Probiotics and prebiotics in periodontal therapy

There has been a paradigm shift toward ecological and microbial community-based approach in understanding oral diseases. A marked improvement in gastrointestinal health has been reported after using probiotic bacteria and/or prebiotic supplements,which has prompted much interest in the use of this approach for oral applications. Treatment of periodontal disease in recent years has moved toward an antibiotic/antimicrobial model of disease management. With increase in the incidence of resistance to antibiotics, probiotics may be a promising area of research in periodontal therapy. This paper reviews the evidences for the use of probiotics or prebiotics for the prevention of dental caries or periodontal diseases, and also adresses the risk associated with their prolonged use. Many questions have been raised pertaining to the benefits of probiotic administration, as the role of probiotics in periodontics is still in infancy, and a complete understanding of the broad ecological changes induced in the mouth by probiotics or prebiotics is essential to assess their long-term consequences for oral health and disease.