The Effect of Toothpastes Containing Natural Extracts on Bacterial Species of a Microcosm Biofilm and on Enamel Caries Development

Enamel Caries Lesion Depth Obtained by Optical Coherence Tomography and Transverse Microradiography: A Comparative Study

INTRODUCTION

Visual imaging of subsurface caries lesions is of vital interest in dentistry, which can be obtained by invasive radiography technique as well as by available non-destructive imaging approaches. Thus, as a first step toward the development of a new innovative approach, Spectral-domain optical coherence tomography (SD-OCT) was applied to detect the lesion depth in comparison to the established reference technique (transverse microradiography [TMR]).

METHODS

Bovine enamel specimens were demineralized for 5 days, following previous studies. For OCT, the resulting artificial lesions were scanned three-dimensionally (SD-OCT) and semi-automated measured (CarLQuant). For TMR, specimens were sectioned and the lesion depth was manually determined (Inspektor Research System).

RESULTS

The range of lesion depth detected with OCT was 24.0-174.0 μm (mouth rinse study), 18.0-178.0 μm (toothpastes study) and with TMR 59.2-198.0 μm (mouth rinse study), 33.2-133.4 μm (toothpastes study). We found a strong correlation between both methods in terms of lesion depth (Spearman rankwith outlierp < 0.001, Rho = 0.75, Spearman rankwithout outlierp = 0.001, Rho = 0.79). The two methods produce similar results (Passing-Bablok regression, 1.16). As deeper is the lesion, the smallest is the difference between both methods as indicated by Bland-Altman-plots.

CONCLUSION

Especially in the case of deep lesions, the values obtained by both methods are in agreement, and OCT can potentially substitute TMR to detect and assess lesion depth with the benefit of being non-destructive.

Antibacterial Effect of Miswak herbal toothpaste Compared to Fluoride Toothpaste in High Caries Risk Patients: Randomized Clinical Trial

Background

Modern toothbrushes origin can be traced to plant-derived chewing sticks, which were documented to be used Babylonians as early as 3500 BC. Chewing sticks are routinely used for cleaning teeth in Asia, Africa, South America, and the Middle East. The aim of the current study was to evaluate the antibacterial effect of miswak herbal toothpaste compared to fluoride toothpaste using a normal toothbrush, against Streptococcus mutans in high caries risk patients.

Material and Methods

A total of 32 participants were recruited to the current clinical trial using convenience sampling randomly either to miswak or fluoride toothpastes groups (n=16). The bacterial count represented as colony-forming units per milliliter (CFU/ml) was assessed at baseline and after 1 week, 1 month and 3 months. Moreover, the ion release for silicone, calcium, phosphorus, and fluoride from both toothpastes was analyzed in addition to the pH of both toothpastes and their supernatants. Intergroup comparison was performed using independent t test, while intragroup comparison was performed using repeated measures ANOVA followed by tukey post-hoc test and paired t test when appropriate.

Results

There was no statistically significant difference between both toothpastes for the S. mutans count within each follow up period, however the bacterial count significantly decreased over time in both groups. Signal Fluoride toothpaste exhibited statistically significant higher ion release when compared to the Dabur Miswak toothpaste. There was no statistically significant difference between either toothpastes regarding pH (P = 0.5368), while comparison between supernatants of toothpastes have shown statistically significant difference (P = 0.0194), with a higher pH in miswak toothpaste.

Conclusions

Miswak herbal toothpaste possesses a potent antibacterial effect, yet its remineralization potential is questionable due to its inferior ion release that will affect the ion substantivity in saliva, which is an important factor in remineralization. Key words:High caries risk, Miswak, Fluoride, Antibacterial, Streptococcus mutans.

In Vitro Study on Green Propolis as a Potential Ingredient of Oral Health Care Products

Propolis is increasingly being discussed as an alternative to commonly used antiseptics. This in vitro study focused on the ethanolic extract of green Brazilian propolis (EEPg) as an additive in an oral health care product. We investigated (i) a potential inflammation-modulation activity of EEPg when a periodontal or Candida biofilm was exposed to monocytic (MONO-MAC-6) cells, (ii) the adhesion of oral pathogens to gingival keratinocytes and (iii) the antimicrobial and antibiofilm effect of different toothpaste formulations. EEPg decreased the levels of interleukin (IL)-1β and increased IL-10 in MONO-MAC cells challenged with a periodontal biofilm. In contact with TIGK cells, EEPg reduced the numbers of adherent Porphyromonas gingivalis to 0.5% but did not affect the adhesion of Candida albicans. The frequent brushing of a cariogenic biofilm with a toothpaste supplemented with EEPg reduced the surface microhardness loss of enamel specimens. Mixing an experimental erythritol toothpaste with 25 and 50 mg/mL of EEPg confirmed the antibacterial activity of EEPg against oral bacteria and particularly inhibited periodontal biofilm formation. The suggested toothpaste formulations seem to have potential in the prevention of caries, gingivitis and periodontitis and should be evaluated in further in vitro research and in clinical trials.

Natural products from traditional medicine as promising agents targeting at different stages of oral biofilm development

Oral cavity is an ideal habitat for more than 1,000 species of microorganisms. The diverse oral microbes form biofilms over the hard and soft tissues in the oral cavity, affecting the oral ecological balance and the development of oral diseases, such as caries, apical periodontitis, and periodontitis. Currently, antibiotics are the primary agents against infectious diseases; however, the emergence of drug resistance and the disruption of oral microecology have challenged their applications. The discovery of new antibiotic-independent agents is a promising strategy against biofilm-induced infections. Natural products from traditional medicine have shown potential antibiofilm activities in the oral cavity with high safety, cost-effectiveness, and minimal adverse drug reactions. Aiming to highlight the importance and functions of natural products from traditional medicine against oral biofilms, here we summarized and discussed the antibiofilm effects of natural products targeting at different stages of the biofilm formation process, including adhesion, proliferation, maturation, and dispersion, and their effects on multi-species biofilms. The perspective of antibiofilm agents for oral infectious diseases to restore the balance of oral microecology is also discussed.