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The Science Behind ProBiotics

» The First Major Breakthrough in Bad Breath Treatment Since TheraBreath
» The Theory Behind ProBiotics
» The Safety of S. Salivarius K12
» The Ingredients of Aktiv-K12 ProBiotics
The First Major Breakthrough in Bad Breath Treatment Since TheraBreath

Here's the fascinating story behind the most revolutionary addition to oral care since the introduction of OXYD-8® and TheraBreath® back in 1994, TheraBreath Aktiv-K12 ProBiotics.

In the Spring of 2003, I came across a very interesting research article in The Journal of Clinical Microbiology, with the "mysterious" title: Diversity of Bacterial Populations on the Tongue Dorsa of Patients with Halitosis and Healthy Patients. It was written by three groups of scientists, one from Harvard University, the second from the Forsyth Institute of Boston, and the remaining group from the University of Michigan. Their study "hit me like a brick", because over the past ten years I had heard countless times from people, just like you, pleading for a method to reverse the negative effects of the sulfur producing "bugs" in their mouth. In essence, they requested an "introduction of good bacteria" into the oral cavity. (Some wanted to know if their tongue could be reshaped or smoothed-out — others asked if they should stop kissing their offending spouse!).

Unbeknownst to me, and completely across the world (and I mean across the world) Professor John Tagg and his research team from the Department of Microbiology, University of Otago in New Zealand, had been working diligently to identify beneficial strains of naturally occurring bacteria, which, by their production of antibacterial protein chains, help protect humans against infection by other destructive bacteria. The term used for these natural antibacterial peptides is B.L.I.S., an abbreviation for Bacteriocin Like Inhibitory Substances. A "bacteriocin", by definition, is a protein chain produced by beneficial bacteria to inhibit the growth of related bacteria. They are at the forefront of medical/dental research because they are made by non-pathogenic bacteria that normally colonize the human body.

Loss of these harmless bacteria following use of antibiotics may allow pathogenic bacteria to invade the human body. [This is another bit of evidence that supports my call to end the use of antibiotics such as Tetracycline and Minocycline for acne. A large percentage of patients at my clinics reported use of these antibiotics during their teens and now have chronic halitosis.]

Looking at our concept of natural bacterial intervention, or "Bacteriotherapy", (the use of strains of beneficial bacteria to control infection by undesirable bacteria), we have learned that certain strains of micro-organisms produce BLIS substances, acting as natural antibiotics, harmless to humans, which control the growth of undesirable bacterial infections. The goal is to use nature's strengths, instead of artificial antibiotic or questionable therapies that have lead to the fact that many antibiotics no longer work, because of their overuse and misuse.

The Theory Behind ProBiotics: A Mutually Beneficial Relationship Between Bacteria

In humans our internal tissues are normally free of micro-organisms. However, the surface tissues, such as the skin and mucous membranes (inside of the mouth, nasal passages, etc), are constantly in contact with the external environment and become easily colonized by certain micro-organisms. The mixture of organisms regularly present at any site is referred to as the normal flora. (In the mouth it is known as the normal oral flora or microflora). This is usually a mutually-beneficial relationship. The normal flora utilizes the supply of nutrients provided by the host, a stable environment, a constant temperature, as well as protection and transport. The host may obtain from the micro-organisms some nutritional benefit, some stimulation of the development of the lymphatic tissues, but the most important general benefit is that colonization by the well-adapted normal flora can exclude other harmful micro-organisms from colonizing the host.
Aktiv-K12 Probiotics - BLIS

The top two circular areas of the photo show the inhibition of bacterial growth coming from BLIS producing bacteria.

As an example of the strength of these "good guy" bacteria, the photo at the right shows the following:

The top two circular areas of the photo show the inhibition of bacterial growth coming from BLIS producing bacteria, versus the five smaller circular inhibition areas on the bottom of the plate, using the same, but "non BLIS producing" bacteria.

Studies show a direct link between low levels of Streptococcus salivarius in the mouth throat and tonsils and the development of halitosis. This is because in-vitro testing has shown that Streptococcus salivarius K12 inhibits the key pathogens responsible for halitosis. Moreover, in-vitro testing has also shown that Streptococcus salivarius K12 inhibits the key pathogens responsible for ear infections and tonsillitis and clinical trials are underway in these indications.

These trials have shown that for the majority of sufferers of chronic bad breath tested, use of the TheraBreath Aktiv-K12 System resulted in a significant improvement in breath scores. The 13 subjects in one trial averaged pre-treatment breath readings which placed many of them in the range of bad breath odor being noticeable several feet away. Following use of TheraBreath Aktiv-K12, a week later 11 of the 13 recorded Halimeter scored below the range associated with bad breath even when tested first thing in the morning before any oral care. Eight of these 11 maintained good breath levels when tested first thing in the morning a further week later. The results of this trial were presented at the TheraBreath sponsored International Conference for Breath Odour in London, on 22 April 2004.

The following readings represent an additional study, showing the significant drop in VSC readings following the use of TheraBreath Aktiv-K12.

Aktiv-K12 Probiotics - VCS Readings

(The VSC levels of eight subjects were significantly lower when tested at one and two weeks after commencing treatment. Average results are presented in the following table)

Some of my dental colleagues are finally getting around to acknowledging the significance of the tongue in the production of breath odor. However, simply brushing, scraping, or cleaning the tongue is NOT enough. Here's the proof:

A control group of three subjects were also monitored using ONLY tongue cleaning and chlorhexidine (an oral antibiotic rinse not available in the US), and showed no improvement in VSC levels at the seven-day point versus pre-treatment VSC levels. In other words, just cleaning your tongue and using strong-tasting mouthwash will not work.

Other measures in the trial such as organoleptic scoring of incubated saliva (smell test), reduction of protein activity and changes in the bacterial profiles and cultural analysis of the oral microflora also generally correlated with the observed reduction in VSC levels. In other words, the study proved that this was a long-term benefit to oral health.

The Safety of S. Salivarius K12

Streptococcus salivarius is a naturally occurring bacterium, a predominant inhabitant of the back of the tongue and the throat area of humans. S. salivarius becomes established in the human oral cavity within two days after birth. The levels of S. salivarius in swab samples taken from newborn infants represent 10% of the total streptococci isolated, increasing to 25-30 % by one month of age. However, only 2% of the population harbors S. salivarius strains that produce BOTH Salivaricin A and Salivaricin B. Fortunately, The California Breath Clinics are now able to provide to nearly everyone, a reproducible method allowing colonization of these "good bugs" onto the tongue and in the oral cavity, so that bad breath can be controlled for much longer periods of time.

In spite of Streptococcus salivarius being one of the predominant organisms in the oral cavity of humans, a search of the literature on this bacterial species found few references linking it to any disease. The only cases that were reported were those that were specifically related to cases involved with infection following surgical intervention with poor hygiene control, major tissue trauma or were opportunistic infections in immune-compromised individuals. Where antibiotic therapy was instituted treatment was successful. No deaths or significant long term illnesses have been reported to result from any case of infection from S. salivarius. Furthermore, S. salivarius has no reported virulence factors that have been described for pathogenic streptococci. A review of the literature in respect of toxicity, carcinogenicity, reproductive and embryo fetal toxicity raised no issues of safety.

One major reason for its history of safety is that Streptococcus salivarius is closely related to Streptococcus thermophilus, the safe bacteria widely used in yogurt and cheese manufacturing.

The idea that Streptococcus salivarius strains may provide some protection against pathogenic bacteria was reviewed by Tagg and Dierksen (2003) and has also been the subject of earlier reports from other groups Huskins and Kaplan (1989); Sanders and Sanders (1982), and Fantinato, Jorge, Schimuzu (1999). 15 In a very recent study to compare the bacterial populations on the dorsal surface of the tongue in healthy subjects and people with halitosis, Streptococcus salivarius was found to be the predominant species in healthy subjects, but was typically at low levels or absent in those subjects suffering from halitosis (Kazor et al, 2003). In fact, sales of BLIS K12 began in New Zealand in May 2002. To date over 50,000 courses have been sold with no adverse reports related to the use of the active organism.

Additional Safety Studies:
  • Streptococcus salivarius is an indigenous organism of the oral cavity in humans. It is found in the highest amounts on the dorsal surface of the tongue and the pharynx (throat).
  • Streptococcus salivarius was tested for mutagenicity in the Ames test and all test results were negative.
  • Streptococcus salivarius K12 was originally isolated from a healthy individual who showed high relative resistance to infection by undesirable oral bacteria.
  • Testing of Streptococcus salivarius K12 has been carried out which showed that theorganism is susceptible to most commonly used antibiotics for upper respiratory conditions, and carries no known virulence factors.
  • In colonisation trials with the product containing Streptococcus salivarius K12, no adverse effects were reported.
  • Since May of 2002, post-marketing surveillance following sales of over 70,000 courses of the active ingredient in Aktiv-K12, has only led to one report of infection which proved not to be Streptococcus salivarius.
  • Streptococcus salivarius is listed in the USA as an organism considered to pose no threat to health or the environment.
Overall, it may be concluded that administration of Streptococcus salivarius K12 to humans in the manner proposed is safe for everyone and is unlikely to result in adverse effects of significance.

The Ingredients of Aktiv-K12 ProBiotics
  • More than 100 Million Cells of Beneficial Bacteria, Streptococcus Salivarius K12
  • Trehalose
  • Maltodextrin
  • Natural Peppermint Flavor