Lactobacillus reuteri oral administration improves periodontal disease in children and adolescents with type 1 diabetes

Objectives: Understanding the clinical manifestations and management of periodontal disease are important for the optimal care of patients with type 1 diabetes (T1D). Probiotics could protect the oral tissues against the action of periodontal pathogenic bacteria. We aimed to assess the effects of the administration of Lactobacillus reuteri as probiotic upon oral health in children and adolescents T1D. Methods: Forty-three patients (11.32.77 yrs.; T1D duration 58.238.0 months) were enrolled and randomly assigned to Group A (probiotic - 5 drops/day, 10^8 CFU/day for 3 months) and Group B (no probiotic). Oral health index [Full Mouth Plaque Score (FMPS), Full Mouth Bleeding Score (FMBS)], insulin dose (IU/kg/day), and HbA1c were measured at baseline (T0) and 3-months after (T1). Results: FMPS significantly improved in both Group A and B (p<0.05). In Group B daily insulin dose increased (p=0.01) and HbA1c improved (p< 0.001) at T1, while in Group A the metabolic control was unchanged. We performed a telephone survey to evaluate the probiotic compliance in Group A. 13 out 22 patients reported a regular probiotic intake (A1), while the other ones used it sporadically (A2). Despite FMPS and FMBS values were not different between groups at T0, they were significantly lower (p< 0.05) in Group A1 respect to Group A2 at T1. FMPS and FMBS longitudinally decreased in Group A1 but not in Group A2. Conclusions: Our preliminary data suggest that 3-months oral administration of probiotic might improve the oral health of children and adolescents with T1D and confirm that glycemic control have also an influence on oral health.