International Journal of Clinical Pediatric Dentistry

Register      Login

VOLUME 17 , ISSUE 9 ( September, 2024 ) > List of Articles

Original Article

EvoraPlus Oral Probiotic Tablet: New paradigm for Caries Prevention in Children

Akanksha Mishra, Siddharth Saurabh

Keywords : Evora Plus oral probiotic tablet, Streptococcus mutans count, Salivary pH, Salivary total bacterial count

Citation Information : Mishra A, Saurabh S. EvoraPlus Oral Probiotic Tablet: New paradigm for Caries Prevention in Children. Int J Clin Pediatr Dent 2024; 17 (9):1044-1048.

DOI: 10.5005/jp-journals-10005-2937

License: CC BY-NC 4.0

Published Online: 30-09-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Abstract

Background: According to the World Health Organization, probiotics are live microorganisms that, when administered in adequate amounts, confer a health benefit to the host. The use of oral probiotics in children to improve oral health may lead to nonpathogenic bacteria replacing cariogenic bacteria. The Evora Plus oral probiotics tablet is the first such oral probiotics tablet containing a proprietary blend of three select species of naturally occurring oral bacteria, each with a specific function for maintaining a healthy oral environment. These strains include Streptococcus oralis KJ3sm, Streptococcus uberis KJ2sm, and Streptococcus rattus JH145. Aim: To compare the levels of salivary total bacterial count, salivary pH levels, and salivary S. mutans count before and after consumption of the Evora Plus oral probiotic tablet. Materials and methods: Around 40 caries-free schoolchildren from Daksh International School, Gadarwara, Madhya Pradesh, India, aged 12–14 years, were selected and divided equally into two groups—group A, in which total salivary bacterial count and pH were evaluated, and group B, in which salivary S. mutans count and pH were evaluated. These groups were further subdivided into group A1 and group B1, which served as the control groups not receiving the Evora Plus oral probiotic tablet, and group A2 and group B2, which were the test groups consuming the Evora Plus oral probiotic tablet for 30 days. Assessment of salivary samples for total bacterial count was done at baseline and after 30 days for groups A1 and B1. Salivary pH estimation was done at baseline and after 30 days for the entire group, and salivary S. mutans count was done at baseline and after 30 days for groups A2 and B2. Salivary pH level was checked using a digital pH meter; nutrient agar was used for salivary total bacterial count, while Mitis salivarius bacitracin agar was used for salivary S. mutans count. The number of colonies was counted and subjected to statistical analysis using unpaired and paired Student's t-test. Results: The study showed a significant reduction in salivary total bacterial count and salivary S. mutans counts, as well as a significant increase in salivary pH after 30 days in the Evora Plus oral probiotic group compared with the group not receiving the Evora Plus oral probiotic tablet. Conclusion: Cariogenic microorganisms could be reduced by an oral probiotic formulation. Thus, the use of the Evora Plus oral probiotic tablet could be recommended for the prevention of enamel demineralization.


PDF Share
  1. Ahola AJ, Yli-Knuuttila H, Suomalainen T, et al. Short-term consumption of probiotic-containing cheese and its effect on dental caries risk factors. Arch Oral Biol 2002;47(11):799–804. DOI: 10.1016/s0003-9969(02)00112-7
  2. Bochner BR, Savageau MA. Generalized indicator plate for genetic, metabolic, and taxonomic studies with micro-organisms. Appl Environ Microbiol 1977;33(2):434–444. DOI: 10.1128/aem.33.2.434-444.1977
  3. Bratthall, D. Mutans streptococci – dental, oral and global aspects. J Indian Soc Pedod Prev Dent 1991;9(1):4–12.
  4. Busscher HJ, Mulder AF, van der Mei CH. In vitro adhesion to enamel and in vivo colonization of tooth surfaces by Lactobacilli from a bio-yoghurt. Caries Res 1999;33(5):403–404. DOI: 10.1159/000016541
  5. Caglar E, Kargul B, Tanboga I. Bacteriotherapy and probiotics’ role on oral health. Oral Dis 2005;11(3):131–137. DOI: 10.1111/j.1601-0825.2005.01109.x
  6. Caglar E, Sandalli N, Twetman S, et al. Effect of yogurt with Bifidobacterium DN-173 010 on salivary mutans streptococci and lactobacilliin young adults. Acta Odontol Scand 2005;63(6):317–320. DOI: 10.1080/00016350510020070
  7. Caufield PW, Li Y, Dasanayake A. Dental caries: an infectious and transmissible disease. Compend Contin Educ Dent 2005;26(5 Suppl 1):10–16.
  8. Chen T, Nakayama K, Belliveau L, et al. Porphyromonas gingivalis gingipains and adhesion to epithelial cells. Infect Immun 2001;69(5):3048–3056. DOI: 10.1128/IAI.69.5.3048-3056.2001
  9. Coykendall AL. Classification and identification of the viridans streptococci. Clin Microbiol Rev 1989;2(3):315–328. DOI: 10.1128/CMR.2.3.315
  10. Demuth DR, Irvine DC, Costerton JW, et al. Discrete protein determinant directs the species-specific adherence of Porphyromonas gingivalisto oral streptococci. Infect Immun 2001;69(9):5736–5741. DOI: 10.1128/IAI.69.9.5736-5741.2001
  11. Grajek W, Olejnik A, Sip A. Probiotics, probiotics and antioxidants as functional foods. Acta Biochim Pol 2005;52(3):665–671.
  12. Guarner F, Perdigon G, Corthier G, et al. Should yoghurt cultures be considered probiotic? Br J Nutr 2005;93(6):783–786. DOI: 10.1079/bjn20051428
  13. Hammond BF, Mallonee D. A selective/differential medium for Wolinella recta [abstract]. J Dent Res 1988;67:327.
  14. Heczko PB, Strus M, Kochan P. Critical evaluation of probiotic activity of lactic acid bacteria and their effects. J Physiol Pharmacol 2006;57(Suppl 9):5–12.
  15. Hillman JD. Lactate dehydrogenase mutants of Streptococcus mutans: isolation and preliminary characterization. Infect Immun 1978;21(1):206–212. DOI: 10.1128/iai.21.1.206-212.1978
  16. Hillman JD, Shivers M. Interaction between wild-type, mutant and revertant forms of the bacterium Streptococcus sanguis and the bacterium Actinobacillus actinomycetemcomitans in vitro and in the gnotobiotic rat. Arch Oral Biol 1988;33(6):395–401. DOI: 10.1016/0003-9969(88)90196-3
  17. Chinnappa A, Konde H, Konde S, et al. Probiotics for future caries control: a short-term clinical study. Indian J Dent Res 2013;24(5):547–549. DOI: 10.4103/0970-9290.123363
  18. Hillman JD, McDonell E, Cramm T, et al. A spontaneous lactate dehydrogenase deficient mutant of Streptococcus rattus for use as a probiotic in the prevention of dental caries. J Appl Microbiol 2009;24(4):120–126.
  19. Zahradnik RT, Magnusson I, Walker C, et al. Preliminary assessment of safety and effectiveness in humans of ProBiora3, a probiotic mouthwash. J Appl Microbiol 2009;107(2):682–690. DOI: 10.1111/j.1365-2672.2009.04243.x
  20. Bhalla M, Ingle NA, Kaur N, et al. Mutans streptococci estimation in saliva before and after consumption of probiotic curd among school children. J Int Soc Prev Community Dent 2015;5(1):31–34. DOI: 10.4103/2231-0762.151970
  21. Hillman JD, McDonell E, Hillman CH, et al. Safety assessment of ProBiora3, a probiotics mouthwash: subchronic toxicity study in rats. Int J Toxicol 2009;28(5):357–367. DOI: 10.1177/1091581809340705
  22. Yakob M, Fuewntis L, Wang MB, et al. Salivary biomarkers for detection of oral squamous cell carcinoma—current state and recent advances. Curr oral Health Rep 2014;1(2):133–141. DOI: 10.1007/s40496-014-0014-y
  23. Schafer CA, Schafer JJ, Yakob M, et al. Saliva diagnostics: utilizing oral fluids to determine health status. Monogr Oral Sci 2014;24:88–98. DOI: 10.1159/000358791
  24. Cildir SK, Germec D, Sandalli N, et al. Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria. Eur J Orthod 2009;31(4):407–411. DOI: 10.1093/ejo/cjn108
  25. Zhu Y, Xiao L, Shen D, et al. Competition between yogurt probiotics and periodontal pathogens in vitro. Acta Odontol Scand 2010;68(5):261–268. DOI: 10.3109/00016357.2010.492235
  26. Hoorizad M, Mirhashemi M, Rahpeyma R, et al. Effect of probiotic yoghurt on the salivary pH of orthodontic patients- a clinical trial study. J Res Dent Sci 2013;10(3):155–159.
  27. Hillman JD, Socransky SS. Bacterial interference in the oral ecology of Actinobacillus actinomycetemcomitans and its relationship to human periodontosis. Arch Oral Biol 1982;27(1):75–77. DOI: 10.1016/0003-9969(82)90180-7
  28. Hillman JD, Socransky SS. The theory and application of bacterial interference to oral diseases. In: Myers HM (Ed). New Biotechnologies in Oral Research. Basel: S. Karger; 1989. pp. 1–17.
  29. Hillman JD, Socransky SS, Shivers M. The relationships between streptococcal species and periodontopathic bacteria in human dental plaque. Arch Oral Biol 1985;30(11-12):791–795. DOI: 10.1016/0003-9969(85)90133-5
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.