AUTHOR=Han Hee-seung , Yum Haeji , Cho Young-Dan , Kim Sungtae 

TITLE=Improvement of halitosis by probiotic bacterium Weissella cibaria CMU: A randomized controlled trial

JOURNAL=Frontiers in Microbiology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2023.1108762

DOI=10.3389/fmicb.2023.1108762

ISSN=1664-302X

ABSTRACT=<p>Several <italic>in vitro</italic> and <italic>in vivo</italic> studies have evaluated the effect of probiotics on oral health; however, human clinical studies are still limited. Therefore, this study aimed to examine the effects of <italic>Weissella cibaria</italic> Chonnam Medical University (CMU)-containing tablets on halitosis. This randomized, double-blinded, placebo-controlled study included 100 adults with halitosis (age, 20–70 years). The participants were randomly assigned to the test group (<italic>n</italic> = 50) and control group (<italic>n</italic> = 50). One tablet [1 × 10<sup>8</sup> colony forming units (CFU)/tablet] was to be taken each day over 8 weeks. The concentrations of volatile sulfur compounds (VSCs), bad breath improvement scores, and oral colonization of <italic>W. cibaria</italic> were measured. Psychosocial indicators including depression, self-esteem, oral health-related quality of life, and subjective oral health status were evaluated. Most variables were assessed at baseline, 4, and 8 weeks, and <italic>W. cibaria</italic> number and safety variables were assessed at baseline and 8 weeks. Intergroup comparisons were carried out using Student’s <italic>t</italic>-test, Chi-square test, or Fisher’s exact test on per-protocol analysis. Intragroup differences before and after intake were analyzed using the linear mixed-effect model (LMM). Per-protocol analysis was carried out in the test group (<italic>n</italic> = 45) and control group (<italic>n</italic> = 46). Total VSC was significantly lower in the probiotics group than in the placebo group at baseline (week 0, <italic>p</italic> = 0.046) and at 8 weeks (<italic>p</italic> = 0.017). The sum of hydrogen sulfide and methyl mercaptan did not differ significantly between the groups at baseline; however, it was significantly lower in the probiotics group than in the placebo group at week 8 (<italic>p</italic> = 0.012). Bad breath improvement (BBI) scores were significantly reduced at week 8 (<italic>p</italic> = 0.006) in the probiotics group. Statistically significant intergroup differences were observed for changes in the level of <italic>W. cibaria</italic> at week 8 (<italic>p</italic> &lt; 0.001). Psychological indicators significantly improved from baseline to week 8 in the probiotics group. No safety issues were observed in either group. The levels of <italic>W. cibaria</italic> was higher in patients with halitosis using <italic>W. cibaria</italic> CMU-containing tablets. The subjective degree of bad breath and psychological indicators were improved in patients with halitosis using <italic>W. cibaria</italic> CMU-containing tablets.</p>