Dental News - What is a probiotic?

Shirley Gutkowski, USA

Tue. 8 January 2013

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Oral probiotics are making some news. As probiotics go, oral probiotics are in a class all of their own. Most probiotics are for the lower part of the human digestive system, used to manage health down there. Oral probiotics help manage oral biofilm. According to the American Journal of Clinical Nutrition: “A probiotic is defined classically as a viable microbial dietary supplement that beneficially affects the host through its effects in the intestinal tract.”[1]

The National Institutes of Health have a website, the National Center for Complementary and Alternative Medicine (NCCAM) at www.nccam.nih.gov, which defines probiotics as: live microorganisms (in most cases, bacteria) that are similar to beneficial microorganisms found in the human gut.

Probiotics also called "friendly bacteria" or "good bacteria." Yogurt and other fermented foods are the main sources of naturally occurring probiotic bacteria in the American diet.[2]

Probiotics available for oral health are not that prolific. The oral probiotics refer to those bacteria from the mouth that are intended to work in the mouth to alter the oral biofilm to be more healthful.

One savvy researcher, Dr. Jeffrey D. Hillman,[3] noticed people in Europe supplementing their gut bacteria nearly every day with a little jug of the probiotic mixture that they drank after a meal. He wondered if people would supplement their oral flora daily. He collected biofilm samples from people with healthy teeth, isolated three particular bacteria, branded them with a specific number and grouped them together with outstanding results.

That bacterial grouping is called ProBiora3 and is found in EvoraPro. This is the only probiotic with original strains cultivated from healthy people. No foods contain these strains. They do not come from the lower intestinal tract. The mission of these strains is to create an oral ecology that favors health. The bacteria in the ProBiora3 are Streptococcus oralis KJ3, Streptococcus uberis KJ2 and Streptococcus rattus JH145.

The strep genuses are the usual initiators of the biofilm. If the strep are mutans, or sobrinus, for instance, any amount of sugar will start the production of acid and slime. By crowding out that bunch with bacteria that don’t exhibit those attributes, the plaque biofilm grows much slower above and below the gingival crest. The probiotic blend manages the biofilm.

Oral probiotics, such as ProBiora3, are freeze-dried. The process is to freeze the bacteria then quickly move from the solid or ice stage to the vapor stage by sublimation.

So by applying pressure to the frozen product, the liquid vaporizes. In the case of probiotics the water is vaporized out of the bacteria, leaving the entire bacteria intact. Their size also allows them to reanimate in the presence of moisture, such as saliva.

With children, probiotics are the easiest way to start a person on the way to oral health. EvoraPro is safe and effective for both children and adults. The child between the ages of 3 to 10 years, once a day simply dissolves the lozenge of compressed freeze-dried ProBiora3 in their mouth. The dose is the same for adults. The tablet is dissolved in the mouth once a day, which is all that’s needed to maintain the new ecology. The EvoraPro and Heraeus Kulzer Venus tablets for adults are intended to be dispensed by the dental office and there are sufficient numbers in the bottle to offer the patient 90 days of coverage.

Because probiotics are so well received by the general public, it makes sense to start offering them from the office. Patients who are trying everything to manage their oral health and not succeeding are the best candidates to start with.

Contraindications

Because probiotics are live bacteria, there is only one type of patient that will present to you who will not be a candidate for any probiotics: a patient who is immunocompromised, such as a person undergoing chemotherapy or presenting with HIV AIDS.

There are other conditions that drive down the immune system, and patients with such conditions also are not good candidates. Xylitol products are a better option for patients with compromised immune systems who need oral biofilm management.

When looking at labels of probiotic mints, learn to be discerning. What sweetener is used? What type of flavoring agent is used? Where are the offered bacteria from? How is it administered? Certainly, swallowing a tablet won’t do as much for the oral ecology as letting it dissolve in the mouth.

With medications altering the human physiology, and environmental and dietary stresses also contributing to oral changes, the time is right for oral probiotics to support oral health.

Note: This article was published in Hygiene Tribune U.S. Edition, Vol. 5, No. 5, November 2012 issue. A complete list of references is available from the publisher.

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