MX2011006488A - Compositions and methods for improved oral health. - Google Patents

Abstract

Compositions and methods for preventing and treating illnesses associated with oral health are provided. In a general embodiment, the compositions and methods of the present disclosure can improve oral health by reducing the incidence of aspiration pneumonia, community-acquired pneumonia and nosocomial pneumonia, allowing for less gingivitis and plaque, and providing improved tongue flora. By utilizing probiotics naturally present in the oral cavity or gastrointestinal tract, the compositions and methods in embodiments of the present disclosure can reduce anaerobic gram-negative bacilli and increase the presence of the normal flora. By preventing and treating problems associated with oral health in a patient, subsequent health problems can be prevented or mitigated, which can result in reduced health care costs for the patient in the future.

Description

COMPOSITIONS AND METHODS FOR IMPROVED ORAL HEALTH BACKGROUND The present description is directed to medical treatments. More specifically, the present disclosure is directed to compositions and methods for improving the oral health of an individual.

Epidemiological studies calculate a prevalence level of dysphagia between the age of 5 years and from 16% to 22% among individuals. There are 2 broad categories of dysphagia: (i) esophageal dysphagia and (i) oral pharyngeal dysphagia.

Esophageal dysphagia affects a large number of individuals of all ages, but is generally treatable with medication and is considered a less serious form of dysphagia. Esophageal dysphagia is frequently a consequence of mucosal, mediastinal or neuromuscular diseases. Mucosal (intrinsic) diseases narrow the lumen by inflammation, fibrosis or neoplasia associated with various conditions (secondary peptic structure for gastroesophageal reflux disease, rings and esophageal membranes [siderophenic dysphagia or Plummer-Vinson syndrome], esophageal tumors, wounds chemicals [eg, caustic ingestion, esophagitis by pills, sclerotherapy for varicose veins], radiation wounds, infectious esophagitis and eosinophilic esophagitis). Mediastinal (extrinsic) diseases obstruct the esophagus by direct invasion or by enlarging the lymph node associated with various conditions (tumors [eg, lung cancer, lymphoma], infections [eg, tuberculosis, histoplasmosis], and cardiovascular [dilated atrium and vascular compression]). Neuromuscular diseases can affect the soft esophageal muscle and its innervation, peristalsis of sphincter interruption or relaxation lower esophageal or both, commonly associated with various conditions (achalasia [idiopathic and associated with Chagas disease], scleroderma, other motility disorders and a consequence of surgery [ie, after fundoplication and antireflection interventions]). Likewise, it is common for individuals with intraluminal foreign bodies to experience acute esophageal dysphagia.

On the other hand, oral paringeal dysphagia is a very serious condition and is not usually treated with medications. Oral paringeal dysphagia also affects individuals of all ages, but is more prevalent in larger individuals. Worldwide oral parenchymal dysphagia affects approximately 22 million people by the age of 50. Oral paringeal dysphagia is often a consequence of an acute event, such as a stroke, brain trauma, or oral or throat cancer surgery. In addition, radiation therapy and chemotherapy can weaken the muscles and degrade the nerves associated with the physiology and nerve innervation of the swallowing reflex.

It is also common for individuals with progressive neuromuscular diseases, such as Parkinson's disease, to experience increased difficulty in swallowing initiation. The representative causes of oropharyngeal dysphagia include the associated neurological diseases (brain tumors, cranial trauma, stroke, cerebral palsy, Guillain-Barre syndrome, Huntington's disease, multiple sclerosis, polio, post-polio syndrome, tardive dyskinesia, metabolic encephalopathies , amyotrophic lateral sclerosis, Parkinson's disease, dementia), infectious diseases (diphtheria, botulism, Lyme disease, syphilis, mucositis [herpetic, cytomegalovirus, candida, etc.], autoimmune diseases (lupus, scleroderma, Sjögren's syndrome), diseases metabolic (amyloidosis, cushing syndrome, thyrotoxicosis, Wilson's disease), myopathic diseases (connective tissue diseases, dermatomyositis, myasthenia gravis, myotonic dystrophy, oculopharyngeal dystrophy, polymyositis, sarcoidosis, paraneoplastic syndromes, inflammatory myopathy), iatrogenic diseases (side effects of medication [eg, chemotherapy, neuroleptic, etc.], post-surgical muscle or neurogenic, radiation therapy, corrosive [wound by pills, intentional], and structural diseases (cricopharyngeal bar, Zenker's diverticulum, cervical nerves, oropharyngeal tumors, osteophytes and skeletal, congenital abnormalities [cleft palate, diverticulitis, fundus sacks, etc.]).

Aspiration pneumonia is a common clinical consequence of dysphagia. The condition frequently requires acute hospitalization and emergency room visits. Among those who develop pneumonia due to aspiration, the differential diagnosis of "aspiration pneumonia" is not necessarily indicated as a result of current care practices.

Based on general studies of US health care utilization in recent years, pneumonia seen during 1, 000,000 hospital outings and an additional 392,000 was attributable to aspiration pneumonia. Individuals who have general pneumonia as the primary diagnosis have a mean hospital stay of 6 days and incur expenses of $ 18,000 for hospital care. It is expected that aspiration pneumonia can lead to higher costs for hospital care based on an average 8-day hospital stay.

Pneumonia is the life that threatens between people with dysphagia and the obstacles of death within 3 months is -50%. In addition, an acute aggravation such as pneumonia frequently initiates the downward spiral in health among the elderly. An aggravation is associated with poor consumption and inactivity, which result in malnutrition, functional decline and weakness. For example, Older people commonly aspirate oropharyngeal contents during sleep.

The risk of aspiration pneumonia is greater when periodontal disease, dental caries and poor oral hygiene are compounded by swallowing disease, poor eating and functional status problems. Aspiration pneumonia is considered to be caused by aspiration of colonized nasopharynx or oropharinx material secondary to dysphagia. Vigorous cough, active ciliary transport and normal immune response are assumed to be protective but inadequate. The microflora present in the oral cavity due to poor oral hygiene has been associated with aspiration pneumonia.

The current standard of care for reducing the incidence of aspiration pneumonia in patients with clinically diagnosed swallowing disorders is chemical disinfection and the use of antimicrobial agents to improve oral health. Additionally, another method called selective decontamination is used. This method is a prophylactic technique in which antimicrobials eradicate the aerobic negative bacteria of the oropharynx while maintaining the normal oral microbial flora. The agents include oral antimicrobial gels with antibiotics, liquid suspensions with the same administered through a nasogastric tube ("NG"), intravenous antibiotics ("IV") and control of severe infection. While this method is superior to the use of antibiotics broad spectra that indiscriminately eradicate all bacteria (beneficial and dangerous), it does not re-inoculate the oral cavity with beneficial bacteria therefore the patient does not re-establish the balanced microflora and remains susceptible to the attack of oral infections like C. albicans (oral candidiasis).

The use of decontamination is also limited due to the risk of bacterial development resistance to antibiotics. In addition, the efficiency of this procedure in the reduction of aspiration pneumonia is questionable as in a recent meta-analysis, it was concluded that oral decontamination with chlorhexidine ("CHX") can prevent associated ventilator pneumonia but the strategy does not reduce ventilator time, length of stay in the intensive care unit ("ICU") or mortality ranges.

SHORT DESCRIPTION The present disclosure relates to compositions and methods for preventing and treating diseases associated with oral health. In a general embodiment, the compositions and methods of the present disclosure can provide: (1) a reduction in the incidence of aspiration pneumonia, (ii) less gingivitis and plaque and (iii) improved tongue flora. The source of chronic microbial challenge to the host may be directed to reduce chronic inflammation in the host, help restore an adequate immune response to physiological challenges and reduce an individual risk of infections. By preventing and treating problems associated with oral health in a patient, subsequent health problems can be prevented or mitigated, which can result in reduced health care costs for the patient in the future.

In a general embodiment, the present disclosure provides a nutritional composition for improving oral health. The composition includes a therapeutically effective amount of a beneficial bacterium such as Lactobacillus reuteri, Lactobacillus phaltarum, Streptococcus Salivarius, Streptococcus salivarius K12, Lactobacillus reuteri ATCC55730, Lactobacillus johnsonii La1, Lactobacillus platarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NCC221 1 (Pelargon chain), and Lacteol, and other ingredients with desired properties according to the present invention include: CGMP which has been shown in the test to prevent the binding of pathogens or a combination thereof. The beneficial bacteria may include one or more indigenous bacteria normally to the oral cavity. For example, the beneficial bacterium may include one or more indigenous strains normally to the oral cavity such as a streptococcus Salivarius K12, Lactobacillus platarum 299, Lactobacillus platarum 299v or a combination thereof. The beneficial bacteria may be living or inactive.

In one embodiment, the composition is in a form as liquids, solids, semi-solids or combinations thereof. The composition can be a complete oral nutritional supplement. The composition may also be in a form such as suckers, candy sticks, envelopes, dissolvable films or a combination thereof.

In one embodiment, the composition is in a form such as food, drink and combinations thereof. The composition may include an ingredient as a thickening agent. In. an alternative embodiment, the composition is a topical compound that can be applied to the surface of the oral cavity.

In another embodiment, the present disclosure provides a method for reducing the incidence of aspiration pneumonia. The method comprises administering to a patient at risk of having aspiration pneumonia a therapeutically effective amount of a composition comprising a bacterium selected from the group consisting of Lactobacillus reuteri, Lactobacillus phaltarum, Streptococcus Salivarius, Streptococcus salivarius K12, Lactobacillus reuteri ATCC55730, Lactobacillus johnsonii Lactobacillus platarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NCC2211 (Pelargon chain), and Lacteol, and other ingredients with desired properties according to the present invention include: CGMP which has been shown in the test for prevent the ligation of pathogens or a combination thereof.

In an alternative embodiment, the present disclosure provides a method for improving oral health. The method comprises administering to a patient at risk of oral health problems a composition comprising a therapeutically effective amount of a beneficial bacterium selected from the group consisting of Lactobacillus reuteri, Lactobacillus phaltarum, Streptococcus Salivarius, Streptococcus salivarius K12, Lactobacillus reuteri ATCC55730 , Lactobacillus johnsonii Lactobacillus platarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NCC221 1 (Pelargon chain), and Lacteol, and other ingredients with desired properties according to the present invention include: CGMP which has been shown in the test to prevent the ligation of pathogens or a combination thereof.

In still another embodiment, the present disclosure provides a method for reducing health care costs. The method comprises administering to a patient at risk of oral health problems a composition comprising a therapeutically effective amount of a beneficial bacterium selected from the group consisting of Lactobacillus reuteri, Lactobacillus phaltarum, Streptococcus Salivarius, Streptococcus salivarius K12, Lactobacillus reuteri ATCC55730, Lactobacillus johnsonii Lactobacillus platarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NCC221 1 (Pelargon chain), and Lacteol, and other ingredients with desired properties according to the present invention include: CGMP which has been shown in the test to prevent the ligation of pathogens or a combination thereof. The reduction in health care costs may be due to decreased incidences of aspiration pneumonia or general pneumonia that can not be diagnosed differentially. Alternatively, the reduction in health care costs may be due to the reduced treatment of infections secondary and / or upward spiral conservation in health. This may include, for example, the loss of functionality, ailment, disability and death.

The reduction in health care costs is due to the overall improved health of the patient or due to decreased dental costs. The reduction in health care costs may be due to the decreased utilization of hospitals and skilled nursing care centers. Decreased utilization may be a few days, a certain number of admissions, certain ER visits, decreased incidence of aspiration pneumonia. The reduction in health care costs may also be due to the decreased use of specialized care.

The reduction in health care costs may also be due to decreased use of antibiotics and / or artificial ventilation and / or pulmonary rehabilitation and / or post-ventilation of physical therapy and / or intravenous fluids. The decreased utilization may be due to the decreased need for the prevention of aspiration pneumonia. The decreased utilization may be due to the treatment of the sequelae of antibiotic use. The sequelae can be fungal infections (thrush) or urinary tract infections ("UTIs") or C. difficile associated with diarrhea or a combination thereof. Sequelae may also be infections of bacteria resistant to antibiotics, methicillin-resistant Staphylococcus aureus or a combination thereof. Reduced sequelae of antibiotic use may be due to decreased incidences of antibiotic resistant bacteria infections.

An advantage of the present disclosure is to provide a composition for improving oral health.

Another advantage of the present disclosure is to provide a method for improving oral health.

Even another advantage of the present disclosure is to provide a method for reduce the incidence of aspiration pneumonia.

Yet another advantage of the present disclosure is to provide a method for reducing health care costs.

The additional features and advantages are described herein and will be apparent from the following Detailed Description.

DETAILED DESCRIPTION The present disclosure relates to the compositions and methods for preventing and treating diseases associated with oral health. In alternative embodiments, the compositions and methods can be used to reduce oral health improvement by reducing the incidence of aspiration pneumonia. The compositions and methods can also be used to reduce the health care costs associated with treating the effects of adverse oral health conditions.

It has been surprisingly found that the use of a therapeutically effective amount of bacteria or probiotics naturally present in the oral cavity can reduce anaerobic gram-negative bacilli ("AGNB") and increase the presence of normal flora by re-introducing Good bacteria to the mouth without increasing the risk of antibiotic resistance or adverse results associated with antibiotics. Additionally, collateral effects such as discoloration of the teeth, mucosal irritation or even serious allergic reactions can be mitigated or eliminated. As the selected probiotics will have beneficial systemic effects, patients can benefit not only from localized oral health improvement (with significant late benefits of reduced aspiration pneumonia), but also improved overall immunity.

The compositions and methods in the embodiments of the present disclosure are beneficial for individuals or clinical patients (diagnosed), subclinical (non-diagnostic) or at risk of swallowing disorders. Patients with swallowing difficulties such as those clinically diagnosed with dysphagia or at risk of developing dysphagia may be malnourished or of legal age and have Parkinson's, Alzheimer's, dementia, head and neck cancer, stroke, Down's syndrome or conditions. lead to the hanging tongue.

The compositions and methods can provide the health benefits to patients at risk or who have silent aspiration (for example, aspirating when asleep or any other time such as when reclining) and those at risk or who have had pneumonia (for example, recurrent pneumonias, immunocompromised people). In addition, the compositions and methods can provide health benefits to those who are at risk or have poor oral health (for example secondary to the use of medications, decreased saliva production, use of the cigar / tobacco, use of alcohol, problems with the liver , oral hygiene methods of not frequent practice, impaired functionality that requires help with oral care).

As used herein, the term "patient" is preferably understood to include an animal, especially mammals and more basically a human being that is receiving or intends to receive treatment, as defined herein.

As used in the present "mammal" includes but is not limited to rodents, aquatic mammals, domestic animals such as dogs and cats, farm animals such as sheep, pigs, cows and horses and humans. Where the term mammals is used, it is contemplated that it also applies to other non-mammalian animals that are capable of the effect exhibited or for the purpose of being exhibited by the mammal.

As used in the present, "complete nutrition" are products preferably nutritious that contains sufficient types and levels of macronutrientres (protein, fats and carbohydrates) and micronutrients that are sufficient that they are a single source of nutrition for the animal to which it is being administered.

As used herein, "effective amount" is preferably an amount that prevents a deficiency, treats a disease or medical condition in an individual or, more generally, reduces symptoms, directs the progression of diseases or provides nutritional, physiological or nutritional benefits. doctors for the individual. A treatment can relate to the patient or the doctor. Furthermore, while the terms "individuals" or "patients" are frequently used herein to refer to a human, the invention is not limited in that way. Accordingly, the terms "individuals" and "patient" refer to any animal, mammal or human being that has or is at risk for a medical condition that may benefit from the treatment.

As used in the present, "incomplete nutrition" are preferably nutritional products that do not contain sufficient levels of macronutrients (protein, fats and carbohydrates) or micronutrients that are sufficient to be a single source of nutrition for the animal to which they are going manage.

As used herein, "long-term administrations" are continuous administrations preferably for more than 6 weeks.

The term "microorganism" means that it includes the bacterium, fungus, a cell growth medium with the microorganism or a cell growth medium in which the microorganism was cultured.

As used herein, a "prebiotic" is preferably food substances that selectively promote the growth of beneficial bacteria or inhibit the growth of pathogenic bacteria in the intestines. They are not activated in the stomach and / or small intestine or absorbed in the Gl tract of the person who ingests them, but are fermented by the gastrointestinal microflora and / or by probiotics. Prebiotics are for example defined by Glenn R. Gibson and Marcel B. Roberfroid, Dietary Modulation of the Human Colon Microflora: Introduction of the Concept of Prebiotics, J. Nutr. 1995 125: 1401-1412.

As used herein, probiotic microorganisms (hereinafter "probiotics") are preferably microorganisms (living, including semi-viable or weakened and / or non-replicating), metabolitesmicrobial cell preparations or microbial components that can confer health benefits in the host when administered in adequate amounts, more specifically, that beneficially affect a host by improving its intestinal microbial balance, leading to health effects or guest welfare. (Salminen S, Ouwehand A. Benno Y. et al) "Probiotics: how they should be defined" Trends Food Sci. Technol. 1999: 10 101 -10). In general, it is considered that these micro-organisms inhibit or have an influence on the growth and / or metabolism of pathogenic bacteria in the intestinal tract. Probiotics can also activate the immune function of the host. For this reason, there have been many different approaches that include probiotics in food products.

As used herein, "short-term administrations" are preferably continuous administrations for less than 6 weeks.

The terms "Tolerable Upper Limit and Upper Limit (UL)" are intended to preferably include the maximum level of nutrients that will probably not pose any risk of adverse events.

As used herein, the terms "treatment", "treatment" and "alleviation" are preferably prophylactic or preventive treatment (which prevents and / or slows down the development of a desired pathological condition or disorder) and curative, therapeutic or modifying disease treatment, including therapeutic measures that cure, reduce, decrease symptoms and / or progression of the interruption of a pathological condition or disorder and the treatment of patients in risk of contracting a disease or suspect who has contracted a disease, as well as patients who are ill or who have been diagnosed as suffering from a disease or medical condition. The term does not necessarily imply that a subject is treated until full recovery. The terms do not necessarily imply that a subject is treated until full recovery. The terms "treatment" and "treating" also refer to the maintenance and / or promotion of health in an individual who does not suffer from a disease but who may be susceptible to the development of an unhealthy condition, such as nitrogen imbalance or loss. of muscle. The terms "treatment", "treatment" and "alleviation" also aim to include potentiation or otherwise the improvement of one or more primary prophylactic or therapeutic measures. The terms "treatment", "treatment" and "alleviation" have as an additional objective to include the dietary management of a disease or condition or dietary management for the prophylaxis or prevention of a disease or condition.

All dose ranges contained within this application are intended to include all numbers, totals or fractions, contained within that range.

As used in the present "commensal bacteria" are the microorganisms that help the digestion of food and that acquires nutrients such as vitamins B and K, and that helps the immune system in preventing the colonization of pathogens that can cause disease competing with they.

As used in the present, a "Commensal Effect" is when a microorganism, by itself, aids another organism in aiding digestion of food and to acquire nutrients such as vitamins B and K, and that helps the immune system in preventing the colonization of pathogens that can cause disease competing with them.

The compositions and methods in the embodiments of the present disclosure provide superior alternatives to current standards of care for the improvement of oral health. The compositions and methods can be used for complementary beneficial bacteria in the patient's oropharynx. The compositions and methods can provide competitive inhibition by the pathogenic bacteria of displacement by competition for adhesion sites and nutrients. The compositions and methods can store microflora balance in the oropharynx, esophagus and the rest of the patient's gastrointestinal tract ("Gl").

The compositions and methods do not need to be used in conjunction with ventilators that can collect pathogens (eg, reservoir) and provide a place to attack them. Under normal circumstances, there is no place for bacteria to be static / colonized, etc.

The compositions and methods can use natural, innate probiotics that reduce the salivary pathogenic bacterial load in the oropharynx and nasopharynx. Through competitive inhibition, natural, inborn probiotics can offer oral health without killing the other bacteria or inducing resistance to antibiotics. However, certain probiotics can kill pathogenic bacteria and inhibit their reproduction (for example, I. reuteri produces natural antibiotics that kill pathogens). Probiotics can compete with receptor signaling sites that mediate systemic inflammation. As a result, ingested probiotics can subsequently provide immune and bowel health benefits. An advantage of this intake can be multiple as it directs the immune response of the oral cavity patient to the systemic immune response.

The compositions and methods in alternative embodiments of the present disclosure can reduce the use of antibiotics in a patient with dysphagia, reduce the pathogenic bacterial burden in a patient with dysphagia, reduce the pathogenic bacterial burden in the oropharynx of a patient with dysphagia, reduce the pathogenic bacterial load in the nasopharynx of a patient with dysphagia, reduce the pathogenic bacterial load in the oropharynx and nasopharynx of a patient with dysphagia, reduce the pathogenic bacterial load in patients with dysphagia (for example, where the pathogenic bacterial is AGNB) , and improve the general and cardiovascular health of the patient.

The compositions and methods in the embodiments of the present disclosure can utilize a therapeutically effective amount of beneficial beneficial bacteria, either live or inactive (eg, probiotics) in the following manner: to. Delivered orally i) Solos (1) Liquids (2) Semi-solids (3) Lozenges (a) Including candies with stick (4) Envelopes (5) Movies ii) In conjunction with 1) Liquids (a) Oral nutritional supplements (i) Premixed in (ii) Modules to be added (i¡¡) Complete oral nutrition supplements ("ONS") for use them as directed by a medical professional, which contains protein, carbohydrates, fats and micronutrients (pound optional) enough to maintain life and other bioactive compounds such as phytochemicals, bacterial products, nucleotides, etc.

(V) incomplete ONS missing one or more of the components of a complete ONS, (v) Contains enriched levels of one or more of the components of a complete ONS, (b) Other beverages (i) Juices, milk, soft drinks, coffee, teas, water, (2) Solids (i) Modules to be sprayed on food 1. Including gravy and sauces 2. Includes semi-solids to. Pudding, jelly, jelly (ii) Bars (iii) Other topical compounds such as vitamin E, vitamin A, Zn, vitamin C, nucleotides and other bioactive compounds such as phytochemicals, bacterial products, nucleotides, etc. (iv) Products / food mixes of a modified consistency (eg puree). (3) Other topical compounds (for example, Vitamin C and Zinc) (4) Improve oral health and / or immunity (i) Substances that affect the binding capacity of pathogens with receptor signaling sites that mediate local and / or systemic inflammation. (b) Decrease the pathogenic burden (i) Substance that creates an environment that is not favorable for the growth of pathogens. 1 . Replaces or binds essential nutrients (eg, sugar-filled, water-free content) that supports the growth of pathogens 2. Alters the pH 3. It generates an anti-microbial substance that inhibits pathogen growth, iii) Binders (1) Starches (2) Rubber based (3) Other plant extracts (a) Bamboo rod (4) Proteins b. Innate bacteria for the oral cavity i) Salivarius streptococcus ii) Lactobacillus reuteri iii) Lactobacillus platarum 299 or 299 v c. Non-innate bacteria for the oral cavity d. Prebiotics and nucleotides and. Substances that promote non-pathogenic bacteria (ie prebiotics) similar in the intestine) i) Optimize the environment (for example, pH, availability of energy source) in favor of the growth of non-pathogenic bacteria, free availability of water I) Other ingredients with desired properties according to the present invention include: CGMP which has been shown in the test to prevent the binding of pathogens and is known to be effective against Streptococcus mutans and Streptococcus sobrinus.

The repeated consumption of the compositions in the modalities of the description present as part of daily life can improve oral health by replacing the pathogenic bacteria with beneficial, non-pathogenic bacteria. Oral health can also be improved as a result of the release of beneficial chemicals by the bacteria (eg, anti-microbial). In addition, since the individual sucks his saliva, the pathogenic bacterial load will be low and the likelihood of insertion of aspiration pneumonia may be reduced.

Non-limiting examples of the bacteria to be used in accordance with this invention include one or more of: Spreptococcus salivarius K12, Lactobacillus reuteri ATCC55730, Lactobacillus johnsonii La1, Lactobacillus plantarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NC221 1 ( Pelargon strain) and Lacteol.

Streptococcus salivarius K12, which produces salivaricin A and B, in the test has been shown to be effective against Streptococcus pyogenes, icrococcus luteus, Streptococcus anginosis, Eubacterium saburreum, Micromonas micros, Moraxella, Prevotella intermedia and Porphyomonas gingivalis.

Lactobacillus reuteri ATCC55730, which produces reuterin, in the test has been shown to be effective against: Streptococcus mutans, EHEC Escherichia coli, ETEC Escherichia coli, Enteric Salmonella, Shigella sonnei, Vibrio cholerae. Additionally, Lactobacillus reuteri ATCC55730 has a commensal effect in L. casei ATCC 344, L. johnsonii ATCC33200, L. acidophilus ATCC 4356, L. gasseri ATCC 33323, Clostridium difficile, Eubacterium eligens, Bifidobacterium longum var infantis, Eubacterium biforme, Bifidobacterium longum, Bifidobacterium catenulatum, Baceroides vulgatus and Bacteroides thetaiotaomicron.

Lactobacillus johnsonii La1, which produces H202, in the test has been shown to be effective against: Escherichia coli (ETEC, EPEC), Salmonella typhimurium, Yersinia pseudotuberculosis, Helocobacter pylori, Clostridium difficile toxin A, Shigella flexneri, Klebsiella pneumoniae, Pseudomonas aeruginosa , Enterobacter cloacae, Staphylococcus aureus, and Listeria monocytogenes.

Lactobacillus plantarum 299v has been shown to help prevent the colonization of pathogens and aid in the prevention of ventilation associated with pneumoniae (VAP). The test has shown that LP299v is effective against: Streptococcus mutans, Streptococcus sobrinus and Escherichia coli.

Lactobacillus rhamnosus GG has also been shown to help prevent the colonization of pathogens and help in the prevention of ventilation associated with pneumoniae (VAP). The test has shown that Lactobacillus rhamnosus GG is effective against: Streptococcus mutans, Streptococcus sobrinus and Escherichia coli.

Streptococcus thermophilus NCC 1561, in the test has been shown to be effective against Actinomyces viscosus and Streptococcus sobrinus.

Lactococcus lactis NCC221 1 (Pelargon strain), in the test has been shown to be effective against Actinomyces viscosus and Streptococcus sobrinus.

Examples of non-replicative Micro-organisms include Lacteol that acts by a mechanism of inhibition of adhesion of pathogens (adheres to Caco 2 and HT29-MRX cells) and has been shown in the test that prevents adhesion of Lysteria monocytogenes, ETEC Escherichia coli, EPEC Escherichia coli, Yersinia pseudotuberculosis and Salmonella typhimurium. Additionally, Lacteol has been shown to have antimicrobial activity against: Staphylococcus aureus, Listeria monocytogenes, Bacillus cereus, Salmonella typhimurium, Shigella flexneri, Escherichia coli, Klebsiella pneumoniae, Salmonella typhimurium, Shigella flexneri, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and enterobacter spp. .

In still another embodiment, the present disclosure provides a method of reducing health care costs. The method comprises administering to a patient at risk or having oral health problems a composition comprising a therapeutically effective amount of a beneficial bacterium selected from the group consisting of Lactobacillus reuteri, Lactobacillus phaltarum, Streptococcus Salivarius, Streptococcus salivarius K12, Lactobacillus reuteri ATCC55730, Lactobacillus johnsonii Lactobacillus platarum 299v, Lactobacillus rhamnosus GG Streptococcus thermophilus NCC 1561, Lactococcus lactis NCC2211 (Pelargon chain), and Lacteol, and combinations thereof. The reduction in health care costs may be due to decreased incidences of aspiration pneumonia or general pneumonia that can not be diagnosed differentially. Alternatively, the reduction in health care costs may be due to reduced treatment of secondary infections and / or upward spiral conservation in health. This may include, for example, the loss of functionality, ailment, disability and death.

More specifically, the economic health benefits can be as follows: • Reduces hospitalizations, re-hospitalizations, sub-acute care, care transitional, home health care, outpatient care, doctor's office visits, and follow-up care. o Reduce medical costs for the health care system due to aspiration pneumonia and general pneumonia that may not be diagnosed differentially.

• Reduce the necessary specialized care o Reduce medical costs for the health care system by dehydration, use of artificial ventilation, emergency room visits, pulmonary rehabilitation and post-artificial ventilation of physical therapy, nosoal infections and recurrence (for example, urinary tract infections, associated diarrhea C. difficile) • Reduces the need for antibiotics o A few killer bacteria that float around (resistant bacteria of antibiotics) Methicillin-resistant Staphylococcus aureus (MRSA) C. difficile • Cost savings due to better overall health o Cardiovascular, diabetes, metabolic syndrome o Avoid the downward spiral in health that can lead to loss of functioning, frailty, increased risk of disease and death wounds, disability, increased caregiver burden (formal and informal) and institutionalization.

• Reduced dental care costs or doctor office visits.

EXAMPLES By way of example and without limitation, the following examples are illustrative of various embodiments of the present disclosure.

EXAMPLE 1 Table 1 mentions the onents of a lete food product (powder or liquid) suitable for the nutritional supply of patients with or at risk of dysphagia, those who are at risk of aspiration, at high risk of pneumonia and at risk of oral health poor.

Table 1 Ingredient Quantity Function Probiotic Chain > 10,000 CFU (powder or Bacteriotherapy (displacement straw, cap or other pathogenic bacteria) delivery mechanism) Caseinate 75 g (20% energy) High quality protein Canola oil 50 g (30% energy) Source of fatty acids and energy Maltodextrin 188 g (50% energy) Carbohydrates and energy source Yeast extract 2.5 g source of RNA nucleotides Vitamin premix Mineral premix Emulsifier Water Optional ingredients As mentioned elsewhere EXAMPLE 2 ositions having thickeners that are suitable for the nutritional supply of patients with or at risk of dysphagia, those who are at risk of aspiration, at high risk of pneumonia and at poor oral health risk may include onents of Table 2. Thickeners can be starches, gums or other thickeners based on plants or animals.

Table 2 EXAMPLE 3 Modular powders or liquid supplements (eg, protein) suitable for the nutritional supplement of patients with or at risk of dysphagia, those who are at risk of aspiration, at high risk of pneumonia and at poor oral health risk may include onents of Table 2 Table 3 It should be understood that various changes and modifications to the currently preferred embodiments described herein will be apparent to those skilled in the art. Such changes and modifications may be made without departing from the scope and purpose of the present matter and without diminishing its intended advantages. Therefore, it is intended that said changes and modifications may be covered by the appended claims.

Claims (21)

1. CLAIMS 1. A composition for improving oral health comprising a therapeutically effective amount of beneficial bacteria characterized in that said beneficial bacteria comprise at least one bacterium normally selected from the group consisting of: i) Salivarius streptococcus; ii) Lactobacillus reuteri; iii) Lactobacillus platarum 299 or 299v; iv) Streptococcus salivarius K12; v) Lactobacillus reuteri ATCC55730; vi) Lactobacillus johnsonii La1; vii) Lactobacillus rhamnosus GG; viii) Streptococcus thermophilus NCC 1561; ix) Lactococcus lactis NCC221 1 (Pelargon chain); Y x) Lacteol. 2. The composition according to claim 1, further characterized in that said beneficial bacterium is at least an innate bacterium normally for the oral cavity. 3. The composition according to claim 1, further characterized in that said composition comprises bacteria that are inactive. 4. The composition according to claim 1, further characterized in that said composition is a lozenge, candy with stick, envelope or film that can be dissolved. 5. The composition according to claim 1, characterized in addition because said composition further comprises a topical compound. 6. The composition according to claim 1, further characterized in that said composition further comprises a thickener. 7. A composition for reducing the incidence of aspiration pneumonia comprising a therapeutically effective amount of beneficial bacteria characterized in that said beneficial bacteria comprise at least one bacterium normally selected from the group consisting of: i) Salivarius streptococcus; I) Lactobacillus reuteri; iii) Lactobacillus platarum 299 or 299v; iv) Streptococcus salivarius K12; v) Lactobacillus reuteri ATCC55730; vi) Lactobacillus johnsonii La1; vii) Lactobacillus rhamnosus GG; viii) Streptococcus thermophilus NCC 1561; ix) Lactococcus lactis NCC221 1 (Pelargon chain); Y x) Lacteol. 8. The composition according to claim 7, further characterized in that said beneficial bacterium is at least an innate bacterium normally for the oral cavity. 9. The composition according to claim 7, further characterized in that said composition comprises bacteria that are inactive. 10. The composition according to claim 7, further characterized in that said composition is a lozenge, candy with stick, envelope or film that can be dissolved. eleven . The composition according to claim 7, further characterized in that said composition further comprises a topical compound. 12. The composition according to claim 7, further characterized in that said composition further comprises a thickener. 13. A method of using a composition for improving oral health that is characterized in that it delivers a selected composition of any one of claims 1 to 6 to a patient. 14. The method according to claim 13, further characterized in that said improved oral health is directed to a reduction in the incidence of aspiration pneumonia. 15. The method according to claim 13, further characterized in that the overall health of the patient is improved. 16. A method of using a composition for reducing the incidence of aspiration pneumonia characterized in that it delivers a selected composition of any one of claims 1 to 6 to a patient. 17. The method according to claim 16, further characterized in that the pathogenic bacterial load in the oropharynx or nasopharynx or oropharynx and nasopharynx of a patient with dysphagia is reduced. 18. The method according to claim 16, further characterized in that the risk of morbidity is reduced. 19. The method according to claim 13 or claim 16, further characterized in that the costs of health care are reduced, wherein said reduction in health care costs are due to a decrease: incidences of aspiration pneumonia, -diagnosis of aspiration pneumonia, treatment of secondary infections, descending spiral treatments in the death, treatment of sequelae of antibiotic use and combinations thereof. 20. The method according to claim 19, further characterized in that said sequelae of the antibiotic use is selected from the group consisting of fungal infections, urinary tract infections, associated diarrhea c. difficile, resistant antibiotic bacteria, methicillin-resistant Staphylococcus aureus, c. difficile and combinations thereof. twenty-one . The method according to claim 19 further characterized in that said reduction in health care costs are due to a decreased utilization of: hospitals, skilled nursing care centers, emergency rooms, specialized care centers, rehabilitation centers, antibiotics, artificial ventilation, pulmonary rehabilitation, post-ventilation physical therapy, intravenous fluids, dental services or combinations thereof.