Effect of Chewing Gums Containing Lactobacillus Reuteri on Oral Malodor

Objectives: Oral malodor is primarily caused by bacterial putrefaction of organic matter on oral surfaces. For treatment purposes, this study aimed to evaluate the effect of chewing gums containing probiotic bacteria on oral malodor. The null hypothesis was that no difference would be displayed compared with placebo gums. Methods: 27 healthy young adults with self-reported malodorous morning breath volunteered to this randomized double-blind placebo-controlled cross-over trial. The design included run-in and wash-out periods interspersed by two intervention periods of 14 days each. The subjects were instructed to chew gums daily (one piece in the morning and one in the evening) containing either two strains of probiotic lactobacilli (L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289) or placebo. The outcome measures were i) organoleptic scores for oral malodor (0-5) by a licensed test panel scoring integers only, ii) concentration of volatile sulfur compounds (VSC) measured with a Halimeter, and iii) concentration of VSC after a standard cysteine challenge. Registrations were made at baseline and after each intervention period at the same time of the day. Follow-up values were compared with baseline by paired statistics and the chi-square test. Results: Baseline organoleptic scores were 2.2±1.1 and 2.2±1.0 with placebo and active gum, respectively. After 14 days of treatment organoleptic scores were significantly reduced in the probiotic test group compared with baseline (p<0.05), which was not the case for the placebo group. Assessments of the VSC levels displayed no significant differences either before or after rinsing with L-cysteine. No adverse effects were registered. Conclusions: The results demonstrated that probiotic chewing gum can have some beneficial effect on oral malodor assessed by organoleptic scores. The results indicate that this type of probiotic gum may affect bacteria that produce malodorous compounds other than VSC's. The study was supported by BioGaia AB, Sweden.