Probiotic Selection Guide
Do not index
Do not index
Probiotics are beneficial bacteria that help combat pathogenic species. There are different kinds of probiotic species available with varying degrees of efficacy.
Bristle Health testing helps you select & recommend the best type of probiotic for your patient based on the pathogenic bacteria in their sample.

Probiotic selection tags

  1. Review the Report: Navigate to the “Detailed Results” section to see the full list of detected microbes associated with specific conditions.
  1. Probiotic Sensitivity Tag: Each pathogenic bacterium will include a tag indicating which probiotic strain is most effective. Note that not all harmful bacteria are responsive to probiotics.
notion image

Put it into practice

Below is an example from a Bristle Health report, showing the detected periodontal pathogens:
  1. Prioritize Major Pathogens: Focus on the highest contributing pathogens, highlighted in red.
  1. Summarize Findings: Determine the required probiotics. For instance:
    1. 4 out of 6 bacteria are sensitive to Reuterin.
    2. 1 out of 6 bacteria is sensitive to Saliviricin.
    3. 1 out of 6 bacteria is non-responsive to probiotics.
notion image

Making Recommendations

Based on the results, probiotics containing L. reuteri and S. salivarius will best address the periodontal pathogens. Recommend either a single probiotic that includes both strains (if available) or two separate probiotics, each containing one strain.
If prioritization is necessary, L. reuteri should be selected as it addresses more high-priority pathogens.

Finding the right probiotic brand

Once we’ve identified the most effective strains, the next step is to select the correct product. You can use the table below to see which brands contain related probiotic strains!
Using the example above, look for the probiotics that contain L. reuteri and S. salivarius.
notion image

Learn more about each strain

S. salivarius
Streptococcus salivarius is a commensal bacterium that is a normal part of the oral microbiome and has a beneficial role in promoting oral health and preventing pathogenic bacteria from colonizing the oral cavity. Research suggests that certain strains of S. salivarius, particularly K12 and M18, may be particularly effective at treating halitosis, and reducing bacterial species that coat the tongue and gum inflammation.
One of the ways in which S. salivarius may promote oral health is through competing with pathogenic species of bacteria for space and resources in the oral cavity. This can help to prevent the growth and colonization of harmful bacteria that contribute to gum inflammation and periodontal disease. In addition, S. salivarius produces bacteriocins, which are antimicrobial peptides that can kill other bacteria in the oral microbiome. These bacteriocins are effective against a wide range of pathogenic bacteria, including those associated with gum disease and halitosis.
S. salivarius may also help to modulate the immune response in the oral cavity, which can further reduce inflammation and promote healing of the gums. In one study, researchers found that individuals with periodontal disease who received treatment with S. salivarius K12 experienced significant reductions in levels of inflammatory markers in their saliva.
L. reuteri
Lactobacillus reuteri is a probiotic bacteria that produces reuterin, a bacteriocin (an antibiotic made by bacteria) that can kill the anaerobic bacteria that cause gum inflammation. Lactobacillus reuteri most likely does not colonize the oral cavity, but exerts its activity transiently through producing bacteriocins.
Studies have suggested that L. reuteri can help to maintain a healthy balance of bacteria in the mouth by inhibiting the growth of harmful bacteria that can contribute to oral health problems such as tooth decay and gum disease. L. reuteri has also been found to help prevent the formation of dental plaque and reduce inflammation in the gums. Some studies have also suggested that L. reuteri can help to stimulate the growth of other beneficial bacteria in the oral microbiome.
L. paracasei
Lactobacillus paracasei SD1 has been shown to reduce the progression of cavities, and may improve remineralization of early tooth decay. This probiotic species may have more beneficial effects in cases for people with high abundance of Streptococcus mutans. Research is still being done to determine their effects on other bacterial species like Streptococcus sobrinus or Scardovia wiggsiae. Interestingly, L paracasei does not need to colonize the oral cavity to exert its effects. This species produces a bacteriocin called Paracaseicin that can kill other potentially harmful species, and improve oral microbiome health.
B. lactis
Bifidobacterium lactis has been clinically studied for its beneficial effects on reducing inflammation, in both the gut and mouth. B. lactis as an oral probiotic can also reduce levels of gum inflammatory pathogens, such as T. forsythia and P. gingivalis. B. lactis also produces compounds that can prevent P. gingivalis from colonizing the gum line.
L. salivarius
Lactobacillus salivarius is a well studied probiotic species that improves oral health. Clinical trials have shown beneficial effects of L. salivarius on halitosisgum disease, and tooth decay. L. salivarius produces potent bacteriocins that can broadly kill pathogenic species that cause oral disease. Additionally, it can help to tune the immune system, potentially reducing chronic inflammation.
L. plantarum
In several clinical trials, Lactobacillus plantarum has been shown to improve both the oral microbiome and clinical parameters of halitosis and gingivitis. L. plantarum can help reduce pathogens at the gum line such as Tannerella forsythia, which can cause both halitosis and gum inflammation. Lactobacillus plantarum produces compounds called plantaricins, which can kill other microorganisms, even Candida.

Join 100+ Dental Practices reinventing oral health!

Join our Provider Program to implement oral microbiome testing through your office. Use root-cause insights to guide functional care.

Join Now