Periodontitis is one of the most common oral diseases, affecting millions of people worldwide. It is considered a widespread disease and, if left untreated, can not only lead to tooth loss but also increase the risk of cardiovascular disease, diabetes, or respiratory illnesses. Given the severity of this disease, the question arises: Can probiotics—"good bacteria"—help prevent or treat periodontitis? This article provides a detailed answer, explains the basics of oral flora, addresses relevant bacterial species, and highlights scientific data, particularly on Streptococcus salivarius M18.
What is periodontitis?
Periodontitis is an inflammatory disease of the periodontal ligament. While simple gingivitis initially affects "only" the gums, periodontitis goes deeper: It destroys the tissue and bone that hold the teeth in place. The result can be loose teeth or even tooth loss.
Causes and risk factors
The disease is primarily caused by bacterial plaque. If plaque isn't removed regularly, it hardens into tartar, which can then harbor new bacteria. However, not everyone with plaque automatically develops periodontitis—the risk also depends on individual factors:
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Genetic predisposition
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Smoke
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Diabetes mellitus
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Hormonal changes (e.g. pregnancy, menopause)
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Weakened immune system (e.g. in chronic diseases)
Symptoms of periodontitis
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Bleeding gums
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Redness and swelling of the gums
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bad breath
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Receding gums
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Loose teeth
The importance of oral flora
The human oral cavity is a complex ecosystem with over 700 different species of bacteria. These microorganisms live in a delicate balance. As long as the balance is correct, the oral flora protects against pathogenic germs. However, if it becomes unbalanced, it can lead to diseases such as tooth decay or periodontitis.
Functions of healthy oral flora
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Protective function: Healthy bacteria prevent pathogenic germs from settling.
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Metabolism: They produce substances that stabilize the pH value in the mouth.
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Immunomodulation: Certain bacteria strengthen the immune system and reduce inflammation.
Dysbiosis – when the balance tips
A disruption of the oral flora, also known as dysbiosis, leads to the proliferation of pathogenic bacteria. Anaerobic bacteria such as Porphyromonas gingivalis , Tannerella forsythia , and Treponema denticola, in particular , are closely linked to periodontitis. They form a highly effective "periodontopathogenic trio" that intensifies inflammation and degrades tissue.
Which bacteria play a role in periodontitis?
The oral flora consists of a mix of "good" and "bad" bacteria. The ratio is crucial.
Bacteria that cause periodontitis
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Porphyromonas gingivalis: A key germ that deceives the immune system and causes inflammation to become chronic.
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Tannerella forsythia: Promotes tissue degradation.
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Treponema denticola: Directly attacks the gum tissue.
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Aggregatibacter actinomycetemcomitans: Particularly relevant in aggressive forms of periodontitis.
“Good” bacteria
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Streptococcus sanguinis: Displaces pathogenic bacteria.
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Streptococcus salivarius: Occurs naturally in the mouth and supports balance.
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Lactobacillus species: Stabilize pH and have antimicrobial effects.
Probiotics – what does that mean?
Probiotics are living microorganisms that, when consumed in sufficient quantities, provide health benefits. They are primarily known for their beneficial effects on the gut (e.g., Lactobacillus or Bifidobacterium ), but they are also becoming increasingly important for the oral flora.
Mechanisms of action of probiotics in the mouth
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Competition for nutrients and space: “Good” bacteria displace pathogenic germs.
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Formation of antimicrobial substances: Some probiotics produce bacteriocins that kill harmful bacteria.
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Influence on the immune system: They can modulate inflammatory reactions.
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Stabilization of the pH value: The environment remains less susceptible to germs.
Which probiotics are relevant for periodontitis?
In contrast to probiotics for the gut, there are only a few strains of bacteria in the area of oral health that have been scientifically well-studied. Streptococcus salivarius M18 is particularly noteworthy .
Streptococcus salivarius M18 – the bearer of hope
Streptococcus salivarius is a natural inhabitant of the oral cavity. The specific subtype M18 has demonstrated remarkable characteristics in studies:
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Production of bacteriocins: These inhibit the growth of Streptococcus mutans (caries pathogens) and periodontal pathogens.
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Formation of enzymes: These enzymes can break down plaque and thus reduce the formation of tartar.
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Anti-inflammatory: M18 modulates the immune system and reduces local inflammation.
Study status on Streptococcus salivarius M18
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Plaque control: Clinical studies show that regular intake of M18 significantly reduces plaque formation.
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Periodontitis prevention: Initial studies suggest that M18 can also reduce the risk of gingivitis and periodontitis. Studies have even shown that taking Streptococcus salivarius M18 can reduce the depth of gingival pockets as a result of periodontitis.
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Safety: The trunk is considered safe and suitable for children and adults.
Other probiotic strains offered in dietary supplements or chewing gum have not yet shown sufficient evidence for periodontitis. Currently, M18 is considered the only probiotic strain with solid research support for the prevention and treatment of periodontitis . Learn more about Streptococcus salvarius M18 in our article " Streptococcus salivarius M18: The Powerful Probiotic for Oral Health ."
Application of Streptococcus salivarius M18
It is usually taken in the form of lozenges , allowing the bacteria to work directly in the mouth. Daily use for several weeks to months is recommended.
Practical tips
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Suck one tablet after brushing your teeth in the evening.
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Do not eat or drink immediately afterwards so that the bacteria have time to settle.
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Use regularly, as colonization will diminish after some time without further supplementation.
Limits of probiotics in periodontitis
As promising as probiotics are, they are not a substitute for professional dentistry. Successful periodontal therapy requires:
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Regular professional teeth cleaning
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Removal of tartar and plaque
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If necessary, systematic periodontal treatment by the dentist
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Thorough oral hygiene at home (brushing teeth, flossing, interdental brushes)
Probiotics can be useful as a supplement to positively influence the oral flora and prevent relapses.
Conclusion
Periodontitis is a serious disease closely linked to an imbalance in the oral flora. While pathogenic bacteria such as Porphyromonas gingivalis increase the risk, beneficial microorganisms can provide protection. Probiotics offer an exciting approach here. However, currently only Streptococcus salivarius M18 has been sufficiently studied and shows promising results in terms of plaque control and anti-inflammatory effects.
In short: Probiotics are not a miracle cure, but they can support oral health – especially in combination with consistent oral hygiene and dental care.
outlook
Research on oral probiotics is still in its infancy. Future studies may identify additional strains with specific effects against periodontitis. Until then, Streptococcus salivarius M18 remains the most promising probiotic ally in the fight against periodontitis.
Frequently Asked Questions (FAQ)
What is the difference between gingivitis and periodontitis?
Gingivitis is a superficial gum inflammation that is reversible. Periodontitis, on the other hand, permanently destroys tissue and bone and can lead to tooth loss.
Can periodontitis be cured with probiotics?
No. Probiotics such as Streptococcus salivarius M18 can be supportive, but existing periodontitis requires professional treatment.
How quickly do probiotics work in the mouth?
The effect usually becomes apparent after a few weeks of regular use. For lasting effects, continued use is recommended.
Are there any side effects of Streptococcus salivarius M18?
No relevant side effects are known so far. The strain is considered safe for adults and children.
Can I simply use probiotics in addition to my dental care?
Yes, probiotics can be useful as a supplement to daily dental care, but they are by no means a replacement for brushing, flossing, and professional teeth cleaning.
Are there foods that contain natural probiotics for the mouth?
Fermented products like yogurt or kefir contain probiotics, but these don't settle permanently in the mouth. For targeted effects, special preparations containing Streptococcus salivarius M18 are required.
How long should you take oral probiotics?
Long-term intake is advisable, as the bacteria cannot establish themselves permanently in the mouth without replenishment.
