Non-Cochrane · intervention · PM41969406
The effects of probiotics intervention on oral health outcomes: a comprehensive umbrella review of meta-analyses.
Tang Zhen, Deng Yunzhen, Guo Gang, et al. · Frontiers in oral health · 2026 · PubMed · doi:10.3389/froh.2026.1768508
Findings
36 findings
| Population | ||||
|---|---|---|---|---|
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Chen 2023; Lactobacillus, Bifidobacterium, Streptococcus; baseline S. mutans <10^5 | RR 2.05 [1.54, 2.72] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Chen 2023; Lactobacillus, Bifidobacterium, Streptococcus; baseline Lactobacillus >10^6 | RR 0.67 [0.34, 1.3] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Shi 2022; Lactobacillus, Bifidobacterium, Streptococcus; baseline S. mutans <10^5 | RR 0.63 [0.5, 0.8] GRADE not reported 6 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Chen 2023; Lactobacillus, Bifidobacterium, Streptococcus; baseline Lactobacillus <10^5 | RR 1.28 [0.93, 1.77] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus, Bifidobacterium, Streptococcus | SMD -0.24 [-0.39, -0.1] GRADE not reported 8 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus, Bifidobacterium, Streptococcus | RR 0.7 [0.54, 0.91] GRADE not reported 10 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Shi 2022; Lactobacillus, Bifidobacterium, Streptococcus; baseline S. mutans >10^5 | RR 1.6 [1.1, 2.34] GRADE not reported 6 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: mixed Lactobacillus, Bifidobacterium and Streptococcus strains | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Chen 2023; Lactobacillus, Bifidobacterium, Streptococcus; baseline S. mutans >10^5 | RR 0.48 [0.28, 0.83] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus paracasei | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus paracasei | RR 0.82 [0.45, 1.5] GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus paracasei | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus paracasei | SMD -0.16 [-0.33, 0.01] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus rhamnosus | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus rhamnosus | RR 0.62 [0.45, 0.87] GRADE not reported 4 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus rhamnosus | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Lactobacillus rhamnosus | SMD -0.41 [-0.6, -0.21] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Bifidobacterium | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Hao 2021; Bifidobacterium | SMD -0.07 [-0.39, 0.26] GRADE not reported 8 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Bifidobacterium | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Hao 2021; Bifidobacterium | RR 0.53 [0.17, 1.66] GRADE not reported 4 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Bifidobacterium | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Hao 2021; Bifidobacterium | RR 0.87 [0.59, 1.29] GRADE not reported 3 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Bifidobacterium | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Hao 2021; Bifidobacterium | SMD -0.32 [-0.67, 0.04] GRADE not reported 4 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Bifidobacterium | Placebo, no intervention or standard oral care | Dental caries incidence/progression Source meta-analysis: Meng 2023; Bifidobacterium | RR 0.86 GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Meng 2023; Lactobacillus | RR 0.62 [0.51, 0.74] GRADE not reported 4 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Shi 2022; Lactobacillus; baseline Lactobacillus >10^5 | RR 0.58 [0.27, 1.23] GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Shi 2022; Lactobacillus | SMD 1.19 [0.46, 1.92] GRADE not reported 6 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Shi 2022; Lactobacillus; baseline Lactobacillus <10^5 | RR 2.01 [1.42, 2.83] GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: Lactobacillus and Bifidobacterium | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Shi 2022; Lactobacillus, Bifidobacterium | SMD -1.17 [-1.85, -0.5] GRADE not reported 10 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: Lactobacillus and Bifidobacterium | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Tovalino 2024; No subgroup in Table 3; strains from Table 1: Lactobacillus/Bifidobacterium | SMD -0.4 [-0.57, -0.24] GRADE not reported 11 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: Lactobacillus and Bifidobacterium | Placebo, no intervention or standard oral care | Streptococcus mutans count Source meta-analysis: Meng 2023; Lactobacillus, Bifidobacterium | SMD -0.16 [-0.33, 0.01] GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: Lactobacillus and Bifidobacterium | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Meng 2023; Lactobacillus, Bifidobacterium | SMD -0.12 [-0.61, 0.37] GRADE not reported 2 studies |
| Children, youth and orthodontic patients (caries and cariogenic bacteria outcomes) | Oral probiotics: Lactobacillus and Bifidobacterium | Placebo, no intervention or standard oral care | Lactobacillus count Source meta-analysis: Tovalino 2024; No subgroup in Table 3; strains from Table 1: Lactobacillus/Bifidobacterium | SMD -0.78 [-1.65, 0.09] GRADE not reported 6 studies |
| Adults with halitosis | Oral probiotics: Lactobacillus, Weissella cibaria and Streptococcus | Placebo, no intervention or standard oral care | Halitosis, organoleptic score (OLP) <4 weeks · Source meta-analysis: Huang 2022; Lactobacillus, Weissella cibaria, Streptococcus | SMD -0.58 [-0.87, -0.3] GRADE not reported 5 studies |
| Adults with halitosis | Oral probiotics: Lactobacillus, Weissella cibaria and Streptococcus | Placebo, no intervention or standard oral care | Halitosis, volatile sulfur compounds (VSC) <4 weeks · Source meta-analysis: Huang 2022; Lactobacillus, Weissella cibaria, Streptococcus | SMD -0.42 [-1, 0.17] GRADE not reported 6 studies |
| Adults with halitosis | Oral probiotics: Lactobacillus, Weissella cibaria and Streptococcus | Placebo, no intervention or standard oral care | Halitosis, organoleptic score (OLP) Source meta-analysis: Offenbacher 2024; Lactobacillus, Streptococcus, Weissella species (strains from Table 1) | SMD 1.85 [-0.77, 4.47] GRADE not reported 3 studies |
| Adults with halitosis | Oral probiotics: Lactobacillus, Weissella cibaria and Streptococcus | Placebo, no intervention or standard oral care | Halitosis, volatile sulfur compounds (VSC) Source meta-analysis: Offenbacher 2024; Lactobacillus, Streptococcus, Weissella species (strains from Table 1) | SMD 2.29 GRADE not reported 4 studies |
| Adults with halitosis | Oral probiotic Weissella cibaria | Placebo, no intervention or standard oral care | Halitosis, volatile sulfur compounds (VSC) >4 weeks · Source meta-analysis: Huang 2022; Weissella cibaria | SMD -0.49 [-1.04, 0.06] GRADE not reported 2 studies |
| Adults with halitosis | Oral probiotics: Lactobacillus and Weissella cibaria | Placebo, no intervention or standard oral care | Halitosis, organoleptic score (OLP) >4 weeks · Source meta-analysis: Huang 2022; Lactobacillus, Weissella cibaria | SMD -0.45 [-0.85, -0.03] GRADE not reported 2 studies |
| Adults with halitosis | Oral probiotics: Weissella cibaria and Streptococcus | Placebo, no intervention or standard oral care | Halitosis, total (OLP and VSC) Source meta-analysis: Valverde 2022; Weissella cibaria, Streptococcus | SMD 0.08 [-0.16, 0.31] GRADE not reported 4 studies |
| Adults with halitosis | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Halitosis, total (OLP and VSC) Source meta-analysis: Yoo 2019; Lactobacillus | SMD -0.98 [-2.25, 0.3] GRADE not reported 6 studies |
| Adults with halitosis | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Halitosis, organoleptic score (OLP) Source meta-analysis: Yoo 2019; Lactobacillus | SMD -1.93 [-2.85, -1.02] GRADE not reported 3 studies |
| Adults with halitosis | Oral probiotic Lactobacillus (genus level) | Placebo, no intervention or standard oral care | Halitosis, volatile sulfur compounds (VSC) Source meta-analysis: Yoo 2019; Lactobacillus | SMD -0.02 [-2.12, 2.07] GRADE not reported 3 studies |
Included primary studies 11
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| He 2023 Clinical interventions with various agents to prevent early childhood caries: A systematic review with network meta-analysis. PMID:36718540 | 2023 | 1 other review | not stated | not extracted yet |
| Chen 2023 Effects of probiotics on the oral health of patients undergoing orthodontic treatment: a systematic review and meta-analysis. PMID:37552088 | 2023 | this review only | not stated | not extracted yet |
| Gruner 2016 Probiotics for managing caries and periodontitis: Systematic review and meta-analysis. PMID:26965080 | 2016 | this review only | not stated | not extracted yet |
| Hao 2021 Effectiveness and safety of Bifidobacterium in preventing dental caries: a systematic review and meta-analysis. PMID:33956564 | 2021 | this review only | not stated | not extracted yet |
| Huang 2022 Efficacy of probiotics in the management of halitosis: a systematic review and meta-analysis. PMID:36600415 | 2022 | this review only | not stated | not extracted yet |
| Lopez-Valverde 2022 Role of Probiotics in Halitosis of Oral Origin: A Systematic Review and Meta-Analysis of Randomized Clinical Studies. PMID:35127785 | 2021 | this review only | not stated | not extracted yet |
| Mayta-Tovalino 2024 Efficacy of Probiotic Consumption on Oral Outcomes in Children and/or Adolescents: A Meta-Analysis. PMID:39025745 | 2024 | this review only | not stated | not extracted yet |
| Meng 2023 Effects of probiotics on preventing caries in preschool children: a systematic review and meta-analysis. PMID:36890746 | 2023 | this review only | not stated | not extracted yet |
| Offenbacher 2024 The Influence of Probiotics in Halitosis and Cariogenic Bacteria: A Systematic Review and Meta-Analysis DOI:10.3390/app14156639 | 2024 | this review only | not stated | not extracted yet |
| Shi 2022 Efficacy of probiotics against dental caries in children: a systematic review and meta-analysis. PMID:35607893 | 2023 | this review only | not stated | not extracted yet |
| Yoo 2017 The Effect of Probiotics on Halitosis: a Systematic Review and Meta-analysis. PMID:29168154 | 2019 | 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 |
|---|---|---|
| Fluoride Varnish for Caries Prevention in Preschoolers: An Overview of Reviews. (2026) | 1 | 0.04 |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Children and adults with normal or impaired oral health | Participants from infancy to adulthood, mean or median age 0.2 to 42.5 years (11 meta-analyses) |
| Intervention | Oral probiotic supplementation | Probiotics (Lactobacillus, Bifidobacterium, S. salivarius, Streptococcus, Weissella cibaria), doses about 5 x 10^5 to 5 x 10^10 CFU |
| Comparison | Placebo, no intervention or standard oral care | Placebo, no intervention or standard care |
| Outcomes | Streptococcus and Lactobacillus counts, halitosis measures, caries incidence or progression | Streptococcus count (4 to 5 meta-analyses), Lactobacillus count (4 to 5), halitosis OLP and VSC (3 to 4), dental caries incidence or progression (3) |
| Study designs | Meta-analyses of clinical trials; in vitro, in vivo, ex vivo, case reports, quasi-experimental studies, RCTs and low-quality meta-analyses excluded | Meta-analyses of controlled trials (n=11) |
| Timing | Not specified | Durations 7 days to 24 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 | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | No | No | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | No | yes |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | No | No | 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: N/A | NRSI: N/A · RCT: No | no |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: N/A · NRSI: N/A | NRSI: N/A · RCT: N/A | no |
| 12Impact of risk of bias on the pooled results | N/A | N/A | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | No | no |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | N/A | N/A | yes |
| 16Conflicts of interest reported | Yes | Yes | yes |
| Overall | Critically Low | Critically Low | yes |