A Novel Microencapsulated Probiotic Oral Rinse Improves Gingival Health and Influences Salivary Matrix Metalloproteinases 8 and 9 in Children with Down Syndrome: A Pilot Randomized Clinical Trial

Abstract

Objectives Children with Down Syndrome (DS) exhibit heightened oral health vulnerabilities owing to their unique physiological characteristics, necessitating the need for tailored interventions. The integration of natural MMP inhibitors such as probiotics has the potential to significantly improve oral health outcomes in this vulnerable population. In this double-blinded randomized controlled trial (CTRI/2023/04/051447), we investigated the effects of a novel sugar-free probiotic oral rinse compared to 0.2% chlorhexidine digluconate on salivary MMP-8 and MMP-9 levels in children with DS. Materials and Methods Thirty children, aged 6–14 years, participated in this study. Baseline assessments involved saliva collection for MMP-8 and MMP-9 quantification using an enzyme-linked immunosorbent assay (ELISA) and evaluation of gingival parameters. Following the baseline evaluations, individualized oral rehabilitative interventions were administered. Two weeks post-rehabilitation, the participants were randomized to receive either a probiotic (Group 1) or chlorhexidine rinse (Group 2). The oral rinses were used for two weeks, followed by repeated salivary MMP quantification and gingival parameter assessments after two weeks and six months. Results Both groups exhibited significant reductions in MMP levels, plaque index (PI), gingival index (GI), oral hygiene index, and bleeding on probing (BOP) (p < 0.05). The probiotic group demonstrated a significant reduction in BOP (p = 0.000). Conclusion This study emphasizes the importance of tailored oral care for children with DS and demonstrates significant post-treatment oral health improvements.