Evaluate the effect of probiotics on Oral Health Status and Its Influence on Salivary Biomarkers in Iraq: Clinical Trial
DOI:
https://doi.org/10.32828/mdj.v22i1.1253Keywords:
probiotics, oral health, gingivitis, Interleukin 1Beta, Matrix Metalloproteinase -8Abstract
Aim of the study: To verify the effect of probiotic tablets on oral health status and to compare their effects on gingival health and potential salivary biomarkers by monitoring the levels of Interleukin-1β (IL-1β) and Matrix metalloproteinases-8 (MMP-8) in saliva of individuals with moderate gingivitis. Materials and methods: A randomized interventional trial was conducted over 28 days, which included 88 healthy male college students aged 18 to 25 years old from Al-Anbar University. The participants have randomly assigned to two groups: study group (A) and control group (B). The gingival health parameter GI has evaluated clinically, and the concentrations of IL-1β and MMP-8 have been quantified in both groups at baseline (0 days), 14 days, and 28 days. Results: GI significantly decreased in study group when compared to the control group. Fuethermore, IL-1β and MMP-8 showed significant reductions only at day 28. Conclusion: Probiotics may improve gingival health by positively affecting the oral flora and regulating the immune system.
References
Alasbily H, Mohamed HH, Asheibi A, Bazina MS, Alkaseh A, Ghaith HM, Fahmi FA, Bazina M. Probiotics in Periodontal Diseases: mechanisms, evidence mapping, limitations, and future directions. Cureus. 2025; 17(11):e96042. doi:10.7759/cureus.96042.
Alshareef A, Attia A, Almalki M, Alsharif F, Melibari A, Mirdad B, Azab E, Youssef AR, Dardir A. Effectiveness of probiotic lozenges in periodontal management of chronic periodontitis patients: clinical and immunological study. Eur J Dent. 2020; 14(2):281-287. doi:10.1055/s-0040-1709924.
Cafiero C, Spagnuolo G, Marenzi G, Martuscelli R, Colamaio M, Leuci S. Predictive periodontitis: The most promising salivary biomarkers for early diagnosis of periodontitis. J Clin Med. 2021; 10(7):1488. doi:10.3390/jcm10071488.
Chauhan DN, Singh PR, Chauhan NS, Shah K. Pharmacological Studies in Natural Oral Care. John Wiley & Sons; 2023. doi:10.1002/9781119865117.
Cosseau C, Devine DA, Dullaghan E, Gardy JL, Chikatamarla A, Gellatly S, et al. The commensal Streptococcus salivarius K12 downregulates the innate immune responses of human epithelial cells and promotes host–microbe homeostasis. Infect Immun. 2008; 76(9):4163–4175. doi:10.1128/IAI.00188-08.
Ebersole JL, Nagarajan R, Akers D, Miller CS. Targeted salivary biomarkers for discrimination of periodontal health and disease(s). Front Cell Infect Microbiol. 2015; 5:62. doi:10.3389/fcimb.2015.00062.
Ebrahimpour-Koujan S, Milajerdi A, Larijani B, Esmaillzadeh A. Effects of probiotics on salivary cytokines and immunoglobulines: a systematic review and meta-analysis on clinical trials. Sci Rep. 2020; 10(1):11800. doi:10.1038/s41598-020-67037-y.
Elgasmi FE, Maghous K, Badre B. Gingivitis in children and adolescents: epidemiological overview and associated factors—a narrative review. Front Oral Health. 2025; 6:1675033. doi:10.3389/froh.2025.1675033.
Gasner NS, Schure RS. Periodontal disease. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025. Updated 2025 May 12. Available from: (https://www.ncbi.nlm.nih.gov/books/NBK554590).
Gheisary Z, Mahmood R, Shivanantham AH, Liu J, Lieffers JRL, Papagerakis P, Papagerakis S. The clinical, microbiological, and immunological effects of probiotic supplementation on prevention and treatment of periodontal diseases: a systematic review and meta-analysis. Nutrients. 2022; 14(5):1036. doi:10.3390/nu14051036.
Hammdallah SH, Fahmi MQM, Al-Waeli H. Effect of Multi-Strain Probiotics on Levels of IL-6 in Saliva, and the Gingival Health Condition in 10 Years Old Children. Mustansiria Dent J. 2025; 21(1):1-17. doi:10.32828/mdj.v21i1.1150.
Ince G, Gursoy H, Ipci SD, Cakar G, Emekli-Alturfan E, Yilmaz S. Clinical and biochemical evaluation of lozenges containing Lactobacillus reuteri as an adjunct to non-surgical periodontal therapy in chronic periodontitis. J Periodontol. 2015; 86(6):746–754. doi:10.1902/jop.2015.140612.
Inchingolo F, Inchingolo AM, Malcangi G, De Leonardis N, Sardano R, Pezzolla C, de Ruvo E, Di Venere D, Palermo A, Inchingolo AD, Corriero A. The benefits of probiotics on oral health: systematic review of the literature. Pharmaceuticals (Basel). 2023; 16(9):1313. doi:10.3390/ph16091313.
Kamil TF, Ali OH. Relation between salivary Matrix-metalloproteinase-8 with periodontal health; dental biofilm induced gingivitis, localized and generalized periodontitis. Mustansiria Dent J. 2023; 19(1):44-54. doi:10.32828/mdj.v19i1.991.
Karaaslan F, Dikilitaş A, Yiğit U. Oral health status and associated factors in a subpopulation of Turkish patients. Cumhuriyet Dent J. 2019; 22(2):100-110.
Kaźmierczyk-Winciorek M, Nędzi-Góra M, Słotwińska SM. The immunomodulating role of probiotics in the prevention and treatment of oral diseases. Cent Eur J Immunol. 2021; 46(1):99-104. doi:10.5114/ceji.2021.104412.
Kim JY, Kim KR, Kim HN. The potential impact of salivary IL-1 on the diagnosis of periodontal disease: a pilot study. Healthcare (Basel). 2021; 9(6):729. doi:10.3390/healthcare9060729.
Löe, H. and Silness, J.: Periodontal disease in pregnancy. Acta Odontol Scan 21: 533, 1963.
Mazziotta C, Tognon M, Martini F, Torreggiani E, Rotondo JC. Probiotics mechanism of action on immune cells and beneficial effects on human health. Cells. 2023; 12(1):184. doi:10.3390/cells12010184.
Meurman JH, Stamatova IV. Probiotics: evidence of oral health implications. Folia Med (Plovdiv). 2018; 60(1):21-29. doi:10.1515/folmed-2017-0080.
Modiri S, Heidari M, Shahmohammadi R, Jabbareh L, Maboudi A, Moosazadeh M, et al. A tangible prospect for the treatment of gingivitis using a potentially probiotic strain Lactobacillus plantarum MK06 isolated from traditional dairy products: a triple-blind randomized clinical trial. BMC Oral Health. 2023; 23(1):870. doi:10.1186/s12903-023-03494-x.
Paqué PN, Hjerppe J, Zuercher AN, Jung RE, Joda T. Salivary biomarkers as key to monitor personalized oral healthcare and precision dentistry: A scoping review. Front Oral Health. 2022; 3:1003679. doi:10.3389/froh.2022.1003679.
Rocha-Ramírez L, Pérez-Solano R, Castañón-Alonso S, Moreno Guerrero S, Ramirez Pacheco A, García Garibay M. Probiotic Lactobacillus strains stimulate the inflammatory response and activate human macrophages. J Immunol Res. 2017; 2017:4607491. doi:10.1155/2017/4607491.
Sachelarie L, Scrobota I, Romanul I, Iurcov R, Potra Cicalau GI, Todor L. Probiotic therapy as an adjuvant in the treatment of periodontal disease: an innovative approach. Medicina (Kaunas). 2025; 61(1):126. doi:10.3390/medicina61010126.
Sachelarie L, Stefanescu CL, Murineanu RM, Grigorian M, Zaharia A, Scrobota I, Hurjui LL. Role of Salivary Biomarkers IL-1β and MMP-8 in Early Detection and Staging of Periodontal Disease. Medicina (Kaunas). 2025; 61(4):760. doi:10.3390/medicina61040760.
Sang-Ngoen T, Czumbel LM, Sadaeng W, Miko A, Nemeth DI, Matrai P, Hegyi P, Toth B, Csupor D, Kiss I, Szabo A. Orally administered probiotics decrease Aggregatibacter actinomycetemcomitans but not other periodontal pathogenic bacteria counts in the oral cavity: a systematic review and meta-analysis. Front Pharmacol. 2021; 12:682656. doi:10.3389/fphar.2021.682656.
Schlagenhauf U, Jockel-Schneider Y. Probiotics in the management of gingivitis and periodontitis. A review. Front Dent Med. 2021; 2:708666. doi:10.3389/fdmed.2021.708666.
Stolte KN, Pelz C, Yapto CV, Raguse JD, Dommisch H, Danker K. IL-1β strengthens the physical barrier in gingival epithelial cells. Tissue Barriers. 2020; 8(3):1804249. doi:10.1080/21688370.2020.1804249.
Zhang Y, Kang N, Xue F, Qiao J, Duan J, Chen F, Cai Y. Evaluation of salivary biomarkers for the diagnosis of periodontitis. BMC Oral Health. 2021; 21(1):266. doi:10.1186/s12903-021-01600-5.
Downloads
Published
Issue
Section
Categories
License
Copyright (c) 2026 BAYDAA YOUNUS, Dr. MOHAMMED I ALZUBIDI
This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles of this journal are licensed under the terms of the Creative Commons Attribution International Public License CC-BY 4.0 that licensees are unrestricted to search, download, share, distribute, print, or link to the full texts of the articles; crawl them for indexing; and reproduce any medium of the articles provided that they give the author(s) proper credit (citation). The journal allows the author(s) to retain the copyright of their published article.
