Comparative evaluation of a herbal mouthwash (Freshol) with chlorhexidine on plaque accumulation, gingival inflammation, and salivary Streptococcus mutans growth

Comparative Assessment of Herbal Mouthwash with Chlorhexidine on Plaque Accumulation, Gingivitis, and Salivary Streptococcus mutans Growth

Objectives

The goal of the current study was to assess the effectiveness of a commercially available herbal mouthwash with chlorhexidine on the number of Streptococcus mutans in the saliva, the condition of the gingival tissue, and plaque development.

Materials and Methods

Twenty-two adults in all, ranging in age from 20 to 30, were divided into two groups at random. Throughout the 14-day clinical trial, Group A (11) and Group B (11) received 10 mL of test herbal mouthwash and chlorhexidine, respectively.

Result

Herbal mouthwash was discovered to be equally as effective as chlorhexidine in lowering the salivary mutans streptococci count and in affecting plaque and gingival scores.

Conclusion

Alternatives from the herbal world may show to be a reliable and secure therapy option.

Efficacy of herbal alternatives in maintaining oral health in cancer patients: A systematic review

Herbal rinses possess different medicinal properties. Numerous studies have reported the usefulness of various herbal oral rinses. Few studies claimed that herbal rinses are superior to synthetic mouth rinses for certain purposes, but there appears to be a lack of sound scientific evidence to prove the efficacy of herbal rinses in controlling oral plaque in cancer patients. This review analyses the various clinical studies on herbal rinses and aims to find the safety and efficacy of red ginseng mouth rinses over other available mouth rinses in carcinoma patients. A thorough electronic search was conducted in various databases and 10 articles were included in the review based on the inclusion and exclusion criteria. The data extracted were tabulated and analyzed. The risk of bias table was drawn. Meta-analysis was not performed due to the heterogeneity of the included studies. Of the 10 clinical trials included in the review, three studies appeared to have low risk of bias. The mean follow-up period was 14 days, ranging from 7 to 21 days. The sample size in each study was reported to be between 10 and 50, except one study with 240 samples. Seven studies have reported a significant difference between the herbal mouth rinse group and the chlorhexidine group. Of all the herbal rinses, mouth rinses with ginger extracts show more efficacy over other herbal rinses and red ginseng appears to be a more safer herbal rinse. Based on the available evidence, herbal mouth rinses are comparable to synthetic mouth rinses in their anti-bacterial properties. The red ginseng with anti-bacterial, anti-inflammatory and anti-cancerous properties may be an alternative mouth rinse in cancer patients. However, further clinical trials with more samples are required for better evidence.

Systematic Review on the Use of Homeopathy in Dentistry: Critical Analysis of Clinical Trials

Objectives: The objective of this research was to systematically map the literature on homeopathy and dentistry studies and to evaluate the effectiveness of using homeopathy in dental practice through the critical analysis of clinical studies. Design: The search for scientific articles in any language, year, and place of publication was made in the databases of Public Medline (PUBMED), Web of Science, Cochrane, and Virtual Health Library; the articles selected were later classified according to the type of study. Gray literature was accessed through Google Scholar. Clinical trials were analyzed for methodological quality. Two previously trained reviewers accomplished the entire process independently. Results: Of the 281 studies retrieved by means of the search, 44 met the eligibility criteria, with prevalence of literature reviews (56.8%), followed by clinical trials (34.1%), cross-sectional studies (6.8%), laboratory research (6.8%), and longitudinal observational studies (4.5%). The clinical trials identified were published from 1965 to 2019, using homeopathy in several dental specialties: in Endodontics, Periodontics, Orofacial Pain, Surgery, Pediatric Dentistry, and Stomatology, as well as in cases of dental anxiety. Qualitative failures, in all criteria investigated, and positive influences of the individual prescriptions on the results of treatments reported were observed. Conclusions: There is still a scarcity of studies about homeopathy and dentistry. The clinical trials selected showed positive effects on oral health; however, when they were critically evaluated, it was possible to recognize qualitative failures, mainly relative to double-blinding. It is necessary to encourage research on the subject, using standardized methodological procedures, to obtain better evaluation of the clinical applicability.

Effect of Herbal Water, Ozonated Water, Water, and Chlorhexidine Mouthrinses on Oral Health Status of Children: A Randomized Controlled Trial

Aim

To evaluate the antibacterial effect of herbal water, ozonated water, and chlorhexidine mouthrinses on salivary Streptococcus mutans level and to assess their effectiveness of these mouthrinses on the oral health status of children.

Materials and methods

A parallel multiarm randomized controlled trial was conducted in 100 children aged 10–12 years. Debris index-simplified (DI-S), calculus index-simplified (CI-S), oral hygiene index-simplified (OHI-S) scores, and Streptococcus mutans counts were recorded at baseline (T₁). They were randomly divided into four equal groups (n = 25): HW, herbal water; OW, ozonated water; W, water; and CHX, chlorhexidine. Intervention period was 15 days and data collection was repeated after 15 days (T₂) and 30 days (T₃). Saliva samples were used to evaluate S. mutans count. Results were tabulated and analyzed statistically.

Results

OW had minimum DI-S score at T₂ and T₃ periods. HW had the minimum CI-S score at T₂ and T₃ periods. CHX had the minimum S. mutans count at T₂ and T₃ periods. OW showed maximum reduction in OHI-S score at T₂ period. HW showed maximum reduction in OHI-S score at T₃ period.

Conclusion

Herbal water and ozone water can be used as an alternative to chlorhexidine in maintaining the oral health status.

Clinical significance

Herbal water and ozonated water can be used in children instead of chemical mouthrinses to avoid any adverse effects.

How to cite this article

Mon J, Asokan S, Priya PRG, et al. Effect of Herbal Water, Ozonated Water, Water, and Chlorhexidine Mouthrinses on Oral Health Status of Children: A Randomized Controlled Trial. Int J Clin Pediatr Dent 2019;12(6):514–519.

The effect of antimicrobial activity of Teucrium Polium on Oral Streptococcus Mutans: a randomized cross-over clinical trial study

Background

The purpose of this study is to determine the effect of a mouthwash containing Teucriumpolium herb on Streptococcus mutans in mouth.

Methods

This study was a randomized, crossover, double-blind clinical trial, where we selected 22 volunteers (dental students) randomly and we divided them into two groups. The study had two phases. In each phase, one group acted as the intervention group, while the other one was the control group. Both the intervention and control groups were given the mouthwash with and without Teucriumpolium, respectively. S. mutans of saliva were measured before and after each phase to compare the effects of the mouthwashes. A three-week washout period was considered between the two phases. An independent two-sample t-test was utilized to compare the mean of S. mutans colonies. Additionally, we used a standard AB/BA crossover model to find the results of the treatment and the impact of carryover on the residual’s biological effects. The significance level was considered 0.05 in this experiment.

Results

There is no significant difference observed between the two groups in the number of S. mutans before using the mouthwashes. When the mouthwash containing Teucriumpolium was used, there was a significant decrease in the number of S. mutans colonies in both phases’ extract (P = 0.002). Conclusion: The results of this study indicate the mouthwash containing aqueous extract of Teucrium polium can majorly reduce the colonization of S. mutans in human saliva.

Trial registration

Ethical issues approved by the Ethics Committee of the Rafsanjan University of Medical Sciences with the approval number of 937/9/31, IRCT code Number of IRCT2013121815842N1 and it was approved on 06/16/2014. The study was conducted in the period of September to November 2014.

Comparison of Antimicrobial Efficacy of (between) 0.2% Chlorhexidine and Herbal Mouthwash on Salivary Streptococcus mutans: A Randomized Controlled Pilot Study

Background:

The chemomechanical plaque control measures are helpful in controlling dental plaque and thus caries, especially in pediatric age group.

Aim:

This study aims to compare effectiveness of herbal mouthrinse containing Terminalia chebula to that of 0.2% chlorhexidine against children's salivary mutans streptococci levels.

Settings and Design:

A double-blind, randomized, controlled study design will be framed for conducting this study.

Methods:

A total of 45 participants were randomly categorized in Group 1, Group 2, or Group 3 (control group, experimental group, or negative control). Baseline unstimulated saliva was collected. All the participants were instructed regarding the use of mouthrinse for 2 weeks. After 2 weeks, again unstimulated saliva was collected. After collection, saliva samples were sent for microbiological analysis.

Statistical Analysis:

The mean colony-forming units (CFU/ml) were determined. Paired t-test, ANOVA test, and post hoc test were applied for statistical analysis.

Results:

Statistically significant difference in CFU count has been observed in 0.2% chlorhexidine and Oratreat groups at 15 days as compared to baseline (P < 0.001). At 15 days, reduction in CFU count has seen more in Oratreat group as compared to 0.2% chlorhexidine group, and the difference is statistically significant (P < 0.001).

Conclusion:

0.2% chlorhexidine and Oratreat mouthwash reduce the salivary Streptococcus mutans count. Oratreat herbal mouthwash has proved to be better as compared to 0.2% chlorhexidine mouthwash.

Effect of Herbal and Fluoride Mouth Rinses on Streptococcus mutans and Dental Caries among 12-15-Year-Old School Children: A Randomized Controlled Trial

To assess and compare the effect of herbal and fluoride mouth rinses on Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries, a parallel group placebo controlled randomized trial was conducted among 240 schoolchildren (12–15 years old). Participants were randomly divided and allocated into Group I (0.2% fluoride group), Group II (herbal group), and Group III (placebo group). All received 10 ml of respective mouth rinses every fortnight for a period of one year. Intergroup and intragroup comparison were done for Streptococcus mutans count and glucan synthesis by Streptococcus mutans and dental caries. Streptococcus mutans count showed a statistically significant difference between Group I and Group III (p = 0.035) and also between Group II and Group III (p = 0.039). Glucan concentration levels showed a statistically significant difference (p = 0.024) between Group II and Group III at 12th month. Mean DMF scores showed no statistical difference between the three groups (p = 0.139). No difference in the level of significance was seen in the intention-to-treat and per-protocol analysis. The present study showed that both herbal and fluoride mouth rinses, when used fortnightly, were equally effective and could be recommended for use in school-based health education program to control dental caries. Trial registration number is CTRI/2015/08/006070.

The Mouthwash War - Chlorhexidine vs. Herbal Mouth Rinses: A Meta-Analysis

INTRODUCTION

Mouthwashes are often prescribed in dentistry for prevention and treatment of several oral conditions. In the recent times the use of naturally occurring products what is otherwise known as grandmothers remedy are used on a large scale. This has now called for a newer age of mouth washes but is the new age mouth washes at par with the gold standard or even better than them this study investigates.

AIM

The aim of the present study was to compare the effect of two broad categories of mouth washes namely chlorhexidine and herbal mouth washes.

MATERIALS AND METHODS

Eleven randomized control studies were pooled in for the meta-analysis. The search was done from the Pub Med Central listed studies with the use keywords with Boolean operators (chlorhexidine, herbal, mouth wash, randomized control trials). The fixed effects model was used for analysis.

RESULTS

This meta-analysis brings to light, the fact that a wide range of newer herbal products are now available. As with a plethora of herbal mouthwashes available it is the need of the hour to validate their potential use and recommendation. This study found that only two studies favor the use of herbal products and four studies favor the use of chlorhexidine, of the 11 studies that were analyzed.

CONCLUSION

More studies are required under well controlled circumstances to prove that herbal products can equate or replace the 'gold standard' chlorhexidine. Herbal products are heterogeneous in nature, their use should be advised only with more scientific proof.

Comparative Evaluation of Antimicrobial Activity of Pomegranate-Containing Mouthwash Against Oral-Biofilm Forming Organisms: An Invitro Microbial Study

INTRODUCTION

Pomegranate is considered "A pharmacy unto itself". Hydrolysable tannins called punicalagins which have free scavenging properties are the most abundant polyphenols found in pomegranate-containing mouthwash.

AIM

To evaluate antimicrobial effect of pomegranate- containing mouthwash on oral biofilm-forming bacteria.

MATERIALS AND METHODS

The mouthwashes used were divided into three groups- Group A: Chlorhexidine mouthwash (Hexidine); Group B: Herbal Mouthwash (Hiora) and Group C: Pomegranate-containing Mouthwash (Life-extension). Each mouthwash was diluted to five different concentrations. Reference strains of Streptococcus mutans (S.mutans) (ATCC 25175), Streptococcus salivarius (S.salivarius) (ATCC 7073), and Aggregatibacter actinomycetemcomitans (A.a) (NCTC 9710) were selected as being colonizers in dental biofilm formation. On each culture plate, five wells of 5mm were prepared and mouthwashes with different concentrations were added, followed by incubation in a CO2 jar for 24 hours at 37°C. Inhibition zone diameters were measured using a digital caliper.

RESULTS

Chlorhexidine (0.12%) presented a zone of inhibition between 38.46% to 96.15% for all the three organisms, while Hiora presented zone of inhibition ranging from 33.33% to 69.23% but was resistant at <10 ml of dilution. Pomegranate mouthwash presented a zone of inhibition ranging from 38.48 to 57.69%, but was resistant at <10ml for S.mutans, and <25ml for A.a and S.salivarius. ANOVA test was done to compare the dilution of mouthwashes for a particular organism and Tukey's multiple comparison tests were done to find the exact difference. A significant difference was seen between all the three groups at 50ml and 75 ml of dilution. At 75 ml concentration, a statistical difference was found between Groups B & C and Groups A & B; and at 50 ml between Groups A&C.

CONCLUSION

All the three types of mouthwash exhibit anti-microbial activity against biofilm forming organisms but at varying concentrations. Although Chlorhexidine still continues to be the gold standard, pomegranate-containing or herbal mouthwashes can be easily substituted for long term use, avoiding the side effects of chlorhexidine.