OBJECTIVE:Lactic acid bacteria are gaining attention not only for their role in regulating the intestinal flora but also for their immunostimulatory effects. Recent clinical trials and in vitro studies have demonstrated the efficacy of heat-killed Enterococcus faecalis 2001 (EF-2001) in treating oral candidiasis, suggesting its potential to improve oral microbial flora. However, its effectiveness in other oral conditions remains unclear. This study aimed to evaluate the clinical utility of EF-2001 in a broader range of oral diseases.
METHODS:A prospective observational questionnaire-based study was conducted on 137 patients who had used granules or paste containing 7.5×10¹¹ EF-2001. Data were collected from November 2020 to March 2021 and from July 2021 to August 2024 at two different facilities.
RESULTS:At facility one (n=38), oral diseases included xerostomia (n=10, 26%), glossitis (n=8, 21%), stomatitis (n=7, 18%), oral candidiasis (n=5, 13%), and oral lichen planus (n=5, 13%). Ten patients were receiving cancer treatment or undergoing perioperative oral care. Intestinal symptoms were reported in 34 patients, mainly constipation (n=27, 71%) and diarrhea (n=7, 18%). Improvement in oral symptoms and intestinal symptoms was observed in 25 of 35 respondents (71%) and 18 of 31 (58%), respectively. The most common time-to-symptom improvement was two to four weeks. A significant association was found between improvements in oral and intestinal symptoms. At facility two (n=99), oral diseases included oral lichen planus (OLP) (n=49, 49%), glossodynia (n=12, 12%), oral candidiasis (n=10, 10%), pemphigus vulgaris (n=6, 6%), and Sjögren's syndrome (n=6, 6%). Intestinal symptoms were reported in 67 patients, mainly constipation (n=51, 52%) and diarrhea (n=16, 16%). Improvement in oral symptoms was reported in 64 of 98 respondents (65%), and in intestinal symptoms in 42 of 65 (65%). The most frequent time-to-improvement was two to four weeks for oral symptoms and four to eight weeks for intestinal symptoms. A significant association was again observed between improvements in oral and intestinal symptoms.
CONCLUSION:Supplementation with EF-2001 resulted in subjective improvements in both oral and intestinal symptoms across various oral diseases, with a notable association between the two types of symptom improvement.