Oral probiotics reduce halitosis in patients wearing orthodontic braces: a randomized, triple-blind, placebo-controlled trial. Effects of probiotic Lactobacillus salivarius WB21 on halitosis and oral health: an open-label pilot trial. Probiotic dietary supplementation in patients with stage 3 and 4 chronic kidney disease: a 6-month pilot scale trial in Canada Impact of Chlorhexidine Pretreatment Followed by Probiotic Streptococcus salivarius Strain K12 on Halitosis in Children: A Randomised Controlled Clinical Trial. Probiotics in Treatment of Allergic Rhinitis Effect of Probiotics on Lipid Profile, Glycemic Control, Insulin Action, Oxidative Stress, and Inflammatory Markers in Patients with Type 2 Diabetes: A Clinical Trial Efficacy of local use of probiotics as an adjunct to scaling and root planing in chronic periodontitis and halitosis: A randomized controlled trial Effects of probiotic on intestinal mucosa of patients with ulcerative colitis. Probiotic administration among free-living older adults: a double blinded, randomized, placebo-controlled clinical trial Effect of alive probiotic on insulin resistance in type 2 diabetes patients: Randomized clinical trial. A double-blind, placebo-controlled, randomized human study assessing the capacity of a novel galacto-oligosaccharide mixture in reducing travellers' diarrhoea Effect of Probiotic Yogurt and Xylitol-Containing Chewing Gums on Salivary S Mutans Count. Randomized clinical trial on the effect of a multispecies probiotic on visceroperception in hypersensitive IBS patients. A Multi-strain Probiotic Reduces the Fatty Liver Index, Cytokines and Aminotransferase levels in NAFLD Patients: Evidence from a Randomized Clinical Trial. Effects of probiotics on serum levels of Th1/Th2 cytokine and clinical outcomes in severe traumatic brain-injured patients: a prospective randomized pilot study The effects of probiotic supplement on hemoglobin in chronic renal failure patients under hemodialysis: A randomized clinical trial Effect of Probiotic Bacteria on Oral Candida in Frail Elderly
Orthodontic braces can impede oral hygiene and promote halitosis . The aim of the study was to investigate the effect of the oral probiotic Streptococcus salivarius M18 on oral hygiene indices and halitosis in patients wearing orthodontic braces . The study was a prospect i ve , r and omized , triple-blind , placebo-controlled trial . Patients undergoing fixed orthodontic treatment were r and omly allocated to a probiotic group  ( n = 32 ) and a placebo group ( n = 32 ) . Patients consumed 2 lozenges d-1 for one month . Assessment s were taken at baseline , at the end of the intervention , and at a 3 month follow-up . The outcome measures were plaque index ( PI ) , gingival index ( GI ) and halitosis-causing volatile sulfur compound ( VSC ) levels . The dental biofilms before and after the intervention were analyzed utilizing next-generation sequencing of bacterial 16S rRNA genes . PI and GI scores were not significantly influenced by the probiotic intervention ( intervention × time : p > 0.05 ) . The level of VSCs decreased significantly in both the probiotic group ( VSC reduction = -8.5 % , 95%CI = -7.4 % to -9.1 % , p = 0.015 ) and the placebo group ( -6.5 % , 95%CI = -6.0 % to -7.4 % , p = 0.039 ) after 1 month intervention . However , at the 3 month follow-up , the VSC levels in the placebo group returned to baseline levels whereas those in the probiotic group decreased further ( -10.8 % , 95%CI = -10.5 % to -12.9 % , p = 0.005 ) . Time , but not treatment , was associated with the decrease in microbial community alpha diversity and a modest effect on beta diversity . Oral probiotic S. salivarius M18 reduced the level of halitosis in patients with orthodontic braces , but had minimal effects on PI , GI and dental biofilm microflora OBJECTIVE The objective of this study was to evaluate whether oral administration of lactobacilli alters the degree of halitosis and clinical conditions associated with halitosis . STUDY DESIGN Twenty patients with genuine halitosis were given 2.0 x 10(9)Lactobacillus salivarius WB21 and xylitol in tablet form daily .  Oral malodor and clinical parameters were evaluated at the same time of day for each patient after 2 and 4 weeks . RESULTS All 20 patients were positive for L. salivarius DNA in their saliva at 2 weeks , although 12 patients were negative for this organism at baseline . Oral malodor parameters significantly decreased at 2 weeks in the subjects with physiologic halitosis . The scores of an organoleptic test and bleeding on probing significantly decreased at 4 weeks in the subjects with oral pathologic halitosis . CONCLUSIONS Oral administration of probiotic lactobacilli primarily improved physiologic halitosis and also showed beneficial effects on bleeding on probing from the periodontal pocket ABSTRACT Aim : This was a pilot clinical trial to assess biochemical and clinical effects of an oral probiotic dietary supplement in chronic kidney disease ( CKD ) patients ( stages 3 and 4 ) . Methods : A prospect i ve , r and omized , double-blind , crossover , placebo-controlled , 6-month trial of probiotic bacteria was conducted in 16 out patients in Ontario , Canada . Primary endpoints included effect on hematologic , biochemical , and fecal variables , and on general well-being as assessed by quality of life ( QOL ) . These outcomes were evaluated from biochemical parameters , mainly blood urea nitrogen ( BUN ) , creatinine , uric acid , and C-reactive protein ( CRP ) as a general inflammatory marker . QOL was assessed on a subjective scale of 1 to 10 as the secondary parameter . Trial registration : This pilot study forms part of registered trial NCT00760162 . Results : A total of 13 patients completed the study . Three patients dropped out : one was the receiver of a transplant . The second dropped out for unknown reasons and the third died of myocardial infa rct ion ( unrelated to probiotic bacteria or the protocol ) . Among the 13 patients who completed the trial , the mean change in BUN concentration during the probiotic treatment period ( −2.93 mmol/L ) differed significantly ( p = 0.002 ) from the mean change in BUN concentration during the placebo period ( 4.52 mmol/L ) . In addition , the mean changes in uric acid concentration were moderate during the KB period ( 24.70 μmol/L ) versus during the placebo period ( 50.62 μmol/L , p = 0.050 ) , and the changes in serum creatinine concentration were insignificant . Neither gastrointestinal nor infectious complications were noted in any subject with improved QOL . Conclusion : Orally administered probiotic bacteria selected to metabolize nitrogenous wastes may be tolerated for as long as 6 months . A major limitation of this trial is its small size that may have precluded detection of changes in other biochemical or hematologic parameters that would be evident in larger cohorts . Extension of the evaluation of this probiotic bacterial mixture will include a dose escalation trial in a similar prospect i ve , placebo-controlled , and double-blind study site PURPOSE The aim of this study was to examine the effect of chlorhexidine disinfection , as a chemical method of oral hygiene practice , and subsequent use of probiotics on  halitosis in children . The effects of mechanical and chemical oral hygiene practice methods on the severity of halitosis were also assessed . MATERIAL S AND METHODS 208 children with organoleptic test ( OLT ) scores of 2 or more were r and omly assigned to four groups : A : conventional oral hygiene practice s ( COH ) including toothbrushing and flossing ; B : COH + tongue scraping ( TS ) ; C : COH + TS + chlorhexidine ; D : COH + TS + chlorhexidine + probiotics . OLT was performed at 1-week and 3-month follow-ups . RESULTS A significant and stable number of participants showed major and moderate levels of improvement in OLT scores in group D ( p < 0.001 ) . The improvement of OLT scores in group C was also significant ( p < 0.001 ) , but not stable over the follow-ups ( p = 0.44 ) . Neither significant nor stable improvements in the OLT scores were detected in groups A and B through follow-ups ( p > 0.05 ) . CONCLUSION Probiotic therapy following oral disinfection with chlorhexidine may reduce the severity of halitosis over longer periods Many r and omized controlled trials ( RCTs ) have been done on role of probiotics as a treatment modality in allergic rhinitis . We conducted a review on the same . A systematic search of published literature was done . RCTs comparing effect of probiotics with placebo were included . A predefined set of outcome measures were assessed . Continuous data were expressed as pooled st and ardized mean difference ( SMD ) with 95 % confidence interval ( CI ) . Dichotomous data were expressed as odds ratio with 95 % CI . P value < 0.05 was considered significant . RevMan version 5 was used for all the analyses . Seven RCTs were eligible for inclusion .  Probiotic intake  improved quality of life score in patients with allergic rhinitis [ SMD -1.17 ( 95 % CI -1.47 , -0.86 ; P < 0.00001 ) ] . Other parameter that improved with probiotic intake was decrease in the number of episodes of rhinitis per year . There was no significant change in blood or immunologic parameters in the probiotic group , SMD -0.10 ( 95 % CI -0.26 , 0.06 ; P = 0.22 ) . Adverse events were not significant . Probiotic therapy might be useful in rhinitis , but the present data do not allow any treatment recommendations Background : The dramatic increase in the incidence of diabetes and its associated complications require a natural and safe solution to control and delay such complications . The present study tested the hypothesis that probiotics may affect biochemical indices of diabetic patients Methods : Thirty four types 2 diabetic patients aged between 25 to 65 years , and diagnosed with diabetes for less than 15 years were selected for this single- blinded clinical trial . Using balanced block r and om sampling , the patients were divided into two groups of intervention ( probiotics ) and placebo . Blood sample s tested for baseline glucose , insulin , TG , total cholesterol , LDL-C , HDL-C , malondialdehyde , high sensitive CRP ( hs-CRP ) and IL-6 . After six weeks of experiment , fasting blood sample s were re-tested and the data obtained were analyzed using SPSS software . Results : There were no significant differences between anthropometric data including body mass index and waist to hip ratio in placebo and treatment groups . There was no significant difference in FBS , Serum TG concentration total cholesterol and LDL-C levels between placebo and treatment groups . HDL-C levels were slightly elevated after probiotic treatment , which were not statistically significant . Insulin , MDA and IL-6 levels were reduced and high sensitive CRP hs . CRP levels were elevated , although , not statistically significant . Conclusion : The result of this study indicates a non- significant declining trend in the level of TG , MDA and IL-6 and insulin resistance after consumption of probiotics Objective : Periodontitis is known to have multifactorial etiology , involving interplay between environmental , host and microbial factors . The current treatment approaches are aim ed at reducing the pathogenic microorganisms . Administration of beneficial bacteria ( probiotics ) has emerged as a promising concept in the prevention and treatment of periodontitis . Thus , the aim of the present study is to evaluate the efficacy of the local use of probiotics as an adjunct to scaling and root planing ( SRP ) in the treatment of patients with chronic periodontitis and halitosis . Methods : This is a r and omized , placebo-controlled , double-blinded trial involving 32 systemically healthy chronic periodontitis patients . After SRP , the subjects were r and omly assigned into the test and control groups . Test group ( SRP + probiotics ) received subgingival delivery of probiotics and probiotic mouthwash , and control group ( SRP + placebo ) received subgingival delivery of placebo and placebo mouthwash for 15 days . Plaque index ( PI ) , modified gingival index ( MGI ) , and bleeding index ( BI ) were assessed at baseline , 1 and 3 months thereafter , whereas probing depth ( PD ) and clinical attachment level were assessed at baseline and after 3 months . Microbial assessment using N-benzoyl-DL-arginine-naphthylamide ( BANA ) and halitosis assessment using organoleptic scores ( ORG ) was done at baseline , 1 and 3 months . Findings : All the clinical and microbiological parameters were significantly reduced in both groups at the end of the study . Inter-group comparison of PD reduction ( PDR ) and clinical attachment gain ( CAG ) revealed no statistical significance except for PDR in moderate pockets for the test group . Test group has shown statistically significant improvement in PI , MGI , and BI at 3 months compared to control group . Inter-group comparison revealed a significant reduction in BANA in test group at 1 month . ORG were significantly reduced in test group when compared to control group . Conclusion : Within the limitations of the study , the present investigation showed that the adjunctive use of probiotics offers clinical benefit in terms of pocket depth reduction in moderate pockets and reduced oral malodor parameters AIM To investigate the effects of probiotic on intestinal mucosae of patients with ulcerative colitis ( UC ) , and to evaluate the role of probiotic in preventing the relapse of UC . METHODS Thirty patients received treatment with sulphasalazine ( SASP ) and glucocorticoid  and then were r and omly administered bifid triple viable capsule ( BIFICO ) ( 1.26 g/d ) , or an identical placebo ( starch ) for 8 wk . Fecal sample s were collected for stool culture 2 wk before and after the r and omized treatments . The patients were evaluated clinical ly , endoscopically and histologically after 2 mo of treatment or in case of relapse of UC . p65 and IkappaB expressions were determined by Western blot analysis . DNA-binding activity of NF-kappaB in colonic nuclear extracts was detected by electrophoretic mobility shift assay ( EMSA ) . mRNA expressions of cytokines were identified by semi-quantitative assay , reverse transcriptase- polymerase chain reaction ( RT-PCR ) . RESULTS Three patients ( 20 % ) in the BIFICO group had relapses during 2-mo follow-up period , compared with 14 ( 93.3 % ) in placebo group ( P<0.01 ) . The concentration of fecal lactobacilli , bifidobacteria was significantly increased in BIFICO-treated group only ( P<0.01 ) . The expressions of NF-kappaB p65 and DNA binding activity of NF-kappaB were significantly attenuated in the treatment group than that in control ( P<0.05 ) . The mRNA expression of anti-inflammatory cytokines was elevated in comparison with the control group . CONCLUSION The probiotic could impede the activation of NF-kappaB , decrease the expressions of TNF-alpha and IL-1beta and elevate the expression of IL-10 . These results suggest that oral administration of this new probiotic preparation is effective in preventing flare-ups of chronic UC . It may become a prophylactic drug to decrease the relapse of UC Background Diseases of the digestive system have been found to contribute to a higher symptom burden in older adults . Thus , therapeutic strategies able to treat gastrointestinal discomfort might impact the overall health status and help older adults to increase their overall health status and optimal functionality . Objective The aim of this double-blinded , r and omized , placebo-controlled clinical trial was to evaluate the effect of the probiotic strain Lactobacillus reuteri on digestive health and wellbeing in older adults . Methods The study enrolled general older adults ( > 65 years ) . After eligibility screening qualified subjects ( n = 290 ) participated in a 2-arm study design , with each arm consisting of 12 weeks of intervention of either active or placebo product . Primary outcome measure was set to changes in gastrointestinal symptoms and secondary outcome measures were changes in level of wellbeing , anxiety and stress . Follow up was performed at 8 and 12 weeks . Results No persistent significant effects were observed on the primary or secondary outcome parameters of the study . A modest effect was observed in the probiotic arm , were levels of stress decreased at week 8 and 12 . Similarly , we found that subjects suffering from indigestion and abdominal pain , respectively , showed a significant decrease of anxiety at week 8 after probiotic treatment , but not at week 12 . Conclusion The RCT failed to show any improvement in digestive health after daily intake of a probiotic supplement containing L. reuteri . Neither was any significant improvement in wellbeing , stress or anxiety observed . Even though the RCT had a negative outcome , the study highlights issues important to take into consideration when design ing trials among older adults . Trial registration Clinical trials.gov/NCT01837940 BACKGROUND Probiotics have beneficial effect on obesity related disorders in animal models . Despite a large number of animal data , r and omized placebo-controlled trials ( RCT ) concluded that probiotics have a moderate effect on glycemic control-related parameters . However , effect of probiotics on insulin resistance are inconsistent . AIM In a double-blind single center RCT , effect of alive multistrain probiotic vs. placebo on insulin resistance in type 2 diabetes patient were assessed . METHODS A total of 53 patients met the criteria for inclusion . They were r and omly assigned to receive multiprobiotic " Symbiter " ( concentrated biomass of 14 probiotic bacteria genera Bifidobacterium , Lactobacillus , Lactococcus , Propionibacterium ) or placebo for 8-weeks administered as a sachet formulation . The primary main outcome was the change HOMA-IR ( homeostasis model assessment -estimated insulin resistance ) which calculated using Matthews et al. 's equation . Secondary outcomes were the changes in glycemic control-related parameters , anthropomorphic variables and cytokines . RESULTS Supplementation with alive multiprobiotic for 8 weeks was associated with significant reduction of HOMA-IR from 6.85 ± 0.76 to 5.13 ± 0.49 ( p = 0.047 ) , but remained static in the placebo group . With respect to our secondary outcomes , HbA1c insignificant decreased by 0.09 % ( p = 0.383 ) and 0.24 % ( p = 0.068 ) respectively in placebo and probiotics groups . However , in probiotic responders ( n = 22 , patient with decrease in HOMA-IR ) after supplementation a significant reduction in HbA1c by 0.39 % ( p = 0.022 ) as compared to non-responders was observed . In addition , from markers of chronic systemic inflammatory state only TNF-α and IL-1β changes significantly after treatment with probiotics . CONCLUSION Probiotic therapies modestly improved insulin resistance in patients with type 2 diabetes Background / Objectives : Prebiotics have attracted interest for their ability to positively affect the colonic microbiota composition , thus increasing resistance to infection and diarrhoeal disease . This study assessed the effectiveness of a prebiotic galacto-oligosaccharide mixture ( B-GOS ) on the severity and /or incidence of  travellers ' diarrhoea ( TD ) in healthy subjects . Subjects/ Methods : The study was a placebo-controlled , r and omized , double blind of parallel design in 159 healthy volunteers , who travelled for minimum of 2 weeks to a country of low or high risk for TD . The investigational product was the B-GOS and the placebo was maltodextrin . Volunteers were r and omized into groups with an equal probability of receiving either the prebiotic or placebo . The protocol comprised of a 1 week pre-holiday period recording bowel habit , while receiving intervention and the holiday period . Bowel habit included the number of bowel movements and average consistency of the stools as well as occurrence of abdominal discomfort , flatulence , bloating or vomiting . A clinical report was completed in the case of diarrhoeal incidence . A post- study question naire was also completed by all subjects on their return . Results : Results showed significant differences between the B-GOS and the placebo group in the incidence ( P<0.05 ) and duration ( P<0.05 ) of TD . Similar findings occurred on abdominal pain ( P<0.05 ) and the overall quality of life assessment ( P<0.05 ) . Conclusions : Consumption of the tested galacto-oligosaccharide mixture showed significant potential in preventing the incidence and symptoms of TD BACKGROUND AND AIMS In addition to improving gastrointestinal health and intestinal microflora , probiotic bacteria have been recently suggested to decrease cariogenic agents in the oral cavity . The aim of this study was to investigate the effects of probiotic yogurt and xylitol-containing chewing gums on reducing salivary Streptococcus mutans levels . STUDY DESIGN This r and omized clinical trial recruited 50 female students with over 105 colony forming units S. mutans per milliliter of their saliva . The participants were r and omly allocated to two equal groups to receive either probiotic yogurt containing Lactobacillus acidophilus ATCC 4356 and Bifidobacteriumbifidum ATCC 29521 ( 200 g daily ) or xylitol-containing chewing gums ( two gums three times daily after each meal ; total xylitol content : 5.58 g daily ) for three weeks . At baseline and one day , two weeks , and four weeks after the interventions , saliva sample s were cultured on mitis-salivarius-bacitracin agar and salivary S. mutans counts were determined . Data were analyzed with independent t-tests , analysis of variance , and Fisher 's least significant difference test . RESULTS In both groups , S. mutans counts on the first day , second week , and fourth weeks after the intervention were significantly lower than baseline values ( P < 0.05 ) . The greatest level of reduction in both groups was observed in the second week after the intervention . Moreover , although the reduction was greater in probiotic yogurt consumers , the difference between the two groups was not statistically significant . CONCLUSION Probiotic yogurt and xylitol-containing chewing gums seem to be as effective in reduction of salivary S. mutans levels . Their constant long-term consumption is thus recommended to prevent caries BACKGROUND Irritable bowel syndrome ( IBS ) is characterized by heterogeneous pathophysiology and low response to treatment . Up to 60 % of IBS patients suffers from visceral hypersensitivity , which is associated with symptom severity and underlying pathophysiological mechanisms . Recently , positive effects of probiotics in IBS have been reported , but overall the response was modest . We performed a study in IBS patients , characterized by visceral hypersensitivity measured with the rectal barostat , aim ing to assess the effect of 6 weeks of multispecies probiotic mix on visceral pain perception . METHODS We conducted a r and omized , placebo-controlled , double-blind trial in forty Rome III IBS patients with visceral hypersensitivity . Prior to intake , patients kept a 2-week symptom diary and underwent a rectal barostat measurement . When hypersensitivity was confirmed , participation was allowed and patients received a multispecies probiotic with in vitro proven potential beneficial effects on mechanisms contributing to visceral hypersensitivity ( six different probiotic strains ; 10(9 ) cfu/g ) , or a placebo product of one sachet ( 5 g ) per day for 6 weeks . At the end of the intervention period , visceroperception and symptoms were reassessed . KEY RESULTS Thirty-five patients completed the trial . The percentage of patients with visceral hypersensitivity decreased significantly in the probiotic and placebo group ( 76.5 % and 71.4 % , respectively ; N.S. between groups ) . Improvement in pain scores and mean symptom score did not differ between the probiotic and placebo group . CONCLUSIONS & INFERENCES In this placebo-controlled trial in IBS patients with visceral hypersensitivity , no significant effect of a multispecies probiotic on viscerperception was observed . The study has been registered in the US National Library of Medicine ( http://www . clinical trials.gov , NCT00702026 ) BACKGROUND Probiotics have a beneficial effect on nonalcoholic fatty liver disease ( NAFLD ) in animal models . R and omized placebo-controlled trials ( RCTs ) in NAFLD are still lacking in humans despite a large number of data from animal research . AIM We performed a double-blind single center RCT of live multi-strain probiotic vs. placebo in type 2 diabetes patients with NAFLD . METHODS A total of 58 patients met the criteria for inclusion . They were r and omly assigned to receive the multi-probiotic " Symbiter " ( concentrated biomass of 14 probiotic bacteria genera Bifidobacterium , Lactobacillus , Lactococcus , Propionibacterium ) or placebo for 8-weeks administered as a sachet formulation in double-blind treatment . The primary main outcomes were the changes in fatty liver index ( FLI ) and liver stiffness ( LS ) measured by Shear Wave Elastography ( SWE ) . Secondary outcomes were the changes in aminotransferase activity , serum lipids and cytokines ( TNF-α , IL-1β , IL-6 , IL-8 , and IFN-γ ) levels . Analysis of covariance was used to assess the difference between groups . RESULTS In the probiotic group , FLI significantly decreased from 84.33+/-2.23 to 78.73+/-2.58 ( p<0.001 ) but it did not change in the placebo group ( 82.57+/-2.45 to 81.6 + /-2.36 ; p=0.367 ) . In both groups a slight but not significant reduction of LS measured by SWE was detected . Analysis of the secondary outcomes showed that probiotics reduced the level of serum AST and GGT . Among the markers of chronic systemic inflammatory state , only TNF-α and IL-6 levels changed significantly after the treatment with the probiotic . CONCLUSION The probiotic " Symbiter "  reduces liver fat , aminotransferase activity , and the TNF-α and IL-6 levels in NAFLD patients . Modulation of the gut microbiota might represent a new therapy for NAFLD , which should be tested in larger studies Introduction Traumatic brain injury ( TBI ) is associated with a profound immunological dysfunction manifested by a severe shift from T-helper type 1 ( Th1 ) to T-helper type 2 ( Th2 ) response . This predisposes patients to infections , sepsis , and adverse outcomes . Probiotic bacteria have been shown to balance the Th1/Th2 cytokines in allergic murine models and patients . For the present study , we hypothesized that the enteral administration of probiotics would adjust the Th1/Th2 imbalance and improve clinical outcomes in TBI patients . Methods We design ed a prospect i ve , r and omized , single-blind study . Patients with severe TBI and Glasgow Coma Scale scores between 5 and 8 were included , result ing in 26 patients in the control group and 26 patients in the probiotic group .  All patients received enteral nutrition via a nasogastric tube within 24 to 48 hours following admission . In addition , the probiotic group received 109 bacteria of viable probiotics per day for 21 days . The associated serum levels of Th1/Th2 cytokines , Acute Physiology and Chronic Health Evaluation ( APACHE ) II and Sequential Organ Failure Assessment ( SOFA ) scores , nosocomial infections , length of ICU stay , and 28-day mortality rate were studied . Results The patients responded to viable probiotics , and showed a significantly higher increase in serum IL-12p70 and IFNγ levels while also experiencing a dramatic decrease in IL-4 and IL-10 concentrations . APACHE II and SOFA scores were not significantly affected by probiotic treatment . Patients in the probiotic group experienced a decreased incidence of nosocomial infections towards the end of the study . Shorter ICU stays were also observed among patients treated with probiotic therapy . However , the 28-day mortality rate was unaffected . Conclusions The present study showed that daily prophylactic administration of probiotics could attenuate the deviated Th1/Th2 response induced by severe TBI , and could result in a decreased nosocomial infection rate , especially in the late period . Trial registration ChiCTR-TRC-10000835 Background : Chronic inflammation is one of the causes of anemia in chronic renal failure patients under hemodialysis . Probiotics probably establish a balance between pro- and anti-inflammatory cytokines . The study was conducted to determine the effects of probiotic supplementation on hemoglobin ( Hb ) in hemodialysis patients . Material s and Methods : A parallel clinical trial was conducted in which patients were r and omly allocated into two groups . The intervention group ( n = 18 ) was given a 500 mg probiotic supplement ( a capsule ) every day whereas the  control group ( n = 18 ) received placebo ( a capsule ) , both for 3 months . Hb levels and C-reactive protein ( CRP ) levels were measured for three periods . The data were analyzed in SPSS-16 using statistical tests including the t-test and repeated- measures ANOVA . Results : In the probiotic supplementation group , the mean Hb was 9.22 ± 1.04 mg/dl before the intervention and reached 10.85 ± 1.177 mg/dl afterward , while in the placebo group , the mean Hb level was 9.38 ± 0.97 mg/dl before the intervention and reached 10.03 ± 1.97 mg/dl afterward ( P > 0.05 ) . During the study , the placebo caused to increase of Hb temporary , but in longer term , the effect of probiotic was more manifested . Hb levels increased in both groups although the change was not statistically significant ( P > 0.05 ) . The findings showed no significant differences between the two groups in either the pre- or post-intervention CRP levels ( P = 0.239 ) . Conclusion : Probiotic supplementation  decreased Hb fluctuations in hemodialysis patients but did not result in a significant increase in Hb levels . Similar studies are therefore recommended to be conducted with a prolonged duration of the study or an increased probiotic dose with larger sample size to complete the results of the present study The aim of this study was to investigate the effect of a daily intake of probiotic lactobacilli on the prevalence and counts of oral C and ida in frail elderly patients living in nursing homes . The study had a double-blind r and omized placebo-controlled design with 2 parallel arms . The study group consisted of 215 older adults ( range , 60 to 102 y ) who were enrolled after informed consent . After baseline examination and r and omization , the subjects were given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri ( DSM 17938 and ATCC PTA 5289 ) or placebo twice daily ( morning and evening ) . The intervention period was 12 wk , and saliva and plaque sample s were collected at baseline and follow-up . The primary end point was prevalence of high C and ida counts assessed from chairside tests . Secondary end points were levels of dental plaque and gingival inflammation . The groups were balanced at baseline . The attrition rate to follow-up was 19 % . There was a statistically significant reduction in the prevalence of high C and ida counts in the probiotic group but not in the placebo group , and the difference was statistically significant in both saliva and plaque ( P < 0.05 ) . No significant differences between the groups were noted concerning the levels of supragingival plaque or bleeding on probing . Thus , daily use of probiotic lozenges may reduce the prevalence of high oral C and ida counts in frail elderly nursing homes residents ( Clinical Trials.gov NCT02391532 )
Current evidence is supportive of recommending probiotics for the management of halitosis .
Based on this review , transient ( average of 2 weeks ) dosing with probiotics ( mainly Lactobacillus strains ) has a moderate effect on halitosis regarding OLT scores , but we could not confirm the effects of probiotics on the VSC reduction .
Although several studies have evaluated the inhibitory effect of  probiotics  on  halitosis  , findings are inconsistent .
This systematic review and meta- analysis of r and omized clinical trials ( RCT ) was conducted to summarize the evidence on the effect of  probiotics on halitosis .