Background
- Periodontitis is the 6th most common chronic inflammatory disease that affects adults worldwide
- If left untreated, the sequelae of chronic inflammation is excessive alveolar bone loss and potential tooth loss; following tooth loss, significant functional, structural, and esthetic complications result
- Chronic periodontitis increases overall inflammatory load, contributing to and exacerbating pre-existing systemic inflammatory conditions like diabetes and cardiovascular disease
- Non-surgical periodontal therapy is the gold standard for treatment and involves mechanical removal of pathogenic bacteria; however, may not result in complete control of inflammation, and thus adjunctive treatments are used
Objective
To determine if probiotics are viable as an adjunctive therapy following scaling and root planning for the treatment of periodontitis
Mechanism of Action
Why Choose Probiotics?
- Probiotics are live microbes found in the normal flora that have health benefits when consumed in adequate amounts
- Probiotics have been shown to be effective in the alleviation of systemic inflammatory diseases
- They have been used since the 1900’s to treat gastrointestinal diseases such as IBS and diarrhea, as well as urinary tract problems
- Minimal adverse effects
Conclusion
Further studies with more extensive trial periods are required before it can be recommended to use probiotics for routine periodontal treatment; however, they may be an option for non-responsive periodontitis.
Costa, R. L., Moreira, J., Lorenzo, A., & Lamas, C. C. (2018). Infectious complications following probiotic ingestion: a potentially underestimated problem? A systematic review of reports and case series. BMC Complementary and Alternative Medicine, 18(1), 329. doi:10.1186/s12906-018-2394-3 Flichy-Fernández, A. J., Ata-Ali, J., Alegre-Domingo, T., Candel-Martí, E., Ata-Ali, F., Palacio, J. R., & Peñarrocha-Diago, M. (2015). The effect of orally administered probiotic Lactobacillus reutericontaining tablets in peri-implant mucositis: A double-blind randomized controlled trial. Journal of Periodontal Research, 50(6), 775–785. doi:10.1111/jre.12264 Gruner, D.,Paris, S., & Schwendicke, F. (2016). Probiotics for managing caries and periodontitis: Dentistry, 48, 16-25. doi: 10.1016/j.jdent.2016.03.002 Ikram, S., Hassan, N., Raffat, M. A., Mirza, S., & Akram, Z. (2018). Systematic review and meta analysis of double-blind, placebo-controlled, randomized clinical trials using probiotics in chronic periodontitis. Journal of Investigative and Clinical Dentistry, 9(3), 1-9. https://doi.org/10.1111/jicd.12338 Martin-Cabezas, R., Davideau, J.L., Tenenbaum, H., & Huck, O. (2016). Clinical efficacy of probiotics as an adjunctive therapy to non-surgical periodontal treatment of chronic periodontitis: A systematic review and meta-analysis. Journal of Clinical Periodontology, 43(6), 520–530. https://doi.org/10.1111/jcpe.12545
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