## 5 Caries Management with Probiotics
\begin{table}
\begin{tabular}{c c c c c c c c c c} \hline \hline
**Baseline** & **Type of** & **Patient** & **Baseline** & **Study Groups** & **Treatment** & **Probiotic** & **Strain Con-** & **Results** \\  
\begin{table}
\begin{tabular}{p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt} p{42.7 pt}} \hline \hline
**Baseline Condition** & **Type of Study** & **Patient Type** & **Baseline Condition** & **Study Groups** & **Treatment** & **Probiotic Strains** & **Strain Contentation** & **Results** \\ \hline \multirow{4}{*}{ \begin{tabular}{} \end{tabular}  } & Clustered, double-blind, & Preschool & & & & \(1\times 150\) mL, probiotic milk (supplemented with 2.5 mg & & Significant reduction in caries development after intervention milk intake \\  & Clustered, double-blind, & Preschool & & & & & & \\ children (2009) [25] & Children & Healthy (1–5 years old) & He  
To cover the lack of knowledge about _L. reuteri's_ effect on Lactobacillusil salivary counts in humans, after the introduction of the strain _Bifidobacterium_ DN-173 010 to the oral probiotic armamentarium [47], [PERSON] et al. selected _L. reuteri_ ATCC 55,730 as intervention strain to illuminate this unknown aspect [27]. As concluded, probiotic-containing straws and tablets could be beneficial to _S. mutans_ confinement. Two years later, [PERSON] and his affiliates presented the strain _Bifidobacterium lactis_ Bb-12 as an anticaries-competent probiotic strain [44]. This study introduced a novel probiotic strain into the race against caries and suggested ice-cream as a possible means for probiotics administration. Given the previous studies about probiotics' role in caries management, [PERSON] et al., came up with the highly promising idea of combining probiotic bacteria with fluoride [25]. This idea was based on the hypothesis that these two agents would act synergistically. Children in both the probiotic and placebo group consumed 150 mL of medium-fat milk at lunch for 21 months. As the results indicated, caries incidence increment was statistically significantly lower in the intervention group than in the control children. In contrast, salivary counts of caries-associated _S. mutans_ and Lactobacillusil were not affected. With time passing by, innovative probiotic strains have been proposed for the fight against dental caries. For instance, _L. acidophilus_ La5 combined with _B. lactis_ Bb-12 [40], _L. paracasei_ GMNL-33 [35], _L. rhamns_ hct 70 [24], _S. salivarius_ M18 [54], _L. paracasei_ SD1 [36], _L. casei Shirota_[33], _L. acidophilus_ ATCC 4356 combined with _B. bifidum_ ATCC 29,521 [39] dismiss _S. mutans_ from the oral cavity. Moreover, _L. paracasei_ SD1, when being received once a day for 4 weeks can be retained in the oral cavity of healthy young adults for 4 additional weeks by the time the regimen has been interrupted [36]. Lately, a shift towards the study of the host-specific alterations caused by probiotics has been recorded. Remarkably, the potential of specific probiotics to decrease caries risk has been correlated with their property to increase saliva's buffering capacity [41; 53], although no probiotic tested for an immediate anticaries ability has been shown to invert early caries development per se [30; 31]. It is worth mentioning that in 2019, a highly promising study was conducted [55]. This trial investigated the effect of a _Bacillus coagul_-subunit cake on _S. mutans_ levels and salivary pH. It pointed out that the sweetened probiotic cake can keep _S. mutans_ amounts low and comparable to those surveyed before cake consumption. Hence, it was proposed that cakes carrying probiotic flora may comprise a novel strategy against _S. mutans_[92]. This proposal is the modern trend in food policy [93].