Effect of Probiotic Lozenges on Salivary Streptococcus mutans Counts of High-Carious-Risk Children: A Double-Blind Randomized Controlled Trial
Submission: 25 August 2025 | Acceptance: 28 September 2025 | Publication: 24 November 2025
1Dr. Sadaf Anwar Qureshi, 2Nazneen Tabassum, 3Marwa Riaz, 4Qaisar Mumtaz, 5Khizer Javed Butt, 6Shafaq Saeed Roghay
1Assistant Professor, Department of Pathology, Ayub Medical College, Abbottabad
2Mayo Hospital, Lahore
3PIMS, Rawalpindi
4UHS, Lahore
5Sir Gangaram Hospital, Lahore
6Baqai Medical University, Karachi
Corresponding: Dr. Sadaf Anwar Qureshi, Assistant Professor, Department of Pathology, Ayub Medical College, Abbottabad
Abstract:
Background: Traditionally, dental caries has ranked as one of the most common diseases of childhood, and Streptococcus mutans, which has been thought to be one of the primary etiologic organisms. More newly, probiotics have been introduced as a non-intrusive method of changing oral flora.
Objective: This study determined the effectiveness of probiotic lozenges on reducing the salivary levels of S. mutans in high caries-risk children.
Methods: This was a double-blinded RCT that involved 60 children aged 6-12 years, highlighted as high caries risk subjects. Later, these children were randomly placed in either the probiotic group, to whom Lactobacillus reuteri lozenges were given, or in the placebo group, for whom participants took identical non-medicated lozenges, for 28-30 days. Unstimulated saliva samples combined at baseline and after intervention were subjected to microbiological analysis by CFU counts.
Results: In the probiotic group children, the mean counts of S. mutans were significantly lower compared with that in the placebo group children. Calculated percentage reduction for the probiotic group was 53%, whereas it was only 8% for the placebo group. This difference between the two groups is drastically significant.
Conclusion: Routine vise consumption of probiotic lozenges was found to reduce salivary S. mutans among children at high carious risk and thus was supposed to be very promising as an adjunctive method for the prevention of caries.
Keywords: probiotics, Lactobacillus reuteri, Streptococcus mutans, high carious risk, children, oral microbiome, randomized controlled trial.