{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T08:09:32Z","timestamp":1770278972889,"version":"3.49.0"},"reference-count":42,"publisher":"MDPI AG","issue":"22","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001871","name":"Funda\u00e7\u00e3o para a Ci\u00eancia e Tecnologia","doi-asserted-by":"publisher","award":["10.54499\/UIDB\/04585\/2020"],"award-info":[{"award-number":["10.54499\/UIDB\/04585\/2020"]}],"id":[{"id":"10.13039\/501100001871","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Background\/Objectives: Streptococcus mutans (S. mutans) is a primary cariogenic bacterium contributing to biofilm acidogenicity and enamel demineralization. Conventional caries prevention relies mainly on mechanical plaque control and dietary modification, but probiotics have emerged as potential adjuncts for oral microbiota modulation. This pilot randomized controlled trial aimed to evaluate the short-term effects of a multi-strain probiotic containing Lactobacillus and Bifidobacterium on clinical and microbiological parameters associated with dental caries in children. Methods: A double-blind, randomized, placebo-controlled clinical trial was conducted in 40 children aged 6\u201314 years from a community setting. Participants were randomly allocated (1:1) to receive either probiotic or placebo lozenges for 30 days. Clinical assessments included the Gingival Index (GI), Plaque Index (PI), International Caries Detection and Assessment System (ICDAS), salivary pH, buffering capacity, and salivary S. mutans concentration. The study was preregistered (10.17605\/OSF.IO\/GKVUW) and ethically approved. Results: The intervention was well tolerated, with no adverse events reported and high participant acceptability. Despite there being no statistically significant differences in any clinical or microbiological parameter (p &gt; 0.05), we found trends toward higher salivary pH, improved buffering capacity, and reduced S. mutans counts in the probiotic group. Conclusions: Short-term probiotic supplementation was safe and well accepted among children but did not produce statistically significant improvements in oral health parameters over 30 days. These findings highlight the feasibility of probiotic use in pediatric populations and support the need for larger, longer-term trials to clarify their potential role as adjuncts in caries prevention.<\/jats:p>","DOI":"10.3390\/nu17223604","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T16:49:51Z","timestamp":1763484591000},"page":"3604","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Effects of Probiotic Short-Term Regiment on Oral Health Parameters in Children: A Pilot Randomized Controlled Trial"],"prefix":"10.3390","volume":"17","author":[{"given":"Edouard","family":"Starck","sequence":"first","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2503-260X","authenticated-orcid":false,"given":"Vanessa","family":"Machado","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1019-8263","authenticated-orcid":false,"given":"Jo\u00e3o","family":"Botelho","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8482-5936","authenticated-orcid":false,"given":"Lu\u00eds","family":"Proen\u00e7a","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4098-5433","authenticated-orcid":false,"given":"Helena","family":"Barroso","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5134-7387","authenticated-orcid":false,"given":"Carla","family":"Ascenso","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-7520","authenticated-orcid":false,"given":"Cec\u00edlia","family":"Rozan","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, 2829-511 Almada, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e187421062203150","DOI":"10.2174\/18742106-v16-e2203150","article-title":"Oral Health: An Unmet Need","volume":"16","author":"Gupta","year":"2022","journal-title":"Open Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"17030","DOI":"10.1038\/nrdp.2017.30","article-title":"Dental Caries","volume":"3","author":"Pitts","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_3","unstructured":"(2025, October 12). WHO Oral Health. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/oral-health."},{"key":"ref_4","unstructured":"(2025, October 12). Oral Health Conditions|FDI. Available online: https:\/\/www.fdiworlddental.org\/oral-health-conditions."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Chen, X., Daliri, E.B.-M., Kim, N., Kim, J.-R., Yoo, D., and Oh, D.-H. (2020). Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms. Pathogens, 9.","DOI":"10.3390\/pathogens9070569"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1016\/bs.aambs.2023.02.001","article-title":"Biofilm Ecology Associated with Dental Caries: Understanding of Microbial Interactions in Oral Communities Leads to Development of Therapeutic Strategies Targeting Cariogenic Biofilms","volume":"Volume 122","author":"Cai","year":"2023","journal-title":"Advances in Applied Microbiology"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e187421062307310","DOI":"10.2174\/18742106-v17-230824-2022-175","article-title":"A Preventive Strategy against Root Caries for the General Dentist: A Cross-Sectional Clinical Study","volume":"17","author":"Qutieshat","year":"2023","journal-title":"Open Dent. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.4103\/jpbs.jpbs_801_21","article-title":"Probiotics: Dawn of a New Era in Dental Caries Management","volume":"14","author":"Abikshyeet","year":"2022","journal-title":"J. Pharm. Bioallied Sci."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Luo, S.-C., Wei, S.-M., Luo, X.-T., Yang, Q.-Q., Wong, K.-H., Cheung, P.C.K., and Zhang, B.-B. (2024). How Probiotics, Prebiotics, Synbiotics, and Postbiotics Prevent Dental Caries: An Oral Microbiota Perspective. npj Biofilms Microbiomes, 10.","DOI":"10.1038\/s41522-024-00488-7"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"99","DOI":"10.5114\/ceji.2021.104412","article-title":"The Immunomodulating Role of Probiotics in the Prevention and Treatment of Oral Diseases","volume":"46","year":"2021","journal-title":"Cent. Eur. J. Immunol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1177\/0022034519845001","article-title":"The Role of Exopolysaccharides in Oral Biofilms","volume":"98","author":"Cugini","year":"2019","journal-title":"J. Dent. Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1007\/978-3-319-31248-4_4","article-title":"The Oral Microbiota","volume":"Volume 902","author":"Schwiertz","year":"2016","journal-title":"Microbiota of the Human Body"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"10-1128","DOI":"10.1128\/microbiolspec.GPP3-0051-2018","article-title":"The Biology of Streptococcus mutans","volume":"7","author":"Lemos","year":"2019","journal-title":"Microbiol. Spectr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1016\/j.fshw.2018.12.001","article-title":"Oral Microbiota: A New View of Body Health","volume":"8","author":"Lu","year":"2019","journal-title":"Food Sci. Hum. Wellness"},{"key":"ref_15","unstructured":"Rathee, M., and Sapra, A. (2025). Dental Caries. StatPearls, StatPearls Publishing."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1159\/000484985","article-title":"Ecological Approaches to Dental Caries Prevention: Paradigm Shift or Shibboleth?","volume":"52","author":"Philip","year":"2018","journal-title":"Caries Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Beattie, R.E. (2024). Probiotics for Oral Health: A Critical Evaluation of Bacterial Strains. Front. Microbiol., 15.","DOI":"10.3389\/fmicb.2024.1430810"},{"key":"ref_18","unstructured":"(2025, October 12). Office of Dietary Supplements\u2014Probiotics, Available online: https:\/\/ods.od.nih.gov\/factsheets\/Probiotics-HealthProfessional\/."},{"key":"ref_19","first-page":"1226","article-title":"Bacteria in Oral Health\u2014Probiotics and Prebiotics A Review","volume":"2","author":"Reddy","year":"2011","journal-title":"Int. J. Biol. Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Tagg, J.R., Harold, L.K., Jain, R., and Hale, J.D.F. (2023). Beneficial Modulation of Human Health in the Oral Cavity and beyond Using Bacteriocin-like Inhibitory Substance-Producing Streptococcal Probiotics. Front. Microbiol., 14.","DOI":"10.3389\/fmicb.2023.1161155"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e27908","DOI":"10.1016\/j.heliyon.2024.e27908","article-title":"Accounting for the Health Risk of Probiotics","volume":"10","author":"Liu","year":"2024","journal-title":"Heliyon"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gul, S., and Durante-Mangoni, E. (2024). Unraveling the Puzzle: Health Benefits of Probiotics\u2014A Comprehensive Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13051436"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Jiang, Q., Stamatova, I., Kainulainen, V., Korpela, R., and Meurman, J.H. (2016). Interactions between Lactobacillus rhamnosus GG and Oral Micro-Organisms in an in Vitro Biofilm Model. BMC Microbiol., 16.","DOI":"10.1186\/s12866-016-0759-7"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1776","DOI":"10.1038\/s41591-025-03635-5","article-title":"CONSORT 2025 Statement: Updated Guideline for Reporting Randomized Trials","volume":"31","author":"Hopewell","year":"2025","journal-title":"Nat. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"121","DOI":"10.3109\/00016356408993968","article-title":"Periodontal Disease in Pregnancy. II. Correlation Between Oral Hygiene and Periodontal Condition","volume":"22","author":"Silness","year":"1964","journal-title":"Acta Odontol. Scand."},{"key":"ref_26","first-page":"193","article-title":"\u201cICDAS\u201d\u2014an International System for Caries Detection and Assessment Being Developed to Facilitate Caries Epidemiology, Research and Appropriate Clinical Management","volume":"21","author":"Pitts","year":"2004","journal-title":"Community Dent. Health"},{"key":"ref_27","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_28","doi-asserted-by":"crossref","first-page":"e20170318","DOI":"10.1590\/1678-7757-2017-0318","article-title":"Effects of a Food Enriched with Probiotics on Streptococcus mutans and Lactobacillus spp. Salivary Counts in Preschool Children: A Cluster Randomized Trial","volume":"26","author":"Villavicencio","year":"2018","journal-title":"J. Appl. Oral Sci."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Ebrahim, F., Malek, S., James, K., MacDonald, K., Cadieux, P., Burton, J., Cioffi, I., L\u00e9vesque, C., and Gong, S.-G. (2022). Effectiveness of the Lorodent Probiotic Lozenge in Reducing Plaque and Streptococcus mutans Levels in Orthodontic Patients: A Double-Blind Randomized Control Trial. Front. Oral Health, 3.","DOI":"10.3389\/froh.2022.884683"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/j.sdentj.2020.05.006","article-title":"Effectiveness of Probiotic Lozenges and Chlorhexidine Mouthwash on Plaque Index, Salivary pH, and Streptococcus mutans Count among School Children in Makkah, Saudi Arabia","volume":"33","author":"Felemban","year":"2021","journal-title":"Saudi Dent. J."},{"key":"ref_31","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_32","doi-asserted-by":"crossref","unstructured":"Babina, K., Salikhova, D., Doroshina, V., Makeeva, I., Zaytsev, A., Uvarichev, M., Polyakova, M., and Novozhilova, N. (2023). Antigingivitis and Antiplaque Effects of Oral Probiotic Containing the Streptococcus salivarius M18 Strain: A Randomized Clinical Trial. Nutrients, 15.","DOI":"10.3390\/nu15183882"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Vesty, A., Gear, K., Boutell, S., Taylor, M.W., Douglas, R.G., and Biswas, K. (2020). Randomised, Double-Blind, Placebo-Controlled Trial of Oral Probiotic Streptococcus salivarius M18 on Head and Neck Cancer Patients Post-Radiotherapy: A Pilot Study. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-70024-y"},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Benavides-Reyes, C., Cabello, I., Mag\u00e1n-Fern\u00e1ndez, A., Rodr\u00edguez-Barranco, M., Usta, S.N., and Mesa, F. (2025). Clinical Effects of Probiotics on the Treatment of Gingivitis and Periodontitis: A Systematic Review and Meta-Analysis. BMC Oral Health, 25.","DOI":"10.1186\/s12903-025-05888-5"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Sa\u00efz, P., Taveira, N., and Alves, R. (2021). Probiotics in Oral Health and Disease: A Systematic Review. Appl. Sci., 11.","DOI":"10.3390\/app11178070"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Sachelarie, L., Scrobota, I., Romanul, I., Iurcov, R., Potra Cicalau, G.I., and Todor, L. (2025). Probiotic Therapy as an Adjuvant in the Treatment of Periodontal Disease: An Innovative Approach. Medicina, 61.","DOI":"10.3390\/medicina61010126"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"105623","DOI":"10.1016\/j.jdent.2025.105623","article-title":"Methods Used to Deliver Adjunctive Probiotic Treatment during the Non-Surgical Management of Periodontitis: A Scoping Review","volume":"155","author":"Holliday","year":"2025","journal-title":"J. Dent."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2530","DOI":"10.3390\/nu5072530","article-title":"The Use of Probiotic Strains in Caries Prevention: A Systematic Review","volume":"5","author":"Cagetti","year":"2013","journal-title":"Nutrients"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Freire, M., Moustafa, A., Harkins, D.M., Torralba, M.G., Zhang, Y., Leong, P., Saffery, R., Bockmann, M., Kuelbs, C., and Hughes, T. (2020). Longitudinal Study of Oral Microbiome Variation in Twins. Sci. Rep., 10.","DOI":"10.1038\/s41598-020-64747-1"},{"key":"ref_40","first-page":"e53567","article-title":"The Impact of Socioeconomic Factors on Pediatric Oral Health: A Review","volume":"16","author":"Almajed","year":"2024","journal-title":"Cureus"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mohamed Rasheed, Z.B., Sheng, C.W., Norfitriah, E., Nasruddin, N.S., and Yazid, F. (2024). Oral Microbiome Dynamics in Treated Childhood Caries: A Comparative Study. Life, 14.","DOI":"10.3390\/life14121576"},{"key":"ref_42","first-page":"52","article-title":"\u201cSmall\u201d Sample Size","volume":"11","author":"Yang","year":"2023","journal-title":"Southwest Respir. Crit. Care Chron."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/22\/3604\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,20]],"date-time":"2025-11-20T05:25:35Z","timestamp":1763616335000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/17\/22\/3604"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,18]]},"references-count":42,"journal-issue":{"issue":"22","published-online":{"date-parts":[[2025,11]]}},"alternative-id":["nu17223604"],"URL":"https:\/\/doi.org\/10.3390\/nu17223604","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,18]]}}}