Periodontal Health Clinical Trial
Official title:
Effect of Lactobacillus Rhamnosus LGG and Bifidobacterium Lactis BB-12 on Gingival Health and Dental Plaque in Healthy Adolescents: a Randomized Controlled Clinical Trial
Some probiotics have been shown to have preventive effects on infectious diseases and allergies. Because their long-term enhancement of the immune responses of children, they have been recommended for infants in some countries. The most promising ones seem to be the combination of Bifidobacterium lactis BB-12 and Lactobacillus rhamnosus GG. Probiotic microbes are mainly ingested orally and the gastrointestinal tract is thus the primary target organ for them. However, the mouth is the first part of the gastrointestinal tract. Most probiotics are in theory cariogenic, thus their effects on oral health should be known. Several probiotics decrease levels of salivary mutans streptococci (MS), but in other respects very little is known about their effects on the oral microbiota. Also effects of probiotics on dental plaque should be studied. This study aims to find out the effects of the combination of BB-12 and LGG, delivered with a lozenge (4 weeks, twice a day) with a mixture of them on the amount of plaque and gingival health
The Food and Agriculture Organization (FAO) of the United Nations and the World Health
Organization (WHO) have defined probiotics as "live micro-organisms, which when administered
in adequate amounts, confer a health benefit to the host" (WHO 2002). They should preferably
be of human origin, be able to temporarily colonize the gastrointestinal tract and survive
in it. They must also be non-pathogenic and non-toxic.
Probiotics are used in the prevention and treatment of infectious diseases and allergies
(Hatakka and Saxelin, 2008; Salminen et al., 2010). In some countries probiotics are
recommended for infants and adults because of their long-term enhancement of the immune
responses. Combinations of probiotics, like Bifidobacterium lactis BB-12 (BB-12) and
Lactobacillus rhamnosus GG (LGG), appear to be most effective in this respect (Isolauri et
al., 2000; Rautava et al., 2009; Smith et al., 2012). Probiotics are mainly ingested orally,
and the gastrointestinal tract is thus the primary target organ for probiotic
micro-organisms. However, when ingested in the form of for example tablets, chewing gums,
cheese and milk, the oral cavity is exposed to the probiotics. With the world-wide increase
in the use of probiotics their effects of on oral health have become a hot topic.
Many types of probiotic bacteria have been explored but the most widely studied species are
those that belong to the genera Lactobacillus and Bifidobacterium. Yogurt and fermented milk
products are considered the simplest source of probiotic administration for humans. The
proven effects of probiotics in general health has led to more research in the oral health
field including dental caries, periodontal disease and halitosis. Some clinical studies have
demonstrated a decrease in the cariogenic mutans streptococci counts and in dental plaque
(Näse et al. 2001, Ahola et al. 2002, Nikawa et al. 2004, Caglar et al. 2007, Twetman &
Keller 2012). Probiotics have also shown improvements in the periodontal status in patients
with periodontal disease (Riccia et al. 2007, Shimauchi et al. 2008, Teughels et al. 2013,
Yanine et al. 2013). Recently, Toiviainen et al. (2015) found that the combination of
Lactobacillus rhamnosus GG (LGG) and Bifidobacterium strain Bifidobacterium lactis (BB-12)
improved the periodontal health in healthy adults by reducing the plaque amount and
subsequently the gingival inflammation without affecting the oral microbiota.
More evidence is necessary to confirm the efficacy of the combination of LGG and BB-12 in
the oral health.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Investigator, Outcomes Assessor), Primary Purpose: Prevention
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