The role of probiotics for preventing dysbiosis in periodontal disease

In this randomized controlled trial, it was aimed to evaluate the effect of probiotic (chewable tablet) and kefir consumption in the initial periodontal treatment of periodontitis patient on the change of oral microbiota and treatment. In this clinical trial, 36 systemically healthy volunteers who were diagnosed with periodontitis who were admitted to Gazi University Faculty of Dentistry, Department of Periodontology were included. Besides the inclusion criteria, the nutritional habits of the patients were evaluated by questionnaire. For diagnosis, plaque index, gingival index, bleeding on probing, probing pocket depth and clinical attachment level were examined. Patients were randomly divided into 3 groups; probiotic, kefir and control group. Following the periodontal diagnosis, clinical index records of the patients and subgingival microbial samples were obtained. The supragingival plaque sample was removed and the subgingival microbial dental plaque sample was gently taken with a sterile gracey curette. In the same session, periodontal initial treatment was started. According to the groups, they were involved simultaneously with the treatment, kefir group was advised to consume kefir as liquid once a day in 14 days; probiotics group was advised to consume as a chewable tablet once a day in 14 days; control group was advised without additional food supplements. Periodontal indexes were repeated in the 1st and 3rd months. Subgingival plaque samples were taken at baseline and at 3 months and DNA sequencing was performed for Tanneralla forsythia (T. forsythia), Porphyromonas gingivalis (P. gingivalis), and Treponema denticola (T. denticola). While significant differences were observed in all groups in intragroup comparisons regarding plaque index, gingival index, bleeding on probing, pocket probing depth and clinical attachment level (p<0.001), no significant differences were found between groups (p>0.0167). There was significant decrease in T. forsythia in all groups (p=0.006). Though the intergroup evaluation, there was no significant differences for T. forsythia, P. gingivalis and T.denticola (p>0.0167). Probiotics and kefir consumption have similar results in the treatment of periodontitis.