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Probióticos e cárie dentária: revisão integrativa de ensaios e estudos clínicos
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Objetivo: Esta revisão integrativa teve como objetivo avaliar os efeitos da ingestão de probióticos orais nos parâmetros associados à cárie dentária em crianças.
Metodologia: Foi realizada uma pesquisa bibliográfica seguindo as diretrizes PRISMA, com foco na pergunta PICO: “Qual é o impacto da ingestão de probióticos por crianças nos parâmetros relacionados com as cáries dentárias?”. Foram incluídos 21 estudos clínicos com grupo controlo, publicados nos últimos 10 anos, entre 2014 e 2025, e selecionados nas bases de dados PubMed e LILACS. Os critérios de inclusão centraram-se em estudos realizados em crianças, que avaliaram indicadores como a concentração de Streptococcus mutans, o pH salivar, a composição do biofilme oral ou a evolução de lesões cariosas. Resultados: A análise dos estudos revelou que a maioria das estirpes probióticas utilizadas, especialmente Lactobacillus paracasei, Lactobacillus rhamnosus e Bifidobacterium, demonstrou uma redução significativa da carga de Streptococcus-mutans na cavidade oral. Alguns estudos reportaram uma regressão de lesões cariosas iniciais, bem como uma diminuição da incidência de novas lesões ao longo do tempo. Adicionalmente, observou-se uma modulação positiva da microbiota oral, com aumento da proporção de bactérias benéficas como Streptococcus oralis e Gemella, e diminuição de espécies patogénicas. Em várias intervenções, registou-se uma melhoria nos parâmetros salivares, como o aumento do pH e da capacidade tampão, sobretudo em tratamentos de duração superior a 4 semanas. Alguns estudos também relataram o impacto dos probióticos na resposta imunitária local, nomeadamente através do aumento de péptidos antimicrobianos salivares (HNP1-3). Os formatos de administração variaram entre leite, pastilhas, gotas e cápsulas, sendo o leite o veículo mais utilizado. A maioria dos estudos foi realizada em crianças com alto risco de cárie ou com cárie precoce da infância. Apesar dos resultados positivos, constatou-se uma grande heterogeneidade metodológica entre os estudos, com diferenças quanto à estirpe utilizada, duração da intervenção, frequência de administração e critérios de avaliação. Conclusão: Os probióticos orais demonstraram um potencial benéfico significativo na prevenção e controlo das cáries dentárias em crianças, atuando sobre múltiplos fatores: redução de microrganismos cariogénicos, melhoria da microbiota oral, regulação do pH salivar e reforço da imunidade local. No entanto, para confirmar e padronizar a sua aplicação clínica, são necessários estudos complementares, com amostras maiores, intervenções mais prolongadas e protocolos uniformizados.
Objective: This integrative review aimed to evaluate the effects of oral probiotic intake on parameters associated with dental caries in children. Methodology: A literature search was conducted following PRISMA guidelines, focusing on the PICO question: “What is the impact of probiotic intake by children on parameters related to dental caries?” Twenty-one clinical studies with control groups, published over the past 10 years, between 2014 and 2025 were included and selected from the PubMed and LILACS.. Inclusion criteria focused on studies conducted in children that evaluated indicators such as Streptococcus mutans concentration, salivary pH, oral biofilm composition, or the progression of carious lesions. Results: The analysis revealed that most probiotic strains used—especially Lactobacillus paracasei, Lactobacillus rhamnosus, and Bifidobacterium—showed a significant reduction in Streptococcus mutans levels in the oral cavity. Some studies reported a regression of early carious lesions as well as a decrease in the incidence of new lesions over time. Additionally, a positive modulation of the oral microbiota was observed, with an increase in beneficial bacteria such as Streptococcus oralis and Gemella, and a reduction in pathogenic species. Several interventions also showed improvements in salivary parameters, such as increased pH and buffering capacity, particularly in treatments lasting more than four weeks. Some studies also highlighted the impact of probiotics on local immune response, namely through the increase of salivary antimicrobial peptides (HNP1-3). The forms of administration included milk, lozenges, drops, and capsules, with milk being the most commonly used vehicle. Most studies were conducted in children at high risk of caries or with early childhood caries. Despite the positive outcomes, a high degree of methodological heterogeneity was noted among the studies, including differences in the strains used, duration of intervention, administration frequency, and evaluation criteria. Conclusion: Oral probiotics have demonstrated significant beneficial potential in the prevention and control of dental caries in children by acting on multiple factors: reducing cariogenic microorganisms, improving the oral microbiota, regulating salivary pH, and enhancing local immunity. However, to confirm and standardize their clinical application, further studies are needed with larger sample sizes, longer interventions, and standardized protocols.
Objective: This integrative review aimed to evaluate the effects of oral probiotic intake on parameters associated with dental caries in children. Methodology: A literature search was conducted following PRISMA guidelines, focusing on the PICO question: “What is the impact of probiotic intake by children on parameters related to dental caries?” Twenty-one clinical studies with control groups, published over the past 10 years, between 2014 and 2025 were included and selected from the PubMed and LILACS.. Inclusion criteria focused on studies conducted in children that evaluated indicators such as Streptococcus mutans concentration, salivary pH, oral biofilm composition, or the progression of carious lesions. Results: The analysis revealed that most probiotic strains used—especially Lactobacillus paracasei, Lactobacillus rhamnosus, and Bifidobacterium—showed a significant reduction in Streptococcus mutans levels in the oral cavity. Some studies reported a regression of early carious lesions as well as a decrease in the incidence of new lesions over time. Additionally, a positive modulation of the oral microbiota was observed, with an increase in beneficial bacteria such as Streptococcus oralis and Gemella, and a reduction in pathogenic species. Several interventions also showed improvements in salivary parameters, such as increased pH and buffering capacity, particularly in treatments lasting more than four weeks. Some studies also highlighted the impact of probiotics on local immune response, namely through the increase of salivary antimicrobial peptides (HNP1-3). The forms of administration included milk, lozenges, drops, and capsules, with milk being the most commonly used vehicle. Most studies were conducted in children at high risk of caries or with early childhood caries. Despite the positive outcomes, a high degree of methodological heterogeneity was noted among the studies, including differences in the strains used, duration of intervention, administration frequency, and evaluation criteria. Conclusion: Oral probiotics have demonstrated significant beneficial potential in the prevention and control of dental caries in children by acting on multiple factors: reducing cariogenic microorganisms, improving the oral microbiota, regulating salivary pH, and enhancing local immunity. However, to confirm and standardize their clinical application, further studies are needed with larger sample sizes, longer interventions, and standardized protocols.
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Probióticos Lactobacilos Bifidobactérias Cáries dentárias Probiotic Lactobacil Bifidobact Dental caries