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    A New Contender in the Fight Against Dental Caries?

    Let’s be honest, not everyone enjoys the thought of having to visit the dentist. Perhaps it’s the reminiscent sound of the dental drill, maybe our schedules are busy or simply we worry about needing dental treatment. Nonetheless, we go anyway because our oral health is part of our overall health and at least we get a fresh toothbrush and free toothpaste! To better understand why we regularly go for checkups we need to understand how tooth decay develops. Tooth decay is another name for dental caries or cavities and can be simply described as holes that develop in our teeth! These holes are caused by tiny rebellious bacteria in our mouths and other factors including diet and our genetics. Believe it or not, the bacteria in our mouths are first passed on from our mothers soon after birth and grow as communities as our teeth begin to erupt. These bacterial communities are referred to as plaque by your dentist! While bad bacteria are a prime suspects for creating cavities there is also good bacteria called probiotics that keep our mouths healthy by fighting off bad bacteria when we have too much of it. Depending on what we eat but more importantly how much sugar we consume, certain bad bacteria like Streptococci Mutans (S. Mutans) can overpopulate and cause cavities. Good bacteria like Lactobacillus Reuteri (L. Reuteri) uses various tools to help keep a natural balance of good and bad bacteria. While Lactobacillus Reuteri can be consumed and seems promising towards reducing bad bacteria associated with dental disease, more research is needed to learn about how this probiotic can benefit our mouths.

    How do cavities form?

    As we know, a high sugar diet is associated with an explosion of bad bacteria in our mouth but that doesn’t mean we have to give up our favourite dessert or altogether stop the occasional late-night fridge raid. Instead we have to under- stand that “like humans” these bad bacteria love sugar and use sugar as an energy source to grow. As soon as they consume it, they produce acids which causes harm to our teeth. While the outer layer of our teeth called enamel is strong and hard, it is no match for acid. Over time, the acid created by this bad bacteria breaks down the enamel armour of our teeth by gradually removing the mineral building blocks. This is the earliest form of a cavity which can form on any tooth surface and even between teeth. Without proper care the acid penetrates another deeper layer called dentine. If the acid extends beyond this final layer of armour it reaches blood vessels and nerves resulting in pain! Without professional treat- ment the tooth may become infected and need to be removed. But why? All for our shared love of sugar.

    How can we fight against cavities?

    The good news is that we can prevent cavities. Many mouthwashes, toothpastes and most water sources have a substance called fluoride in them which helps strengthen our teeth by restoring their armour to defend against acid. Although sometimes our genetics can get in the way, the best way to avoid cavities is to cut down on sugar intake and practice good oral hygiene that removes bad bacteria and its food source. This includes toothbrushing, flossing and avoid- ing starchy foods that stick to our teeth. More interestingly, probiotic L. Reuteri is shown to send out agents that kill and stop the growth of bad bacteria like S. Mutans which is associated with cavities. Another ability of L. Reuteri is it can help our immune system fight against infection and other more severe diseases like periodontitis that result from developed communities of bad bacteria in our mouths. One last tool L. Reuteri uses is itself! That’s right, this probiotic can bind to your teeth and act as a barrier to prevent harmful bacteria from attacking. Studies have shown that we have a substantial amount of this good bacteria, such as L. Reuteri, at birth. As we get older, the amount of this good bacteria lowers leading to increased risk for developing dental disease, such as caries, overtime.

    What does the research say about L. Reuteri? Should we take this probiotic?

    L. Reuteri is one of the most well-studied probiotics. Many high-quality studies have shown the potential impact L. Reuteri has in keeping a natural balance of good and bad bacteria in our mouths. Studies further support that the pres- ence of good bacteria like L. Reuteri reduces the number of bad bacteria like S. Mutans that cause cavities. Lastly, research has shown us that young individuals who are at high risk of developing cavities experience less to no cavities when consuming L. Reuteri as a supplement compared to those who do not. Although promising, we still need to conduct more research to understand, on a scientific level, how L. Reuteri works to prevent dental diseases. Overall, L. Reuteri probiotic supplements are beneficial and should be considered if you are at higher risk for cavities based on its ability to benefit the mouth and keep bad bacteria in check. However, considering the common side effects of this probiotic, which include stomach gas or bloating, consultation with your dentist or physician is advised before taking.

    Source: Adriano B. Brescacin, Second Year Dental Student at Melbourne Dental School

    Resources:

    Stensson, M., Koch, G., Coric, S., Abrahamsson, T. R., Jenmalm, M. C., Birkhed, D., & Wendt, L. K. (2014). Oral administration of Lactobacillus reuteri during the first year of life reduces caries prevalence in the primary dentition at 9 years of age. Caries research, 48(2), 111-117.

    Teughels, W., Durukan, A., Ozcelik, O., Pauwels, M., Quirynen, M., & Haytac, M. C. (2013). Clinical and microbiological effects of Lactobacillus reuteri probiotics in the treatment of chronic periodontitis: a randomized placebo‐controlled study. Journal of clinical periodontology, 40(11), 1025-1035.

    Vestman, N. R., Chen, T., Holgerson, P. L., Öhman, C., & Johansson, I. (2015). Oral microbiota shift after 12-week supplementation with Lactobacillus reuteri DSM 17938 and PTA 5289; a randomized control trial. PLoS One, 10(5), e0125812.

    Disclaimer: The statements made in the above article are published on authority of the author and have not been peer reviewed. They do not necessarily reflect the views of Dental Digest and publishing them is not to be regarded as an endorsement of them by Dental Digest.

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