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Early intervention with probiotic Lactobacillus paracasei F19 has no long-term effect on caries experience
Umeå University, Faculty of Medicine, Department of Odontology.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Paediatrics.
Umeå University, Faculty of Medicine, Department of Odontology.
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2013 (English)In: Caries Research, ISSN 0008-6568, E-ISSN 1421-976X, Vol. 47, no 6, 559-565 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to evaluate possible long-term effects of a cereal diet supplemented with Lactobacillus paracasei F19 (LF19) during weaning on caries experience, mutans streptococci (MS) and lactobacilli (LBC) in a group of 9-year-old children. A secondary aim was to evaluate if the intervention resulted in the permanent integration of LF19 as part of the oral microbiota. The study followed up on a double-blind placebo-controlled randomised trial. Among 179 infants that were randomised to a daily diet that included cereals with or without LF19 from 4 to 13 months of age, 56 from the probiotic group and 62 from the placebo group participated in the follow-up at 9 years. Data were collected by oral clinical examination and questionnaires. MS and LBC levels were assessed with conventional cultivation; LF19 was detected by using randomly amplified polymerase chain reactions (RAPD-PCR). At the follow-up, neither decayed, missing and filled surfaces for primary teeth (dmfs) nor decayed, missing and filled surfaces for permanent teeth (DMFS) differed significantly between the probiotic and placebo groups (p > 0.05). MS and LBC levels were similar in both groups (p > 0.05). RAPD-PCR showed no evidence of oral colonisation with LF19 in the study group. It is concluded that an early intervention with LF19 did not affect the frequency of dental caries, MS or LBC. LF19 did not establish itself as a permanent facet of the oral microbiota in any of the subjects included in this study.

Place, publisher, year, edition, pages
Karger , 2013. Vol. 47, no 6, 559-565 p.
Keyword [en]
Dental caries, Lactobacilli, Mutans streptococci, Probiotic intervention

National Category
Dentistry
Research subject
Odontology
Identifiers
URN: urn:nbn:se:umu:diva-67782DOI: 10.1159/000350524OAI: oai:DiVA.org:umu-67782DiVA: diva2:614309
Available from: 2013-04-04 Created: 2013-04-03 Last updated: 2017-12-06Bibliographically approved
In thesis
1. Probiotic Lactobacilli in the context of dental caries as a biofilm-mediated disease
Open this publication in new window or tab >>Probiotic Lactobacilli in the context of dental caries as a biofilm-mediated disease
2013 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: The World Health Organization defines probiotics as ‘live microorganisms which, when administered in adequate amounts, confer a health benefit to the host’. Traditionally, probiotic microorganisms have been used to prevent or treat gastrointestinal tract diseases. In the last 15 years, there has been increasing interest of a possible probiotic impact on the oral microbiota and dental caries. Dental caries is a multifactorial disease, and the causative factor in the oral microbiota includes a shift from a balanced microflora to a microflora that includes more aciduric species such as mutans streptococci (MS), non-mutans streptococci, and Actinomyces. MS is considered an opportunistic pathogen although several other bacteria also contribute to the disease. Early acquisition of MS is associated with early development of caries; therefore a desirable complement to other prophylactic measures would be a MS colonization inhibitor.

Objective: To better understand how selected strains of probiotic lactobacilli interact with MS in vitro and in vivo and to study the impact of probiotic lactobacilli on caries development during childhood.

Material and methods: The in vitro properties of probiotic lactobacilli were studied with regard to (i) acid production from sugars and sugar alcohols, (ii) growth inhibition capacity on clinical isolates and reference strains of MS as well as Candida albicans and (iii) the capacity to co-aggregate with MS. A randomized controlled trial (RCT) tested the short-term effect of intervention with two Lactobacillus reuteri strains on MS, which was evaluated after treatment with chlorhexidine. The re-growth patterns of MS and 19 other selected strains were also evaluated. In the second clinical study  we investigated the long-term effect on MS prevalence and dental caries after an intervention with Lactobacillus paracasei ssp. paracasei F19 (LF19) between 4 and 13 months of age.

Results: The results from the in vitro testing showed that strains of probiotic lactobacilli differed in their fermentation patterns, inhibition capacity and their capacity to co-aggregate, which should be kept in mind in the translation to clinical research. The clinical study on short-term effects of two L. reuteri strains on MS and other oral strains showed no effect on re-growth patterns after intervention. The clinical study on long-term effects of LF19 showed no effect on the prevalence of MS. Furthermore, the clinical follow-up at 9 years of age showed no differences in either decayed, missing, and filled surface (dmfs) or DMFS between the probiotic and placebo groups. Evaluation of saliva samples showed no signs of oral colonization with LF19 in the study group.

Conclusion: The in vitro testing showed potentials of the selected probiotic Lactobacillus strains for interference with MS and C. albicans. The results from the clinical studies showed no such effect on MS or dental caries. Evidence regarding the effectiveness of specific probiotic applications in the prevention of dental caries is limited and does not allow for conclusions concerning the use of probiotic bacteria as a preventive measure.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2013. 57 p.
Series
Umeå University odontological dissertations, ISSN 0345-7532 ; 125
Keyword
caries prevention, co-aggregation, dental caries, growth inhibition, mutans streptococci, probiotic lactobacilli, re-colonization
National Category
Dentistry
Research subject
Odontology
Identifiers
urn:nbn:se:umu:diva-67843 (URN)978-91-7459-574-1 (ISBN)
Public defence
2013-05-03, Sal B, Tandläkarhögskolan, Norrlands universitetssjukhus, Umeå, 13:00 (Swedish)
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Available from: 2013-04-12 Created: 2013-04-04 Last updated: 2013-04-12Bibliographically approved

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Hasslöf, PamelaWest, ChristinaKarlsson Videhult, FridaStecksén-Blicks, Christina

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