Role Of Probiotics In Preventing Tooth Decay

Introduction

Many of us visit the dentist to get our teeth fixed in case we get decay or tooth pain. Well, this is the curative step that we do to save our teeth once the decay has started or has already been done. So, have you ever wondered why you get tooth decay?

The World Health Organization estimates that about half of people suffer from oral diseases out of which tooth decay is most common.¹

Maintaining good oral health is essential for everyone, not just for the aesthetics of a radiant smile but also for overall well-being. Our mouth, teeth, gums, and entire orofacial structures function well in normal oral health. However, a slight disturbance in one of these may hamper our oral health.

Tooth decay is a complex interplay where specific bacteria and dietary sugars we consume interact together and produce acids that lead to tooth decay.

Well in this article, you’ll get to know how tooth decay starts, the main risk factors or causative agents involved and how we can prevent our teeth at the very initial stage from getting decayed. We will explore the current understanding of probiotics and their potential role in preventing tooth decay. We will discuss the various ways probiotics may exert their beneficial effects and delve into the existing research findings. By the end, you’ll gain an understanding of how these little organisms might contribute to a healthy smile.

How does the tooth decay start?

Let’s understand how tooth decay starts. Tooth decay occurs due to multiple factors. Dietary sugars, poor oral health, high counts of cariogenic bacteria, dental plaque, inadequate saliva flow, and insufficient fluoride exposure are among the environmental risk factors that cause tooth decay.² However, the composition of the oral microbiome is an important factor in its development.³

When the oral environment gets disrupted due to multiple factors the dominance of good bacteria is lost causing an increase in the count of bad bacteria.

The main bacteria responsible for the development of cavities are Streptococcus mutans and species of Lactobacilli.⁴

Whenever we consume dietary sugars these bad bacteria act upon them and produce acid acid-dropping pH of saliva below critical pH 5.5 which results in teeth dissolution. The earlier model used to say tooth, diet, and dental plaque were interlinked leading to tooth decay.

However, many other modifying factors have been observed since then, resulting in a more complex model that includes saliva, the immune system, time, socioeconomic status, level of education, lifestyle behaviours, and the use of fluorides.

What are probiotics and how are they important to oral health?

Probiotics are “living microorganisms that, when ingested in sufficient quantities, provide health benefits to the host”.⁵ We can say, they are special types of bacteria that can contribute to a healthy mouth. They work similarly to the probiotics found in your gut. These friendly bacteria help to crowd out harmful bacteria, promoting a good balance within the mouth's natural bacterial community, known as the oral microbiome.

While oral probiotics share some similarities with their gut counterparts, they're not the same. The specific strains used in oral probiotics are chosen to target the unique environment of the mouth and its particular needs. They act as an anti-inflammatory agent. Probiotics’ key- benefits are the prevention of tooth decay, gum disease, bad breath, and oral thrush.

Oral microbiome probiotic strains considered most beneficial to oral health are:⁶

• Lactobacillus reuteri
• Lactobacillus salivarius
• Streptococcus salivarius K12
• Streptococcus salivarius M18
• Lactobacillus paracasei
• Lactobacillus sakei

Here are five remarkable ways in which oral probiotics help prevent tooth decay:⁷

• Certain probiotic strains directly challenge the overgrowth of harmful bacteria like Streptococcus mutans, a major culprit in tooth decay
• Probiotics can work together within the dental plaque (biofilm) to prevent the initial growth of harmful bacteria, creating a stronger barrier against decay
• Some probiotics produce natural antimicrobials and enzymes that directly target and kill harmful bacteria like Streptococcus mutans and some Lactobacillus strains
• Probiotics can communicate with the body's immune system, ensuring it mounts a proper defence against harmful oral bacteria
• Probiotics can act as anti-inflammatories, aiding the mouth's natural healing processes and promoting oral health

Application of probiotics for oral health

Taking oral probiotic supplements can help prevent tooth decay and plaque buildup.

These supplements come in various forms like lozenges, drinks, mouth rinse, or chewable tablets. The most effective ways to take them are through chewable tablets or lozenges.

These chewable tablets and lozenges deliver the helpful bacteria straight to the surfaces of your mouth where bacteria form biofilms.

It's important not to swallow them; instead, chew or let them melt in your mouth.

The good news is that oral probiotics are generally safe and shouldn't cause any side effects.

The best dental probiotics for cavities include:⁸

• L. acidophilus
• L. paracasei
• L. rhamnosus
• L. reuteri
• L. casei
• L. salivarius
• Bifidobacillus
• S. thermophilus

To keep the good bacteria in your mouth healthy, it's essential to eat foods rich in prebiotics. Prebiotics are like fibres that nourish these helpful bacteria.

When picking a probiotic, choose one with good strains like S. salivarius K12, S. salivarius M18, L. rhamnosus, and L. reuteri. Make sure the product has a high strain count, measured in colony-forming units (CFUs), for effectiveness.

You can also boost the benefits of oral probiotics by including foods with probiotic bacteria in your diet. It's a simple way to support your oral health and keep those good bacteria thriving.

Common probiotic foods include:

• Kombucha
• Yoghurt
• Miso
• Kimchi
• Natto
• Sauerkraut
• Kefir
• Tempeh

FAQs

How do probiotics prevent tooth decay?

Oral probiotics promote the growth of good or beneficial bacteria and stop the growth of bad (pathogenic) or harmful bacteria. They create biofilm and replace those created by bad bacteria. New biofilm supports the health of teeth and gum and reduces inflammation.

What is the best probiotic for teeth?

Products that contain strains such as Lactobacillus reuteri and Lactobacillus rhamnosus, have shown potential benefits for dental health. Keep in mind that scientific research on this topic is ongoing, and individual responses to probiotics may vary. It's recommended to consult with a healthcare professional or dentist before starting any new supplement regimen, as they can provide guidance based on your specific health needs and considerations.

When choosing a probiotic product, look for reputable brands that provide information on the strains of bacteria present, the quantity of viable organisms (colony-forming units or CFUs), and any additional ingredients.

What is the main cause of tooth decay?

There are billions of bacteria in your mouth and most of them are good and beneficial for you and some are not. A group of bad bacteria increase their count and form a layer called plaque on the surface of teeth so, whenever we consume dietary sugars (carbohydrates) they feed upon it and produce acids to break down and dissolve tooth enamel. Along, with these bad bacteria, dietary sugars and poor oral hygiene are the main causes of decay.

How long does it take for probiotics to work on teeth?

Seeing the benefits of dental probiotics takes time, so be patient. Use them consistently for a month – one in the morning and one at night before bedtime. For best results, maintain good oral hygiene and take the tablets after brushing your teeth. This allows the helpful bacteria to spread and establish control.

Avoid disrupting the good bacteria by eating or brushing immediately after taking a tablet. Doing so could disturb them, making them less effective in the long run. Give the friendly bacteria about half an hour to settle in and establish their position in your mouth. Patience and a little wait time can lead to better results for your oral health.

Summary

If you address tooth decay at the initial stage, you can remineralise tooth enamel and reverse the incipient stage of decay with probiotics, proper oral hygiene, and dietary and lifestyle changes but if you leave it unchanged and let bad bacteria continue to feed, decay will start in the next layer of the tooth called dentin resulting in irreversible damage and this will require a dental filling.

Furthermore, if you leave it like this long enough it will damage the nerve and blood supply inside the tooth leading to infection which requires root canal treatment (RCT) or extraction. That’s why, it is always encouraged to visit the dentist for a regular check-up.

Incorporating oral probiotics into dental care is not a substitute for proper oral hygiene, a healthy diet, or regular dental checkups. However, used with other oral care strategies, oral probiotics can provide a significant benefit to your oral and overall health.

The health of your oral microbiome has implications for the overall health of your body. Your body is a complex system of interactions, with no isolated interactions from one part to another.