Compatibility of toothpastes with probiotics for periodontal health: an in vitro and ex vivo study.

INTRODUCTION: Dental biofilms are associated with oral diseases such as periodontitis, peri-implantitis, halitosis, and tooth decay. These diseases are characterized by dysbiosis, an imbalance between the host and microbiome. Current treatments rely on the mechanical removal of the biofilm and suppressing the microbiome with broad spectrum antimicrobials. However, the antimicrobial componentseliminate bacteria nonselectively, which can also harm beneficial commensalbacteria. Pro-microbial strategies, particularly probiotics, hold promise forrebalancing the oral microbiome toward a symbiotic state rather than eradicatingit. Limosilactobacillus reuteri is one of the most researched strains for modulating the oral microbiome. However, uncertainties persist, particularly regarding the impact of toothpastes on probiotic survival and efficacy. METHODS: In this study, in vitro experiments assessed the effects of selected toothpastes on L. reuteri viability, adhesion to hydroxyapatite discs, and biofilm incorporation and modulation. In the ex vivo experiment, the survival of L. reuteri was evaluated in saliva samples collected from ten volunteers after brushing with the selected toothpastes. RESULTS: The results demonstrated that the antimicrobial effect of the selected toothpastes on the probiotics was concentration and strain dependent. The adhesion of probiotics to hydroxyapatite discs was inhibited by some toothpastes. However, compared with the control, the toothpastes did not influence L. reuteri colonization within multi-species biofilms and, additionally, did not influence the effect of the probiotics on multi-species biofilm composition. Saliva taken after brushing with a specific toothpaste did not decrease the probiotic viability. CONCLUSION: In conclusion, in vitro, colonization and biofilm modulation by probiotics are dependent on the toothpaste used. The survival of the probiotic in saliva was not affected by the toothpaste ex vivo.