Evaluating the Efficacy of Probiotic Toothpaste in Reducing Plaque Around Orthodontic Brackets: A Randomized Controlled Trial
Keywords:
Probiotic toothpaste, Orthodontic brackets, Dental plaque, Lactobacillus reuteri, Fixed appliances, Oral hygieneAbstract
Background: Plaque accumulation around orthodontic brackets presents a significant risk for enamel demineralization and gingival inflammation during fixed appliance therapy. Conventional toothpastes offer limited antibacterial activity at bracket sites. Probiotic-containing toothpastes have shown promise in promoting oral microbial balance and reducing pathogenic biofilms. This study aimed to evaluate the effectiveness of probiotic toothpaste in minimizing plaque formation around orthodontic brackets.
Materials and Methods: A randomized controlled clinical trial was conducted involving 60 orthodontic patients aged 15–25 years undergoing fixed orthodontic therapy. Participants were randomly assigned into two groups: Group A used probiotic toothpaste containing Lactobacillus reuteri, and Group B used a conventional fluoride toothpaste. Both groups followed standardized brushing instructions twice daily for 4 weeks. Plaque index (PI) scores around brackets were recorded at baseline and after 4 weeks using the Turesky modification of the Quigley-Hein Index. Data were analyzed using paired and unpaired t-tests, with p<0.05 considered statistically significant.
Results: At baseline, mean PI scores were similar between Group A (2.15 ± 0.28) and Group B (2.13 ± 0.26). After 4 weeks, Group A showed a statistically significant reduction in PI (1.14 ± 0.21), whereas Group B showed a moderate reduction (1.78 ± 0.25) (p=0.001). The intergroup comparison indicated a significantly greater reduction in plaque levels in the probiotic group compared to the control group (p<0.01).
Conclusion: Probiotic toothpaste demonstrated superior efficacy in reducing plaque accumulation around orthodontic brackets compared to conventional toothpaste. Incorporating probiotic-based oral care products may offer additional benefits for maintaining oral hygiene in orthodontic patients
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Jose JE, Padmanabhan S, Chitharanjan AB. Systemic consumption of probiotic curd and use of probiotic toothpaste to reduce Streptococcus mutans in plaque around orthodontic brackets. Am J Orthod Dentofacial Orthop. 2013;144(1):67–72.
Alp S, Baka ZM. Effects of probiotics on salivary Streptococcus mutans and Lactobacillus levels in orthodontic patients. Am J Orthod Dentofacial Orthop. 2018;154(4):517–23.
Ai H, Lu HF, Liang HY, Wu J, Li RL, Liu GP, et al. Influences of bracket bonding on mutans streptococcus in plaque detected by real-time fluorescence-quantitative polymerase chain reaction. Chin Med J (Engl). 2005;118(23):2005–10.
Jagdish N, Padmanabhan S, Chitharanjan AB. Effect of oil pulling on the Streptococcus mutans concentration in plaque around orthodontic brackets – A prospective clinical study. J Indian Soc Pedod Prev Dent. 2024;42(3):235–9.
Pandis N, Papaioannou W, Kontou E, Nakou M, Makou M, Eliades T. Salivary Streptococcus mutans levels in patients with conventional and self-ligating brackets. Eur J Orthod. 2010;32(1):94–9.
Jung WS, Yang IH, Lim WH, Baek SH, Kim TW, Ahn SJ. Adhesion of mutans streptococci to self-ligating ceramic brackets: in vivo quantitative analysis with real-time polymerase chain reaction. Eur J Orthod. 2015;37(6):565–9.
Ahn SJ, Lim BS, Lee SJ. Prevalence of cariogenic streptococci on incisor brackets detected by polymerase chain reaction. Am J Orthod Dentofacial Orthop. 2007;131(6):736–41.
Srinivasan S, Chandrasekhar S, Shashikumar KV, Payne D, Maclure R, Kapadiya B, et al. Plaque triclosan concentration and antimicrobial efficacy of a new calcium carbonate toothpaste with 0.3% triclosan compared to a marketed 0.3% triclosan toothpaste. J Clin Dent. 2013;24(2):68–72.
Pinto GS, Cenci MS, Azevedo MS, Epifanio M, Jones MH. Effect of yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 probiotic on dental plaque and saliva in orthodontic patients. Caries Res. 2014;48(1):63–8.
Cildir SK, Germec D, Sandalli N, Ozdemir FI, Arun T, Twetman S, et al. Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria. Eur J Orthod. 2009;31(4):407–11.
Sadeq A, Risk JM, Pender N, Higham SM, Valappil SP. Evaluation of the co-existence of the red fluorescent plaque bacteria P. gingivalis with S. gordonii and S. mutans in white spot lesion formation during orthodontic treatment. Photodiagnosis Photodyn Ther. 2015;12(2):232–7.
Petersson LG, Edwardsson S, Koch G, Kurol J, Lodding A. The effect of a low fluoride containing toothpaste on the development of dental caries and microbial composition using a caries generating model device in vivo. Swed Dent J. 1995;19(3):83–94.
Lombardo L, Ortan YÖ, Gorgun Ö, Panza C, Scuzzo G, Siciliani G. Changes in the oral environment after placement of lingual and labial orthodontic appliances. Prog Orthod. 2013;14:28.
Attin R, Yetkiner E, Aykut-Yetkiner A, Knösel M, Attin T. Effect of chlorhexidine varnish application on Streptococcus mutans colonisation in adolescents with fixed orthodontic appliances. Aust Orthod J. 2013;29(1):52–7.
Anhoury P, Nathanson D, Hughes CV, Socransky S, Feres M, Chou LL. Microbial profile on metallic and ceramic bracket materials. Angle Orthod. 2002;72(4):338–43.
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