Current Evidence of Using Pre- and Probiotics in the Prevention and Management of Caries and Oral Candidiasis

Abstract Body: Recent insights on the decisive role of the oral microbiome in health and disease have paved the way for pre- and probiotics in the prevention and management of oral diseases. Pre- and probiotics are however not separate entities as they always act in concert. For dental caries and oral candidiasis, local mechanisms of action in the biofilm seem predominant; growth inhibition, release of antibacterial substances and reduction of metabolic biofilm activity. Among the traditional prebiotics, arginine and xylitol supplements are effective for the ecological management of dental caries. Due to risk of bias in many of the clinical trials, the certainty of evidence is so far low. For probiotics, the first 1000 days of life provide a window of opportunity for modulating the microbiota through interventions with beneficial bacteria. Consequently, multiple studies have addressed early childhood caries prevention with milk containing probiotic bacteria served at daycare centers. A systematic review covering seven trials have indicated a prevented fraction of 43%. Studies are also available from caries-active schoolchildren and frail elderly with promising but yet not confirmed results. Probiotics exert excellent antifungal activities and may be suitable for ageing populations with mycosis due to chronic diseases and polypharmacy. Systematic reviews indicate that probiotics are superior to the placebo for the prevention and treatment of oral candidiasis in the elderly and denture wearers. Further clinical trials on the synergistic effects of pre- and probiotics are welcome to optimize the applications for oral health.