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What Are the Two Main Etiologies Behind Halitosis?
In dentistry, probiotic supplements are usually employed as one of the mainline adjuncts in reducing dental caries development and suppressing fungal or oral cavity infection caused by Candida species. However, probiotics can also play a role in controlling oral bad breath or halitosis (bad odor).
Why would bad breath be caused first? Well, that is because of a plaque-induced gingivitis infection, or rather, gum or gingival inflammation owing to the adherence of bacterial biofilm that forms around your teeth. Gingivitis eventually leads to the destruction of the supporting periodontium tissue that embeds your tooth in the underlying bone, also called periodontitis. Periodontitis is mainly responsible for tooth mobility, and it is eventual loss or exfoliation.
Both gingivitis and periodontitis are considered to be the main inflammatory disease continuum of these inflammatory processes in your oral cavity, which results in bad breath or halitosis commonly. While the emphasis dentally is on relieving the symptoms of gingivitis or periodontitis by opting for regular dental follow-ups, routine oral prophylaxis, or dental scaling procedures, surgical adjuncts are curettage of the gums, gingival, and periodontal therapies that are aimed at relieving these oral infections or inflammatory disease processes from progressing further.
Further, mechanical debridement, antibiotic or antimicrobial prophylaxis, and non-surgical treatment modalities exist for treating these common oral diseases causing halitosis, that is, for managing gingivitis and periodontitis.
Can Probiotic Supplements Relieve Bad Breath or Periodontal Diseases?
One of the new-age research studies is linking the nutritional requirements and role of your diet to your oral health. According to current medical researchers, diet and oral health do have an intimate link or connection.
A growing number of research studies over the last decade have supported the pivotal role of probiotic therapies in treating oral halitosis indirectly. By treating the cause of halitosis, gingivitis, or periodontitis, the dentist and the nutritionist can collaborate to give holistic advice on the long-term management of oral halitosis.
Oral administration of probiotics is now considered to be one of the most effective present-day adjuncts owing to its promising potential in the reduction of oral pathogenic bacteria. As probiotics directly are shown to reduce the overall bacterial load in the mouth causing gingivitis and periodontitis, they can also be implicated in alleviating the clinical signs of these diseases. Probiotics, hence, play a role in replacing traditional antibiotic prophylaxis or non-surgical periodontal therapies as a substitute for managing periodontal infections or relieving bad breath.
What Is the History and Current Recommendations for Probiotics?
Russian scientist Elie Metchnikoff was the first to originally postulate that gastrointestinal microbiota (gut flora) are clearly affected by the physiological impact associated with the aging process. In 1908, this scientist (also a Nobel Prize winner) attributed that the consumption of fermented dairy consisting of Lactobacillus had the ability to counteract the negative effects of gut or gastrointestinal pathogens.
Just like the Lactobacillus bacterium, many other symbiotic links have been established since the last century that observe the role of these beneficial gut bacterium harbored by the probiotic foods- can hence counteract the gut and gastrointestinal pathologies as well. In the field of dentistry, clinical studies, including the recommendation by the WHO (World Health Organization), now implicate the innate role or use of probiotics, especially in their supplemental forms, in controlling periodontal diseases or infections, which we shall explore below in detail.
The clinical trials also indicate that increased consumption of fermented dairy products or probiotic foods such as yogurt, kimchi, sauerkraut, kombucha, miso, tempeh, cheese, kefir, etc are linked to improved oral hygiene.
What Are the Research-Based Dental Benefits of Probiotic Supplements?
However, the use of probiotic supplements has been implicated in reducing gingival or periodontal inflammatory parameters, the reduced acidogenic potential of dental caries, and the reduction of the acidogenic potential of dental plaque-producing bacteria like Streptococcus and Staphylococcus species.
Though a majority of changes that can be observed clearly by medical research in the gastrointestinal microbiome, be it in the stomach or the small intestine, are induced by probiotics only- more research is being linked and investigated now into the direct interaction of probiotic supplements in the oral cavity and specifically for the management of gingivitis, periodontitis and the resultant clinical feature of oral halitosis or bad breath. This research, hence, that is focused on the ingestion of probiotics and their ability to impact the oral bacterium, or the resident community species of the bacteria, through several types of trophic interactions is listed below.
These mechanisms of action are how probiotic foods and supplements tend to improve oral immunity and destroy pathogenic bacterium that causes gingivitis and periodontitis. Have a look:
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Probiotics that produce lactic acid, which is mainly a short-chain fatty acid, can penetrate bacterial membranes and thereby inhibit the proliferation of pathogenic periodontal infection-causing organisms like Porphyromonas gingivalis, Streptococcus mutans and Prevotella intermedia species.
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Probiotics can also possibly inhibit the growth of pathogenic bacteria by producing hydrogen peroxide. For example, Streptococcus sanguinis, which is produced by some probiotic foods, can reduce the levels of the pathogenic Aggregatibacter actinomycetemcomitans and Streptococcus mutans bacteria.
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These foods can help eliminate the attachment of Streptococcus mutans by modifying the probiotic protein at the sites of cellular attachment of pathogenic bacteria, resulting in a decreased risk of dental disease.
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The beneficial gut production of biosurfactants by probiotic supplements also prevents bacterial adhesion. For example, Streptococcus mitis results in a biosurfactant that can prevent the adhesion of Streptococcus mutans and several periodontal pathogenic bacteria upon your enamel surface.
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Bifidobacterium longum bacteria have a potent anti-oxidant effect. They inhibit the formation of the linolenic acid pathway and release hydrogen peroxide to counteract periodontal pathogens.
Conclusion
Though supplements may not always be required for the healthy individual, probiotic supplementation holds ample future scope and promising potential in treating gingival and periodontal diseases and, subsequently, in preventing bad breath or halitosis, as per current dental research.
