Is a probiotic the key to better oral health?

Weissella cibaria strain CMU, a probiotic lactic acid bacterium, may improve gingival bleeding and reduce levels of periodontal germs linked to diabetes and other diseases, according to a study published on September 2 in BMC Oral Health.

Supplementing with W. cibaria may improve overall oral health, the authors wrote.

"W. cibaria treatment could lead to an improvement in the bleeding index and the suppression of propagation of some oral bacteria in people without periodontitis," wrote the group, led by Mi-Sun Kang, an employee of OraPharm in Korea, which provided the supplement OraCMU for the study.

Using the good to fight the bad

When normal gingival sulcus transforms into pathological periodontal pockets, it causes changes in bacterial distribution in the oral cavity and, eventually, damages tissue and causes inflammation. In recent years, evidence has shown that probiotic bacteria may competitively inhibit the attachment and growth of pathogens, lower the metabolism of environmental pH, and have direct antimicrobial effects. Therefore, researchers believe probiotics may be beneficial in dentistry, such as in preventing or treating caries, gingivitis, or periodontitis by improving the bacterial environment in the oral cavity.

A recent study showed that a strain of lactobacilli bacteria found in Sichuan pickles may prevent microbes that cause tooth decay and caries.

Knowing the potential, OraPharma and a team from Kangwon National University in South Korea set out to evaluate the effects of W. cibaria CMU, which is commercially available as an oral care probiotic in Korea, on periodontal health and the oral microbiome.

About 90 adults between the ages of 20 and 39 who did not have gum disease participated in a randomized, double-blind, placebo-controlled trial. The participants underwent scaling and planing and were given a probiotic or placebo. They had to take the tablets daily before bed after brushing their teeth for eight weeks. Also, they were instructed not to have any food or drink after taking the tablets. Bleeding on probing, probing depth, and gingival and plaque indexes, as well as the bacterial environment in the gingival sulcus, were analyzed in the participants, according to the authors.

Adults who took the probiotic not only experienced less bleeding on probing after eight weeks but also showed significant improvements in bleeding in their maxillary buccal and lingual sites, Kang and colleagues found.

Also, those who took the probiotics had fewer oral bacteria, including a dramatic reduction in their levels of Fusobacterium nucleatum, a periodontal germ linked to other diseases, including bacterial vaginosis. Recent research has shown that patients who experience inflammation due to periodontitis may experience more severe COVID-19 complications.

On to something

Though supplementation with W. cibaria may have its benefits, the study did have limitations, including the fact that the participants had healthy mouths. Therefore, the findings could not be generalized to those with gingival disease. More studies are needed to better determine whether probiotics are beneficial for all patients, the authors wrote.

Nevertheless, "W. cibaria CMU is considered an oral care probiotic that can improve oral health and prevent oral disease," they wrote.