One of the most common concerns for patients in the dental chair is the battle with bad breath. It is also one of the most uncomfortable topics for patients to bring up during a dental appointment. Overall, about 25% of people suffer from malodor, and it has many social implications that affect a person’s overall confidence and well-being.
Patients look to their dental professionals for answers to this problem, but are we providing the best solutions? Is there a better way to solve the problem of bad breath?
There are many causes for bad breath, including lack of oral hygiene, dry mouth, and ear-nose-throat issues. Eighty-five percent of the time breath malodor arises from insufficient oral hygiene, such as periodontitis, coating of the tongue, and lack of plaque control. These conditions in the mouth favor the formation and microbial degradation of offensive smelling volatile sulfur compounds (VSC).
Methyl mercaptan, hydrogen sulfide, and dimethyl sulfide are three of the most well-known VSCs, which form from gram-negative anaerobic bacteria. Hydrogen sulfide smells like rotten eggs, and methyl mercaptan smells like rotten cabbage.3 Even more strange, the smell of dimethyl sulfide is comparable to rotten seaweed.
The advantage of using oral probiotics
Over-the-counter dental products used for fighting bad breath focus on masking the odor or attempting to kill bacterial culprits in the oral cavity. Some of these products specifically target VSCs. The problem with this is that bacteria repopulate quickly, so the relief from bad breath is usually short-lived.4 Another aspect to consider is that when a bacterial population is reduced, something always replaces it, whether good or bad. This is where dental probiotics step in to combat bad breath in an entirely different way.
Dental probiotics focus on promoting the growth of good bacteria in the oral cavity and curtailing the growth of pathogenic bacteria. There are normally more than 700 different bacterial species found in the human mouth.5 With dental probiotics, daily exposure helps to colonize the oral cavity with bacteria that do not produce VSCs. Research has shown that 85% of people who took oral probiotics for one week experienced a significant reduction in volatile sulfur compounds.4 Even more impressive is the fact that the majority of study participants maintained a reduced level of VSCs for two weeks following exposure to oral probiotics. With this treatment modality, there is finally the potential for a more long-term solution to bad breath.
Other benefits of dental probiotics
One of the most amazing things about oral probiotics is that they have multiple applications beyond simply treating oral malodor. Conditions such as dental caries, gingivitis, periodontitis, pharyngitis, tonsillitis, and oral candidiasis are all inhibited by exposure to the K12 and M18 strains of S. salivarius.4 These additional benefits hold much promise in dentistry, as many patients have difficulty with home care and these probiotics are easy to use.
In the battle against dental caries, the M18 strain has a molecular mechanism that reduces plaque formation and increases oral pH. Specifically, this bacteria releases salivaricin M, a substance that limits the growth of the caries-causing bacterial species, such as Streptococcus mutans and Streptococcus sobrinus.7
In patients with gingivitis, M18 lozenges have been found to significantly reduce supragingival plaque, gingival inflammation, sulcular bleeding, and pocket depth.8 Both strains K12 and M18 are effective in reducing levels of P. gingivalis, A. actinomycetemcomitans, and F. nucleatum-induced IL-6 and IL-8, which are typically indicators of periodontal disease.
COMPOSITION OF PROBIOTICS
Probiotics can be bacteria, molds, or yeast. However, most probiotics are bacteria. Among bacteria, lactic acid bacteria are more popular. Lactobacillus acidophilus, Lactobacillus casei, Lactobacillus lactis, Lactobacillus helviticus, Lactobacillus salivarius, Lactobacillus plantrum, Lactobacillus bulgaricus, Lactobacillus rhamnosus, Lactobacillus johnsonii, Lactobacillus reuteri, Lactobacillus fermentum, Lactobacillus del-brueckii, Streptococcus thermophilus, Enterococcus faecium, Enterococcus faecalis, B. bifidum, Bifidobacterium breve, B. longum, and Saccharomyces boulardii are commonly used bacterial probiotics. A probiotic may be made out of a single bacterial strain or it may be a consortium as well. Probiotics can be in powder form, a liquid form, gel, paste, granules, or available in the form of capsules, sachets, etc.
Mechanisms of action explaining beneficial probiotic effects include modulation of host immune response leading to strengthening of the resistance to pathogenic challenge and alteration of the composition and metabolic activity of host micro-flora at the specific location. Among paramount selection criteria for probiotics are:
Adhesion and colonization (at least transitory) in the human body. Adhesion may increase the retention time of a probiotic and place bacteria and host surfaces (body fluids and epithelial cells) in close contact, thus facilitating the further probiotic activity.
Enhancement of the non-specific and specific immune response of the host.
Production of antimicrobial substances and competition with pathogens for binding sites.
Survival and resistance to human defense mechanisms during the oro-gastro-intestinal transit.
Safety to the macro-organism.
Probiotics are provided in products in one of the following basic ways:
A culture concentrate is added to a beverage or food (such as a fruit juice).
Inoculated into prebiotic fibers.
Inoculants into a milk-based food (dairy products such as milk, milk drink, yogurt, yogurt drink, cheese, kefir, and bio-drink).
As concentrated and dried cells packaged as dietary supplements (non-dairy products) such as powder, capsule, gelatin tablets.
Role of probiotics in dental caries
Side effects and risks
Some live micro-organisms have a long history of use as probiotics without causing illness in people. Probiotics’ safety has not been thoroughly studied scientifically. More information is especially needed on how safe they are for young children, elderly people, and people with compromised immune systems.
Side effects of probiotics, if they occur, tend to be mild and digestive (such as gas or bloating). More serious effects have been seen in some people. Probiotics might theoretically cause infections that need to be treated with antibiotics, especially in people with underlying health conditions. They could also cause unhealthy metabolic activities, too much stimulation of the immune system, or gene transfer (insertion of genetic material into a cell).
Probiotic products taken by mouth as a dietary supplement are manufactured and regulated as foods, not drugs. Furthermore, uncertainty about specificity of probiotics effects and their mechanism of action is a cause of concern.
Replenish the Good Dental Improves Your Oral Health
From cavities to bad breath and periodontitis, many oral problems have their roots with undesirable bacteria building up in your oral cavity. By introducing good bacteria in the mouth through our Dental probiotic, the amount of harmful bacteria is significantly reduced and good bacteria restored, which improves the health of the mouth environment.
3 Billion CFU & 4 strains selected based on extensive clinical data regarding oral health benefits. Our proprietary Dental formula has an optimal balance of CFU count for each strain to help ensure enough good bacteria survive. Contains L. paracasei, L. reuteri, BLIS K-12 & BLIS M-18 (particular S. salivarius strains).
patented LiveBac process extends shelf life to 18 months from the date of manufacture without refrigeration. Most companies won’t tell you how many viable bacteria will be left at expiration because often there are none left!
We love our patients and love to help them form healthy dental life that will last them a lifetime. For more information call us today to answer all of your questions, so get an appointment today.