Volume 2 - Issue 3 (May-Jul)

Role of ‘Live Microorganisms’ (Probiotics) in Prevention of
Caries: Going on the Natural Way Towards Oral Health
Vineet Agrawal*, Sonali Kapoor**, Nimisha Shah †
*Senior Lecturer
**Professor
Dept. of Conservative and Endodontics, MP Dental College and Oral
Research Institute, Vadodara
†
Professor, Dept. of Conservative and Endodontics, KM Shah Dental
College, Vadodara
Address for correspondence
Dr Vineet Agrawal
E-mail: vineetdent@yahoo.co.in
Abstract
Science is providing us the tools to diagnose and treat an infection before it causes damage. For some decades now, bacteria
known as probiotics have been added to various foods because of their beneficial effects for human health. Very encouraging
studies have come up in recent past exploring probiotics in fields of caries, periodontal diseases and few other areas and the
results tend to suggest beneficial effects of probiotics on oral health and on whole body in general. The application of probiotic
strategies may, in near future, provide an end to many infections occurring in oral cavity. This article reviews the probiotic
approaches, such as genetically modified Streptococcus mutans and targeted antimicrobials in the prevention of caries and
discuss its future directions.
Key words: Probiotics, dental caries, prevention, Bifidobacterium, Lactobacillus
W
D Miller first described dental caries as a
bacterially-mediated process more than
100 years ago. 1 Today, we know that dental
caries is a multifaceted disease process. Several models
have been put forward describing mechanism of caries
formation. One of the earlier models that is familiar
to most dentists was put forth by Fitzgerald and
Keyes. 2 They used three overlapping circles describing
the host, bacteria and nutrients required to foment
the production of organic acids and the subsequent
demineralization activity. The beauty of this model is
that all three elements must be present for the disease
to progress. Since all three are required for disease
initiation and progression, removal of any one element
ostensibly leads to the interception of the disease
process.
The surgical approach has been the predominate
mode of caries management for the past 150 years.
Dentistry has, however, in recent years moved
toward an antibiotic/antimicrobial model of disease
management. This approach, however, raises serious
questions: 1) Do the antibiotic/antimicrobial agents
Review article
(chlorhexidine, povidone-iodine, fluoride, etc.) kill
all offending organisms?; 2) if so, do the agents
preclude the re-entry of the same organisms from
external sources? and 3) if the agents do kill all the
offending organisms, do any remaining pathogenic
organisms have selective advantage in repopulating the
tooth surfaces? To overcome the problems inherent
in an antibiotic/antimicrobial approach, probiotic
methods are currently under study as means of caries
management.
What are Probiotics, Prebiotics and
Synbiotics
The term ‘probiotic’ is derived from the Latin preposition
pro (‘for’) and the Greek adjective (biotic), the latter
deriving from the noun (bios, ‘life’). 3 It was first used
by Lilly and Stillwell in 1965 to describe “substances
secreted by one microorganism, which stimulates the
growth of another” and thus was contrasted with the
term antibiotic. 4 Today, two main definitions are used.
According to a WHO/FAO report (2002), probiotics
are “live microorganisms which, when administered in
adequate amounts, confer a health benefit on the host”.
International Life Science Institute (ILSI) Europe
suggests a definition according to which a probiotic is
“a live microbial food ingredient that, when ingested
in sufficient quantities, exerts health benefits on the
consumer”. Probiotics are microorganisms, basically
bacteria, that when ingested would confer health
benefit beyond the basic nutrition. 5
Indian Journal of Multidisciplinary Dentistry, Vol. 2, Issue 3, May-July 2012
491