The role of probiotics in preventing dental caries: a systematic review of clinical evidence.
- 2025-12-02
- Frontiers in oral health 6
- Alessio Danilo Inchingolo
- Angelo Michele Inchingolo
- Irene Palumbo
- Mariafrancesca Guglielmo
- Lilla Riccaldo
- Roberta Morolla
- Francesco Inchingolo
- Andrea Palermo
- Gianna Dipalma
- PubMed: 41409473
- DOI: 10.3389/froh.2025.1720036
Background
Probiotics have emerged as a promising adjunctive strategy for oral health, particularly in the prevention of dental caries, a multifactorial disease driven by ecological imbalances in the oral microbiome.Methods
A systematic search of PubMed, Scopus, and Web of Science was conducted for studies published between January 2014 and January 2025, focusing on the use of probiotics for caries prevention in children and young adults. Clinical trials and observational studies were included, and a qualitative synthesis was performed based on the extracted outcomes.Results
Twenty-one studies met the inclusion criteria. Most clinical trials reported a significant reduction in Streptococcus mutans levels following administration of probiotic strains, particularly Lactobacillus paracasei, Lactobacillus rhamnosus, and Bifidobacterium lactis. Several studies also demonstrated a decreased incidence of new carious lesions and an improvement in salivary immune markers. However, a minority of studies found no significant effect, highlighting potential variability due to strain type, dosage, delivery method, and population characteristics.Conclusion
The current evidence supports the potential of specific probiotic strains to reduce cariogenic bacterial loads and contribute to caries prevention. Further standardized, long-term trials are needed to clarify the most effective formulations and regimens for clinical application.Systematic review registration
PROSPERO CRD42025646287.Research Insights
| Supplement | Health Outcome | Effect Type | Effect Size |
|---|---|---|---|
| Bifidobacterium animalis subsp. lactis BB-12 | Increased Immune Marker Levels | Beneficial | Small |
| Bifidobacterium animalis subsp. lactis BB-12 | Reduced Caries Lesions | Beneficial | Small |
| Bifidobacterium animalis subsp. lactis BB-12 | Reduced Cariogenic Bacteria | Beneficial | Moderate |
| Bifidobacterium animalis subsp. lactis BB-12 | Reduced Streptococcus Mutans Levels | Beneficial | Moderate |
| Bifidobacterium bifidum/lactis Bb-02 | Reduced Caries Incidence | Beneficial | Small |
| Bifidobacterium bifidum/lactis Bb-02 | Reduced Cariogenic Bacteria | Beneficial | Moderate |
| Lactobacillus acidophilus L-92 | Increased Immune Marker Levels | Beneficial | Small |
| Lactobacillus acidophilus L-92 | Reduced Caries Incidence | Beneficial | Small |
| Lactobacillus acidophilus L-92 | Reduced Cariogenic Bacteria | Beneficial | Moderate |
| Lactobacillus paracasei 431 | Increased Immune Marker Levels | Beneficial | Small |
| Lactobacillus paracasei 431 | Reduced Caries Incidence | Beneficial | Small |
| Lactobacillus paracasei 431 | Reduced Streptococcus Mutans Levels | Beneficial | Moderate |