Clinical Efficacy of Probiotics on Oral Health: A Systematic Review of Clinical Trials

Introduction: Periodontal diseases and dental caries are the two most common dental diseases caused by the dental plaque. Objective: The aim of the present study was to review the clinical efficacy of probiotics for oral health in randomized controlled trials. Methods: An electronic search was conducted in December 2021 in Embase, Medline, The Cochrane Library, ProQuest, and Google Scholar using the following keywords: “mouthwash” and “probiotics”. The titles and abstracts of 3,775 articles were screened and 24 publications that fulfilled the inclusion criteria were included. Results: A total of 24 clinical trials were reviewed, including 1612 participants receiving either probiotics or mouth treatments. The results of this review indicated that individuals receiving probiotic products have a significant reduction (65% reduction; p < 0.05) in the count of Streptococcus mutants in their mouths. It was also found that probiotic products were more effective or equal in effect compared to chlorhexidine in reducing oral pathogens, gingival index, and plaque index scores. On the other hand, the consumption of xylitol mouthwash was shown to cause an improvement in salivary parameters. Considering their safety and effectiveness, the use of probiotic products, such as kefir and mouthwashes, has been recommended against cariogenic bacteria and periodontal diseases. Conclusion: Probiotics are considered a safe alternative to conventional therapies, such as chlorhexidine and fluoride. Co-administration of chlorhexidine, fluoride, and probiotics seems to be a perfect package.