Antiplaque Agents Research Articles

A comparative study of antiplaque and antigingivitis effects of herbal mouthrinse containing tea tree oil, clove, and basil with commercially available essential oil mouthrinse.

Background:The relatively safe nature and cost-effectiveness of herbal extracts have led to a resurgent interest in their utility as therapeutic agents. Therefore, this prospective, double-blind, randomly controlled clinical trial was designed to compare the antiplaque and antigingivitis effects of newly formulated mouthrinse containing tea tree oil (TTO), clove, and basil with those of commercially available essential oil (EO) mouthrinse.Materials and Methods:Forty patients were selected for a 21-day study period and randomly divided into two groups. The test group patients were given newly formulated herbal mouthrinse and the control group patients were given commercially available EO mouthrinse. The Plaque Index (PI), Gingival Index (GI), and Papillary Marginal Attachment (PMA) Index were recorded at baseline, 14 days, and 21 days. The microbial colony forming units (CFU) were assessed at baseline and 21 days.Results:Test group patients using herbal mouthrinse showed significant improvement in GI (0.16), PI (0.57), and PMA (0.02) scores. These improvements were comparable to those achieved with commercially available EO mouthrinse. However, the aerobic and anaerobic CFU of microbiota were reduced with the herbal mouthrinse (P = 0.0000).Conclusion:The newly formulated herbal mouthrinse and commercially available mouthrinse were beneficial clinically as antiplaque and antigingivitis agents. Newly formulated mouthrinses showed significant reduction in microbial CFU at 21 days. So, our findings support the regular use of herbal mouthrinse as an antiplaque, antigingivitis, and antimicrobial rinse for better efficacy.

Short-Term Results in Evaluating a Gingiva-Adhesive Hydrophobic-Chlorhexidine-Gel for Chronic Periodontitis.

Background and Aims:Oral mucosa and interproximal spaces of the teeth could favor the colonization of periodontopathogenic bacteria, which could be targeted by chemical antiplaque agents such as chlorhexidine, present in different oral hygiene products, thus improving the control of biofilm growth and delaying microbial accumulation. The study aimed to evaluate whether the use of a hydrophobic gel with good gingival adhesion for 14 days after the scaling and root planing of patients with chronic periodontitis would improve the treatment outcome, when compared with the use of a regular hydrophyllic gel.Material and Methods:Patients with moderate disease were included in two study groups. At baseline and 3 months after the treatment the following parameters were recorded: pocket depth, Approximal Plaque Index, Modified Gingival Index, Simplified Oral Hygiene Index, bleeding on probing. Patients received scaling and root planing in two sessions at 24 hours interval. After the treatment, patients in the test group applied the hydrophobic adhesive chlorhexidine gel once a day, every other day, while in the control group the gel was used twice daily.Results:Both treatments resulted in significant improvement in all clinical indices, except Approximal Plaque Index, which deteriorated significantly in both groups. Three months after mechanical treatment, the mean probing depth changed in the test group from 4.16±0.45 mm to 2.80±0.42 mm, and in the control group from 4.16±0.30 to 2.69±0.19.Conclusions:Both adjunctive anti-infective therapies induced clinical improvement 3 months from baseline. The differences between the two treatments were not statistically significant.

A randomized clinical trial to evaluate and compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized patients with periodontal diseases.

Triphala is a combination of three medicinal plants, extensively used in Ayurveda since ancient times. Triphala mouthwash is used in the treatment of periodontal diseases because of its antimicrobial and antioxidant properties. The aim of this study is to compare the efficacy of triphala mouthwash with 0.2% chlorhexidine in hospitalized periodontal disease patients. In this double-blind, randomized, multicenter clinical trial, 120 patients were equally divided into three groups. Patients in group A were advised to rinse their mouths with 10 mL of distilled water, group B with 0.2% chlorhexidine, and group C with triphala mouthwash for 1 minute twice daily for two weeks. The plaque index (PI) and the gingival index (GI) were recorded on the first and the fifteenth day. There was no significant difference when the efficacy of triphala was compared with 0.2% chlorhexidine in hospitalized patients with periodontal disease. However, a statistically significant difference was observed in PI and GI when both group B and group C were compared with group A and also within groups B and C, after 15 days (P<0.05). The triphala mouthwash (herbal) is an effective antiplaque agent like 0.2% chlorhexidine. It is significantly useful in reducing plaque accumulation and gingival inflammation, thereby controlling periodontal diseases in every patient. It is also cost effective, easily available, and well tolerable with no reported side effects.

Influence of Sub-Lethal and Lethal Concentrations of Chlorhexidine on Morphology and Glucosyltransferase Genes Expression in &amp;lt;i&amp;gt;Streptococcus mutans&amp;lt;/i&amp;gt; UA159

Chlorhexidine (CHX) is regarded as one of the most successful antiplaque agents in controlling the formation of dental biofilm. Nevertheless, molecular mechanisms of their effects in Streptococcus mutans are largely unknown. In this work, the effects of sub-lethal and lethal concentrations of chlorhexidine (CHX) on planktonic or biofilm-organized Streptococcus mutans cells were investigated in dose- and time-dependent manner. The Minimum Inhibitory Concentration (MIC) and the Minimum Bactericidal Concentration (MBC) for planktonic cells and biofilm conditions were determined by standard methods. Quantitative PCR (qPCR) was used to quantify the relative levels of glucosyltransferase B (gtfB), gtfC and gtfD transcription of S. mutans in the presence of CHX. The CHX activity in the initial biofilm structure and morphological alterations in planktonic cells were examined by Scanning Electron Microscopy (SEM). The results indicate that CHX increased expression of gtfC and gtfD in planktonic S. mutans cells and CHX reduced the expression of gtfB, gtfC, and gtfD in biofilms. High concentrations of CHX resulted in several wilted S. mutans planktonic cells with spilled intracellular material, while decreased cells’ chain length and matrix was found when the initial biofilm was exposed to increasing concentrations of CHX. CHX’s effects against bacteria depend on the type of growth organization and the concentration and time of exposure to the drug. At sub-lethal concentrations, CHX affects the expression of glucosyltransferases, which may have anticariogenic effect.

A comprehensive study into the impact of a chitosan mouthwash upon oral microorganism's biofilm formation in vitro

Modern dentistry emphasizes the importance of dental plaque control to improve oral health. To that end the development of oral care formulations has been geared toward the incorporation of antiplaque agents that may play a crucial role in oral health maintenance. In later years the research into antiplaque agents has led to the discovery of compounds with significant capability to affect biofilm formation. Among these compounds was chitosan, a polysaccharide which showed great ability to interfere with Streptococcus mutans biofilm formation. As such the aim of this work was to incorporate chitosan into a mouthwash matrix and assess its effect upon biofilm formation of oral microorganisms. This assessment was performed via study of the impact the mouthwash upon microbial adherence, biofilm formation and mature biofilms. Additionally, the action of the chitosan mouthwash was compared with two commercially available mouthwashes. The results here obtained show that only the chitosan containing mouthwash was capable of interfering with all microorganisms’ adherence, biofilm formation and mature biofilms while at the same time showing vastly superior activity than both commercial mouthwashes assayed. As such a chitosan mouthwash shows great potential as a natural and efficient alternative to traditional mouthwashes.

Characterization and application of a flow system for in vitro multispecies oral biofilm formation

Bacteria in the oral cavity grow in the form of biofilms; these structures are subject to constant saliva or gingival crevicular fluid flow conditions. The aims of this study were: (i) to develop and to characterize an in-vitro biofilm model with oral bacteria growing under flow and shear conditions; and (ii) to demonstrate the usefulness of the model for evaluating the activity of three antiplaque agents. We used a bioreactor to grow the oral bacteria Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis under planktonic conditions. Biofilms were established using a modified Robbins device on hydroxyapatite (HAP) discs. Three- to 7-d-old biofilms were analysed using culture methods, scanning electron microscopy, Live/Dead staining and fluorescence in-situ hybridization (confocal laser scanning microscopy). Finally, we assessed the antimicrobial activity of three mouthrinses [0.12% chlorhexidine (CHX), 0.12% chlorhexidine and sodium fluoride (CHX+NaF) and 0.12% chlorhexidine and 0.05% cetylpyridinium chloride (CHX+CPC)] using a planktonic test (short interval-killing test) and in our 4-d biofilm model. The viable cell counts showed that each species was consistently found in the biofilms throughout the study. The architecture and cell distribution were similar to those described for biofilms in situ, with the exception of a thin layer of living cells that was found close to the HAP. The effectiveness test of the mouthwashes demonstrated that cells in biofilms showed more tolerance compared with planktonic cells. Moreover, it was observed that in 4-d biofilm formed in vitro, CHX+CPC caused significantly higher mortality compared with CHX (p = 0.003) and CHX+NaF (p < 0.001). Our results suggest that we have a highly reproducible system for multispecies oral biofilm formation and that it is a useful tool for assessing antibacterial molecules before their clinical evaluation. It also has great potential to be used in basic research on supragingival and subgingival biofilms.

Evaluation of dental staining using a dentifrice containing chlorhexidine and zinc acetate. A doble blind randomized clinical trial

Chlorhexidine is an antiplaque and anti-gingivitis agent that has a well-known efficacy in dentistry. It has been incorporated in toothpastes and when associate with mechanical cleaning, it can improve the biofilm control. The zinc acetate associated with antiseptics attempts to minimize the staining caused by these products and to enhance the effect of the chlorhexidine. The aim of this study was to evaluate and compare a dentifrice containing chlorhexidine gluconate associated or not with zinc acetate, as the emergence of extrinsic tooth stain and check if there are still improvements of clinical gingival parameters. For this, 30 volunteers 18-50 years of age, of both sexes, among patients FOSJC / UNESP were enrolled. The volunteers were randomly divided into three groups: CHX+Z, consisting of 10 participants who used a dentifrice with 0.8% chlorhexidine gluconate and zinc acetate 1.16%; CHX group, with 10 participants who used a similar formulation dentifrice but zinc acetate, and the Placebo group also with 10 participants who used a dentifrice formulation similar but without the chlorhexidine and zinc acetate. Patients were assessed at day zero, 15, 30, 45 and 60 days when the indexes of plaque, gingival bleeding and staining were collected. The results showed that by day 60, there was a decrease of both plaque index(PI) and the gingival index(GI) for all groups. Additionally, it was observed that both groups using dentifrice containing chlorhexidine, showed more stain than placebo. The CHX+Z group showed less stain compared to the CHX group, but the difference was not statistically significant. The difference between Placebo and Chlorhexidine Groups was statistically significant (p&lt;0,05) when considered the stain intensity and area plus intensity scores. The CHX+Z group was as efficient in PI and GI reduction as the CHX group.KEYWORDS: Chlorhexidine; Zinc acetate; Staining index; Plaque index; Gingival index.

Release Kinetics of Calcium and Quercetin from Chewing Gum as a Novel Antiplaque and Antimicrobial Device

There is a growing interest in the use of anticariogenic and antimicrobial agents to prevent demineralization and promote remineralization of dental enamel for the prevention of oral diseases. The purpose of this study was to develop a novel chewing-system containing as Casein-Phosphopeptides-Amorphous-Calcium-Phosphate (CPP-ACP) as Quercetin (Qt) and evaluate their release using in vitro and in vivo experiments. In vitro and in vivo experimental protocols were designed to test the percentages of Ca from CPP-ACP and Qt released with time and their delivery rate from a chewing gum. The in vitro experiments were performed using a specifically designed chewing apparatus to test the release of Ca and Qt in artificial saliva in function of chewed time, while the in vivo experiments required a chew-out method with volunteers and the residual CPP-ACP and Qt present in the chewed gums was analyzed. This study demonstrated that both CPP-ACP'Ca and Qt were released during chewing although CPP-ACP'Ca was released from the chewing gum in a slower and more controlled manner than Qt. They were also both effectively retained in the oral cavity for all the investigated chewing time and according to their monitored release concentrations they were able to serve as a novel antiplaque agent. This research concludes that both drugs were efficiently released during the mastication process to fully exploit their anti-carious activity.

Evaluation of the antimicrobial and physical properties of an orthodontic photo-activated adhesive modified with an antiplaque agent: An in vitro study

This study was designed to investigate the antimicrobial and physical properties of orthodontic composite resin modified by the addition of an antimicrobial agent. Transbond XT (3M Unitek), a photo-activated, light-cured composite resin, modified by the addition of chlorhexidine, in concentrations 2.5 wt% was formed into a uniform disc and also used for direct bonding of the brackets on the freshly extracted premolars for testing. The tablets of each group and a control group were subjected to the agar plate diffusion test to measure the zone of bacterial inhibition. In addition, they were incubated for 24 h in brain heart infusion medium inoculated with Streptococcus mutans and examined for antimicrobial action. A total of 80 extracted premolars were collected and divided into two sets of 40 teeth each. Stainless steel preadjusted edgewise appliance (PEA) brackets were bonded by using control and experimental composites. A universal testing machine was used to determine the shear bond strength. The first set of teeth was tested after 24 h and the second set after 25 days of storage in distilled water. Time-dependent release of antimicrobial agents from the modified composites was also monitored spectrophotometrically. The findings indicated that (1) addition of chlorhexidine to the orthodontic composite resin enhanced its antimicrobial properties, (2) there was no significant difference between the bond strengths of the control and the experimental resins tested after 24 h and 25 days and (3) maximum release of chlorhexidine from the modified resin was much higher than the minimum inhibitory concentration level.

Efficacy of silver diamine fluoride as an antibacterial as well as antiplaque agent compared to fluoride varnish and acidulated phosphate fluoride gel: An in vivo study

Silver diamine fluoride (SDF) is already proven as an antibacterial agent in vitro. Present study was formulated to compare the efficacy of SDF as an antibacterial as well as antiplaque agent in vivo with fluoride varnish and acidulated phosphate fluoride (APF) gel. Total 123 children (male = 82, female = 41) were included in the study for a period of 18 months. Children were divided into three different groups-Group 1: SDF; Group 2: fluoride varnish; and Group 3: APF gel. All subjects were evaluated via plaque score at 6 th, 12 th, and 18 th months as well as Streptococcus mutans counts in saliva at 72 h, 6 th, 12 th, and 18 th months of follow-up. Significant reduction was found in plaque score as well as S. mutans counts irrespective of group division. On intergroup comparison, no statistically significant difference was found in plaque score, but significant reduction in S. mutans counts was found in Group 1 as compared with Groups 2 and 3, while no significant difference was found between Groups 2 and 3. In vivo application of SDF on enamel significantly decreases S. mutans counts as compared to fluoride varnish and APF gel.

Comparative evaluation of anti-plaque efficacy of herbal and 0.2% chlorhexidine gluconate mouthwash in a 4-day plaque re-growth study

Background:Chlorhexidine gluconate mouthwash has earned eponym of gold standard to treat and/or prevent periodontal disease. However, it has been reported to have local side-effects on long-term use. To explore a herbal alternative, the present study was carried out with an aim to compare the anti-plaque efficacy of a herbal mouthwash with 0.2% chlorhexidine gluconate mouthwash and normal saline.Materials and Methods:It was an examiner-blinded, parallel designed clinical trial, in which 90 pre-clinical dental students with gingival index (GI) ≤1 were enrolled. To begin with, GI and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After that, randomized 3 groups were made (of 30 subjects each - after excluding the drop-outs) who were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash (0.2% chlorhexidine gluconate mouthwash, herbal mouthwash, or normal saline) as per therapeutic dose for 4 days. Then, GI and PI scores were re-evaluated on 5th day by the same investigator, and the differences were compared statistically by ANOVA and Student's ‘t’-test.Results and Observations:Least post-rinsing GI and PI scores were demonstrated with 0.2% chlorhexidine gluconate mouthwash, followed by herbal mouthwash and highest scores with normal saline. The difference of post-rinsing PI scores between the chlorhexidine and herbal mouthwash groups was statistically non-significant, whereas this difference was significant between chlorhexidine and saline groups, and the difference between herbal and saline groups was non-significant. It was concluded that 0.2% chlorhexidine gluconate mouthwash remains the best anti-plaque agent. However, when socio-economic factor and/or side-effects of chlorhexidine need consideration, presently tested herbal mouthwash may be considered as a good alternative.

Prevention of demineralization around orthodontic brackets using two different fluoride varnishes

This in-vitro study was done to evaluate the effects of two different seal materials, Duraflor™ and Enamel Pro(®) Varnish, on enamel demineralization adjacent to orthodontic fixed appliances. Seventy-two extracted solid premolars were allocated to three groups as one control and two study groups after brackets were placed and bonded with Transbond™ XT. The control group received no topical fluoride application after bonding, whereas in the study groups two fluoride varnishes, Enamel Pro(®) Varnish and Duraflor™ were applied on the teeth adjacent to brackets. All specimens were then immersed separately in demineralization solution for 96 hours at constant temperature. Demineralization of the enamel surface was evaluated quantitatively by cross-sectional microhardness testing: indentations were made at the edge of the bracket base (0 μm) and at 100 and 200 μm distant from it. In all of these positions, 5 indentations were made at 10, 20, 40, 70 and 90 μm of depths from the external surface of the enamel. The results revealed that, Enamel Pro(®) Varnish and Duraflor™ group values are higher than the values of control group at every depth. The differences between the depths showed that the microhardness values decreased significantly when the depth increased. In the control group, more demineralization occurred in every indentation compared to the study group. Duraflor™ and Enamel Pro(®) Varnish can be considered for use in clinic as an effective method to prevent or reduce demineralization during orthodontic treatment, especially in patients with poor oral hygiene.

Cephalometric comparison of obstructive sleep apnea patients and healthy controls

This study aimed to compare the cephalometric characteristics of obstructive sleep apnea (OSA) patients with those of healthy subjects and to determine possible relationships between cephalometric measurements of OSA patients and control subjects. Standardized lateral cephalograms of 16 OSA patients and 16 healthy controls were obtained. Airway dimensions and dentofacial parameters were measured using a cephalometric analysis program (Dolphin Imaging Cephalometric and Tracing Software, Chatsworth, CA, USA). All statistical analyses were conducted using SPSS version 17.0.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were calculated for all measurements, and the Mann-Whitney U test was used to evaluate intergroup differences. Midface length was significantly shorter and upper lip E-plane length was significantly longer in the OSA group than in the controls (P<.05). SNA, SNB, and mandibular plane angles (GoGn-SN), anterior and posterior facial heights, and posteroanterior face height ratio were similar in both groups. Maxillary length was slightly longer in the OSA group, whereas the mandibular length showed a slight increase in the control group (P<.05). The axial inclination of the lower incisor to its respective plane was normal, whereas the upper incisor was significantly protrusive (P<.05) in the OSA group. Distance between the hyoid and mandible was significantly greater in the OSA group than in the controls, indicating that the hyoid bone was positioned more downward in the OSA group (P<.05). In this study, the patients with OSA demonstrated significant differences in several craniofacial measurements. OSA patients showed reduced midface length and inferiorly placed hyoid bone and tended to have smaller airway dimensions.

Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent

Background:Calendula officinalis (C. officinalis), commonly known as pot marigold, is a medicinal herb with excellent antimicrobial, wound healing, and anti-inflammatory activity.Aim:To evaluate the efficacy of C. officinalis in reducing dental plaque and gingival inflammation.Materials and Methods:Two hundred and forty patients within the age group of 20-40 years were enrolled in this study with their informed consent. Patients having gingivitis (probing depth (PD) ≤3 mm), with a complaint of bleeding gums were included in this study. Patients with periodontitis PD ≥ 4 mm, desquamative gingivitis, acute necrotizing ulcerative gingivitis (ANUG), smokers under antibiotic coverage, and any other history of systemic diseases or conditions, including pregnancy, were excluded from the study. The subjects were randomly assigned into two groups – test group (n = 120) and control group (n = 120). All the test group patients were advised to dilute 2 ml of tincture of calendula with 6 ml of distilled water and rinse their mouths once in the morning and once in the evening for six months. Similarly, the control group patients were advised to use 8 ml distilled water (placebo) as control mouthwash and rinse mouth twice daily for six months. Clinical parameters like the plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), and oral hygiene index-simplified (OHI-S) were recorded at baseline (first visit), third month (second visit), and sixth month (third visit) by the same operator, to rule out variable results. During the second visit, after recording the clinical parameters, each patient was subjected to undergo a thorough scaling procedure. Patients were instructed to carry out regular routine oral hygiene maintenance without any reinforcement in it.Results:In the absence of scaling (that is, between the first and second visit), the test group showed a statistically significant reduction in the scores of PI, GI, SBI (except OHI-S) (P < 0.05), whereas, the control group showed no reduction in scores when the baseline scores were compared with the third month scores. Also, when scaling was performed during the third month (second visit), there was statistically significant reduction in the scores of all parameters, when the third month scores were compared with the sixth month scores in both groups (P < 0.05), but the test group showed a significantly greater reduction in the PI, GI, SBI, and OHI-S scores compared to those of the control group.Conclusion:Within the limits of this study, it can be concluded that calendula mouthwash is effective in reducing dental plaque and gingivitis adjunctive to scaling.

Halitosis: A mirror of systemic and oral health

Halitosis is known as unpleasant oral odor affecting large proportion of population and may be the cause of a significant social and psychological handicap. People who are not aware of their bad breath may encounter romantic, social and professional rejection without knowing the reason. 85% cases of halitosis originate from microbial putrefaction within the oral cavity itself. Modern analytical and microbiological techniques permit diagnosis of halitosis. Management of oral malodor is directed at managing and reducing the bacterial load from oral cavity by instituting proper oral hygiene measures, control of tongue flora by brushing or scraping, and possibly the adjunctive use of antiplaque agents. Keywords - : Chlorhexidine, oral malodor, organoleptic rating, tongue coatings, volatile Sulphur Compounds.

Clinical and microbiologic effects of commercially available gel and powder containing Acacia arabica on gingivitis

There is a need for an anti-plaque agent that can be used on a daily basis without the side effects of antibacterial chemicals such as chlorhexidine. The present study was designed to evaluate the clinical and microbiologic effects of commercially available gel and powder containing Acacia arabica in subjects with gingivitis. One hundred and twenty subjects with chronic generalized gingivitis were selected and randomly divided into four groups: Group 1 - placebo group; Group 2 -Acacia arabica gel group; Group 3 -Acacia arabica powder group; and Group 4 - 1% chlorhexidine gel group. Microbial counts of plaque samples, the gingival index of Loe and Silness and the plaque index were evaluated at baseline, 6 weeks, 12 weeks and 24 weeks. Microbial counts of plaque samples were evaluated at all visits. Acacia arabica gel and powder showed significant clinical improvement in gingival and plaque index scores as compared to a placebo. This improvement was comparable to 1% chlorhexidine gel. The difference between gel and powder with regard to clinical and microbiological parameters was not found to be significant at any time interval. Both Acacia arabica gel and powder may be useful herbal formulations for chemical plaque control in subjects with gingivitis.

Prevention of artificial dental plaque formation in vitro by plant extracts

A number of previous studies have shown that plant extracts can inhibit formation of dental plaque. The ability of extracts of Rosmarinus officianalis L., Salvia officianalis L., unfermented cocoa, red grape seed and green tea to inhibit plaque bacteria, glucosyltransferase activity, glucan and plaque formation in an in vitro model using bovine teeth was examined. The antimicrobial activity of the plant extracts against oral bacteria was determined using a standard susceptibility agar dilution technique. Inhibition of growth and acid production from glucose and sucrose by Streptococcus mutans in liquid culture was investigated. Prevention of plaque formation on bovine teeth initiated by Strep.mutans was studied using an artificial mouth. The plant extracts inhibited the growth of oral bacteria and prevented acid production by Strep.mutans. Extracts inhibited glucosyltransferase activity and glucan production and inhibited adhesion to glass. Extracts of R.officianalis L. and S.officianalis L. at 0·25mgml(-1) reduced plaque growth by >80%. Green tea extract completely inhibited plaque formation but resulted in a greenish discolouration of the teeth which could not be removed by scrubbing. The plant extracts, particularly those from R.officianalis L. and S.officianalis L., inhibited glucosyltranferase activity, glucan production and plaque formation in vitro. The results suggest that the extracts of R.officianalis L. and S.officianalis L. may be useful as antiplaque agents in foods and dental preparations. Bovine teeth can be used as an alternative to hydroxyapatite for studies of plaque formation, but they need to be carefully sterilized before use.

Contemporary perspective on plaque control

The aim of this review article is to provide a scientific platform that will enable the dental team to develop a rational approach to plaque control based on the latest knowledge of the role of the oral microflora in health and disease. The resident oral microflora is natural and forms spatially-organised, interactive, multi-species biofilms on mucosal and dental surfaces in the mouth. These resident oral microbial communities play a key function in the normal development of the physiology of the host and are important in preventing colonisation by exogenous and often undesirable microbes. A dynamic balance exists between the resident microflora and the host in health, and disease results from a breakdown of this delicate relationship. Patients should be taught effective plaque control techniques that maintain dental biofilms at levels compatible with oral health so as to retain the beneficial properties of the resident microflora while reducing the risk of dental disease from excessive plaque accumulation. Antimicrobial and antiplaque agents in oral care products can augment mechanical plaque control by several direct and indirect mechanisms that not only involve reducing or removing dental biofilms but also include inhibiting bacterial metabolism when the agents are still present at sub-lethal concentrations.

Comparative evaluation of 0.1% turmeric mouthwash with 0.2% chlorhexidine gluconate in prevention of plaque and gingivitis: A clinical and microbiological study

Background:The aim of our clinical trial was to assess the efficacy of 0.1% turmeric mouthwash as an anti-plaque agent and its effect on gingival inflammation and to compare it with 0.2% chlorhexidine gluconate by evaluating the effect on plaque and gingival inflammation and on microbial load.Materials and Methods:60 subjects, 15 years and above, with mild to moderate gingivitis were recruited. Study population was divided into two groups. Group A-30 subjects were advised chlorhexidine gluconate mouthwash. Group B-30 subjects were advised experimental (turmeric) mouthwash. Both the groups were advised to use 10 ml of mouthwash with equal dilution of water for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque and gingival index at day 0, on 14 th day, and 21 st day. Subjective and objective criteria were assessed after 14th day and 21st day. The N-benzoyl-l-arginine-p- nitroanilide (BAPNA) assay was used to analyze trypsin like activity of red complex microorganisms.Results:On comparison between chlorhexidine and turmeric mouthwash, percentage reduction of the Plaque Index between 0 and 21 st day were 64.207 and 69.072, respectively (P=0.112), percentage reduction of Gingival Index between 0 and 21st day were 61.150 and 62.545 respectively (P=0.595) and percentage reduction of BAPNA values between 0 and 21st day were 42.256 and 48.901 respectively (P=0.142).Conclusion:Chlorhexidine gluconate as well as turmeric mouthwash can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. Both the mouthwashes have comparable anti-plaque, anti-inflammatory and anti-microbial properties.

OA01.08. A comparative study of dantasharkara lekhankarma and lekhankarmottar Arimedadi Tailam pratisarana

Purpose: Modern treatment for dantasharkara is antiplaque agent and scraping but it causes discolouration, dantakshaya and dantaharsh (hypersesitivity). Ayurved advocates lekhankarma and Arimedadi pratisaran. Charaka, Bhavprakasha and Yogratnakar Arimedaditaila as mukhrognashaka. The present study aimed to study the effect of lekhankarma karma and Arimedadi Tailam on dantasharkara. Method: 30 patients having dantasharkara were selected and scaling done with ultrasonic maschine in control group. In trial group, scaling was done in thirty patients followed by Arimedadi Tailam pratisarana for two times a day for one month. Result: After scaling the Dantasharkara in both groups was persistent on third day but after 90 days only 4 patients had the problem in trial group and 25 patients in control group. Dantaveshtashoth, putiasyata and puyaraktasrava were relieved but in the next follow up, recurrence was observed in control group whereas in trial group there was no recurrence. Conclusion: Recurence of Dantasharkara is delayed. Dantaveshtashotha, putiasyata and puyaraktastrava got reduced immediately and there was no recurrence. Arimedadi Tailam does not produce dantaharsha symptom after scaling. Arimedadi Tailam has number of drugs, which acts as raktastambhak, shothahar, kaphavatashamak and mukhadurgandhinashak on account of which it reduces above symptoms and also prevents dantaharsha and dantakshaya.