Anti-Bacterial and Anti-Inflammatory Effects of Toothpaste with Swiss Medicinal Herbs towards Patients Suffering from Gingivitis and Initial Stage of Periodontitis: from Clinical Efficacy to Mechanisms.

Zaira F Kharaeva,Chiara De Luca,Ismail H Gazaev,Wolfgang Mayer,Liudmila G Korkina,Larisa Z Blieva,Lukas Steiner,Anzor V Khazhmetov,Magomet Sh Mustafaev

doi:10.3390/dj8010010

Zaira F Kharaeva, Chiara De Luca + Show 7 more

Open Access

https://doi.org/10.3390/dj8010010

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Abstract

Objective: To distinguish clinical effects and mechanisms of sodium monofluorophosphate plus xylitol and herbal extracts of Swiss medicinal plants (Chamomilla recutita, Arnica montana, Echinacea purpurea, and Salvia officinalis). Materials and Methods: A 2-month-long comparative clinical study of toothpaste containing 1450 ppm sodium monofluorophosphate and xylitol (control, 15 patients) and toothpaste additionally containing extracts of the medicinal herbs (experiment, 35 patients) was performed on patients with gingivitis and the initial stage of periodontitis. Clinical indices of gingivitis/periodontitis were quantified by Loe & Silness’s, CPITN, OHI-S, and PMA indexes. The pro-inflammatory and anti-inflammatory interleukins, nitrites/nitrates, total antioxidant activity, and bacterial pattern characteristic for gingivitis and periodontitis were quantified in the gingival crevicular fluid and plaque. In the in vitro tests, direct anti-bacterial effects, inhibition of catalase induction in Staphylococcus aureus, in response to oxidative burst of phagocytes, and intracellular bacterial killing were determined for the toothpastes, individual plant extracts, and their mixture. Results: Experimental toothpaste was more efficient clinically and in the diminishing of bacterial load specific for gingivitis/periodontitis. Although the control toothpaste exerted a direct moderate anti-bacterial effect, herbal extracts provided anti-inflammatory, anti-oxidant, direct, and indirect anti-bacterial actions through inhibition of bacterial defence against phagocytes. Conclusions: Chemical and plant-derived anti-bacterials to treat gingivitis and periodontitis at the initial stage should be used in combination amid their different mechanisms of action. Plant-derived actives for oral care could substitute toxic chemicals due to multiple modes of positive effects.

Highlights

The regular use of adequate toothpastes with safe active ingredients possessing anti-bacterial, anti-inflammatory, anti-oxidant, and regenerative properties is one of the most effective strategies for prevention and treatment of gingivitis, periodontal pathologies, and caries leading to teeth loss.The mouth, like other areas of the digestive tract, possesses a natural microflora, the presence of which confers several beneficial properties to the host
In the absence of adequate oral hygiene, dental plaque can accumulate beyond levels compatible with oral health. This leads to shifts in the balance of the predominant bacteria away from those associated with health; such shifts can predispose a site to caries, gingivitis, or periodontal diseases [1]
In the present clinical laboratory study, we evaluated the clinical efficacy of the toothpaste containing chemical anti-bacterial substances (sodium monofluorophosphate (1450 ppm) and Xylitol) and four medicinal plant extracts (Arnica montana, Salvia officinalis, Chamomilla recutita, and Echinacea purpurea) in a group of patients with gingivitis and initial stages of periodontitis

Summary

Introduction

The regular use of adequate toothpastes with safe active ingredients possessing anti-bacterial, anti-inflammatory, anti-oxidant, and regenerative properties is one of the most effective strategies for prevention and treatment of gingivitis, periodontal pathologies, and caries leading to teeth loss.The mouth, like other areas of the digestive tract, possesses a natural microflora, the presence of which confers several beneficial properties to the host. The regular use of adequate toothpastes with safe active ingredients possessing anti-bacterial, anti-inflammatory, anti-oxidant, and regenerative properties is one of the most effective strategies for prevention and treatment of gingivitis, periodontal pathologies, and caries leading to teeth loss. In the absence of adequate oral hygiene, dental plaque can accumulate beyond levels compatible with oral health. This leads to shifts in the balance of the predominant bacteria away from those associated with health; such shifts can predispose a site to caries, gingivitis, or periodontal diseases [1]. Possible strategies to maintain the stability and beneficial properties of the natural oral microflora include improvements to oral hygiene, for example, by using products containing safe anti-plaque antimicrobial anti-inflammatory and anti-oxidant substances. Prevalence of Fusobacterium nucleatum and Prevotella oulorum species has been associated with gingivitis [5]

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