Randomised clinical trial of the probiotic BLIS M18 (Streptococcus salivarius) on the post-radiotherapy oral microbiome and periodontal health

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Radiotherapy to the head and neck region permanently damages salivary glands, resulting in a decrease in salivary flow that manifests as a dry mouth. Post-radiotherapy, head and neck cancer patients suffer long-term changes to the oral environment, including a reduction in salivary flow that results in a loss of salivary buffering capacity. Ultimately, an increase in bacterial load and alteration of the bacterial community structure potentially have negative effects on the patient’s oral health. Oral probiotics have been successfully shown to improve oral health, particularly in terms of reducing periodontal inflammation. The benefits of gut probiotics are well documented and include modulation of immune responses and metabolic effect – therefore, the potential mechanisms of oral probiotic action are hypothesised to be similar to those seen in the intestines: antagonism against pathogens and the reduction of inflammation and tissue destruction. Hence, this pilot study proposes that the provision of Streptococcus salivarius in the form of an oral probiotic (BLIS M18) post-radiotherapy treatment may favorably alter the composition of the oral microbial community, reducing periodontal inflammation and improving oral health.

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