02/19/2010 Treatment of children for primary acute herpetic gingivostomatitis with lactobacillus in aqueous suspension

Resident: J. Hencler Date: 02/19/2010

Article title: Treatment of children for primary acute herpetic gingivostomatitis with lactobacillus in aqueous suspension

Author(s): William F. McCord, DDS
Journal: Pediatric Dentistry: December, 1988 – V 10, #4, Pg 307-308
Major topic: Treatment of primary acute herpetic gingivostomatitis (PAHG)
Type of Article: Clinical trial

Main Purpose: To evaluate the effectiveness of a lactobacillus aqueous preparation in the treatment of PAHG.

Overview of method of research: Study was performed in a private dental office and included 15 males and 18 females ranging from 2-10 years old. Treatment prescribed for each child included a stabilized aqueous suspension of lactobacilli. Parents were instructed to have children swish 1 tsp of the medication in their mouth for as long as possible b/f swallowing and repeat 4x for 7 days.

Findings: All patients experience total relief of pain w/in 72 hrs and all symptoms including lesions and inflammation disappeared w/in 7 days.

Key points in the article discussion: Peak incidence of PAHG is around 2 yo. CC is extreme pain and soreness of the mouth so severe that the child has difficulty eating, drinking, and swallowing. One major problem associated w/ PAHG is dehydration. Results showed relief of pain and lesion healing may have occurred in a shorter period of time than with use of alternate forms of lactobacillus or when lesions remain untreated. The mechanism in which lactobacillus suspension produces a therapeutic response in patients is unknown. It is important to note that this therapeutic approach employs viable organisms of one type (lactobacillus) to combat viable organisms of another type (herpes simplex virus) by acting as a virostatic agent. There is no evidence from this study that the lactobacilli were virostatic other than clinical observation demonstrating cessation of pain, disappearance of lesions, the ability of the child to swallow more easily, the improvement of malaise, and reduction in fever.

Summary of conclusions: This clinical trial presents preliminary evidence that lactobacilli in a liquid form greatly aids in the relief of pain and other symptoms of PAHG. In this study, aqueous lactobacillus preparation showed a high degree of palatability, ease of administration, and may be useful in treating herpetic lesions.

Assessment of article: Small sample size with good results. This was a very interesting article and very easy to read. At the time it was published more research was needed on this tx regimen.