Probiotics in Children – A Pediatric Dentist's Overview

Probiotics including living microbes beneficially affect the health of the host. It is abundantly available in yogurt and other dairy products. According to the International Scientific Association, Probiotics and Prebiotics are defined as “Live microorganisms, which when administered in adequate amounts, confer a beneficial effect on the health of the host.” Prebiotics are non-digestible food ingredients such as fructooligosaccharides (FOS), Lactulose and inulin that beneficially affect the host by selectively stimulating growth and increase the activity of a limited number of probiotic like bacteria in a colon. Probiotics can be varied; they can be yeast, bacteria or moulds. Most commonly, bacterial species are predominant. Some of these species are:

• Lactic Acid Producing Bacteria (LAB): Lactobacillus, Bifidobacterium, Streptococcus
• Non-lactic acid-producing bacterial species: Bacillus, Propionibacterium
• Non-pathogenic yeasts: Saccharomyces
• Non-spore forming and non flagellated rod or coccobacilli

Advantages of Lactobacillus

• It produces enzymes responsible for the metabolism and digestion of carbohydrates and proteins
• Helps in synthesis of vitamin B and vitamin K
• Helps in breakdown of bile salts
• Enhances innate and acquired immunity
• Inhibit pro-inflammatory mediators.

Advantages of Bifidobacterium

• Metabolises lactose and generates lactic acid
• Synthesizes vitamins
• Ferments indigestible carbohydrates
• Produces beneficial short-chain fatty acids

Properties of Probiotics

• Non-pathogenic and non-toxic
• Produces a beneficial effect
• Tolerates the gastrointestinal environment
• Has a good shelf life
• Replaces and restates intestinal microflora

Role of Probiotics in dental caries

Probiotic and modulation in bacterial molecular genetics have been used to replace cariogenic organisms such as mutans streptococci and Lactobacillus species with strains of bacteria that are not cariogenic. One such example is S. mutans with a glucosyltransferase C (gtf C) gene mutation. The acidogenic potential theory and formation of water-insoluble extracellular polysaccharides (glucans) from sucrose lead to the adhesion of colonisation of bacteria causing dental caries. These glucans are synthetise by glucosyltransferase B, glucosyltransferase C, and glycosyltransferase D genes. The mutated gtfC gene lowers the ability of S. mutans to produce extracellular glucan, and the decrease is from 51% - 33% of the biofilm volume in extracellular matrix component of mixed oral biofilms. Hillman et al. obtained S. mutans strain that produces a bacteriocin active in other S. mutans strains into the oral cavity that replaces the naturally-occurring cariogenic strains.