Postbiotics may surpass traditional probiotics in preventing and managing caries by stopping the growth of cavity-causing bacteria. This review was recently published in Clinical and Experimental Dental Research.
Additionally, postbiotics may effectively regulate oral microbiota, strengthen host immunity, and help maintain a neutral mouth pH, the authors wrote.
"Postbiotics act against pathogenic mechanisms at the root of caries development, potentially enhancing existing preventive approaches," wrote the authors, led by Faezeh Heidari of Shahed University in Iran (Clin Exp Dent Res, March 11, 2025).
The purpose of the review was to evaluate the effectiveness of postbiotic therapies in preventing dental caries; their potential mechanisms of action; and the optimal dosage, frequency, and duration of administration. Also, it aimed to synthesize existing data to provide valuable insights for researchers, dental professionals, and policymakers, they wrote.
The review included 21 studies, encompassing randomized controlled trials, quasi-experimental, observational, and in vitro studies.
Postbiotics derived from various Lactobacillus species were shown to inhibit Streptococcus mutans growth, biofilm formation, and virulence gene expression. Their anticaries effects were attributed to multiple mechanisms, including direct antimicrobial activity, inhibition of bacterial adhesion, biofilm disruption, immune modulation, and pH buffering, they wrote.
Human trials revealed reduced salivary S. mutans counts and increased salivary pH following postbiotic interventions. Postbiotics exerted antimicrobial effects through compounds like organic acids, hydrogen peroxide, and bacteriocins, which inhibit cariogenic bacteria. Additionally, they helped maintain a neutral oral pH by producing alkaline compounds or buffering acids, preventing enamel demineralization.
However, the study had limitations. The studies varied in postbiotic types, administration methods, and intervention durations, making it difficult to determine the optimal regimen for caries prevention, the authors added.
"Postbiotics have shown potential in preventing and managing dental caries through a multisectoral mechanism that inhibits the growth of cariogenic bacteria, modulates oral microbiota, enhances host immunity, and maintains neutral mouth pH," Heidari and colleagues wrote.
