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Can these “healthy mouth bugs” keep your dentist happy?

August 27, 2019 (Updated: August 3, 2021)
Lily Moran

When it comes to maintaining good oral and dental health, everyone knows the basics—brush twice a day, floss every night, and visit the dentist regularly for cleanings and checkups. But perhaps we need to add another important item to this list: Taking probiotics.

It’s well known that having a diverse variety of beneficial bacteria (probiotics) in your gut is important for good health and strong immunity. But perhaps what’s less known is that these colonies of friendly bacteria line our entire gastrointestinal tract—starting in the mouth and sinus cavity and extending all the way down to the colon. In fact, scientists have identified upwards of 700 different species of bacteria just in the oral cavity alone.1

The vast majority of the bacteria in this oral “ecosystem” are completely harmless and work together to maintain a balanced and healthy environment. This delicate balance of the right beneficial bacteria is what helps ensure good health in your mouth and sinuses—which obviously extends to the rest of your body.

However, some pathogenic strains of bacteria exist in the mouth too. These are associated with cavities, periodontal disease, bad breath, strep throat, tonsillitis, other oral health issues. When they’re left unchecked by the probiotics in the mouth, they can multiply out of control, resulting in oral health issues.

It stands to reason that, by boosting levels of beneficial bacteria, you can prevent a wide variety of dental issues. Research is starting to confirm this, too, so here’s what you need to know about friendly microbes and oral health, and which strains can be most helpful.

Research Supports Probiotics for Oral Health

Most importantly, a robust population of friendly bacteria in the mouth has been associated with reduced risk of gingivitis (inflamed gums) and periodontal disease. This advanced form of gum disease causes swollen, sensitive, bleeding gums and is one of the top causes of tooth loss. Not only that, periodontal disease increases risk of other health problems, including cardiovascular conditions.

In a meta-analysis that looked at 50 studies (3,247 participants), probiotic supplementation significantly reduced bleeding with probing and gingival index (a measure of gum inflammation). The researchers concluded that use of probiotics is “supportive towards managing gingivitis or periodontitis.”2

Similarly, a 2016 review of 12 studies revealed that the use of probiotics improved the signs and symptoms of periodontal disease, including bleeding, pocket depth, and tooth loss. The probiotics also reduced the levels of bacteria responsible for periodontal disease. These researchers concluded that continuous use of probiotics, particularly the Lactobacillus species, was necessary to maintain these benefits.3

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Studies also suggest that the Lactobacillus (L. rhamnosusL. caseiL. reuteri, in particular) and Bifidobacterium species can decrease the number of Mutans Streptococci in saliva, which are bacteria responsible for plaque and cavities.4

Other issues for which probiotics have been studied and may help treat are halitosis (bad breath) and oral Candida (yeast).4

Which Strains?

Existing research has shown that taking a probiotic with various Lactobacillus and Bifidobacterium species can prove to be most beneficial for the prevention of oral health diseases and maintenance of good dental health. Fortunately, these species are available in most probiotic supplements on the market.

Other bacterial strains are starting to be studied as well, and they’re proving to be just as helpful. Streptococcus salivarus K12 is one such strain.

In a pilot study of a probiotic mouthwash containing S. salivarus K12, “the probiotic mouthwash was able to substantially affect the levels of dental pathogens in saliva and periodontal pathogens in subgingival plaque.”5

In another review study of S. salivarus K12, researchers found “promising results in the treatment of halitosis.” It might also play a role in minimizing the occurrence and/or severity of middle ear infections, and in preventing streptococcal and viral pharyngitis and tonsillitis in children.6

You can (and should) take probiotics in capsule form—look for probiotics that are enterically coated or microencapsulated to ensure safe passage through your stomach to your lower gut. But for a more direct impact on your mouth, teeth, and gums, consider trying lozenges and mouthwashes that contain S. salivarus K12 and other probiotic strains. To populate the friendly bacteria in your mouth, use the mouthwash or suck on a lozenge after brushing/flossing in the morning and at night. This is a good way to ensure it becomes part of your regular routine.

Finally, be aware that alcohol-based mouthwash may make your mouth feel fresh and clean, but it may do more harm than good. The alcohol doesn’t discriminate between good and bad bacteria, so it kills both. For the best chance of keeping your mouth healthy, avoid these mouthwashes and stick with brushing, flossing, and using an alcohol-free, probiotic-based mouthwash.


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