BioGaia’s oral health probiotic reduces pregnancy gingivitis

Background: Pregnancy causes hormonal changes that increase the risk of developing gingivitis, which half of all pregnant women will experience. Research have suggested that women with pregnancy gingivitis may be more likely to deliver babies prematurely or with low birth weight than mothers with healthy gums.

This was a double blind, placebo-controlled study in 45 women with pregnancy gingivitis, but otherwise healthy, enrolled at the beginning of the third trimester. Participants were examined toevaluate the extent of gingivitis and plaque index, and instructed to continue with their usual brushing habits. They were randomly provided with a supply of lozenges to be consumed twice daily until birth, each containing 2×10^8 cfu of Lactobacillus reuteri Prodentis (L. reuteri ATCC PTA 5289 + DSM 17938, n=24)), or the equivalent placebo lozenges (n=21).

Within two days after birth (approximately seven weeks after enrolment), the participants were re-evaluated. Both gingival index and plaque index of the Prodentis group were significantly reduced compared to baseline, and compared to the placebo group (p<0.0001). Within the placebo group there were no significant changes versus baseline. Gingival index was categorized as 0 (no inflammation) in approximately 79% and 37% of the subjects in the probiotic and placebo group, respectively.


Conclusion: The conventional methods to maintain oral health during pregnancy are brushing, flossing and seeing a dentist or a dental hygienist. L. reuteri Prodentis lozenges may be a useful adjunct in the control of pregnancy gingivitis.

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L. reuteri Prodentis shown to reduce Candida in the elderly

This was a double-blind, randomised, placebo-controlled trial in 215 elderly persons (mean age 88 years) living in 20 nursery homes in southern Sweden.

The study objective was to investigate the effect of a daily intake of the probiotic L. reuteri Prodentis (L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289) on the prevalence and counts of oral Candida in frail elderly patients living in nursery homes.

Patients were given two lozenges per day of either Lactobacillus reuteri Prodentis (n=95) or placebo (n=103) for 12 weeks.

Primary outcome was measured as prevalence and amount of Candida growth. Secondary outcomes was measured as levels of dental plaque and gingival inflammation.

There was a statistically significant reduction of 53% in the prevalence of high Candida counts in saliva in the L. reuteri Prodentis group but not in the placebo group, and the difference was statistically significant in both saliva and plaque (P < 0.05).

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Daily use of L. reuteri Prodentis lozenges may reduce the prevalence of high oral Candida counts in frail elderly nursing home residents. This indicates that probiotic lozenges may be beneficial for patients at risk for oral candidosis.

Role of probiotics in the prevention of the enteric colonization by Candida in preterm newborns

This open, prospective and randomised study investigated whether two different probiotics could decrease the risk of gastrointestinal colonisation of Candida species, of late-onset sepsis and neurological outcome in preterm neonates in an intensive care unit.

249 infants, of which 56 had a birth weight <1500 g, were consecutively assigned to either supplementation with Lactobacillus reuteri ATCC 55730 (10^8 CFU/day, group I), supplementation with Lactobacillus rhamnosus ATCC 53103 (=LGG, 6×10^9 CFU/day, group II) or no supplementation (group III). The supplementation started within 72 hours of admittance and continued for six weeks or until discharge.

Compared to the control group, both probiotics significantly reduced the incidence of high Candida faecal counts (>10^4 CFU/g of faeces), p<0.01, and there were also fewer fungal and bacterial infections, although the differences were not statistically significant. The number of infants with gastrointestinal symptoms was significantly reduced in the Lactobacillus reuteri group (3/83) vs. group II (29/83) and III (36/83), p<0.05. Consequently, the infants given Lactobacillus reuteri were weaned from parental nutrition more quickly and the time to reach full energy intake was also significantly shorter. Days on antibiotic treatment were reduced by Lactobacillus reuteri: 3.4 days vs. 5.8 days and 6.9 days in group II and III, respectively (p<0.05). Hospital stays were also significantly shorter in the Lactobacillus reuteri group: 18 days vs. 27 and 31 in group II and III, respectively (p<0.0001). At the follow-up of neurological outcomes at 12 months there were significantly fewer children with suboptimal scores in both probiotic groups compared to the control group, p<0.05.

Both probiotics reduced the incidence of high faecal counts of Candida in these preterm infants and demonstrated no safety problems. Fewer infants given Lactobacillus reuteri needed antibiotic treatment, fewer of them had any gastrointestinal problems and the hospital stay was reduced; these outcomes were significantly different to the results for the infants in the LGG and the control group. Infants supplemented with probiotics had a significantly reduced incidence of suboptimal neurological outcome at one year of age compared to the control group.

Transferability of tetracycline resistance gene from Lactobacillus reuteri to bacteria in human gastrointestinal tract

This double-blind study determined whether consumption of a Lactobacillus reuteri strain harbouring a plasmid containing the tetracycline resistance gene resulted in a detectable tetracycline resistance signal in faecal bacteria including enterococci, bifidobacteria and lactobacilli.

Subjects consumed either an Lactobacillus reuteri strain harbouring the tetracycline resistance gene (ATCC 55730) (n=7) or a control strain (n=7) from which the plasmid had been removed (DSM 17938).

For both arms of the study the Lactobacillus reuteri dose was 5 x 10^8 CFU/day for 14 days. Both strains were detectable at similar levels in the faeces but no tetracycline resistance signal was detected in any of the bacterial DNA samples collected.

Conclusion: Gene transfer during intestinal passage of the probiotic strain Lactobacillus reuteri ATCC 55730 was non-detectable under the conditions tested.

Cow’s milk allergic children can present sensitisation to probiotics

Study with the aim to evaluate sensitivity to probiotic products in children with cow’s milk allergy. Eighty-five children with atopic dermatitis were screened for possible cow’s milk allergy by skin prick test (SPT).

36/85 had a positive SPT (mean wheal diameter ≥ 3 mm) to cow’s milk and were further skin prick tested with preparations of three probiotic products, in Italy sold under the brands of Fiorilac® (L. paracasei I 1688 and L. salivarius I 1794, sachet product), Dicoflor® (L. GG, sachet product) and Reuterin® (Lactobacillus reuteri, oil suspension).

Positive SPT was found in 26/36 subjects for Fiorilac, in two patients for Dicoflor, and in one child to Reuterin. In four children, the mean diameter of the SPT wheal with Fiorilac was greater than the predictive cut-off index of positive response to oral challenge (> 6 mm for children less than 2 years old and > 8mm for older patients). No child that was SPT- positive for Dicoflor or Reuterin had a mean wheal diameter > 6 mm. However, oral challenge with the probiotic products was not performed.


When considering the use of probiotic products with limited information on content of allergens, it is advisable to do a screening SPT in high risk, cow’s milk allergic children to evaluate contamination with allergens.

Probiotics in the prevention of bacterial and Candida infections in newborns

An open, prospective and randomised study that investigated the effects of daily oral probiotic supplementation on the incidence of bacterial and fungal infections, the incidence of gastrointestinal symptoms, and time to tolerate enteral nutrition in surgical newborns attending a Neonatal Intensive Care Unit (NICU).

24 newborns with a gestational age of 36.4 ± 2.7 weeks, a birth weight of 2568.3 ± 644 g, and admitted in the NICU due to greater surgical interventions were included.

Group 1 (n=8) was supplemented with Lactobacillus reuteri ATCC 55730, group 2 (n=8) was supplemented with Lactobacillus GG and group 3 (n=8) was not given probiotics. Both probiotics were administered from the time of admittance to the NICU.

The clinical parameters evaluated were: No. of bacterial and Candida infections, No. of days with antimycotic treatment, duration of parenteral nutrition, time to tolerance of enteral/oral food intake, weight increase, gastrointestinal symptoms, and duration of hospital stay.

Results: Significantly fewer infective episodes were observed in groups 1 and 2 compared with controls: 0%, 12%, and 37.5%, respectively, for bacterial infections and 12.5%, 25%, 37.5% for Candida infections. Group 3 needed antimycotic treatment for a significantly longer period of time: the medium duration of antimycotic treatment was 19 days in group 1, 29 days in group 2, and 41 days in group 3. The medium duration of parenteral nutrition was 18 days in group 1, 34 days in group 2, and 42 in group 3 (p<0.05).


Conclusion: Probiotic supplementation to this high-risk group of newborns can reduce the risk of bacterial and Candida sepsis, shorten the period of time with parenteral nutrition, reduce gastrointestinal symptoms and increase oral food tolerance, with significant reduction in hospital stay.

Safety of D(-)-lactic acid producing bacteria in the human infant

Lactobacillus reuteri is one of many species of Lactobacillus known to produce both L(+)-lactic acid and D(-)-lactic acid through normal sugar fermentation. As part of a prospective study of decreasing the risk of allergy during the first years of life, a safety investigation was performed of the levels of D(-)-lactic acid in the blood at the age of 6 and 12 months.

A sample group of 24 infants were randomly chosen from the total study population of 232 infants. They had been supplemented with Lactobacillus reuteri ATCC 55730, or placebo, for twelve months from birth. The daily dose of Lactobacillus reuteri was 10^8 CFU, suspended in oil. 14 infants were supplemented with Lactobacillus reuteri and 10 with placebo. All 24 infants had very low levels of D(-) lactic acid (range 0.020 – 0.130 mmol/L), and there was no difference between the infants ingesting Lactobacillus reuteri and those receiving placebo.

The daily supplementation of Lactobacillus reuteri to healthy newborns during their first 12 months was safe, also in regard to the levels of D(-)-lactic acid in the blood.










The highest level observed was well within the normal range seen in humans (0.020 – 0.250 mmol/L) and far below levels associated with D-lactic acidosis in humans (> 3 mmol/L). No symptoms were reported that would normally be associated with acidosis, and there were no safety problems in any of the participating children.

Conclusion: The daily supplementation of Lactobacillus reuteri to healthy newborns during their first 12 months was safe, also in regard to the levels of D(-)-lactic acid in the blood.

Safety of Lactobacillus reuteri in neonates

A randomised, double blind, placebo-controlled study on healthy newborn, full-term children. The aim was to study safety aspects following the daily intake of Lactobacillus reuteri given from the day of birth and the following 28 days.

Four groups of children were studied: Lactobacillus reuteri ATCC 55730 in the doses 10^5 CFU/day (n=12), 10^7 CFU/day (n=25) or 10^9 CFU/day (n=25), and placebo (n=28).

All dose levels of Lactobacillus reuteri were well tolerated. The degree of Lactobacillus reuteri colonisation, measured as the number of living cells in stool samples, was related to the given dose. The occurrence of watery diarrhoea was significantly lower in children given Lactobacillus reuteri.

ConclusionLactobacillus reuteri was safe to consume for healthy full-term newborns during their first four weeks of life, in doses up to 10^9 CFU/day.