Abstract
BackgroundIn the author’s earlier in vitro investigation, a combination of 0.25 mg/ml green tea and 7.82 mg/ml Salvadora persica L. aqueous extracts was found to exhibit significant synergistic anti-bacterial and anti-adherence effects against primary plaque colonizers biofilm. A clinical trial was needed to support these preliminary in vitro results and to investigate its efficacy as a mouthwash in the control of dental plaque.MethodsA 24 h plaque re-growth, double-blinded, randomized crossover trial was carried out. Participants (n = 14) randomly rinsed with test formulation, 0.12% chlorhexidine (control) and placebo mouthwashes for 24 h. A week before the trial, all participants received scaling, polishing and oral hygiene education. On the trial day, the participants received polishing at baseline and rinsed with 15 ml of randomly allocated mouthwash twice daily without oral hygiene measures. After 24 h, plaque index was scored and then the participants entered a 6-days washout period with regular oral hygiene measures. The same protocol was repeated for the next 2 mouthwashes.ResultsThe results were expressed as mean (±SD) plaque index. The test mouthwash (0.931 ± 0.372) significantly reduced plaque accumulation when compared with placebo (1.440 ± 0.498, p < 0.0167) and chlorhexidine (1.317 ± 0.344, p < 0.0167) mouthwashes. No significant difference was found between chlorhexidine and placebo (p > 0.0167).ConclusionsThe test mouthwash has an anti-plaque effect for a 24 h period. Longer-term clinical studies are highly encouraged to investigate its anti-plaque effect for longer periods.Trial registrationThis study was registered in ClinicalTrials.gov as NCT02624336 in December 3, 2015.Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1487-0) contains supplementary material, which is available to authorized users.
Highlights
In the author’s earlier in vitro investigation, a combination of 0.25 mg/ml green tea and 7.82 mg/ml Salvadora persica L. aqueous extracts was found to exhibit significant synergistic anti-bacterial and anti-adherence effects against primary plaque colonizers biofilm
Mechanical plaque control procedures merely focus on teeth, while gingivitis and periodontitis can develop from microbial
* Correspondence: noradinar@um.edu.my 1Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia Full list of author information is available at the end of the article plaque accumulated on oral soft tissue that serves as a source of bacteria to colonize tooth surface [3]. These findings suggest the need for using chemical plaque control to help in controlling dental plaque
Summary
In the author’s earlier in vitro investigation, a combination of 0.25 mg/ml green tea and 7.82 mg/ml Salvadora persica L. aqueous extracts was found to exhibit significant synergistic anti-bacterial and anti-adherence effects against primary plaque colonizers biofilm. A clinical trial was needed to support these preliminary in vitro results and to investigate its efficacy as a mouthwash in the control of dental plaque. Dental plaque is the aetiology of caries and periodontal diseases. Controlling dental plaque is crucial for oral health. Mechanical plaque control procedures merely focus on teeth, while gingivitis and periodontitis can develop from microbial. Chlorhexidine (CHX) is the gold standard mouthwash used for chemical plaque control [4]. CHX mouthwashes containing anti-discolouration agents were reported to have no consistent beneficial effects on plaque and gingivitis [6]. This encourages many researchers to find alternatives for CHX
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