Modulation of Oral Microbiome by Probiotics and Prebiotics in Periodontal Disease Management

AbstractPeriodontal disease is a chronic inflammatory condition initiated by dysbiosis of the oral microbiome, leading to progressive destruction of the supporting tooth structures. Current management strategies emphasize not only reducing pathogenic biofilms but also restoring microbial balance. Probiotics live microorganisms that provide health benefits when administered in sufficient amounts have emerged as a promising adjunctive therapy in periodontics. Specific strains, particularly Lactobacillus and Bifidobacterium, have demonstrated the ability to reduce periodontopathogen load, modulate host immune responses and lower proinflammatory markers. Clinical studies suggest that probiotics can improve periodontal outcomes by reducing plaque accumulation, halitosis, pocket depth, and attachment loss. Moreover, when combined with prebiotics, their efficacy may be enhanced by promoting the growth and activity of beneficial microbial species. Despite encouraging evidence, further well-designed trials are required to establish standardized protocols, optimal strains, and long-term benefits of probiotics in periodontal therapy.