Lactobacillus casei is a probiotic bacterium increasingly studied for its potential benefits in oral health, including applications related to oral surgery. The scientific rationale for its use centers on its ability to modulate the oral microbiome, inhibit pathogenic bacteria, and influence immune responses that may aid in healing and infection prevention following oral surgical procedures.

Several clinical studies and reviews have investigated the effects of probiotic supplementation—often including L. casei—in patients undergoing procedures such as tooth extraction, periodontal surgery, or implant placement. Evidence suggests that probiotics can reduce postoperative inflammation, decrease the risk of alveolar osteitis (dry socket), and lower the incidence of surgical site infections. A randomized controlled trial published in 2018 found that patients given a probiotic lozenge containing L. casei experienced significantly less postoperative pain and swelling after third molar extraction compared to placebo. Mechanistically, L. casei may compete with pathogenic bacteria for adhesion sites, produce antimicrobial substances, and enhance mucosal barrier function.

However, while the current evidence is promising, it is not yet definitive. The quality and size of clinical trials are variable, and more well-designed studies are needed to establish standardized protocols, optimal dosing, and duration of probiotic use. Overall, the use of L. casei to support oral surgery recovery is scientifically plausible and supported by preliminary clinical evidence, but it has not yet reached the highest levels of clinical validation.