Probiotic supplementation in dental caries: is it possible to replace conventional treatment?

Background: Probiotic supplementation alters oral microbiota composition and could reduce the risk or treat oral cavity diseases, such as dental caries, which are considered a public health problem. Aim: To summarize the therapeutic effects of probiotics in caries and to verify whether this intervention is capable of replacing conventional treatment in human beings. Methods: The search of the studies was carried out in the PubMed database in October 2017, without limiting the publication period. The keyword combination used was “Probiotics” and “Dental caries.” Forty-two original articles that evaluated the effect of probiotic supplementation on caries treatment in humans were included in the study. Results: Most of the studies evaluated bacteria of the genus Lactobacillus. The main therapeutic effects are related to the reduction of the Streptococcus mutans oral count, increased Lactobacillus oral count, and reduction in the incidence of caries. Evidence on the therapeutic effects of the Bifidobacterium and Streptococcus genres is scarce and conflicting, making it difficult to recommend them for use in clinical practice. Only a few studies administered probiotics without conventional treatments, such as fluoride. Although probiotic supplementation presented interesting properties, the therapeutic effects are more pronounced when probiotic and fluoride are applied together. Conclusion: Probiotics, especially of the Lactobacillus genus, can be used as adjuvants, but cannot replace the conventional treatments of caries.