A reader asked for what probiotics to use for dry-mouth or hyposalivation or Xerostomia.. “is often seen as a side effect of many types of medication, and associated with Sjögren’s syndrome. Over 500 medications produce xerostomia.

• “Probiotic intervention reduced the risk of high yeast counts by 75% , and the risk of hyposalivation by 56%. Thus,probiotic bacteria can be effective in controlling oral Candida and hyposalivation in the elderly.” [2007] [Full article] – “107 cfu (colony-forming units)/g of each of the probiotic strains, L. rhamnosus GG (ATCC 53103), L. rhamnosus LC705, and Propionibacterium freudenreichii ssp shermanii JS (Valio Ltd, Joensuu, Finland) “
• “Cluster I is made up 76% of subjects with hyposalivation …have higher.. genera Veillonella, Dialister, Prevotella, Fusobacterium, and Streptococcus.”[2014]
• “species of Candida tropicalis and Parapsilosis were more detected in the primary Sjogren’s syndrome “[2013]
• “the primary Sjogren’s syndrome subjects displayed an increased frequency of C.albicans, Staphylococcus aureus, enterics, and enterococci”[2001]
• “These results suggest that particular Candida species are involved in the pathogenesis of oral mucosal disorders in patients with xerostomia.”[2012]

So which probiotics?

If you live in Finland (or planning to visit soon), you may be able to get the one probiotic cited above.

• “given 1 lozenge containing 2 strains of the probiotic bacterium Lactobacillus reuteri (DSM 17938 and ATCC PTA 5289) … There was a statistically significant reduction in the prevalence of high Candida counts in the probiotic group but not in the placebo group,”[2015]
• “consumption of the probiotic Yakult LBz(®) (Lactobacillus casei and Bifidobacterium breve)…showed a statistically significant reduction (p<0.05) in Candida prevalence (from 92.9% to 85.7%), in CFU/mL counts of Candida and in the number of non-albicans species after consumption” [2012]
• “the probiotic Yakult LB® for 20 days, showed a significant reduction in Candida prevalence (46%) and mean Candida CFU/mL counts (65%).[2009]

Oral Probiotic tablets usually contain S. salivarius K12, it and M18 appears to have no explicit significant impact on Candida[2013]. It is unclear if they will have impact on Dry Mouth (so they are worth a try if the L.Reuteri longenze or L.Reuteri Oral Probiotics are not easily obtainable).

• “S. salivarius Strain K12, the prototype S. salivarius probiotic, originally introduced to counter Streptococcus pyogenes infections”[2012]
• “The study included 67 salivary and subgingival lactobacilli of 10 species…but none inhibited Candida albicans.”[2008]

Yakult LB is a good candidate (two studies) if you can get it (it is sold in Brazil). Regular Yakult (or DanActive) and Bifidobacterium breve may be an alternative

The following contain mainly L.Reuteri:

• BioGaia Chewable (Chewable Tablets) L.Reuteri probiotic
• Nova Diet Oraldiet

Propionibacterium freudenreichii is only available in Nutricology, Securil

L.Reuteri included as part of a mix in these Oral Probiotics

• Powerful Oral Probiotics with 7 STRAINS of beneficial bacteria
• PRO-Dental: Probiotics for Oral & Dental Health

Tradition Guidance for dry mouth should also be checked/tried, like this post. Many of the items are already the norms for CFS patients, i.e. no coffee or alcohol….

Other’s have distinctive CFS/IBS/FM versions:

• “sugar-free chewing gum” — all of the fake sugars are worse than real sugar for the microbiome. Use Mastic Gum instead.
• “a hard candy into your mouth to stimulate your saliva glands and aid production.”
  • Use spezzatina instead (pure licorice)
• xylitol washwash is a strongly not recommended.