The term endodontics is derived from two Greek words - "endo" meaning inside and "odons" meaning tooth. Taken together, these words mean study of the inner part of the tooth, the dental pulp. Endodontic treatments include several different procedures of which root canal is one of the most common … and feared!
In the last decades, root canal treatments have been object of many controversies and several observations found an association between root canals and chronic health issues.
What is certainly not controversial is that specific probiotics play an important role in endodontic treatments and, more in general, in dental health.
In a recent study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5343683/
researchers looked at two persistent pathogenic microbes often found in tooth infections: Enterococcus faecalis and Candida albicans. The authors selected beneficial probiotic bacteria (such as Lactobacillus and Bifidobacterium) to see if they could keep the invading pathogens in check. During the first stage of the study, they introduced the beneficial bacteria into agar cups containing the pathogenic microbes to see if there was an anti-pathogenic effect. The second phase followed the same processes using biofilm instead of agar cups.
The results found that the beneficial probiotic bacteria acted against one pathogen (E. faecalis) in the agar cup and against both (E. faecalis and Candida albicans) on the biofilm. The lab tests suggest that the right beneficial probiotic bacteria may be useful in the treatment of endodontic infections, possibly as an alternative to or alongside a root canal procedures.
Why not just use a method previously proven effective in the first place? In part, because root canal therapy doesn’t always work, according to these researchers and when it does fail, it can leave dangerous bacteria behind. This would indicate that probiotic treatments might work in conjunction to the root canal to increase the success rate of endodontic therapies.
This isn’t the first time that probiotics have been considered in the dental world. In 2008, two researchers published a study in the International Journal of Antimicrobial Agents suggesting that beneficial bacteria in probiotic products might help contain plaque generating bacteria. Plaque is a sticky substance produced by oral bacteria as they break down sugar.
Plaque buildup is at the core of periodontal disease because it contains pathogenic microbes able to destroy tooth enamel and soft tissue. According to this study, introducing a small sample of good probiotic bacteria might reduce the influence of these plaque generating microbes, improving oral hygiene and reducing plaque-related damage.
There is also evidence that some Lactobacillus species help reduce episodes of gingivitis and even eliminate chronic halitosis, both precursors to periodontal disease. In one study, a group of patients suffering from moderate gingivitis was given Lactobacillus formulations each day. The colonization of the Lactobacillus proved effective to reduce their gingivitis.
Although it seems clear that probiotics may be used to create a more diverse oral microbiome improving dental hygiene and saving teeth in the process, as of today there’s no clear understanding about the practical use of probiotics in this field.
Yours truly,
Marco Ruggiero