Pomegranate extract in polyphosphate-fluoride mouthwash reduces enamel demineralization.

OBJECTIVES: To evaluate the anti-demineralizing effect of a mouthwash comprising pomegranate peel extract (PPE 3%), sodium trimetaphosphate (TMP 0.3%), and fluoride (F 225 ppm) in an in situ study, and to assess its irritation potential in an ex vivo study. METHODS: This double-blind crossover study was conducted in four phases with 7 days each. Twelve volunteers used palatal appliances containing enamel blocks, which were subjected to cariogenic challenges. The ETF formulation (PPE + TMP + F, pH 7.0), TF formulation (TMP + F, pH 7.0), deionized water (W, pH 7.0), and essential oil commercial mouthwash (CM, 220 ppm F, pH 4.3) were dropped onto the enamel twice daily. The percentage of surface hardness loss, integrated loss of subsurface hardness, calcium, phosphorus, and fluoride in enamel and biofilms were determined. In addition, alkali-soluble extracellular polysaccharide concentrations were analyzed in the biofilms. The irritation potential was evaluated using the hen's egg chorioallantoic membrane test through the vascular effect produced during 300-s of exposure. RESULTS: ETF was the most efficacious in preventing demineralization. It also showed the highest concentrations of calcium and phosphorus in the enamel and in the biofilm, as well as the lowest amount of extracellular polysaccharides in the biofilm. In the eggs, ETF produced light reddening, whereas CM led to hyperemia and hemorrhage. CONCLUSIONS: The addition of PPE to formulations containing TMP and F increased its anti-demineralizing property, and this formulation presented a lower irritation potential than the CM. CLINICAL RELEVANCE: ETF can be a promising alternative alcohol-free mouthwash in patients at high risk of caries.

Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases.

Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully incorporated into toothpastes and mouthwashes to control plaque biofilms and to prevent and treat gingivitis and periodontitis. The aim of this article was to review recent developments in the antiplaque, anti-gingivitis, and anti-periodontitis properties of some common compounds in toothpastes and mouthwashes by evaluating basic and clinical studies, especially the ones published in the past five years. The common active ingredients in toothpastes and mouthwashes included in this review are chlorhexidine, cetylpyridinium chloride, sodium fluoride, stannous fluoride, stannous chloride, zinc oxide, zinc chloride, and two herbs-licorice and curcumin. We believe this comprehensive review will provide useful up-to-date information for dental care professionals and the general public regarding the major oral care products on the market that are in daily use.

Evaluation of the Effectiveness of Crotoxin as an Antiseptic against Candida spp. Biofilms.

The growing number of oral infections caused by the Candida species are becoming harder to treat as the commonly used antibiotics become less effective. This drawback has led to the search for alternative strategies of treatment, which include the use of antifungal molecules derived from natural products. Herein, crotoxin (CTX), the main toxin of Crotalus durissus terrificus venom, was challenged against Candida tropicalis (CBS94) and Candida dubliniensis (CBS7987) strains by in vitro antimicrobial susceptibility tests. Minimum inhibitory concentration (MIC), minimum fungicidal concentration (MFC), and inhibition of biofilm formation were evaluated after CTX treatment. In addition, CTX-induced cytotoxicity in HaCaT cells was assessed by MTT (3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide) colorimetric assay. Native CTX showed a higher antimicrobial activity (MIC = 47 µg/mL) when compared to CTX-containing mouthwash (MIC = 750 µg/mL) and nystatin (MIC = 375 µg/mL). Candida spp biofilm formation was more sensitive to both CTX and CTX-containing mouthwash (IC100 = 12 µg/mL) when compared to nystatin (IC100 > 47 µg/mL). Moreover, significant membrane permeabilization at concentrations of 1.5 and 47 µg/mL was observed. Native CTX was less cytotoxic to HaCaT cells than CTX-containing mouthwash or nystatin between 24 and 48 h. These preliminary findings highlight the potential use of CTX in the treatment of oral candidiasis caused by resistant strains.

[Effects of Oral Gargling with Aroma Solution in Psychiatric Inpatients: A Non-Randomized Controlled Trial].

PURPOSE: The purpose of this study was to examine the effects of oral gargling with an aromatic solution on xerostomia, objective oral status, and oral health-related quality of life in psychiatric inpatients. METHODS: A nonequivalent control group with a non-synchronized design was used in this study. The experimental group (n=34) received oral gargling with an aroma solution, while the control group (n=33) gargled with 0.9% normal saline. Dependent variables were measured at pre-, post-, and follow-up test. Data were analyzed using an χ²-test, Fisher's exact probability test, t-tests, and repeated measures ANOVA using SPSS/WIN v.21.0. RESULTS: After the intervention, significant differences were revealed in xerostomia (F=15.30, p <.001), objective oral status (F=38.44, p <.001), and oral health-related quality of life (F=62.70, p <.001) with an interaction effect between group and time. CONCLUSION: These findings indicate that gargling with an aroma solution is more effective than 0.9% normal saline for the oral health of psychiatric inpatients. Therefore gargling with an aroma can be safely recommended as a brief, economical, and positive intervention in clinical settings.

Effect of black tea and matrix metalloproteinase inhibitors on eroded dentin in situ.

Purpose of this in situ study was to evaluate the surface properties of eroded dentin specimens activated with three different matrix metalloproteinase (MMP) inhibitors (chlorhexidine [CHX], fluoride, green tea), black tea, and water. One hundred eighty dentin samples were prepared from extracted third molars and then samples divided into six groups. Ten volunteers were carried three specimens of each group, on acrylic palatal appliances, which were fabricated exactly for them (n = 3). Erosive cycles were done by immersing appliances in cup containing Cola and was followed by rinsing with test solutions. Microhardness values were measured. Surface properties were investigated by atomic force microscopy (AFM). Lowest change in microhardness was shown in fluoride group whereas negative control group (water) had the highest change. There were no statistically significant differences among surface roughness changes (p > .05). The least change in microhardness was seen in the fluoride group (13.05 ± 8.07), while the control group showed the highest change (33.80 ± 12.42) and was statistically significant when compared to other groups (p < .05). Besides lowest depth, values were shown in fluoride group as well. AFM evaluations showed macromolecular deposits on surfaces of fluoride, CHX, and black tea groups. No superior results were detected in CHX + fluoride group and black tea showed similar surface characteristics as green tea. Mouthrinses containing not only green tea but also black tea could be beneficial for patients with exposed dentin surfaces. Catechines and theaflavins in teas could be useful for improving surface quality.

The Contribution of Photodynamic Inactivation vs. Corsodyl Mouthwash to the Control of Streptococcus mutans Biofilms.

This work compared the inhibition effect of the commercially available mouthwash Corsodyl, containing 0.1% chlorhexidine digluconate, and photodynamic inactivation (PDI) employing methylene blue (MB) with irradiation from a red laser on 24-h biofilms formed by Streptococcus mutans strains on hydroxyapatite surfaces. The cytotoxicity of Corsodyl and MB was evaluated by Galleria mellonella surviving assay. The viability of biofilm cells after exposure to mouthwash and PDI was determined by counting colony-forming units. The inhibitory effect of antimicrobial agents was confirmed by confocal scanning laser microscopy. MB did not exhibit a cytotoxic effect on larval survival. Non-diluted Corsodyl slightly decreased the survival of larvae. Using our PDI parameters achieved better inhibition than with non-PDI, proving a significant effect on the eradication of S. mutans biofilms and therefore could be an appropriate supplement for the eradication of dental caries.

Design and study of anticaries effect of different medicinal plants against S.mutans glucosyltransferase.

BACKGROUND: The present study was aimed to evaluate the molecular level anticaries effect of different medicinal plants against Streptococcus mutans (S.mutans) glucosyltransferases (gtf). METHODS: A total of six natural sources named as Terminalia chebula (T.chebula), Psidium guajava (P.guajava), Azadirachta indica (A.indica) and Pongamia pinnata (P.pinnata); two essential oils, clove (Syzygium aromaticum) and peppermint oil (Mentha piperita) were selected as test samples. Hydroalcoholic plant extracts and essential oils were examined for their inhibitory potential on gtf isolated from S.mutans. Polyherbal mouth wash was prepared and its effect on gtf activity was compared with commercial chlorhexidine mouth wash (5%w/v). Enzyme kinetic study was carried out in order to explore the molecular mechanism of enzyme action. RESULTS: Out of six natural sources tested, A.indica has shown maximum inhibitory effect of 91.647% on gtf and T.chebula has shown IC50 of 1.091 mg/ml which is significant when compared to standard chlorhexidine. From the final result of kinetic analysis it was found that T.chebula, P.guajava and P.pinnata have show uncompetitive inhibition where as A.indica has shown non-competitive inhibition. Surprisingly, both essential oils have shown allosteric inhibition (sigmoidal response). The polyherbal moutwash has shown significant inhibitory potential on gtf (95.936%) when compared to commercial chlorhexidine mouthwash (p < 0.05). CONCLUSION: All the tested samples have shown considerable gtf inhibitory action. Moreover polyherbal mouth wash has shown promising noncompetitive inhibitory activity against gtf and it could be the future formulation to combat dental caries.

Clinical, in vitro and phytochemical, studies of Scrophularia striata mouthwash on chronic periodontitis disease.

ETHNOPHARMACOLOGICAL RELEVANCE: Chronic periodontitis is an inflammatory process of the oral cavity that is caused by different reasons. Streptococcus mutans bacteria is the main cause of the disease. Scrophularia striata in Iranian traditional medicine is used to heal inflammation of gum and mouth. Also, In vitro anti-bacterial effect of S. striata in S. mutans have been demonstrated. AIM OF THE STUDY: Clinical, in vitro and chemical constituent studies of S. striata on chronic periodontitis disease. MATERIALS AND METHODS: This study is a randomized clinical trial that was performed in Dental College, Hamadan University of Medical Sciences. Fifty patients with chronic periodontitis (20-50 years old) were selected and the study was approved and registered in Iranian Registry of Clinical Trials as number IRCT2015081323468N1 prior to the experiment. The 50 patients were divided into two groups. One group used herbal mouthwash that was made from hydro alcoholic extract of S. striata and another group used Irsha mouthwash (Iranian form of Listerine mouthwash). Patients were followed up after two weeks and four weeks of using mouthwash for assessment of plaque index (PI), pocket depth (PD), bleeding on probing (BOP) and counting Streptococcus mutans. The mouthwash was standardized according to gallic acid, quercetin and apigenin reference using the RP-HPLC method. The total phenolic and flavonoids contents were also determined spectrophotometerically. RESULTS: S. striata in the short term, improve plaque index, pocket depth and bleeding on probing but the number of Streptococcus mutans changed significantly in the long term and is more potent in comparison to Irsha mouthwash. The mouthwash was standardized according to gallic acid, quercetin and apigenin standard (3, 24, 11 µg, respectively). The total phenolic and flavonoid content of mouthwash were 120.7 µg GAE/100 cc and 78.6 µg QE/100 cc respectively. CONCLUSIONS: S. striata mouthwash is effective in the treatment of chronic periodontitis disease and is more potent comparing the Iranian Irsha mouthwash.

Effectiveness of an Alcohol-Free Chitosan-Curcuminoid Mouthwash Compared with Chlorhexidine Mouthwash in Denture Stomatitis Treatment: A Randomized Trial.

Objective: An alcohol-free mouthwash of curcuminoids purified from the turmeric (Curcuma longa Linn.) rhizome was formulated using a cosolvent system, comprising chitosan and polyethylene glycol (PEG) 400, and determined for its efficacy and safety in management of denture stomatitis (DS) in comparison with a chlorhexidine (CHX) mouthwash. Design: A single-center, randomized, controlled parallel-arm trial was conducted. Setting: The study took place at the Faculty of Dentistry, Prince of Songkla University, Hat-Yai, Thailand, between June 2016 and June 2017. Subjects: Participants were 20 years old or older adults of both genders, using removable dentures, and with a confirmed diagnosis of DS from an oral medicine specialist. Interventions: A total of 30 patients were randomly assigned to 3 different interventions, including the chitosan-curcuminoid (CHI-CUR) mouthwash, CHX mouthwash, and a vehicle formulation comprising chitosan and PEG 400. Ten milliliters of each intervention was given to the patient to be used for 30 sec, three times a day at 8 am, 12 pm, and 4 pm, for 2 weeks. Outcome measures: Outcome measures included complete relief of erythematous lesions under the denture and reduction in the number of candida colonies present in the denture-fitting surface. Results: Eight of 10 patients (80%) using the CHI-CUR mouthwash had a complete response after the 2-week treatment course compared with 30% of patients using the CHX mouthwash (p < 0.05). Both interventions exerted comparable anticandida efficacy. No oral or systemic adverse events that could possibly be related to the use of mouthwash were documented. Conclusions: The finding indicated that an alcohol-free CHI-CUR mouthwash may serve as a safe and potential topical therapeutic alternative in treating generalized or candida-associated DS.

Benefits of sea buckthorn (Hippophae rhamnoides) pulp oil-based mouthwash on oral health.

AIM: The purpose of this study was to conduct phytochemical analysis of sea buckthorn pulp oil and to evaluate the antimicrobial, anti-biofilm and antioxidant activities of its mouthwash form. METHODS AND RESULTS: Fatty acid composition of the sea buckthorn pulp oil was determined by GC-MS analysis, which revealed that, mono-unsaturated fatty acid, palmitoleic acid and saturated fatty acid, palmitic acid, were the major constituents. The antimicrobial and the anti-biofilm capacities of sea buckthorn pulp oil mouthwash form were evaluated against Streptococcus gordonii, Porphyromonas gingivalis, Actinomyces viscosus and Candida albicans, according to the European Norms, and the Biofilm Ring Test® , respectively. These activities were then compared with those of chlorhexidine and herbal mouthwashes. The sea buckthorn-based mouthwash was bactericidal against S. gordonii and P. gingivalis, bacteriostatic against A. viscosus and showed no antifungal effect. Regardless of the strains used, complete inhibition of biofilm formation was achieved. The antioxidant activity of this experimental mouthwash was also assessed by DPPH and NBT assays. CONCLUSION: Sea buckthorn mouthwash showed anti-biofilm activities against select single and multiple oral bacterial species. SIGNIFICANCE AND IMPACT OF THE STUDY: In this study, a mouthwash derived from sea buckthorn (Hippophae rhamnoides) pulp oil has been experimented, for the first time, in order to overcome the problem of a large number of available synthetic mouthwashes which have side effects on teeth, gums and mucous membranes. This mouthwash seemed to be a suitable alternative for a preventive agent for periodontal inflammation.

An Herbal Alternative to Control Nosocomial Pathogens in Aerosols and Splatter During Ultrasonic Scaling

Abstract Objective: To evaluate the efficacy of herbal mouthwash (Himalaya Hiora Regular) against methicillin-resistant Staphylococcus aureus and Acinetobacter baumanni during ultrasonic scaling. Material and Methods: Group B (n=25) received herbal mouthwash and Group A (n=25) received 0.12% chlorhexidine mouthwash respectively as a preprocedural rinse. The aerosols produced by the ultrasonic unit were collected on MeReSa and Leeds Acinetobacter Agar plates. The experimental setting included eight different locations covering all areas of the operatory. The plates exposed to aerosols for a period of 30 minutes were incubated aerobically at 37ºC for 48hrs and the colony forming units (CFU) were statistically analyzed Results: Herbal mouthwash (Himalaya Hiora Regular) showed a significant reduction in mean CFU of MRSA compared to 0.12% chlorhexidine. While herbal mouthwash was on par with 0.12% chlorhexidine in the reduction of A. baumannii Conclusion: Herbal mouthwash was found to be more effective against MRSA than 0.12% Chlorhexidine mouthwash as a pre-procedural rinse. Both herbal mouthwash and chlorhexidine mouthwash was found to be effective against A. baumannii. Herbal mouthwash may be a safe alternative to chlorhexidine against nosocomial pathogens like MRSA and A. baumannii.

Effect of a Toothpaste/Mouthwash Containing Carica papaya Leaf Extract on Interdental Gingival Bleeding: A Randomized Controlled Trial.

Clinical research on herbal-based dentifrice +/- mouth rinse products is very limited compared with the plethora of research on conventional oral care products under normal oral hygiene conditions. The aim of this study was to determine the anti-inflammatory effects of a novel plant Carica papaya leaf extract (CPLE) on interdental bleeding in healthy subjects. In this randomized, single-blind parallel-design study, the eligible subjects were generally healthy non-smokers, aged 18⁻26, who exhibited healthy periodontal conditions upon study entry. The participants were equally randomized into the following four groups: CPLE dentifrice, CPLE dentifrice and mouthwash, sodium lauryl sulfate (SLS)-free enzyme-containing dentifrice and SLS-free enzyme-containing dentifrice with essential oil (EO) mouthwash. Subjects were instructed to brush their teeth twice a day without changing their other brushing habits. Interdental bleeding (BOIP) was measured from inclusion (T0) until the fourth week (T4) of the study. Clinical efficacy was assessed after one, two, three and four weeks of home use. The analyses compared BOIP between groups and were then restricted to participants with ≥70% and then ≥80% bleeding sites at T0. Pairwise comparisons between groups were performed at T0 and T4, and a logistic regression identified correlates of gingival bleeding (T4). Among 100 subjects (2273 interdental sites), the median percentage of bleeding sites per participant at T0 was 65%. The bleeding sites dramatically decreased in all groups between T0 and T4 (relative variations from -54% to -75%, p < 0.01 for all). Gingival bleeding did not significantly differ between the CPLE dentifrice and the SLS-free dentifrice +/- EO mouthwash groups (from p = 0.05 to p = 0.86), regardless of the baseline risk level. Among the CPLE dentifrice users, fewer bleeding sites were observed when toothpaste and mouthwash were combined compared to bleeding sites in those who used toothpaste alone (21% vs. 32%, p = 0.04). CPLE dentifrice/mouthwash provides an efficacious and natural alternative to SLS-free dentifrice +/-EO-containing mouthwash when used as an adjunct to mechanical oral care to reduce interdental gingival inflammation.

Characterization of phenolic compounds in tincture of edible Nepeta nuda: development of antimicrobial mouthwash.

The activity of edible Nepeta nuda L. (Lamiaceae) tincture and Listerine towards a selected group of oral pathogenic microorganisms (4 bacterial and 9 fungal strains) has been explored. Their potentials to inhibit the formation of biofilm and to diminish established biofilm have been compared. The amount of N. nuda tincture and swishing time necessary for reaching better or equivalent antimicrobial effect than that of Listerine have been predicted. Phenolic compounds in N. nuda tincture are determined by LC-DAD/ESI-MSn. Both Listerine and N. nuda tincture possess good antimicrobial potentials (MIC in the range of 0.8-15 µL per well) including inhibition of biofilms. Rosmarinic acid and verminoside are the most dominant phenolic compounds present in the N. nuda tincture. Based on in vitro results, we infer that it is more desirable to swish 20 mL of mouthwashes (Listerine and N. nuda tincture, 100 mg mL-1) for 30 s when dealing with selected microorganisms in general and for 60 s (N. nuda tincture) when dealing with bacterial biofilms.

Assessment of Ions released from Three Types of Orthodontic Brackets immersed in Different Mouthwashes: An in vitro Study.

AIM: Herbs are used widely in medicine. The purpose of the present study was to assess the ion release from gold-plated orthodontic bracket compared with other stainless steel brackets, and based on the findings of the study, the orthodontists can choose the most biocompatible brackets and mouthwashes useful in the clinical practice. MATERIALS AND METHODS: A total of 150 orthodontic brackets from Orthotechnology™ Company, USA (50 stainless steel one-piece brackets, 50 stainless steel two-piece brackets, and 50 gold brackets) were immersed in four mouthwashes in addition to distilled water. Ten of each type of brackets in every media were immersed under 37°C for 45 days. Ions released in these mouthwashes were measured, and comparisons among different bracket types and among various mouthwashes were done by one-way analysis of variance (ANOVA) and then with Games-Howell tests. RESULTS: Increased amounts of ions released in herbal mouth-washes were recorded in gold and two-piece brackets in comparison with one-piece stainless steel brackets. CONCLUSION: Herbal mouthwashes must be used with caution as they showed an increased amount of ions released in comparison with chlorhexidine. One-piece stainless steel bracket system is the most compatible bracket type, as they released the least amount of ions. CLINICAL SIGNIFICANCE: One-piece stainless steel brackets are better than two-piece brackets in terms of ions released.

Phytochemical composition and in vitro screening of the antimicrobial activity of essential oils on oral pathogenic bacteria.

In this study, the activity of essential oils (EOs) against microorganisms involved in oral diseases was evaluated. Fourteen EOs were selected and subjected to gas chromatographic analysis, including Illicium verum, Eucaliptus globulus, Eugenia caryophyllata, Leptospermum scoparium, Mentha arvensis, Mentha piperita, Myrtus communis, Salvia officinalis, Melaleuca alternifolia, Rosmarinus officinalis, Lavandula x intermedia, Thymus capitatus and Thymus vulgaris. These EOs were tested for their antimicrobial activity on Streptococcus mutans and Lactobacillus species clinically isolated from dental surgery patients. The antibacterial activity was evaluated by means of the disc diffusion and the minimum inhibitory concentration (MIC). Five EOs, having shown an interesting antimicrobial activity, were selected for a second screening in combination between them and with chlorhexidine. From the second assays, two EO-EO and three EO-chlorhexidine associations gave interesting results as potential constituents of mouthwashes, especially for the contribution of oxygenated monoterpenes, including menthol, thymol and carvacrol.

Whitening Efficacy of Whitening Mouth Rinses Used Alone or in Conjunction With Carbamide Peroxide Home Whitening.

OBJECTIVES: The aim of this study was to compare the effectiveness of whitening mouth rinses on teeth previously whitened or not, exposed to food dyes. METHODS AND MATERIALS: One hundred twenty enamel-dentin specimens, 3 mm in diameter, were obtained from bovine incisors. The specimens were stained for 14 days in staining broth. After staining, the initial color reading was performed via a spectrophotometer CM-2600d (Konica Minolta). Half of specimens were submitted to whitening (10% carbamide peroxide [CP]) for 14 days. They were then divided into three groups and were submitted to cycles of staining (five minutes) and mouth rinses (two minutes) for 12 weeks, with the following: CP-LI, Listerine Whitening; CP-PL, Plax Whitening; CP-BP, bromelain + papain; CP-DW, deionized water. LI, PL, BP, and DW groups were submitted to the same cited cycles but with no prior bleaching. The color measurements were performed after four, eight, and 12 weeks of treatment with mouth rinses. Data were submitted to repeated measures analysis of variance (ANOVA) and Tukey's test for multiple comparisons, with significance level at 5%. RESULTS: The results showed that the CP-LI, CP-PL, LI, and PL groups had greater color change than did the others. The CP-BP and BP groups were similar to CP-DW and DW. CONCLUSIONS: We therefore conclude that Listerine Whitening mouth rinse presented the highest bleaching effect, followed by Plax Whitening mouth rinse. Both maintained CP bleaching effect after 12 weeks of dye-rinse cycles. However, none of these rinses were able to produce whitening similar to CP. Bromelain- and papain-containing mouth rinses did not show bleaching effect, being similar to the control groups.

Oil-based compositions as saliva substitutes: A pilot study to investigate in-mouth retention.

OBJECTIVES: This pilot study aimed to compare the in-mouth retention of an oil-based saliva substitute (emulsion, consisting of rice bran oil, soy lecithin and water) with water and a 1% w/v methylcellulose suspension (polymer) in healthy volunteers. METHODS: Each formulation was tagged with 1 mmol/L lithium and participants (n=30) rinsed their mouth with one randomly assigned formulation (emulsion, polymer or water) for 30s, before expectorating into a cup. Concentration of lithium expectorated was measured and amount of each formulation remaining in the mouth was estimated. Patient acceptability was investigated using questionnaires, and Fourier-Transform Infrared spectroscopy (FTIR) was used to determine the presence of oil in expectorated samples. RESULTS: Immediately after rinsing, taste was rated lower in the emulsion group compared to the polymer or water groups (p>0.05), although variability was high. Mean retention was highest in the emulsion group, with a difference of 8.34 ± 2.71% (p=0.003) and 4.57 ± 2.71% (p=0.06) compared with the water and polymer groups, respectively. FTIR confirmed the presence of oil in all expectorated emulsion samples. CONCLUSION: The emulsion was not inferior to the polymer in terms of retention immediately after rinsing. The next step is to conduct larger clinical studies over longer time periods in participants with salivary hypofunction.

Baccharis dracunculifolia-based mouthrinse alters the exopolysaccharide structure in cariogenic biofilms.

Baccharis dracunculifolia is a native plant from Brazil with antimicrobial activity. The purpose of this study was to investigate whether a B. dracunculifolia-based mouthrinse (Bd) changes the structure of insoluble exopolysaccharides (IEPS) in Streptococcus mutans UA159 cariogenic biofilm. Biofilms were grown on glass slides and treated with Bd, its vehicle (VC), chlorhexidine digluconate (CHX), or saline solution (NaCl). Among the treatments, only CHX significantly reduced the biofilm biomass and bacterial viability (p<0.05). Gas chromatography-mass spectrometry and nuclear magnetic resonance analyses revealed that IEPS from the four biofilm samples were α- glucans containing different proportions of (1→6) and (1→3) glycosidic linkages. The structural differences among the four IEPS were compared by principal component analysis (PCA). PCA analysis indicated that IEPS from VC- and NaCl-treated biofilms were structurally similar to each other. Compared with the control, IEPS from Bd- and CHX-treated biofilms were structurally different and had distinct chemical profiles. In summary, the fact that Bd changed the IEPS chemical composition indicates that this mouthrinse may affect the cariogenic properties of the S. mutans biofilm formed.

Anti-plaque and antimicrobial efficiency of different oral rinses in a 3-day plaque accumulation model.

The idea of incorporating a mouthrinse with normal tooth brushing could be a useful adjunct to oral hygiene. Despite the principle nature of the toothpaste vehicle, most alcohol-based chemical plaque-control agents have been evaluated and later formulated in the mouthrinse vehicle. The current study was aimed to investigate the persistence of antimicrobial action and plaque inhibitory properties of a new alcohol-free mouthrinse when compared with positive control, chlorhexidine 0.12% and placebo control, physiologic saline solution mouthrinses. The evaluation of the antimicrobial activity was performed by saliva samples collected during the 3 days of usage. The results of this study indicate that this new oral rinse has an equivalent plaque inhibitory action to chlorhexidine, and the plaque inhibitory action of the rinse appears to be derived from a persistence of antimicrobial action in the mouth. Furthermore, no side effects were reported during the study, and the additional benefit of no alcohol presence in the rinse solution.

Effectiveness of an alcohol-free essential oil-containing mouthwash in institutionalised elders receiving long-term care: a feasibility study.

OBJECTIVES: To conduct a feasibility study on investigating the effectiveness of an alcohol-free essential oil mouthwash (AF-EOMW) to reduce plaque accumulation and oral pathogen levels in institutionalised elders receiving long-term care and to obtain preliminary results. BACKGROUND: Although simple, cost-effective strategies to improve oral hygiene in seniors such as the use of mouthwashes have been shown to reduce the risks of respiratory diseases, little information is available on the feasibility of implementing these measures. METHODS: Twenty-five elderly participants with significant loss of autonomy were initially recruited and divided into two groups. A test group rinsed with an AF-EOMW twice a day, and a control group rinsed with tap water. Data on demographic characteristics, dental history and tobacco use were collected from a questionnaire. Problems encountered during recruitment and data collection were documented. Plaque index, denture cleanliness and salivary levels of several pathogens were measured at three time points: baseline (T0 ), day 22 (T1 ) and day 45 (T2 ). RESULTS: Eighteen participants completed the study. Several problems were encountered during recruitment and execution of the study protocol. No significant differences in clinical or microbiological measures were found between the test group and controls at three time points (p > 0.05). CONCLUSION: This pilot study shows that, if sufficient logistical and financial resources are available, it is feasible to conduct randomised clinical trials in a seniors' facility. The use of an AF-EOMW to improve oral hygiene in seniors was not found to be superior to tap water. However, larger controlled clinical studies are needed to confirm these results.