Benefits of Greek Yogurt in the Oral Cavity

Jacqueline A Martinez

Lamar Institute of Technology

DHYG 2301: Dental Hygiene Care

Lori Rogers

April 11, 2024

 Benefits of Greek Yogurt in the Oral Cavity

Greek yogurt is commonly known for having probiotics, these findings show that those same

probiotics can assist in reducing bacteria in the oral cavity. Recent studies have shown

microorganisms found in Greek yogurt, such as Lactobacillus, can inhibit bacteria commonly

found in caries and periodontitis. Moreover, Greek yogurt was shown to regulate and increase

pH in the oral cavity, which inhibited bacterial growth as it did not have an acidic environment to

thrive in. With these findings Greek yogurt could be recommended to a patient’s dietary habits,

along with proper hygiene care, for additional bacterial reduction in the oral cavity. As medical

professionals, it is important to understand alternate methods of treatment for patients and as oral

health professionals, we must understand that patients' diet is a contributing factor to poor oral

health. We hope to inform dentists and dental hygienists on the positive effects of Greek yogurts

probiotics in the oral cavity to further improve oral home care education amongst patients.

I. What are Probiotics?

Probiotics are live microorganisms that are already living in our body and provide health

benefits. FAO/WHO has defined probiotics as microorganisms that grant health benefits beyond

basic nutrition when administered in adequate amounts. They are mainly known for residing in

the gut and when increasing the amount of probiotic consumption, helps gut health. Probiotics

such as Lactobacillus, Bifidobacterium, and Lactococcus species are the most well studied

species with Lactococcus commonly being found in the gut and Lactobacillus strains commonly

being found in many yogurts and other fermented foods (Cornacchione et al., 2019). FAO/WHO

has also determined many Lactobacillus strains are Generally Recognized As Safe (GRAS) by

the U.S Food and Drug Administration (FDA). However, before the FDA could approve the use
of probiotics, studies and research had to have been conducted to discover the purpose of

probiotics.

II. History of Probiotics

The term probiotic was first used by Lilly and Stillwell in 1965 and was brought about in

contrast to the term antibiotic. At the time, it was used to describe “substances secreted by one

microorganism which, when administered in adequate amounts, confer a health benefit on the

host,” (Agrawal et al., 2012). However, probiotics have been used long before this. According to

the Probiotics and Oral Health article, the use of microorganisms can be traced back to the

classical Roman literature; and in a Persian version of the Old Testament, it states that ‘Abraham

owed his longevity to the consumption of sour milk,’ (Bhaskar et al., 2015). As stated in the

previous paragraph, fermented foods contain probiotics that grant health benefits, meaning

Abraham was practicing the use of probiotics through consumption. In 1894 Elie Metchnikoff, a

Ukrainian-born 1908 Nobel prize laureate, was possibly the first to propose fermented dairy

products had beneficial properties by showing that cholera could be prevented by antagonistic

organisms in the intestine (Bhaskar et al., 2015). In the first decade of 1900, Metchnikoff had

discovered Lactobacillus bulgaricus and dedicated the last decade of his life to studying the

lactic-acid producing bacteria to increase human longevity (Bhaskar et al., 2015). In 1984 Hull

identified the first probiotic species Lactobacillus acidophilus and in 1994 WHO described

probiotics as the next most important in the immune defense system following antibiotic

resistance (Bhaskar et al. 2015). Without these amazing discoveries, we would not have the

probiotics to aid in our health today.

III. MOA
 The mechanism of action of Greek yogurt in the oral cavity works in a number of ways.

Probiotics cling to the oral cavity and begin to protect and prevent pathogens from sticking to the

teeth, gum tissue, and other surfaces inside. In short, the probiotics form a protective film over

the teeth that prevent pathogens from adhering to and causing an acid attack or from disrupting

the oral cavity. Probiotics also work as a passive local immunization against caries by using

antibodies and decreasing the number of Streptococci (Agrawal et al, 2012). Bacteriocins are

antimicrobial proteins that the probiotic, Lactobacilli, uses to obstruct the expansion of other

bacteria in the oral cavity. In addition, the enzymatic activity of pyruvate oxidase, involved with

not just one but multiple of the Lactobacillus strains, produces hydrogen peroxide which works

as a protective feature by obstructing Listeria monocytogenes, Staphylococcus aureus, and

Pseudomonas species which are microorganisms that can cause diseases (Cornacchione et al.,

2019). Therefore, probiotics work antagonistically as they kill and inhibit the growth of

pathogenic bacteria. Probiotics use direct interaction, competitive exclusion, and modulation of

host immune responses which all allow probiotics to act in favor of protecting the oral cavity

against harmful pathogens. Direct interaction between the probiotics and the bacteria is how the

diseases are less likely to surface. Competitive exclusion uses helpful microorganisms to

compete with pathogenic bacteria for substrates available in the oral cavity to thrive in the

environment. This causes the pathogenic bacteria to have nothing to adhere to or thrive on,

eventually leading to their demise. Probiotics also use the modulation of host immune responses

by working alongside the immune system to prevent any harmful diseases (Agrawal et al, 2012).

IV. Positive effects shown through studies and Adverse Effects

Probiotics have been shown to have more positive than negative effects in the oral cavity.

Just as xylitol is known to help prevent tooth decay and inhibits the growth of harmful bacteria,
the probiotics in Greek yogurt has proven to be nearly just as effective, thanks to its similar

antibacterial effect on plaque and salivary bacteria (Shaalen et al, 2021). A study was done by

Hadier Gad, Mona Riad, and Omar Shaalan in which 96 high caries risk geriatric patients were

split into two equal randomized groups. One group was given probiotic yogurt once per day and

the other received xylitol chewing gum three times per day. This study lasted 3 months and as a

result proved that the probiotics in yogurt were just as effective as xylitol gum in reducing

salivary bacteria count and plaque bacteria count. In addition, the study also showed that the

group that consumed the yogurt had an overall higher pH, ranging from 7.4 to 7.6, than the group

who chewed xylitol gum which ranged from 7.3 to 7.5. This information is significant as acids

will start to break down enamel in a 5.5 pH environment. Furthermore, the probiotic group had

significantly less plaque adherence than the xylitol group after the three months. This study is

beneficial as xylitol gum is a common recommendation in the dental setting. Perhaps if

additional factors were added to the greek yogurt, such as mechanical factors like crunchy fruits,

the probiotics and mechanical factors could work together to be more effective than xylitol gum.

Moreover, although research is minimal so far, probiotics have been shown to interfere with

chromosomes and DNA damage which are responsible for oral cancer. In addition to its

anticancer properties, probiotics work as a treatment for gut and mouth halitosis. (Bhaskar et al,

2015). Probiotics can even help lower blood pressure and cholesterol which can overall improve

the body’s function and health. (Bhaskar et al, 2015). While these are just a few of the numerous

positive effects of probiotics, some negative effects include stomach bloating and gas which can

leave a person feeling uncomfortable. On a more serious note, people with underlying health

issues can catch infections caused from the probiotics thanks to the characteristic of it
heightening and stimulating the immune system and some strains of Lactobacilli can cause a rare

case of bacteremia (Bhaskar et al, 2015).

V. Conclusion

Probiotics offer many positive effects and minimal adverse reactions in the oral cavity.

This live bacterium is a more natural method that fights the disease causing bacteria that can

cause caries and other negative effects that cause long term damage to the mouth. It acts in

several different effective ways to maintain good health such as inhibiting the adhesion of plaque

and caries bacteria and regulating or increasing the pH of the mouth. The studies provided also

showed that the Greek yogurt probiotics were just as effective as xylitol gum. With these

findings Greek yogurt could be recommended to a patient’s dietary habits just as xylitol gum is

recommended. We hope to inform dentists and dental hygienists on the positive effects of greek

yogurts probiotics in the oral cavity to further improve the oral health of patients.
 References

Agrawal, Vineet, Sonali Kapoor, and Nimisha Shah. 2012. “Role of ‘Live Microorganisms’
(Probiotics) in Prevention of Caries: Going on the Natural Way Towards Oral Health.”
Indian Journal of Multidisciplinary Dentistry 2(3):491–96. Retrieved November 20, 2023
(https://www.researchgate.net/publication/267392145_Role_of_’Live_Microorganisms’_P
robiotics_in_Prevention_of_Caries_Going_on_the_Natural_Way_Towards_Oral_Health/
citation/download).

Bhaskar, Dara John, Monika Kalra, Himanshu Punia, and Vikas Jinghala. 2015. “Probiotics and
Oral Health.” Journal of Contemporary Dentistry 5(2):104–6. Retrieved November 20,
2023 (https://www.researchgate.net/publication/281176097_Probiotics_and_Oral_Health).

Cornacchione, Louis P., Brian A. Klein, Margaret J. Duncan, and Linden T. Hu. 2019.
“Interspecies Inhibition of Porphyromonas Gingivalis by Yogurt-Derived Lactobacillus
Delbrueckii Requires Active Pyruvate Oxidase.” Applied and Environmental Microbiology
85(18). Retrieved November 20, 2023
(https://journals.asm.org/doi/full/10.1128/aem.01271-19).

Mahmoud Ahmed Gad, Hadier, Mona Ismail Riad, and Omar Shaalan. 2021. “Comparison of
Antibacterial Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gum in Geriatric
Patients: A Randomized Controlled Clinical Trial.” Acta Stomatologica Croatica
55(4):380–89. Retrieved November 20, 2023
(https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8734452/).