Limosilactobacillus reuteri as a supplement for improving periodontal health when oral hygiene is compromised
The effect of probiotics on periodontal health was investigated in a German study conducted on a group of sailors during their service at sea. Among the most common causes of the overgrowth of virulent pro-inflammatory microorganisms in the oral microbiota is impaired oral hygiene, which is significantly hindered in the conditions of a naval mission.
Oral Microbiota and Periodontal Health
According to current etiological concepts, dysbiotic overgrowth of virulent pro-inflammatory microorganisms in the sulcular microbiota is a key factor for the clinical manifestation of gingivitis and periodontitis. This dysbiosis can have various causes, but one of the most common is impaired oral hygiene, whether due to objective reasons or patient laxity. Limosilactobacillus reuteri has shown promise in previous studies for suppressing pathogens in the periodontium, even without additional expert intervention.
Investigation in Real Conditions
This effect was also examined in the presented study conducted by the University of Würzburg in collaboration with the German Institute of Naval Medicine. The study involved administering lozenges containing L. reuteri to sailors on a training mission, where – due to the specific circumstances of naval service and the tasks performed – oral hygiene often lapses, reflecting in their periodontal health. The aim was to assess whether regular consumption of probiotics could improve the known deterioration of periodontal health during deployment at sea.
Methodology and Course of the Study
The study recruited 72 healthy sailors (age 27.0 ± 5.0 years) from the Brandenburg frigate on a training mission at sea, and they were randomly provided with a supply of lozenges to consume 2× daily for the next 42 days. These lozenges either contained probiotic strains Limosilactobacillus reuteri (DSM 17938 and ATCC PTA 5289) (n = 36) or were placebo without lactobacilli (n = 36).
At baseline, day 14, and day 42, the following parameters were assessed: bleeding on probing (primary outcome), gingival index, plaque control record, level of attached gingiva on probing, and depth of any pockets in Ramfjord's index teeth.
Results
Initially, there were no significant differences between the groups. However, by day 14 and day 42, the scores for all evaluated parameters significantly improved in the L. reuteri group (p < 0.001) compared to both baseline values and the placebo group, which showed significant deterioration (p < 0.001) in all parameters at the end of the study. Notably, there was a slight but statistically significant reduction in pocket depth in the L. reuteri group (while the placebo group showed deterioration in all parameters).
In the placebo group, at the study's start, bleeding on probing was detected in an average of 37 ± 19 % of index teeth, increasing to 43 ± 17 % by day 42. In the probiotic group, improvement was observed from 40 ± 22 % at baseline to 10 ± 13 % after 6 weeks of use.
Conclusion
Based on the results of this study, it can be stated that regular consumption of products containing the probiotic L. reuteri – strains DSM 17938 and ATCC PTA 5289 – is an effective and easily implementable measure for maintaining or improving periodontal health in medically healthy individuals, regardless of their personal oral hygiene efficacy. This could offer new therapeutic and preventive possibilities in the clinical control of plaque-related gingival inflammation in individuals with compromised access to effective oral hygiene.
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Source: Schlagenhauf U., Rehder J., Gelbrich G., Jockel-Schneider Y. Consumption of Lactobacillus reuteri-containing lozenges improves periodontal health in navy sailors at sea: a randomized controlled trial. J Periodontol 2020; 91 (10): 1328−1338, doi: 10.1002/JPER.19-0393.
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