Effect of probiotic mouthwashes in comparison to chlorhexidine on periodontal health
Systematic review and meta-analysis
Keywords:
Adults, Adolescents, Children, Chlorhexidine, Mouthwash, ProbioticAbstract
Aim: To evaluate and compare the efficacy of Chlorhexidine and Probiotic mouthwashes in reducing plaque accumulation and gingivitis. Materials and methods: PubMed, Ovid SP, Embase, and Google Scholar databases were searched from years 1980 upto April 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria by two independent reviewers. Studies comparing Probiotics and Chlorhexidine in mouthwash form were included and evaluated for outcomes such as plaque score, gingival score. Results: A total of eleven articles were included for qualitative analysis, among them seven studies qualified for quantitative analysis. Random effects model was carried out to perform meta-analysis, basing on heterogeneity. Plaque index (PI): Significant reduction of plaque scores post-intervention were found when compared to baseline in both Probiotic mouthwash group [p=0.00001, MD: 0.87, 95% CI: 0.41 to 1.33] and chlorhexidine mouthwash groups [p=0.00001, MD: 0.97, 95% CI: 0.66 to 1.28]. No significant intergroup difference was found between Chlorhexidine and Probiotic mouthwash groups (p= 0.73). Gingival index (GI): Significant reduction of gingival index scores post-intervention were found when compared to baseline in both Probiotic mouthwash group [p=0.001, MD: 0.48, 95% CI: 0.19 to 0.77] and chlorhexidine mouthwash groups [p=0.0001, MD: 0.46, 95% CI: 0.23 to 0.68].
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References
Rondanelli M, Faliva MA, Perna S, Giacosa A, Peroni G, Castellazzi AM. Using probiotics in clinical practice: Where are we now? A review of existing meta-analyses. Gut Microbes 2017;8:521-43.
Makrgeorgou A, Leonardi-Bee J, Bath-Hextall FJ, Murrell DF, Tang ML, Roberts A, et al. Probiotics for treating eczema. Cochrane Database Syst Rev 2018;11:CD006135-CD.
Bo L, Li J, Tao T, Bai Y, Ye X, Hotchkiss RS, et al. Probiotics for preventing ventilator-associated pneumonia. Cochrane Database Syst Rev 2014;10(10):CD009066-CD.
Ho SN, Acharya A, Sidharthan S, Li KY, Leung WK, McGrath C, et al. A Systematic Review and Meta-analysis of Clinical, Immunological, and Microbiological Shift in Periodontitis After Nonsurgical Periodontal Therapy With Adjunctive Use of Probiotics. J Evid Based Dent Pract 2020;20:101397.
Barboza EP, Arriaga PC, Luz DP, Montez C, Vianna KC. Systematic review of the effect of probiotics on experimental gingivitis in humans. Braz Oral Res 2020;34:e031.
Akram Z, Shafqat SS, Aati S, Kujan O, Fawzy A. Clinical efficacy of probiotics in the treatment of gingivitis: A systematic review and meta-analysis. Aust Dent J 2020;65:12-20.
Yoo JI, Shin IS, Jeon JG, Yang YM, Kim JG, Lee DW. The Effect of Probiotics on Halitosis: a Systematic Review and Meta-analysis.Probiotics Antimicrob Proteins 2019;11:150-7.
Shu Z, Li P, Yu B, Huang S, Chen Y. The effectiveness of probiotics in prevention and treatment of cancer therapy-induced oral mucositis: A systematic review and meta-analysis. Oral Oncol 2020;102:104559.
Mundula T, Ricci F, Barbetta B, Baccini M, Amedei A. Effect of Probiotics on Oral Candidiasis: A Systematic Review and Meta-Analysis. Nutrients 2019;11:E2449.
Poorni S, Srinivasan MR, Nivedhitha MS. Probiotic Streptococcus strains in caries prevention: A systematic review. J Conserv Dent 2019;22:123-8.
Meurman JH, Stamatova I. Probiotics: contributions to oral health. Oral Dis 2007;13:443-51.
Barboza EP, Arriaga PC, Luz DP, Montez C, Vianna KC. Systematic review of the effect of probiotics on experimental gingivitis in humans. Braz Oral Res 2020; 30;34:e031.
Sajedinejad N, Paknejad M, Houshmand B, Sharafi H, Jelodar R, Shahbani Zahiri H, et al. Lactobacillus salivarius NK02: a Potent Probiotic for Clinical Application in Mouthwash. Probiotics Antimicrob Proteins 2018;10:485-95.
Klarin B, Adolfsson A, Torstensson A, Larsson A. Can probiotics be an alternative to chlorhexidine for oral care in the mechanically ventilated patient? A multicentre, prospective, randomised controlled open trial. Crit Care 2018;22:272.
Yousuf A, Sidiq M, Ganta S, Nagaraj A, Vishnani P, Jan I. Effect of Freeze Dried Powdered Probiotics on Gingival Status and Plaque Inhibition: A Randomized, Double-blind, Parallel Study. Contemp Clin Dent 2017;8:116-21.
Sujlana A, Goyal R, Pannu P, Opal S, Bansal P. Visual pedagogy and probiotics for hearing impaired children: A pilot study. J Indian Soc Pedod Prev Dent 2017;35:353-8.
Jindal V, Mahajan N, Goel A, Kaur R, Mahajan A, Malhotra PT. Clinical efficacy of probiotic mouthwash in the treatment of gingivitis patients in Himachal population. J Int Clin Dent Rrs Organ 2017;9:41-4.
Jothika M, Vanajassun PP, Someshwar B. Effectiveness of probiotic, chlorhexidine and fluoride mouthwash against Streptococcus mutans - Randomized, single-blind, in vivo study.J Int Soc Prev Community Dent 2015;5:S44-8.
Dhawan R, Dhawan S. Role of probiotics on oral health: A randomized, double-blind, placebo-controlled study. J Interdiscip Dentistry 2013;3:71-8.
Noordin K, Kamin S.The Effect of probiotic mouthrinse on plaque and gingival inflammation. Annal Dent Univ Malaya 2007;14:19-25.
Vivek K, Amritha, Mahender P. Comparison of The Effectiveness of Probiotic and Chlorhexidine Mouth Rinses on Plaque Accumulation and Gingival Inflammation.Int.J.Drug Res.Dental Sci 2019;1:1-5.
Sharma P, Datta G, Gandhi K, Kumar D. A comparative evaluation of efficacy of probiotic and chlorhexidine mouthrinses on gingival health and plaque accumulation in 6-9 year old children. Int J Appl Dent Sci 2019; 5: 156-62.
Shah SS, Nambiar S, Kamath D, Suman E, Unnikrishnan B, Desai A, et al. Comparative Evaluation of Plaque Inhibitory and Antimicrobial Efficacy of Probiotic and Chlorhexidine Oral Rinses in Orthodontic Patients: A Randomized Clinical Trial. Int J Dent 2019;1964158.
Kandaswamy SK, Sharath A, Priya PG. Comparison of the Effectiveness of Probiotic, Chlorhexidine-based Mouthwashes, and Oil Pulling Therapy on Plaque Accumulation and Gingival Inflammation in 10- to 12-year-old Schoolchildren: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2018;11:66-70.
Deshmukh MA, Dodamani AS, Karibasappa G, Khairnar MR, Naik RG, Jadhav HC. Comparative Evaluation of the Efficacy of Probiotic, Herbal and Chlorhexidine Mouthwash on Gingival Health: A Randomized Clinical Trial. J Clin Diagn Res 2017;11:Zc13-zc6.
Nadkerny PV, Ravishankar PL, Pramod V, Agarwal LA, Bhandari S. A comparative evaluation of the efficacy of probiotic and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A randomized controlled clinical study. Journal of Indian Society of Periodontology 2015;19(6):633-9.
Shah RK. Comparative Evaluation of Efficacy of Probiotic, Chlorhexidine and Flouride Mouthrinses in Children : A Short-Term Clinical Study. Int J Dent Med Res 2014;1:21-6.
Mishra R, Tandon S, Rathore M, Banerjee M. Antimicrobial and plaque inhibitory potential of herbal and probiotic oral rinses in children: A randomized clinical trial. Indian J Dent Res 2014;25:485-92
Thakkar PK, Imranulla M, Naveen Kumar P G, Prashant G M, Sakeenabi B, Sushanth V H. Effect of probiotic mouthrinse on dental plaque accumulation: A randomized controlled trial. Dent Med Res 2013;1:7-12
Ingle NA, Chaly PE, Reddy VC. Effectiveness of probiotic and chlorhexidine mouthrinses on reduction of plaque, gingivitis & mutans streptococci count in saliva-a clinical trial. J Indian Assoc Public Health Dent 2013;11:23.
Harini P M, Anegundi R T. Efficacy of a probiotic and chlorhexidine mouth rinses: A short-term clinical study. J Indian Soc Pedod Prev Dent 2010;28:179-82.
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