{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T20:34:01Z","timestamp":1790886841712,"version":"4.1.0"},"reference-count":46,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T00:00:00Z","timestamp":1759449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of Health\u2014Current Research IRCCS"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background: In recent years, scientific interest in probiotics in oral health has grown exponentially. This systematic review aims to analyze the effectiveness of probiotic use in dentistry, specifically in two areas: orthodontics and pediatric dentistry. Methods: Forty studies (RCTs, systematic reviews, clinical and preclinical studies) published between 2001 and 2025 were selected from the literature (PubMed) to evaluate the impact of probiotics on clinical, microbiological, and patient-specific parameters. Results: Results generally indicate that the most observed effect is the reduction in Streptococcus mutans levels, while in orthodontics, probiotics have proven beneficial primarily in reducing halitosis and traumatic lesions. In pediatric dentistry, early and prolonged use of probiotics has been shown to benefit both the reduction in caries and the improvement of gingival health, with significant results also observed in pediatric patients with special needs. Conclusions: Although the data obtained so far are very encouraging, further clinical studies are needed to define standardized protocols, identify the most effective strains, and evaluate the effects of long-term probiotic use. Probiotics therefore represent a promising and potentially valuable addition to preventive strategies in dentistry, particularly in orthodontics and pediatric dentistry, when integrated into a sustainable and personalized approach to patient oral health.<\/jats:p>","DOI":"10.3390\/nu17193153","type":"journal-article","created":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T07:57:27Z","timestamp":1759478247000},"page":"3153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Applications of Probiotics in Pediatric Dentistry and Orthodontics\u2014A Systematic Review"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3132-1750","authenticated-orcid":false,"given":"Lucia","family":"Giannini","sequence":"first","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanna","family":"Stella","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cattaneo","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianna","family":"Dipalma","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Department of Interdisciplinary Medicine, University of Bari Aldo Moro, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5930-1698","authenticated-orcid":false,"given":"Cinzia","family":"Maspero","sequence":"additional","affiliation":[{"name":"Department of Biomedical, Surgical and Dental Sciences, University of Milan, 20122 Milan, Italy"},{"name":"Fondazione IRCCS C\u00e0 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"159","DOI":"10.3920\/BM2014.0103","article-title":"The History of Probiotics: The Untold Story","volume":"6","author":"Ozen","year":"2015","journal-title":"Benef. Microbes"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1335","DOI":"10.4014\/jmb.1906.06064","article-title":"Role of Probiotics in Human Gut Microbiome-Associated Diseases","volume":"29","author":"Kim","year":"2019","journal-title":"J. Microbiol. Biotechnol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"S116","DOI":"10.1097\/MCG.0000000000000697","article-title":"Probiotics History","volume":"50","author":"Gasbarrini","year":"2016","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_4","first-page":"e282","article-title":"Probiotics and Oral Health: A Systematic Review","volume":"22","year":"2017","journal-title":"Med. Oral Patol. Oral Cir. Bucal"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1288","DOI":"10.1177\/15353702231187645","article-title":"Oral Microbiota in Human Health and Disease: A Perspective","volume":"248","author":"Santacroce","year":"2023","journal-title":"Exp. Biol. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.cden.2016.11.002","article-title":"Normal Oral Flora and the Oral Ecosystem","volume":"61","author":"Samaranayake","year":"2017","journal-title":"Dent. Clin. N. Am."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"201","DOI":"10.2334\/josnusd.16-0856","article-title":"The Oral Microbiome and Human Health","volume":"59","author":"Yamashita","year":"2017","journal-title":"J. Oral Sci."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Rad, A.H., Pourjafar, H., and Mirzakhani, E. (2023). A Comprehensive Review of the Application of Probiotics and Postbiotics in Oral Health. Front. Cell. Infect. Microbiol., 13.","DOI":"10.3389\/fcimb.2023.1120995"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1597\/12-243","article-title":"Effect of Probiotics Containing Lactobacillus paracasei SD1 on Salivary Mutans Streptococci and Lactobacilli in Orthodontic Cleft Patients: A Double-Blinded, Randomized, Placebo-Controlled Study","volume":"51","author":"Ritthagol","year":"2014","journal-title":"Cleft Palate-Craniofacial J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"036010","DOI":"10.1088\/1752-7163\/ab1c81","article-title":"Oral Probiotics Reduce Halitosis in Patients Wearing Orthodontic Braces: A Randomized, Triple-Blind, Placebo-Controlled Trial","volume":"13","author":"Benic","year":"2019","journal-title":"J. Breath. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1093\/ejo\/cjv015","article-title":"Effect of the Probiotic Bacterium Lactobacillus reuteri on White Spot Lesion Development in Orthodontic Patients","volume":"38","author":"Gizani","year":"2016","journal-title":"Eur. J. Orthod."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1111\/ocr.12448","article-title":"Lactobacillus Brevis CD2 Attenuates Traumatic Oral Lesions Induced by Fixed Orthodontic Appliance: A Randomized Phase 2 Trial","volume":"24","author":"Silva","year":"2021","journal-title":"Orthod. Craniofac. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"100938","DOI":"10.1016\/j.ortho.2024.100938","article-title":"Effect of Probiotic Toothpaste and Regular Toothpaste on Gingival Health and Plaque Levels of Adult Orthodontic Patients\u2014An Open Label Randomized Controlled Trial","volume":"23","author":"Tahir","year":"2025","journal-title":"Int. Orthod."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hedayati-Hajikand, T., Lundberg, U., Eldh, C., and Twetman, S. (2015). Effect of Probiotic Chewing Tablets on Early Childhood Caries\u2014A Randomized Controlled Trial. BMC Oral Health, 15.","DOI":"10.1186\/s12903-015-0096-5"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.17796\/1053-4625-42.5.2","article-title":"Effect of Probiotic Lactobacillus reuteri on Salivary Cariogenic Bacterial Counts among Groups of Preschool Children in Jeddah, Saudi Arabia: A Randomized Clinical Trial","volume":"42","author":"Alamoudi","year":"2018","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1159\/000354412","article-title":"Oral Administration of Lactobacillus reuteri During the First Year of Life Reduces Caries Prevalence in the Primary Dentition at 9 Years of Age","volume":"48","author":"Stensson","year":"2014","journal-title":"Caries Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e030638","DOI":"10.1136\/bmjopen-2019-030638","article-title":"A Single-Centre Investigator-Blinded Randomised Parallel Group Clinical Trial to Investigate the Effect of Probiotic Strains Streptococcus Salivarius M18 and Lactobacillus acidophilus on Gingival Health of Pediatric Patients Undergoing Treatment with Fixed Orthodontic Appliances: Study Protocol","volume":"9","author":"Kaklamanos","year":"2019","journal-title":"BMJ Open"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1159\/000235581","article-title":"Effect of Long-Term Consumption of Milk Supplemented with Probiotic Lactobacilli and Fluoride on Dental Caries and General Health in Preschool Children: A Cluster-Randomized Study","volume":"43","author":"Twetman","year":"2009","journal-title":"Caries Res."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1159\/000047484","article-title":"Effect of Long-Term Consumption of a Probiotic Bacterium, Lactobacillus rhamnosus GG, in Milk on Dental Caries and Caries Risk in Children","volume":"35","author":"Nase","year":"2001","journal-title":"Caries Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1111\/idh.12821","article-title":"Probiotics for Maintaining Oral Health during Fixed Orthodontic Treatment: A Systematic Review and Meta-Analysis","volume":"23","author":"Robin","year":"2025","journal-title":"Int. J. Dent. Hyg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1093\/ejo\/cjad046","article-title":"Effects of Probiotics on the Oral Health of Patients Undergoing Orthodontic Treatment: A Systematic Review and Meta-Analysis","volume":"45","author":"Chen","year":"2023","journal-title":"Eur. J. Orthod."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1379","DOI":"10.11607\/jomi.7392","article-title":"Do Chlorhexidine and Probiotics Solutions Provoke Corrosion of Orthodontic Mini-Implants? An In Vitro Study","volume":"34","author":"Pavlic","year":"2019","journal-title":"Int. J. Oral Maxillofac. Implants"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1016\/j.ajodo.2018.01.010","article-title":"Effects of Probiotics on Salivary Streptococcus mutans and Lactobacillus Levels in Orthodontic Patients","volume":"154","author":"Alp","year":"2018","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Hadj-Hamou, R., Senok, A.C., Athanasiou, A.E., and Kaklamanos, E.G. (2020). Do Probiotics Promote Oral Health during Orthodontic Treatment with Fixed Appliances? A Systematic Review. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-01109-3"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1007\/s12602-020-09683-2","article-title":"Role of Probiotics in Oral Health Maintenance Among Patients Undergoing Fixed Orthodontic Therapy: A Systematic Review of Randomized Controlled Clinical Trials","volume":"12","author":"Pietri","year":"2020","journal-title":"Probiotics Antimicrob. Proteins"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e2119350","DOI":"10.1590\/2177-6709.26.5.e2119350.oar","article-title":"Antimicrobial Activity of Probiotics against Oral Pathogens around Orthodontic Mini-Implants: An In Vitro Study","volume":"26","author":"Lemos","year":"2021","journal-title":"Dental Press. J. Orthod."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Duffles, L.F., Menino, A.P., Taira, T.M., de Oliveira, S., Salvador, S.L., Messora, M.R., Vinolo, M.A.R., and Fukada, S.Y. (2022). Probiotic Bifidobacterium animalis subsp. Lactis Consumption Slows down Orthodontic Tooth Movement in Mice. Arch. Oral Biol., 134.","DOI":"10.1016\/j.archoralbio.2021.105324"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.archoralbio.2017.02.017","article-title":"Probiotic Consumption Decreases the Number of Osteoclasts during Orthodontic Movement in Mice","volume":"79","author":"Pazzini","year":"2017","journal-title":"Arch. Oral Biol."},{"key":"ref_29","first-page":"66","article-title":"Efficacy of Dentaq\u00ae Oral and ENT Health Probiotic Complex on Clinical Parameters of Gingivitis in Patients Undergoing Fixed Orthodontic Treatment: A Pilot Study","volume":"27","author":"Kolip","year":"2016","journal-title":"J. Clin. Dent."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ajodo.2013.02.023","article-title":"Systemic Consumption of Probiotic Curd and Use of Probiotic Toothpaste to Reduce Streptococcus mutans in Plaque around Orthodontic Brackets","volume":"144","author":"Jose","year":"2013","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1007\/s00056-017-0106-0","article-title":"Effekte Verschiedener Zahnpasten Auf Bracketnahe White-Spot-L\u00e4sionen, Ermittelt Mit Quantitativer Lichtinduziertern Fluoreszenz (QLF): Eine In-vitro-Studie","volume":"78","author":"Gokce","year":"2017","journal-title":"J. Orofac. Orthop."},{"key":"ref_32","first-page":"496","article-title":"Changes in Biochemical Parameters of Oral Fluid in Patients during the Orthodontic Treatment with a Bracket System under the Action of a Developed Mucosal Gel with Probiotic","volume":"71","author":"Voronkova","year":"2018","journal-title":"Wiad. Lek."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1093\/ejo\/cjn108","article-title":"Reduction of Salivary Mutans Streptococci in Orthodontic Patients during Daily Consumption of Yoghurt Containing Probiotic Bacteria","volume":"31","author":"Cildir","year":"2009","journal-title":"Eur. J. Orthod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"353","DOI":"10.4103\/JISPPD.JISPPD_146_17","article-title":"Visual Pedagogy and Probiotics for Hearing Impaired Children: A Pilot Study","volume":"35","author":"Sujlana","year":"2017","journal-title":"J. Indian Soc. Pedod. Prev. Dent."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1111\/scd.12920","article-title":"Anti-Caries Streptococcus spp.: A Potential Preventive Tool for Special Needs Patients","volume":"44","author":"Mato","year":"2024","journal-title":"Spec. Care Dent."},{"key":"ref_36","first-page":"56","article-title":"Probiotics and Their Effect on Oral Bacteria Count in Children: A Pilot Study","volume":"16","year":"2015","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1016\/j.identj.2024.06.013","article-title":"Efficacy of Probiotic Consumption on Oral Outcomes in Children and\/or Adolescents: A Meta-Analysis","volume":"74","author":"Hernandez","year":"2024","journal-title":"Int. Dent. J."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"184","DOI":"10.4103\/ijdr.IJDR_232_20","article-title":"Evaluation of the Efficacy of Plaque Reduction and Gingival Health among 6-12 Years Old School Children before and after a Short Term Daily Intake of Probiotic Lozenge\u2014A Comparative Study","volume":"33","author":"Kavitha","year":"2022","journal-title":"Indian J. Dent. Res."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"20587384211031107","DOI":"10.1177\/20587384211031107","article-title":"The Use of Lactobacillus reuteri DSM 17938 and ATCC PTA 5289 on Oral Health Indexes in a School Population: A Pilot Randomized Clinical Trial","volume":"35","year":"2021","journal-title":"Int. J. Immunopathol. Pharmacol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1007\/BF03262809","article-title":"A Comparative Evaluation of Probiotics on Salivary Mutans Streptococci Counts in Indian Children","volume":"12","author":"Jindal","year":"2011","journal-title":"Eur. Arch. Pediatr. Dent."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"55","DOI":"10.17796\/jcpd.38.1.b481624264142082","article-title":"Effectiveness of CRT at Measuring the Salivary Level of Bacteria in Caries Prone Children with Probiotic Therapy","volume":"38","author":"Cannon","year":"2013","journal-title":"J. Clin. Pediatr. Dent."},{"key":"ref_42","first-page":"383","article-title":"Microbiological Profiles in Saliva and Supragingival Plaque from Caries-Active Adolescents before and after a Short-Term Daily Intake of Milk Supplemented with Probiotic Bacteria\u2014A Pilot Study","volume":"8","year":"2010","journal-title":"Oral Health Prev. Dent."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1159\/000335567","article-title":"Bifidobacterium animalis subsp. Lactis BB-12 Administration in Early Childhood: A Randomized Clinical Trial of Effects on Oral Colonization by Mutans Streptococci and the Probiotic","volume":"46","author":"Taipale","year":"2012","journal-title":"Caries Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1159\/000348424","article-title":"Administration of Bifidobacterium animalis subsp. Lactis Bb-12 in Early Childhood: A Post-Trial Effect on Caries Occurrence at Four Years of Age","volume":"47","author":"Taipale","year":"2013","journal-title":"Caries Res."},{"key":"ref_45","first-page":"295","article-title":"Class II division 1 malocclusions: Comparisons between one- and two-step treatment","volume":"19","author":"Maspero","year":"2018","journal-title":"Eur. J. Paediatr. Dent."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"593","DOI":"10.3920\/BM2017.0139","article-title":"Effect of Lactobacillus rhamnosus and Bifidobacterium lactis on Gingival Health, Dental Plaque, and Periodontopathogens in Adolescents: A Randomised Placebocontrolled Clinical Trial","volume":"9","author":"Alanzi","year":"2018","journal-title":"Benef. Microbes"}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/19\/3153\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T11:02:00Z","timestamp":1764068520000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/19\/3153"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,3]]},"references-count":46,"journal-issue":{"issue":"19","published-online":{"date-parts":[[2025,10]]}},"alternative-id":["nu17193153"],"URL":"https:\/\/doi.org\/10.3390\/nu17193153","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,3]]}}}