Background. Dental caries can be experienced at various ages which is marked by the appearance of white spots on the tooth surface by S. mutans bacteria. Manalagi apples contain compounds that are effective as antibacterial, namely polyphenols, saponins, alkaloids, tannins and flavonoids. Gel toothpaste formula with variations in CMC-Na of F1(1.5%), F2 (2%), and F3 (2.5%).
 Purpose. The purpose of this study was to determine the effect of variations in CMC-Na concentration on the physical quality and antibacterial activity of S. mutans in the Manalagi apple extract gel toothpaste.
 Methods. In addition, apple simplicia was extracted using 70% ethanol. Manalagi apple extract 15% was formulated into 3 formulas F1, F2, and F3 with CMC-Na concentrations of 1.5, 2, and 2.5%, respectively. Toothpaste gel preparations were tested for physical quality for 21 days, stability test for 3 cycles and antibacterial activity test against S. mutans by disc diffusion method. The data were processed with Shapiro-wilk statistics, ANOVA and Krustal Wallis, followed by the Paired t test and Wilcoxon
 Results. The study showed that F1, F2, F3 affected the physical quality, among others, caused a decrease in the dispersion area but increased viscosity, pH and vice versa, and the Manalagi apple extract gel toothpaste with varying concentrations had antibacterial activity with inhibition zones 39 , respectively. 8; 39.6 and 37.3 mm, and the best formula was F1.
 Conclusion. Manalagi apple extract has activity in inhibiting the growth of S. Mutans bacteria with a strong to very strong category, statistically there is a significant difference between variations in the concentration of CMC-Na.
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