The Adjunctive Role of Probiotics in Periodontal Therapy: A Narrative Review

Periodontitis is a chronic inflammatory disease driven by microbial dysbiosis and an exacerbated host immune response. This leads to progressive breakdown of periodontal tissues. Although scaling and root planing remains the standard treatment, its capacity to fully restore immune balance and host–microbiota homeostasis is limited. Probiotics have emerged as promising adjunctive strategies to modulate pathways involved in periodontal disease progression. This review aimed to evaluate current clinical evidence on the use of probiotics as adjuncts in periodontal therapy. The review followed the Scale for the Assessment of Narrative Review Articles criteria, applied exclusively as a reporting-quality framework. A literature search was conducted in MEDLINE via PubMed for manuscripts indexed through January/2026, using MeSH terms related to periodontitis and probiotics. Probiotics demonstrate potential as adjunctive agents in periodontal therapy, as evidenced by improvements in clinical parameters (probing depth, clinical attachment level, and/or bleeding on probing) reported in clinical studies. However, the findings remain heterogeneous across trials. Variability in probiotic strains, CFU concentrations, administration routes, and treatment durations highlights the need for standardized clinical protocols to improve comparability and reproducibility and better establish their clinical efficacy. Stronger, long-term evidence is required to standardize therapeutic protocols.