Antimicrobial efficacy of the combinations of Acacia nilotica,Murrayakoenigii (Linn.) Sprengel, Eucalyptus, and Psidiumguajava on primary plaque colonizers: An in vitro study.

BACKGROUND: The rise in disease incidence, increased resistance of pathogenic bacteria to currently used antibiotics and chemotherapeutics, opportunistic infections in immunocompromised individuals, and financial considerations in developing countries necessitates alternate preventive and treatment strategies for oral diseases. OBJECTIVE: The objective of the study is to assess the antimicrobial efficacy of triple and quadruple combinations of Acacia nilotica (AN), Murraya koenigii (Linn.) (MKL) Sprengel, Eucalyptus (Euca), and Psidium guajava (PS) on primary plaque colonizers. MATERIALS AND METHODS: The phytochemicals in four plants were extracted using Soxhlet apparatus. The dried extracts were diluted with dimethyl sulfoxide (DMSO) to prepare stock solutions (100 mg/ml) of each plant. The triple and quadruple combinations were prepared after mixing equal quantities of stock solutions from each plant extracts. The antimicrobial efficacy testing was done on Streptococcus mutans, Streptococcus sanguis, and Streptococcus salivarius using agar well diffusion method. Chlorhexidine of 0.2% composition and DMSO were used as positive and negative controls, respectively. The mean diameter of inhibition zone between different categories was compared using one-way analysis of variance. RESULTS: The combination of AN + MKL Sprengel + Euca + PS produced the highest mean diameter of inhibition zone (23.5 ± 2.17 mm) against S. mutans. The combination of AN + MKL Sprengel + Euca produced the maximum antimicrobial efficacy against S. sanguis (19.83 ± 1.33). CONCLUSION: All the triple and quadruple combinations of the plant extracts offered antimicrobial benefits either superior or comparable to 0.2% chlorhexidine against S. mutans, S. sanguis, and S. salivarius.

Herbal extracts in oral health care - A review of the current scenario and its future needs.

BACKGROUND: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. OBJECTIVE: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. MATERIALS AND METHODS: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. SUMMARY AND CONCLUSION: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. "Herbal shotgun" or "synergistic multitarget effects" are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance.