Comparative Effectiveness of Different Probiotic Delivery Methods in Oral Candidiasis: A Systematic Review

Oral candidiasis, mainly from Candida albicans, affects immunocompromised individuals, the elderly, and denture wearers. Probiotics offer immunomodulatory and microbiota-balancing benefits as potential antifungal alternatives. However, the comparative impact of different probiotic delivery methods remains inadequately explored. This systematic review evaluated the effectiveness of various probiotic delivery methods in reducing Candida colonization and clinical symptoms in oral candidiasis. Following PRISMA 2020 guidelines, a systematic review search across multiple databases included human clinical studies based (Medline, Web of Science, ScienceDirect, and ProQuest) on PICO criteria across all age groups. Outcomes assessed included Candida load, oral microbiota changes, symptom improvement, and disease recurrence. Of 297 articles screened, 10 met inclusion criteria. Delivery methods investigated included lozenges, capsules, yogurt, and cheese. Most studies reported reductions in Candida colony-forming units (CFUs) or prevalence, mainly for C. albicans and for non-albicans species, with probiotics such as Lactobacillus reuteri, L. rhamnosus, L. acidophilus, and Bifidobacterium strains. Some studies reported improved immunological markers, while symptom relief, especially when probiotics were combined with antifungals. Probiotics reduce Candida colonization and symptoms, with potential prolonged effects. They show promise as adjunctive therapies, but standardized, large-scale trials are needed for optimization.