Can We Combine Mouthrinses With Probiotics? An Evaluation of Their Compatibility and Combined Therapy on Oral Biofilms

AIM: Multiple oral pathologies requiring antiseptic mouthrinses for prevention or treatment. However, nonselective elimination of the microbes may also harm beneficial commensal, healthy bacteria. Promicrobial strategies, such as probiotics, aim to rebalance the oral microbiome rather than eradicate it; however, we hypothesised that their incorporation might be challenged due to the microbiome's inherent resistance to outsiders. In this study, their combined effect on an in vitro oral biofilm model was assessed. Instead of comparing mouthrinses to probiotics, could they be combined to obtain the best of both worlds? METHODS: The compatibility of two commonly used Limosilactobacillus reuteri strains with 13 commercially available mouthrinses was tested by evaluating probiotic survival in the mouthrinses and their combined effect on a multispecies in vitro biofilm model. RESULTS: Differences in compatibility were observed. Several mouthrinses showed moderate compatibility and improved the probiotics incorporation into biofilms. One mouthrinse (O7 Active Oxygen) demonstrated the most favourable compatibility, enabling abundant probiotic incorporation and beneficial biofilm composition changes. CONCLUSION: The combination of mouthrinses and probiotics has the potential to improve the treatment of oral pathologies and promote a healthier oral microbiome, although compatibility varies.