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EDITORIAL
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 1-2

Is balance ... the real key?


Department of Periodontolgy, National Dental College and Hospital, Dera Bassi, Punjab, India

Date of Web Publication20-Sep-2013

Correspondence Address:
Ranjan Malhotra
Department of Periodontolgy, National Dental College and Hospital, Dera Bassi, Punjab
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-6944.118508

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How to cite this article:
Malhotra R. Is balance ... the real key?. Indian J Oral Sci 2013;4:1-2

How to cite this URL:
Malhotra R. Is balance ... the real key?. Indian J Oral Sci [serial online] 2013 [cited 2019 Sep 20];4:1-2. Available from: http://www.indjos.com/text.asp?2013/4/1/1/118508

Despite traditional periodontal therapy being the mainstay for several years, periodontal infections still remain a major burden in health care, with their huge prevalence and not so cost-effective therapeutic protocols. Drug-resistant bacteria continue to emerge as the antibiotic pipeline dries up and pathogenic microorganisms are being linked with increased risk or worsening of many chronic general body diseases. Confronting this alarming situation, our scientists and researchers are all the more striving hard to find ways in order to provide an oral environment that is conducive for the ultimate survival and utility of the oro-dental tissues.

With the oral ecology and microbiota being quite complex and dental biofilms being difficult therapeutic targets to tackle, the encouraging effects of probiotics in different fields of healthcare have recently led to the introduction of probiotics for oral healthcare. "PRO-BIOTIC," signifying for life, endorsed by the Food and Agriculture Organization (FAO) and the World Health Organization (WHO), in 2001, describes them as live microorganisms which when administered in adequate amounts confer health benefits to the host. There is ample contemporary literature available, supporting the effects of probiotics in different fields of oral healthcare such as halitosis, oral candidiasis, and tooth decay.

Although the beneficial effect of lactic acid bacteria, as they were so called, on inflammatory infections of the oral mucosa were reported about half a century ago, some anecdotal Russian reports in the early 1990s too stress upon the use of probiotics in the treatment of periodontitis.

The reason why these sound workable is related to the fact that periodontal disease, being an immune inflammatory entity, is usually manifested when there is a disruption of balance between the host and microbes, with the balance tipping in favor of the growth of pathogenic microorganisms. The standard treatment for periodontitis consisting of scaling, root planning, and the antibiotics aims to shift this state toward a less pathogenic microbiota, but this alteration is very short spanned and temporary, with re-establishment of more aggressive microbiota within weeks to months. Therefore, restoring the oral ecosystem with these reduced numbers of beneficial bacteria via probiotics might be another viable alternative in the prevention and treatment of plaque-related periodontal diseases. Probiotics might not only suppress the emergence of endogenous pathogens or prevent the superinfection with exogenous pathogens but also might protect us through the promotion of a beneficial host response.

The scientific introduction of probiotics is followed almost immediately by their commercial exploitation with claimed beneficial effects on periodontal health. The selection of the best probiotic strains for preventing periodontal diseases and halitosis is still an open issue in that. It seems necessary to perform specific screenings for selecting appropriate strains and to strictly adhere to several guidelines suggested by a joint FAO of the United Nations and WHO working group. The issue of safety of a probiotic is again worth focusing on. Given the potent paradigm shift that this phenomenon of oral probiotics brings about in the field of periodontal healthcare, it should, therefore, be based on solid clinical evidence.

Let us head toward a better oral health in future by winning the evil with the good "ones"...!

 
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