Role of probiotics in the prevention of early childhood caries

Early childhood caries (ECC) is the most common childhood disease, deemed as a chronic, infectious, and preventable disease. The etiology of ECC is complex and multifactorial; hence, early preventive measures should be implemented. Several strategies have been investigated in the past for ECC prevention. The use of probiotics in the management of gastrointestinal diseases has shown promising results. In this context, effectiveness of probiotic bacteria to re-establish a balanced oral microbiota has gained interest in the dental research community during recent years, with focus on caries prevention. To our knowledge, there is only one review, published in 2016, on the prevention of ECC with probiotic bacteria. This paper aims to present an in-depth review of probiotics as a preventive strategy for ECC. The efficacy of probiotic bacteria may be strain specific. Results of the studies investigating the effect of probiotic administration on reduction of caries risk are contradictory, with some showing reduction in Mutans streptococcus and Lactobacillus counts, while others showing no change. Long-term studies also have reported contradictory findings, with either no difference or decrease in the prevalence of caries when evaluated later in life following early administration of probiotics. As these studies offer ample evidence of the potential of probiotics in the prevention of ECC, further long-term, controlled studies should be planned to study the benefits.