Probiotic supplements and postoperative complications after tooth extractions and third molar surgery: a systematic review

INTRODUCTION: Probiotics have gained considerable attention as intervention for various conditions in dentistry. The purpose of this review is to evaluate the current literature on the efficacy of probiotic supplements for alleviating symptoms after tooth extractions and third molar surgery. EVIDENCE ACQUISITION: We searched the PubMed and Google Scholar databases up to October 15, 2021 using pertinent keywords to retrieve relevant literature. Based on abstracts, the authors reviewed the full text papers, extracted key outcome data, and assessed the risk of bias. EVIDENCE SYNTHESIS: Four articles based on three RCT's were included of which three allowed compilation. There were no beneficial effects on the occurrence of postoperative infections or alveolitis, but we disclosed a significant trend towards less self-reported pain one week after the tooth extractions (RD -0.22; 95% CI -0.33; -0.11; P<0.05). Findings concerning swelling, discomfort and use of painkillers were inconsistent. CONCLUSIONS: Probiotic supplements may offer clinical benefits within oral surgery, such as alleviating pain after tooth extractions. However, the certainty of these findings was very low due to risk of bias, heterogeneity, and inconsistencies across the studies. Further and larger investigations are required to strengthen the level of evidence.