An introduction to probiotics for dental health

Abstract

The maintenance of dental health relies on the physical removal of dental plaque in conjunction with dentifrices and mouthwashes which may be augmented with antibacterial compounds. Although the development and successful deployment of such products will undoubtedly remain an intrinsic part of effective dental hygiene regimes, research into the potential efficacy of live bacterial supplements or probiotics has increased over the past decade. In 2008, the UK launch of a probiotic lozenge containing active Lactobacillus reuteri and accreditation by the British Dental Health Foundation represent firsts for an oral health product of this type. The oral cavity rivals the gastrointestinal tract (GIT) in terms of microbial diversity and, as with the GIT, the presence and activities of bacteria in the oral cavity have major implications for host health, both locally and, in some cases, systemically. The oral cavity, however, fundamentally differs from the GIT, both anatomically and microbiologically. For example, controlled acidification through bacterial fermentation is viewed as a desirable process in the colon and promoted by intestinal proand prebiotics; however, similar processes have been implicated in enamel demineralisation and dental caries in the mouth. A nuanced approach to the selection of suitable probiotic strains is therefore required. This article aims to introduce the concept of dental probiosis and considers current evidence and future potential in the context of the composition, activities and health implications of the oral microbiota.