Probiotics Support Resilience of the Oral Microbiota during Resolution after Experimental Gingivitis-A Randomized, Double-Blinded, Placebo-Controlled Trial.

Christine Lundtorp Olsen, Laura Massarenti, Vincent Frederik Dahl Vendius, Ulvi Kahraman Gürsoy, Annina Van Splunter, Floris J Bikker, Mervi Gürsoy, Christian Damgaard, Merete Markvart, Daniel Belstrøm

Journal: Nutrients 2023;15(22):4805

PMID: 38004199

Free Full Text on MDPI View on PubMed

Plain Language Summary

Gingivitis is a widespread condition that affects up to 90% of the population worldwide, and if left untreated, can lead to periodontitis and further health risks. While research suggests that probiotics may have a protective role, the limited number of studies and variations in utilised probiotic strains make it challenging to gain conclusive evidence. This study investigated if probiotics can protect and help restore induced gingivitis. Eighty healthy participants aged 19-33 refrained from brushing for 14 days, then resumed oral hygiene for 14 days thereafter. Meanwhile, half of them took a Lactobacillus-based probiotic, while the other half received a placebo. At the beginning, day 14, and day 28, plaque and gum bleeding were assessed, the microbiota was sequenced and plaque and saliva were analysed for enzyme activity and inflammatory markers. After 14 days without brushing, both groups showed no significant differences, with opportunistic pathogens thriving in all participants. Consistent with previous findings, abstaining from brushing led to an increase in bacteria associated with gingivitis, like Selenomonas and Fusobacterium, and a decrease in Rothia, linked to good oral health. Probiotic supplements did not prevent the immediate detrimental effects on oral microbiome shifts. However, by day 28, the placebo group still had elevated levels of harmful bacteria compared to the probiotics group, whereby more beneficial bacteria were abundant in the probiotics group, indicating that probiotics may help the return to a healthy baseline composition during gingivitis recovery. There were minimal differences in clinical symptoms of plaque or bleeding between the two groups, suggesting probiotics primarily influence microbial composition. Similarly, salivary inflammatory markers and enzyme activity also showed no significant differences between groups. These findings suggest that probiotics primarily support the resilience of oral microbiota during the resolution phase after gingivitis through modulation of the microbial composition.

Abstract

The present study aims to test whether probiotics protect against experimental gingivitis incited by 14 days of oral hygiene neglect and/or subsequently support the restoration of oral homeostasis. Eighty systemically and orally healthy participants refrained from oral hygiene procedures for 14 days, followed by 14 days with regular oral hygiene procedures. Additionally, participants consumed either probiotics ( = 40) or placebo ( = 40) throughout the trial. At baseline, day 14, and day 28, supragingival plaque score and bleeding-on-probing percentage (BOP %) were registered, and supragingival plaque and saliva samples were collected. The supragingival microbiota was characterized using 16S sequencing, and saliva samples were analyzed for levels of pro-inflammatory cytokines and proteases. At day 28, the relative abundance of ( = 0.014), ( = 0.046), ( = 0.033), and ( = 0.0078) genera were significantly higher in the placebo group compared to the probiotics group, while the relative abundance of ( = 0.047) species was associated with the probiotics group. was associated with the probiotics group, while was associated with the placebo group. No difference was observed in salivary cytokines, albumin, or any enzyme activity. The present study suggests that probiotics support the resilience of the oral microbiota in the resolution period after gingivitis.

Address: Section for Clinical Oral Microbiology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.; AMD Denmark A/S, 3390 Hundested, Denmark.; Section for Oral Biology and Immunopathology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark.; Department of Periodontology, Institute of Dentistry, University of Turku, 20520 Turku, Finland.; Department of Oral Biochemistry, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, 1081 LA Amsterdam, The Netherlands.

DOI: 10.3390/nu15224805