Dental Hygienists' Society, and recently stepped down as vice president of professional development. In 2013, she received the Sunstar/RDH Award of Distinction. She is an independent contractor on behalf of Waterpik, conducting lunch-and-learn presentations in the northern San Diego and Riverside County areas. She can be reached at [email protected].

References

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