Effects of natural herb-containing dental toothpaste on periodontal pathogenic bacteria and clinical parameters: A randomized clinical trial

Abstract

ObjectivesToothpastes containing natural herbs (NHs) have been commercially sold based on the claim that NHs possess anti-inflammatory, astringency, and antibacterial activities that reduce gingival inflammation. However, there have been few reports on the effects of such toothpastes on periodontitis or oral bacteria. The aim was to investigate the effects of a toothpaste containing NHs (Acess®) on clinical parameters and oral bacteria. MethodsSeventy-four patients with periodontitis were divided into test and control (n = 37 each) groups. Participants were then instructed to use either the test or the control toothpaste twice per day (in the morning and at night) to brush their teeth for 5 min for 4weeks.The NHs present in the test toothpaste was rhatany tincture (1.25%), chamomile tincture (1.25%), and myrrh tincture (0.62%). The control toothpaste contained the basic components of general toothpaste without any of the medicinal components present in Acess. The plaque control record (PCR), gingival index (GI), bleeding on probing (BOP), and probing depth (PD) at baseline and 2 and 4 weeks was measured. Bacterial samples from periodontal pockets or saliva at each time point was also collected. ResultsCompared with the control group, the test group showed significant improvement in PD, GI, and BOP at 2 and 4 weeks after the intervention (p < 0.01). Bacteriologic evaluation of samples from periodontal pockets indicated no changes for both groups. Over time, total bacterial counts and the counts of Treponema denticola, Tannerella forsythia, and Prevotella intermedia in the bacterial samples from the saliva of the test group decreased (p < 0.01). No significant changes were detected in the count of Porphyromonas gingivalis (p = 0.55). There was a significant decrease in the total bacterial counts in the test group compared with the control group (p < 0.01). ConclusionsA toothpaste containing NHs significantly improves clinical periodontal parameters and lower oral bacterial counts, including that of periodontal pathogenic bacteria in saliva.Clinical significance:The use of toothpaste containing NHs reduces periodontitis symptoms.