Probiotics
Place in Therapy
The evidence behind the use of probiotics for the treatment of halitosis is not very strong. While they appear to be safe, the clinical trials conducted were small and focused on disease-oriented outcomes rather than patient-oriented outcomes that matter. For example, the trial that tested the efficacy of S.Salivarius K12 was conducted in only 23 patients with the primary outcome of reduction in volatile sulphur compounds (VSC). While the product was shown to reduce VSC in the treatment group, it is not clear if this necessarily translates into a reduced level of halitosis to a level that is clinically meaningful for the patient. Furthermore, in the trial, the product was used in conjunction with chlorhexidine gluconate which is also known to help reduce halitosis so it is difficult to determine if the probiotic had a true benefit. Advise the patient that proper oral care (non-pharmacological measures) is the key to reducing halitosis and reassure them that oral probiotic gums are safe to try but evidence for efficacy is not currently strong for the treatment of halitosis. Probiotics can be safely used on a daily basis as part of the patient’s daily oral care routine if the patient so desires.
References
References
- Periobalance ® Patient Information Pamphlet. Obtained from, http://www.periobalance.com/n/pdffiles/periobalance/PB-Pat-Edu-Pamphlet.pdf. Accessed May 25, 2013
- Cultured Care Probiotic Gum with BLIS K12. Obtained from, http://culturedcare.com/faq/. Accessed May 25, 2013