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Probiotics use different mechanisms, such as improving the intestinal barrier, bacterial translocation, and maintaining intestinal microbiota homeostasis to treat cancer. The ability of probiotics to induce apoptosis against tumor cells makes them more effective in treating cancer. Furthermore, probiotics stimulate immune function through an immunomodulation mechanism that induces an antitumor effect. There are different strains of probiotics, but the most important are lactic acid bacteria (LAB) that have antagonistic and antimutagenic activities. Live and dead probiotics have anti-inflammatory, antiproliferative, antioxidant and antimetastatic properties that are useful in fighting different diseases, especially cancer.

https://link.springer.com/article/10.1007/s11033-022-08023-7 (2023).---

Oral probiotics favorably influence the oral microbiota and provide benefits to the oral ecosystem in periodontal diseases, cariology, halitosis, orthodontics and management of oral mucositis derived from cancer treatment.

Probiotics commonly form biofilms as protective mechanisms against oral pathogens. They also fill spaces where cariogenic bacteria could reside and compete with pathogens to colonize the cavity. Some probiotics have also been shown to inhibit the growth of oral pathogens associated with periodontitis. Other mechanisms include competition for nutrients or adhesion sites with other pathogens, production of antimicrobial substances and toxin-degrading substances, and local or systemic immunomodulation.

Table 1 also describes several oral probiotics and their mechanisms of action against common oral pathogens that frequently contribute to chronic oral inflammation, which precedes oral cancer.

Synbiotics were developed to increase the survival of probiotics in microhabitats such as the oral cavity.

The administration of synbiotics could also help maintain the oral microbiome by preserving the survivability of beneficial oral bacteria in the oral cavity, subsequently preventing the colonization of oral pathogens such as Candida spp. and Streptococcus mutans.

Furthermore, Lactobacillus rhamnosus, Lactobacillus helveticus and Lactobacillus casei have been shown to exhibit strong cytoprotective effects against cadmium-induced tissue injury, which could be due to their anti-inflammatory and antioxidant properties.

Postbiotic is defined as the “preparation of inanimate microorganisms and their components that confers a health benefit to the host.” It is suggested that postbiotics may have therapeutic and protective activities, similar to probiotics, with less risk, particularly for immunocompromised patients.

Prebiotics could greatly help in promoting the growth of beneficial oral bacteria such as Lactobacilli spp, Streptococcus parasanguinis and Streptococcus gordonii. This is important as dysbiosis can contribute to unresolved inflammation in addition to other independent cancer-causing mechanisms that lead to oral cancer.

Arabinose, xylose and xylitol are the three saccharides that can potentially function as prebiotics. They act by supporting the growth of Lactobacilli spp. and prevent the growth of common oral pathogens such as Strep. mutans and C. albicans. Xylitol was also shown to have inhibitory effects on Strep development. mutans and C. albicans in the presence of glucose.

https://link.springer.com/article/10.1007/s12602-022-09985-7 (2023).---

https://www.nature.com/articles/s41432-022-0246-y (2022).---

https://www.mdpi.com/2076-3417/11/17/8070 (2023).---

https://journals.lww.com/crst/_layouts/15/oaks.journals/downloadpdf.aspx?an=02201859-202306030-00012 (2023).---

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