Oral health ingredients: New research gives natural product and dietary supplement formulators a reason to smile

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The oral health ingredients market is benefiting from a renewed focus on mouth health as an indicator of overall health. The United States Department of Health and Human Services Office of Disease Prevention and Health Promotion declared oral health a Leading Health Indicator in 2020, citing links between poor oral health and heart disease, stroke, and diabetes. Emerging research even suggests a possible link between gum disease and Alzheimer’s disease.¹

As more research connects oral health to other aspects of general health, consumer focus on oral health ingredients will grow. Market researcher Mordor Intelligence forecasts a 6.32% compound annual growth rate for the broader global oral care market through to 2026². This market growth will open up opportunities for various types of new oral health ingredients. Here are some of the emerging developments pushing oral health support ingredients forward.

Probiotic Blend Outperforms Mouthwash in Pediatric Trial

Probiotic ingredients are seeing a flurry of research activity for their oral health potential. Camille Binachon, product manager for Lallemand Health Solutions (Montreal, QC, Canada), says probiotics’ beneficial effects on oral health are well documented. Lallemand’s branded Oralis SB, a blend of the probiotic strains L. helveticus, L. rhamnosus, B. longum, and S. boulardii from Lallemand’s Rosell line, has undergone at least seven clinical studies showing an effect on oral health.

“Two clinical studies demonstrated that Oralis SB helped maintain dental health by controlling S. mutans growth,” Binachon says. “Five other clinical studies on gum health showed decreased Plaque Score and Gingival Index in patients. In some of these studies, Oralis demonstrated similar or better results than conventional mouthwashes.”

The most recent of these trials was a 2019 randomized parallel-group study³ on 60 children aged 6 to 9. The children were assessed for Plaque Index and Gingival Index scores at baseline, on day 3, and on day 14. All of the children were instructed to brush their teeth twice per day with an assigned toothbrush and non-fluoridated toothpaste. The subjects were randomly assigned to rinse their mouth for 60 seconds once or twice per day with either distilled water (n = 20), or 10 ml of 0.02% chlorhexidine mouthwash (n = 20), or Lallemand’s Darolac-brand probiotic mouthwash (n = 20). (Darolac is the brand name for Oralis SB in India. It is sold by Lallemand’s India distribution partner Aristo Pharmaceuticals.) Subjects’ parents carefully monitored the subjects’ oral healthcare habits.

The study found that after 14 days, the probiotic group’s Plaque Index score decreased by 1.58, while the chlorhexidine group experienced a 1.33 decrease, and the control group’s score was the same on day 14 as it was at baseline. Similarly, the probiotic group experienced a larger decrease in Mean Gingival Index scores than the chlorhexidine group, while the control group’s scores did not change over time. These results show that the probiotic mouthwash outperformed chlorhexidine after 14 days.

Oralis SB has a Natural Product Number from Health Canada and has received approval for the following health claim: “Oralis SB helps promote dental health through the control of S. mutans growth and plaque formation.”

S. salivarius Helps Prevent Black Teeth Staining

Black dental stainingis a somewhat uncommon but unsightly form of staining that is estimated to affect between 2% and 18% of the population.⁴ Nena Dockery, scientific and regulatory affairs manager for Stratum Nutrition (Carthage, MO), says that while this type of staining can be removed during a professional dental cleaning, it tends to recur. Now, two recent studies have demonstrated that some probiotics may be able to prevent black staining recurrence.

One 2020 in vitro study⁵ tested BLIS Probiotics’ (Dunedin, New Zealand) M18-brand S. salivarius and BioGaia’s (Stockholm, Sweden) Prodentis-brand L. reuteri strains to determine whether they could inhibit the growth of A. actinomycetemcomitans and A. naeslundii. The study, which was conducted independently without involvement by or funding from BLIS Probiotics, tested the probiotics in a planktonic growth inhibition test using cell-free fermentative broth. Both of the probiotics reduced bacteria concentrations in a dose-dependent manner, with S. salivarius outperforming L. reuteri.

Meanwhile, a 2020 randomized controlled trial⁶, also conducted without BLIS Probiotics’ involvement or funding, examined the effects of BLIS’s branded S. salivarius ingredient M18 on black stain recurrence in 58 children aged 4 to 10. Four children were excluded from the analysis because they started antibiotic therapy partway through the study. The children were randomly assigned to receive either one tablet of a slow-dissolving version of M18 containing 1 billion CFU of S. salivarius per day (n = 28),or nothing (n = 26), for 90 days. The slow-dissolving tablet was designed by SIIT (Trezzano sul Naviglio, Italy). Staining was assessed at baseline, after three months, and after six months.

Both groups had no black stains at baseline. After three months, six children in the M18 group developed black stains compared to 13 children in the control group. After six months, nine children in the M18 group and 14 children in the control group had black stains. The study authors concluded that S. salivarius inhibited black stain formation.

S. salivarius is one of the most abundant species of bacteria found in the mouths of healthy people, Dockery says. She explains that beneficial bacteria can outcompete unfavorable strains in the mouth.

“Some of these beneficial strains produce compounds called bacteriocin-like inhibitory substances (BLIS) that target and inhibit the growth of select pathogenic strains,” Dockery notes. “The use of these strains to develop probiotics can help support the health of the oral cavity, especially in individuals in whom the oral cavity microbiome is unbalanced.”

Vitamins and Minerals Show Promise for Oral Health

Some of the ingredients that have demonstrated efficacy in improving oral health are more traditional in nature. Dockery says vitamins and minerals like vitamin A, vitamin C, vitamin D, selenium, and zinc have been shown to have beneficial effects on both dental surfaces and gum tissue.

“There has been a growing interest in nutrients that can support oral health,” Dockery notes. “Vitamin C deficiency, for instance, is known to increase the risk of periodontal disease. In one noteworthy clinical trial, it was demonstrated that not only are serum levels of certain minerals like zinc and selenium lower in individuals with chronic periodontitis than in healthy controls, but a high level of copper in relation to zinc was correlated with the incidence of periodontitis in conjunction with type 2 diabetes.”

Oral Health Ingredients Gain Validation

The growth of the natural oral health products market is fueling new research on a variety of ingredients. Vitamins, minerals, and supplements like probiotics are showing strong efficacy in clinical trials. As more consumers become aware of the connection between oral health and general health, opportunities for the oral health market will likely grow.

References

1. Harvard Health Publishing. “Good Oral Health May Help Protect Against Alzheimer’s.” Published online September 1, 2019.
2. Mordor Intelligence report. “Oral Care Market – Growth, Trends, COVID-19 Impact, and Forecasts (2021-2026).” Published online 2021.
3. Sharma P et al. “A comparative evaluation of efficacy of probiotic and chlorhexidine mouthrinses on gingival health and plaque accumulation in 6-9 year old children.” International Journal of Applied Dental Sciences, vol. 5, no. 1 (January-March 2019): 156-162
4. Zyla T et al. “Black stain and dental caries: A review of the literature.” BioMed Research International. Published online February 24, 2015.
5. Gobbi E et al. “In vitro inhibitory effect of two commercial probiotics on chromogenic actinomycetes.” European Archives of Paediatric Dentistry, vol. 21, no. 6 (December 2020): 673-677
6. Bardellini E et al. “Does Streptococcus salivarius strain M18 assumption make black stains disappear in children?” Oral Health and Preventive Dentistry, vol. 18, no. 1 (2020): 161-164