The oral microbiome plays a major role in shaping oral health/disease state; thus, a main challenge for dental practitioners is to preserve or restore a balanced oral microbiome. Nonetheless, when pathogenic microorganisms install in the oral cavity and are incorporated into the oral biofilm, oral infections, such as gingivitis, dental caries, periodontitis, and peri-implantitis, can arise. Several prophylactic and treatment approaches are available nowadays, but most of them have been antibiotic-based. Given the actual context of antimicrobial resistance (AMR), antibiotic stewardship in dentistry would be a beneficial approach to optimize and avoid inappropriate or even unnecessary antibiotic use, representing a step towards precision medicine. Furthermore, the development of new effective treatment options to replace the need for antibiotics is being pursued, including the application of photodynamic therapy and the use of probiotics. In this review, we highlight the advances undergoing towards a better understanding of the oral microbiome and oral resistome. We also provide an updated overview of how dentists are adapting to better manage the treatment of oral infections given the problem of AMR.

Purpose: Probiotics may exclude or antagonize oral pathogens and be useful to prevent oral dysbiosis and treat oral diseases. The objective of this review was to assess the benefits of probiotics in oral health and disease, and in dental practice; Methods: Primary articles published between January 2012 and 30 December 2020 with full text available were searched in PubMed, ClinicalTrials.gov, ScienceDirect, Google Scholar, B-on, and SciELO; Results: The electronic search identified 361 references of which 91 (25.2%) met all the inclusion criteria. In total, data from 5374 participants with gingivitis, periodontitis, peri-implantitis, caries, orthodontic conditions, halitosis, or oral conditions associated with chemo-radiotherapy were included. Despite major inconsistencies between clinical trials, probiotics have been found to contribute to reduce S. mutans counts (L. paracasei SD1), reduce probing depth in chronic periodontitis (B. animalis subsp. lactis DN-173010 with L. reuteri), reduce levels of volatile sulfur compounds and halitosis (L. salivarius WB21), treat oral mucositis and improve the quality of life of patients undergoing cancer chemo-radiotherapy (L. brevis CD2). Combinations of probiotic bacteria tend to lead to higher clinical efficacy than any individual probiotic agent; Conclusion: Oral probiotics influence favorably the oral microbiota and provide benefits to the oral ecosystem in periodontal diseases, cariology, halitosis, orthodontics and management of oral mucositis resulting from cancer treatment. However, the use of probiotics in dental practice or in self-management preventive strategies requires additional well controlled clinical trials to determine the most effective probiotic combinations, the most appropriate probiotic vehicle, and the frequency of administration.

Objective The aim of this study was to investigate the healing effect of advanced platelet-rich fibrin (A-PRF) clot membranes in palatal wounds, resulting from free gingival graft (FGG) harvesting, on the reepithelization rate and on the pain experience after surgery. Materials and Methods Twenty-five patients requiring FGG have participated in this prospective cohort study. After FGG harvesting, the test group (n = 14) received A-PRF clot membranes at the palatal wound and the control group (n = 11) received a gelatin sponge. Epithelialization rate of the palatal wound, wound healing area, correspondent percentage of reduction, and postsurgical pain experience were assessed at 2, 7, 14, 30, and 90 days. Results A-PRF group had higher palatal wound reduction than the control group, at 7, 14, and 30 days of follow-up. The highest difference between the groups was attained at 30 days (91.5% for A-PRF vs. 59.0% control group). At 14 days, a significant difference in the proportion of patients showing total epithelization was found: 64.3% for A-PRF versus 9.1% for the control group. At 90 days, both groups showed total recovery. The control group experienced higher pain level and discomfort until the 14th day, being notably higher on the second day. Conclusion The results suggest that A-PRF membranes haste the healing process, and promote greater reduction along the recovery period and less painful postoperative period.

Halitosis, or bad breath, is an oral health problem characterized by an unpleasant malodor emanating from the oral cavity. This condition can have different origins and causes a negative burden in social interactions, communication and quality of life, and can in uncommon cases be indicative of underlying non-oral non-communicable diseases. Most cases of halitosis are due to inadequate oral hygiene, periodontitis and tongue coating, yet the remaining proportion of cases are due to ear–nose–throat-associated (10%) or gastrointestinal/endocrine (5%) disorders. For this reason, the diagnosis, treatment and clinical management of halitosis often require a multidisciplinary team approach. This comprehensive review revisits the etiology of halitosis as well as standard and novel treatment that may contribute to higher clinical success.

This study aimed to describe the prevalence and extent of periodontal diseases among adults in the southern region of the Lisbon Metropolitan Area. This population-based cross-sectional study included 1,064 randomized participants (aged 18 to 95 years, 617 females/447 males). Sociodemographic, behaviours and medical information were recorded. Periodontal conditions were assessed with a full-mouth circumferential periodontal examination. It was used the American Association of Periodontology/European Federation of Periodontology 2017 case definitions. A logistic regression analysis was applied to ascertain hypothetical risk factors towards periodontitis. The prevalence of periodontitis was 59.9%, with 24.0% and 22.2% of the participants exhibiting severe and moderate periodontitis, respectively. The risk of periodontitis significantly increased with age (OR = 1.05, 95% CI: 1.04–1.06), for active and former smokers (OR = 3.76 and OR = 2.11, respectively), with lower education levels (OR = 2.08, OR = 1.86, for middle and elementary education, respectively) and with diabetes mellitus (OR = 1.53). This study confirms a high burden of periodontitis in the target (Portuguese) sub-population. The findings provide a comprehensive understanding that will empower appropriate national public oral health programmes and population-based preventive actions.