Four-day randomized controlled crossover trial evaluating the antiplaque effect of a combination of green tea and Salvadora persica L. mouthwash

Abstract

BackgroundA combination of 0.25 mg/ml green tea (leaves of Camellia sinensis var. assamica) and 7.82 mg/ml Salvadora persica L. root-sticks aqueous extract mouthwash (CoM) has been reported to exhibit antibacterial and anti-adherence effects against primary plaque colonizer biofilm in vitro and an antiplaque effect for a period of 24 h in vivo. AimTo assess the antiplaque effect of CoM during a four-day period. MethodsA four-day plaque re-growth randomized crossover trial was conducted. A week after receiving dental scaling and polishing, all participants (n = 15) underwent polishing at baseline and a rinse with 15 ml of randomly allocated mouthwash (CoM, 0.12 % chlorhexidine (CHX) mouthwash, or placebo [Plc]) twice daily without oral hygiene measures for four days. After 2 h, samples of saliva were collected, using a quantitative polymerase chain reaction, to determine the bacterial load. After 24 h and four days’ time points, plaque quantity (using digital plaque image analysis) was recorded. Subsequently, the participants entered a six-day washout period with regular oral hygiene measures. The same protocol was repeated for the next two mouthwashes. ResultsCoM significantly reduced plaque accumulation (31.933 ± 10.025) compared to Plc (54.629 ± 17.555) for a period of four days; a comparable effect was ascribed to CHX (34.903 ± 11.871). Moreover, it significantly reduced the amount of Streptococcus sanguinis, Actinomyces viscosus, and Actinomyces naeslundii (primary colonizers) in saliva. ConclusionUsing CoM for four days twice daily could reduce plaque accumulation and might be considered as an alternative to synthetic mouthwashes.