“Our goal is to make oral synbiotics an accessible preventive tool for childhood caries”

Iveta Ramonaite, Dental Tribune International

Tue. 11. November 2025

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In many parts of the world, unequal access to oral health professionals and facilities makes it difficult for communities to receive adequate care. This highlights the importance of preventive approaches that do not require clinical intervention. Dr Céline M. Lévesque, a professor of oral microbiology in the Faculty of Dentistry at the University of Toronto in Canada, is jointly leading a project to develop a probiotic-based solution for preventing dental caries. The research team is currently investigating which materials best support the growth of beneficial oral bacteria, how these probiotics function in the body and their potential health benefits through preclinical studies.

Prof. Céline M. Lévesque of the University of Toronto is leading research on a synbiotic developed to prevent childhood dental caries and designed for easy incorporation into common foods for use in diverse and low-resource settings. (Image: Prof. Céline M. Lévesque)

Prof. Lévesque, what led you to explore the use of synbiotics for the prevention of childhood caries?
The idea for this project emerged when we identified a child who was free of caries during the analysis of dental plaque samples from children with severe early childhood caries. From this child, we isolated a beneficial bacterial strain demonstrating antagonistic activity against cariogenic species. This finding prompted us to investigate ways to promote the colonisation and persistence of beneficial bacteria in the oral cavity.

Doing so assumed particular urgency given the scale of the problem. Dental caries is the most common chronic disease in children worldwide, and more than 500 million children have untreated caries in their primary teeth. For many, this means daily pain, missed schooldays, difficulty eating and speaking, and even emotional distress due to damaged teeth—issues that interfere with learning, development and overall well-being.

The oral environment is highly dynamic, and maintaining a healthy microbial balance is essential to preventing disease. By combining a promising probiotic strain with a carefully selected substrate that supports beneficial bacteria but not caries-causing species, we developed a synbiotic formulation. This formulation promotes a resilient, health-associated oral microbiome and offers a new way to prevent childhood caries and improve children’s quality of life globally.

How does your synbiotic formulation work, and how does it differ from existing strategies?
The human mouth hosts a complex community of bacteria—some helpful, others harmful. Previous research has indicated potential benefits of probiotics; however, they often do not stay in the mouth long enough to make a lasting difference.

To address this, we created a synbiotic formulation that combines probiotics with a prebiotic—a substrate that selectively nourishes beneficial bacteria. This dual approach helps the beneficial bacteria persist and become more active, creating a healthier microbial balance—especially important for young children whose oral microbiomes are still developing.

Unlike fluoride-based strategies, which focus on strengthening enamel and reducing bacterial activity externally, our synbiotic works from within by fostering a balanced, protective environment. It is designed to be safe, easy to use and adaptable to different cultural contexts and diets, representing a potential adjunct to established preventive oral health strategies.

What is your vision for delivering this solution worldwide, and what challenges do you foresee?
Our goal is to make oral synbiotics an accessible preventive tool for childhood caries, particularly in regions with limited access to oral healthcare. Our synbiotic can be easily integrated into daily routines—by adding it to culturally familiar foods or dietary supplements, such as milk or yogurt—so that families can care for their children’s teeth without expensive treatments or clinical visits.

This approach could complement existing oral health strategies and reduce reliance on costly clinical interventions. By intervening early, we hope to prevent caries at its earliest stages, reducing the long-term health and economic burden of dental disease.

As we move towards real-world application, we anticipate challenges related to regulatory approval, product formulation and distribution logistics, particularly in low-resource settings. Ensuring stability, scalability and affordability will be critical.

“The synbiotic is administered via orally ingested products and does not require clinical intervention.”

How can partnerships and community engagement facilitate implementation?
Although we are not yet pursuing partnerships, collaboration with public health organisations, local producers and community networks will be essential for equitable implementation. Future work will focus on establishing collaborations with community-based organisations experienced in health initiatives. For example, Yoba for Life, a non-profit that empowers East African communities through local probiotic yogurt production, represents the type of partnership that could bring synbiotic-based caries prevention to scale. This approach may represent a paradigm shift towards preventive, microbiome-centred caries management.

How might this approach reduce disparities and make preventive care more accessible?
Dental caries disproportionately affects those in underserved communities. Many families have limited access to dental professionals, and treatments can be expensive or even not available. Our synbiotic formulation is designed as a preventive strategy and could help reduce the incidence of advanced carious lesions requiring restorative intervention. Additionally, the synbiotic is administered via orally ingested products and does not require clinical intervention. This makes it particularly suitable for low-resource settings. Ultimately, our goal is to create an affordable, scalable and culturally adaptable solution that helps close the gap in oral health outcomes and makes preventive care accessible to children everywhere.

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