Probiotics for caries prevention and control

Modulation of the microbiota for restoring and maintaining health is a growing issue in medical science. A search for relevant clinical trials on the use of probiotic bacteria as a potential and clinically applicable anti-caries measure was performed. According to predetermined criteria, papers were selected and key data on study design, sample size, intervention, duration, and results were extracted. Two animal and 19 human studies were retrieved. Most studies were short-term and restricted to microbiological endpoints, and only 3 human studies reported a caries endpoint. A high degree of heterogeneity among the included investigations hampered the analysis. Significant reductions of mutans streptococci in saliva or plaque following daily intake of probiotic lactobacilli or bifidobacteria were reported in 12 out of 19 papers, whereas 3 reported an increase of lactobacilli. Three caries trials in preschool children and the elderly demonstrated prevented fractions of between 21% and 75% following regular intakes of milk supplemented with L. rhamnosus. No adverse effects or potential risks were reported. The currently available literature does not exclude the possibility that probiotic bacteria can interfere with the oral biofilm, but any clinical recommendation would be premature. Large-scale clinical studies with orally derived specific anti-caries candidates are still lacking.     

No strong predictors available for future caries activity

J Evid Base Dent Pract 2002;2:233-4     

Biological factors as indicators of future caries

During the last ten years the principal biological factors which have been used as indicators of future caries activity are counts of mutans streptococci and lactobacilli. The evidence that these micro-organisms play a key role in the development of dental caries has now become very strong. Methods for the identification and enumeration of mutans streptococci and lactobacilli in saliva and plaque material have been developed which are both feasible and reliable. In a few studies counts of these micro-organisms together with other factors have been related to caries incidence. The validity of the various tests show a large variation but in some studies the predictive value has been high. The best prediction of future caries activity is obtained by the combination of factors which are important contributors to the pathogenesis of dental caries.     

Preschool caries as an indicator of future caries: a longitudinal study

PURPOSE: This study was performed to compare the increment of carious surfaces per year in preschool-age children with early childhood caries (ECC), children with posterior caries only, and caries-free children after 7 to 10 years. METHODS: One hundred and fifty files of children were included in the study. The first examination referred to the ages of 3 to 5 years (T1), and follow-up visits took place after at least 7 years (T2). The number of carious surfaces was recorded. The study population was divided into 3 groups: (1) caries free children (CF), (2) children with ECC, and (3) children with posterior caries only (PC). There were 50 patients in each group. RESULTS: Children with ECC had 1.15+/-0.97 new affected surfaces per year, while caries-free children had an increment per year of 0.41+/-0.60, and children with posterior caries only showed an increment per year of 0.74+/-0.64. A statistically significant difference was found between the ECC and caries-free groups, and between the ECC and posterior caries groups. The high increment in the ECC group is influenced by the high number of affected surfaces in the primary teeth, CONCLUSIONS: Children with ECC may have a high risk to develop future carious lesions compared with caries-free children. Children with posterior caries demonstrate less carious lesions by the age of 12 years, however, they resemble ECC children when they reach their mid-teens.