This document provides an overview of probiotics in dentistry. It discusses the history of probiotics, ideal properties of probiotics, microorganisms considered probiotics such as various Lactobacillus and Bifidobacterium species. It describes the mode of action of probiotics including competitive exclusion and modulation of the immune response. The document outlines the role of probiotics in the oral cavity for conditions like periodontal disease, halitosis, dental caries, oral candidiasis, and orthodontic treatment. It also discusses probiotic products and the probiotics market in India.

1. Good Morning
PROBIOTICS IN DENTISTRY
By- Dr. Rohan Shrivastava
MDS- JR1

2. CONTENTS
List of Microorganisms
Mode of Action
Selection Criteria
Introduction
History
Ideal Properties
Probiotic Products
Mechanism of Action
Role in dentistry
Conclusion
References

3. Introduction
• By the age of 2 years, the flora established is practically
definitive.
• Every individual tends to have a relatively stable flora.
• Negative modification is done by Antibiotics.
• Positive modification is done by Probiotics.

4. Introduction
• Probiotics are living microorganisms that are
consumed in order to obtain a beneficial effect
regardless of their intrinsic nutritional value.

5. Introduction
• According to the World Health Organization (WHO),
probiotics are “live microorganisms which, when
administered in adequate amounts, confer a benefit to the
health of the host”.

6. Introduction
• Probiotics can improve the condition of the patient in
disorders such as diarrhea, gastroenteritis, inflammatory
bowel disease (Crohn’s disease and ulcerative colitis),
cancer, inadequate lactase digestion, pediatric allergy,
hyperlipidemia, liver disease, and infection with
Helicobacter pylori infections.

7. Introduction
Antibiotics VS Probiotics
Antibiotics Probiotics
Pathogenic Bacteria
Good Bacteria
Favors Good Bacteria
and Decrease Pathogenic
Bacteria

8. Introduction
Antibiotic resistance and
recolonization by
Pathogenic Bacteria
Need for new Paradigm

9. History
• In 1990’s at the start of 20th
century, Russian Nobel Prize
winner and Father of modern
Immunology, Elie Metchnikoof,
a scientist at the pasture
institute was the first to
conceptualize “ PROBIOTICS”

10. History
Elie Metchnikoff in his book “ prolongation of life”
(1907) proposed a diet containing milk fermented by
Lactobacilli, which produce large amounts of lactic acid
that could increase the life span of Humans.
In ancient Indian society, it became common place and
still is to enjoy a before dinner yogurt drink called a lassi.
These Indian tradition were based on the principle of
using sour milk as a probiotic delivery system to the
body.

11. Ideal properties of probiotics
• Able to survive the passage through digestive system.
• Able to attach to the dental surface and epithelia.
• Able to maintain good viability.
• Able to utilize the nutrients and substrates in a normal
diet.
• They are non- pathogenic.
• They are non- toxic.
• Capable of exerting a beneficial effect on host.

12. Microorganisms considered as probiotics
Lactobacillus species
• L. Acidophilus
• L. Amylovoros
• L. Casei
• L. Gallinarum
• L. Gasseri
• L. Johnsonii
• L. Paracaesi
Bifidobacterium species
• B. Animalis
• B. Bifidum
• B. Breve
• B. Lactis
• B. Longum
• B. Infantis
• B. Adolescentis

13. Microorganisms considered as probiotics
Lactobacillus species Bifidobacterium species
• Lactococcus lactis sub spec Cremoris
• Enterococcus faecalum
• Streptococcus salivarius sub spec
Thermophilus
• Streptococcus Intermedius
• Yeast and Moulds
Other Species

14. Mode of Action:
Lactobacillus species
Mode of
Action
Lower blood cholesterol
levels
Immunomodulation
Treatment of lactose
intolerance
Prevention of Cancer
Inhibit the growth of Pathogen
Restore the normal intestinal flora
during antibiotic therapy
Produce vitamin B and
Folic acid
Prevention of Diarrhea
Positive effects in
intestinal microflora
Treatment of allergy

15. What Lactobacillus actually does?
Lactobacillus species
• Enhance Innate and Acquired Immunity.
• Inhibition of pro inflammatory mediators.
• Production of enzymes to digest and
metabolize proteins and carbohydrates.
• Synthesis of Vitamin. B and Vitamin. K and
facilitates breakdown of bile salts.

16. What Bifidobacterium actually does?
Lactobacillus species
• Metabolization of lactose, generate lactic ions
from lactic acid and synthesize vitamins.
• Ferment indigestible carbohydrates and
produce beneficial short chain fatty acids.

17. What Other species actually does?
Lactobacillus species
• Streptococcus thermophilus and lactobacillus
bulgaricus metabolize lactose, improve lactose
tolerance and antimicrobial activity.

18. Selection criteria for probiotics
Lactobacillus species
• Adhesion and Colonization in the human body.
• Enhancement of the specific and non-specific immune
response of the host.
• Production of Antimicrobial substances and competition with
pathogens for binding sites.
• Survival and resistance to human defense mechanism.
• Should considered as the safe microorganism.

19. Probiotic Products
Lactobacillus species
Fruit juice Probiotic + Fiber Probiotic Milk Probiotic Cheese

20. Probiotic Products
Natural Occurring
• Breast milk
• Fish
• Pork
• Beef
• Salted Crabs
• Soyabeans
• Vegetables
• Ginger and Garlic
• Papaya
• Cheese
• Butter
• Yogurts
Shrivastava Rupali; Gupta Sonal, PROBIOTICS AND ITS ROLE IN PREVENTION
OF DENTAL CARIES Guident Journal Feb2021, Vol. 14 Issue 3, p37-40. 4p.

21. Probiotic Products
Lactobacillus species
Commercially
available
• SPOROLAC – Bacillus
coagulans
• REGNTOL – Bacillus
subtilis and Bacillus
coagulans
• PRE PRO KID –
Lactobacillus rhmnosus
• BIFILAC – Bacillus coagulans
• BIFILAC GG – lactobacillus
rhmnosus
• GUT PRO – Bacillus clausi
• VIZYLAC – Bacillus coagulans

22. Mechanism of action
Lactobacillus species
1. Direct Interaction
2. Competitive Exclusion
3. Modulation of Host Immune Response

23. Competitive Exclusion
Lactobacillus species
In a report addressing the total exclusion of Salmonella
typhimurium from maggots of blowflies published in 1969,
Greenberg first used the ‘competitive exclusion’ term for the
scenario in which one species of bacteria more vigorously
competes for receptor sites in the intestinal tract than another
species.

24. Role of Probiotics and Oral Cavity
Lactobacillus species
In periodontal infection and Halitosis
• Probiotics decrease the pH of oral cavity so that they prevent
the biofilm formation as most of bacteria can not survive in
the low Ph.
• They produce antioxidants so they prevent biofilm formation
by neutralizing the free electrons that are needed for the
mineral formation and reduces bad Oduor from oral cavity.

25. Kang et. al reported a significant
reduction in toxic sulfur compound
after gargling with 15ml Weissella
Ciberia CMV for 2 mins.
Mi-Sun Kang, Byung-Gook Kim, Jin Chung, Hyun-Chul
Lee, Jong-Suk Oh Inhibitory effect of Weissella
cibaria isolates on the production of volatile sulphur
compounds Journal of Clinical Periodontology 2006,
33(3):226-232
Burton et. al reported a significant
reduction in volatile sulfur compounds
for the probiotic group compared to the
placebo group when probiotic
streptococcus was used.
JP Burton, CN Chilcott, JR Tagg The rationale and
potential for the reduction of oral malodour
using Streptococcus salivarius probiotics
Journal of Oral Diseases 2005, 11(1):29-32

26. Role of Probiotics and Oral Cavity
In Dental Caries
• Streptococcus mutans is the main causative organism in caries development
due to its ability to produce highly branched, water-insoluble glucan,
mutan.
• The main characteristics of virulence Streptococcus mutans are their
acidogenicity, ability to survival in acidic environments, the ability of
biofilm formation and adherence to the tooth.
Shrivastava, Rupali; Gupta Sonal, PROBIOTICS AND ITS ROLE IN PREVENTION OF
DENTAL CARIES Guident Journal Feb2021, Vol. 14 Issue 3, p37-40. 4p.

27. Strains of Lactobacillus rhamnosus, L. casei, L. reuteri and
Bifidobacterium spp. have all demonstrated the potential to alter
colonization of cariogenic bacteria and thus prevent dental caries.
Nase et al and Wu et al (2014-follow-up to six months) have studied
the effect of the probiotic Lactobacillus rhamnosus GG on the risk
of tooth decay and have demonstrated a reduction in caries and
reduced levels of Streptococcus mutans in patients taking the
probiotics of Lactobacillus group.
Näse L, Hatakka K, Savilahti E, Saxelin M, Pönkä A, Pouss a T, Korpela R,
Meurman JH.Effect of long-term consumption of a probiotic bacterium,
Lactobacillus rhamnosus GG, in milk on dental caries and caries risk in
children. Caries Res 2001; 35: 412-420.
Wu A, Switzer-Nadasd i R. The role of health behavior in preventing dental
caries in resource-poor adults: a pilot intervention. J Tenn Dent Assoc 2014;
94: 17-21.

28. Role of Probiotics and Oral Cavity
In Oral Candidiasis case
Candida species constitutes a part of oral flora in approximately
50% of healthy subjects but are able to cause clinically apparent
lesion if the immune defenses are breached either on the local level
or systemic level.
One study has shown that the subjects who consumed cheese
containing the probiotic L. Rhamnosus GG exhibited reduction in
the prevalence of oral candidiasis.

29. Role of Probiotics and Oral Cavity
In Voice Prosthesis
There is no research regarding relationship between dental
restorative materials and probiotics. However , in Larynx the
second barrier after oropharynx, probiotics strongly reduce the
pathogenic bacteria and biofilms.

30. Role of Probiotics and Oral Cavity
In Orthodontic Treatment
Orthodontic brackets and wire create the environment for the
cariogenic bacteria to grow. Also it causes white spot lesions after
removal of brackets.
Fruit yogurt with Bifidobacterium sub species Lactis is helpful in
the reduction of salivary mutans streptococcus in orthodontic
patients with fixed ortho appliances.

31. Role of Probiotics and Oral Cavity
In Oral Cancer
Probiotics are known to interfere at various stages of the
cancer process by interfering with Chromosomal and DNA
damage.
However , further study is required to develop specific
regulations on their consumption.

32. Probiotics status in India
Lactobacillus species
Indian probiotic market was valued at $2
million as per 2010 estimates. According
to figures released by US-based research
firm, Frost and Sullivan, in August 2012,
probiotic products in India generated
revenue of US $522.8 million in 2018
Balaji RR, Kantha DA. Market potential for
probiotic nutritional supplements in India. Afri J
Busi Manag 2011; 5: 5418-23.
The latest addition to the list of probiotics
in India is ViBact (genetically modified
Bacillus mesentricus), which acts as an
alternate to B-complex capsules. Daily
intake of 1.5-2 dl per day is recommended
dose.
Suvarna VC, Boby VU. Probiotics in human health:
A current assessment. Curr. Sci.
2005;88(11):1744-48.

33. Probiotics status in India
Lactobacillus species
The Indian market is big, but difficult to
reach since cold storage and cold
distribution chain are underdeveloped in
India, especially in the rural areas.
Realizing these drawbacks, YAKULT has
taken an initiative in this direction, and has
already announced to target tier II cities in
their next phase. The strongest sale of
Yakult is recorded from Delhi/ NCR.
Shailendra Raghuwanshi, Swati Misra, Rohit Sharma and P.S. Bisen Indian perspective for probiotics: A review Indian J.
Dairy Sci. 68(3), 2015

34. Future Aspects
Lactobacillus species
Probiotics are already gained access in the western countries
very fast. Various processing advances, such as
microencapsulation and bacterial coating and addition of
prebiotic compounds used as growth factors for probiotic
organisms, will provide a means to optimize the delivery and
survival of strains at the site of action.
However, all the products effective in oral health care are
required to be administered daily, so a possible way of
administration could be incorporate probiotics in toothpaste,
mouthwash, chewing gums, sugar-less candy for kids etc.
Reddy SR, Swapna LA,
Ramesh T, Singh TR,
Vijayalaxmi N, Lavanya R.
Bacteria in oral health –
Probiotics and prebiotics A
review. Int J Bio Med Res.
2011;2(4):1226-33.

35. Conclusion
Lactobacillus species
Probiotic is the natural way to maintain overall health and also
protect the oral cavity from the various dental diseases. Dairy
products and yogurt containing probiotic strains of bacteria are
useful in the prevention of caries in early childhood.

36. Conclusion
Lactobacillus species
During childhood, the gastrointestinal flora is not established and
administration of probiotics at that time gives positive life-long
health. Therefore, a pediatric dentist plays vital role in
maintaining and installing positive life-long health through
probiotics.

37. References
Lactobacillus species
• Shrivastava, Rupali; Gupta, Sonal, PROBIOTICS AND ITS ROLE IN PREVENTION OF DENTAL CARIES Guident Journal
Feb2021, Vol. 14 Issue 3, p37-40. 4p.
• Petersson, L. G., Magnusson, K., Hakestam, U., Baigi, A., & Twetman, S. (2011). Reversal of primary root caries lesions after daily
intake of milk supplemented with fluoride and probiotic lactobacilli in older adults. Acta Odontologica Scandinavica, 69: 6, 321–
327.
• Sornplang P, Piyadeatsoontorn S. Probiotic isolates from unconventional sources: a review Journal of Animal Science and
Technology 2016; 58:26
• Kesavelu D, Rohit A, Karunasagar I, et al. (November 05, 2020) Composition and Laboratory Correlation of Commercial
Probiotics in India. Cureus 12(11):11334.
• Balaji RR, Kantha DA. Market potential for probiotic nutritional supplements in India. Afri J Busi Manag 2011; 5: 5418-23.
• Suvarna VC, Boby VU. Probiotics in human health: A current assessment. Curr. Sci. 2005;88(11):1744-48.
• Shailendra Raghuwanshi, Swati Misra, Rohit Sharma and P.S. Bisen Indian perspective for probiotics: A review Indian J. Dairy
Sci. 68(3), 2015
• P. Chugh, et al. Journal of Functional Foods 70 (2020) 103985
• Saraf K, Shashikanth MC, Tulasi P, Nishant S, Nallan C. Probiotics – Do they have a role in Medicine and Dentistry?JAPI. 2010;
58:1-6.
• Spacova et al. Future of Probiotics and Prebiotics the Implications for Early Career Researchers Food Microbiology, a section of the
journal Frontiers in Microbiology June 2020.
• Reddy SR, Swapna LA, Ramesh T, Singh TR, Vijayalaxmi N, Lavanya R. Bacteria in oral health – Probiotics and prebiotics A
review. Int J Bio Med Res. 2011;2(4):1226-33.
• Reid G. How science will help shape future clinical applications of probiotics.CID,2008;46:62- 66.
20. 21. 22. 23. 24. 25. 26. 27. 28. 29.

38. THANKYOU