Non-Cochrane · intervention · PM41593561
Comparative effectiveness of probiotics, prebiotics, synbiotics, and postbiotics in preventing dental caries: a meta-analysis from an oral microbiota modulation perspective.
Lu Chuan, Zhang Shuai, Hong Guang · BMC oral health · 2026 · PubMed · doi:10.1186/s12903-026-07707-x
Findings
6 findings
| Population | ||||
|---|---|---|---|---|
| Children (pediatric trials) | Probiotics (e.g. L. rhamnosus, L. reuteri; lozenges, dairy products) | Placebo, no intervention or standard care | New or progressive dental caries (caries incidence) Trim-and-fill adjusted (publication bias sensitivity) | RR 0.83 [0.69, 1.01] GRADE not reported 12 studies |
| Children (pediatric trials) | Probiotics (e.g. L. rhamnosus, L. reuteri; lozenges, dairy products) | Placebo, no intervention or standard care | New or progressive dental caries (caries incidence) Meta-regression: duration of intervention (per month) | Meta-regression slope -0.031 GRADE not reported Studies not reported |
| Children (pediatric trials) | Probiotics (e.g. L. rhamnosus, L. reuteri; lozenges, dairy products) | Placebo, no intervention or standard care | New or progressive dental caries (caries incidence) | RR 0.79 [0.67, 0.94] Moderate 12 studies · 2300 participants |
| Adults | Probiotics | Placebo, no intervention or standard care | New or progressive dental caries (caries incidence) | RR 0.94 [0.79, 1.12] GRADE not reported 6 studies · 1100 participants |
| Children and adults | Synbiotics | Placebo, no intervention or standard care | Caries (clinical endpoint) | RR 0.87 [0.61, 1.24] Low Downgraded: imprecision 2 studies |
| Humans of any age | Postbiotics | Placebo, no intervention or standard care | New or progressive dental caries (caries incidence) Unresolved: the two extractors disagree on this row. | RR 0.85 [0.60, 1.20] GRADE not reported Studies not reported |
Included primary studies 14
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Hedayati-Hajikand 2015 matched by author and year (probable) | NR | 1 other review | not stated | not extracted yet |
| Banakar 2023 Antimicrobial Effects of Postbiotic Mediators Derived from Lactobacillus rhamnosus GG and Lactobacillus reuteri on Streptococcus mutans DOI:10.31083/j.fbl2805088 | 2023 | this review only | not stated | not extracted yet |
| Banakar 2023 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Ghamari 2025 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hasslof 2022 Prevention of Recurrent Childhood Caries with Probiotic Supplements: A Randomized Controlled Trial with a 12-Month Follow-Up DOI:10.1007/s12602-022-09913-9 | 2022 | this review only | not stated | not extracted yet |
| Hasslof 2022 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Hedayati-Hajikand 2015 Effect of probiotic chewing tablets on early childhood caries – a randomized controlled trial DOI:10.1186/s12903-015-0096-5 | 2015 | this review only | not stated | not extracted yet |
| Porksen 2023a The effect of a lozenge combining prebiotic arginine and probiotics on caries increment in children during 10–12 months, a randomized… DOI:10.1016/j.jdent.2023.104599 | 2023 | this review only | not stated | not extracted yet |
| Porksen 2023a matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Porksen 2023b The efficacy of combined arginine and probiotics as an add-on to 1450 ppm fluoride toothpaste to prevent and control dental caries in… DOI:10.1016/j.jdent.2023.104670 | 2023 | this review only | not stated | not extracted yet |
| Porksen 2023b matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Rodriguez 2016 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
| Rodriguez 2016 Expression of IL-2 receptor p55 and p75 chains by human B lymphocytes: effects of activation and differentiation. PMID:2016116 | 1991 | this review only | not stated | not extracted yet |
| Twetman 2018 matched by author and year (probable) | NR | this review only | not stated | not extracted yet |
Overlap with other reviews
Reviews that include the same primary studies are not independent evidence. Shared counts match studies by PMID, DOI or NCT, and otherwise by author and year (a probable match). Only the non-Cochrane dental reviews have study lists, so overlap with Cochrane reviews is not counted yet.
| Review | Shared studies | Jaccard |
|---|---|---|
| Nonrestorative Treatments for Caries: Systematic Review and Network Meta-analysis. (2019) | 1 | 0.01 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Human participants of any age | Children and adults (2 years to older adults), mostly pediatric |
| Intervention | Probiotics, prebiotics, synbiotics, postbiotics to prevent dental caries | Probiotics (n=19), prebiotics (n=3), synbiotics (n=3), postbiotics (n=2) |
| Comparison | Placebo, no intervention, standard care, or active comparators | Placebo, standard milk, fluoride toothpaste, standard care |
| Outcomes | Caries incidence or progression (DMFT/dmft, ICDAS); secondary: S. mutans counts, plaque pH, adverse events, acceptability, adherence | Caries increment (DMFT, ICDAS, ds), S. mutans counts, plaque pH, adverse events |
| Study designs | RCTs, quasi-randomized trials, controlled clinical trials; observational studies for safety only | 27 controlled trials, 19 RCTs in meta-analysis |
| Timing | Not specified | Follow-up 4 weeks to 24 months (median 6 months) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Partial Yes | Yes | no |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | Partial Yes | Partial Yes | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | RCT: Yes · NRSI: No | NRSI: No · RCT: Yes | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: Yes · NRSI: N/A | NRSI: N/A · RCT: Yes | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | No | No | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |