Mouthwash Research Articles

Improving predoctoral education related to caries risk assessment in adults.

This project examined patterns of adult patient management using a caries risk assessment (CRA) protocol at East Carolina University, School of Dental Medicine. Usage of the CRA protocol from 2014 to 2019 was assessed. Non-operative anti-caries treatments were measured against caries risk status (high, moderate, low, or none). Steps to improve the appropriate management of patients based on caries risk are presented to align with accreditation standards for predoctoral education programs. The CRA protocol is based on the Caries Management by Risk Assessment approach. Risk-based patterns for two non-operative interventions were examined: (1) prescriptions for 0.12% chlorhexidine gluconate (CHX) mouth rinse and (2) prescriptions for 5000 ppm fluoride toothpaste (PreviDent 5000 [PreviDent]). Statistical analyses included chi-square tests and logistic regression. Over the study period only 16.4% of adult patients had completed the CRA form. Among 29,411 patients from nine community sites, treatment rates for PreviDent were 18.7% among high-risk patients, 11.6% for moderate-risk adults, and 6.4% for low-risk adults (p<0.01). Treatment rates for CHX were 23.0%, 22.6%, and 17.1%, respectively (p<0.05). Patients without a CRA status were least likely to receive any anti-caries treatments, indicating that CRA status affects clinical, non-operative care. Patterns for prescription of PreviDent and CHX are consistent with CRA status. Future efforts to improve usage of the CRA protocol using faculty calibration, tracking with quality improvement tools, and reassessment. Training in the community-based educational setting is enhanced through data-based tracking to assure evidence-based decision making.

Cannabis sativa: 2023-Outbreak and Re-emergence of Nipah virus (NiV) in India: Role of Hemp oil

This review paper highlights and updates the outbreak of Nipah virus (NiV), an emerging zoonotic bat borne virus that can cause severe respiratory illness and deadly encephalitis in humans. Nipah virus (NiV) outbreak was first reported in 1998 from Malaysia and then recorded in Bangladesh, India, Philippines, Singapore and Thailand. A recent fifth outbreak of Nipah virus (NiV) during August-September 2023 in Kerala State, India brought this emerging-re-emerging virus into the spotlight again. Due to the lack of vaccines and drugs with proven effectiveness against Nipah virus (NiV), treatment of patients is limited to supportive and prophylactic. Fruit bats are the main reservoir for this virus, which can cause disease in humans and animals. Nipah virus (NiV) can be transmitted from bats or livestock to humans, typically via contaminated food (fruit or raw date palm sap), and person-to-person through respiratory secretions. Hemp seed oil has gained remarkable popularity due to its perceived therapeutic properties, particularly antiviral properties for potential health benefits. During the recent outbreak of Nipah virus (NiV), the local traditional healers in India used hemp oil as the mouth wash for controlling throat infections, head ache, vomiting and suggested for the consumption of hemp seeds and oil as the functional food. However, clinical trials and scientific data supporting antiviral activity of Cannabis oil (CBD oil) against Nipah virus (NiV) is lacking. Therefore, further research should focus on exploring the molecular mechanisms of hemp oil against Nipah virus (NiV) is warranted. Multicenter clinical trials should be performed to validate the efficacy of hemp oil alone or in the form of formulations for the treatment of viral infections.

Correlations between different protein species of oral rinse MMP-8 and patient-related factors.

The aim of this study is to examine correlations between different oral rinse matrix metalloproteinase (MMP)-8 protein species in western blot (WB) analysis, quantitative MMP-8 measurements, and patient-related factors. Elevated activated MMP-8 (aMMP-8) associate with periodontitis and a diagnostic point-of-care technology has been developed based on aMMP-8. In WB, different MMP-8 protein species can be analyzed. Relative abundancyof fragmented 20-25 kDa forms in WB has been associated with and reflects MMP-8 activation and related fragmentation and elevated quantitative aMMP-8 measurements. A random sample of 192 participants from a periodontal disease screening study was used for this study. Oral rinse samples for biomarker analyses were collected before clinical periodontal examinations. aMMP-8 immunofluorometric (IFMA) and WB analysis (utilizing the same monoclonal antibody, 8708), polymorphonuclear leukocyte (PMN) elastase activity test and tissue inhibitor of metalloproteinases (TIMP)-1 ELISA levels were performed from the oral rinse samples. Distinct MMP-8 protein species were differentiated in the WB analysis. Principal component (PC) analysis was conducted to explore correlation patterns between the different species. Adjusted correlation analysis between the extracted PCs of WB and aMMP-8 IFMA levels and multilevel regression analysis were conducted to explore if the other periodontal disease-related biomarkers and clinical surrogate measures and patient-related factors are co-variating with the extracted components. Distinct correlation patterns between the MMP-8 protein species were observed. The first four PCs explained 89% of the whole variance in PC analysis. Statistically significant correlation (p < 0.05) were observed as follows: PC1 positively with 21 kDa (r = .69) and 25 kDa fragments (r = .55) and negatively with 150 kDa complexes (r = -.46). PC2 correlated with 45 (r = .70) and 55 kDa (r = .65) activated forms, PC3 with 70-80 kDa latent proforms (r = .63) and 90-100 kDa complexes (r = .67), and PC4 with 35 kDa fragments (r = .81). There were significant correlations between quantitative (IFMA) aMMP-8 measurements and PC1 (p < 0.001), PC2 (<0.05) and PC3 (<0.05) but not with PC4. In multilevel regression models age, PMN elastase activity, TIMP-1 levels, and a number of 4-5 mm periodontal pockets were associated with PC1, nonsmoking with PC2, ageand PMN elastase activity with PC3, and age and smoking with PC4. Relative abundancy of fragmented 21-25 kDa protein species was correlated with the quantitative aMMP-8 (IFMA) measurements, which is in line with previous results. Different patient-related factors (smoking, age, proteolytic activity) may modify the formation of different MMP-8 protein species in oral rinse samples and may cause variability in quantitative aMMP-8 measurement.

Assessment regarding dental practitioners’ knowledge, attitude, and practices towards pre-procedural mouth rinse during COVID-19 pandemic – A cross-sectional study in Tamil Nadu

Objectives: Evolving strains of SARS-CoV-2 causing the COVID-19 disease has challenged the scientific world in limiting the disease and curbing the pandemic. Several factors such as increased salivary viral load in COVID-infected patients, procedures generating aerosols put the dental professionals at high risk of acquiring the disease. The present study aims to assess the knowledge, attitude and practices regarding the use of pre-procedural mouth rinse among the dental practitioners in Coimbatore. Material and Methods: A descriptive, cross-sectional study was conducted among dental practitioners in Coimbatore using a pre-validated questionnaire which comprised of sections interrogating knowledge, awareness, and practice of the use of pre-procedural mouth rinse in dental setup. One hundred and twenty-five dental practitioners in Coimbatore responded to the questionnaire. Results: Assessment of knowledge regarding the effectiveness of pre-procedural mouthwashes in reducing the bacterial and viral load was 97%. About 89% of dental practitioners were aware of the superior antimicrobial properties of Povidone Iodine in comparison with Chlorhexidine. Only 65% of dental practitioners used pre-procedural mouthwashes in practice. Conclusion: There is high inquisitiveness among dental practitioners in acquiring knowledge regarding preventive measures for SARS-CoV-2 alike the use of pre-procedural mouth rinses in reducing the viral load in COVID-19 infected patients. Although there is high awareness, there exists reluctance in implementing the knowledge acquired in real practice.

Microphysiological Modeling of Gingival Tissues and Host-Material Interactions Using Gingiva-on-Chip.

Gingiva plays a crucial barrier role at the interface of teeth, tooth-supporting structures, microbiome, and external agents. To mimic this complex microenvironment, an in vitro microphysiological platform and biofabricated full-thickness gingival equivalents (gingiva-on-chip) within a vertically stacked microfluidic device is developed. This design allowed long-term and air-liquid interface culture, and host-material interactions under flow conditions. Compared to static cultures, dynamic cultures on-chip enabled the biofabrication of gingival equivalents with stable mucosal matrix, improved epithelial morphogenesis, and barrier features. Additionally, a diseased state with disrupted barrier function representative of gingival/oral mucosal ulcers is modeled. The apical flow feature is utilized to emulate the mechanical action of mouth rinse and integrate the assessment of host-material interactions and transmucosal permeation of oral-care formulations in both healthy and diseased states. Although the gingiva-on-chip cultures have thicker and more mature epithelium, the flow of oral-care formulations induced increased tissue disruption and cytotoxic features compared to static conditions. The realistic emulation of mouth rinsing action facilitated a more physiological assessment of mucosal irritation potential. Overall, this microphysiological system enables biofabrication of human gingiva equivalents in intact and ulcerated states, providing a miniaturized and integrated platform for downstream host-material and host-microbiome applications in gingival and oral mucosa research.

The relationship between children’s oral health behaviours and oral health-related quality of life: a cross-sectional study

BackgroundUnderstanding oral health behaviour s and their impact on Oral Health-Related Quality of Life (OHRQoL) may serve as an instrument to articulate the conventional oral health policy framework, thereby ameliorating the overall health of young individuals in the long term.ObjectiveThe aim of this study was to investigate the relationship between children’s oral health behaviour s and Oral Health-Related Quality of Life in the capital governorate, Kuwait.MethodsA cross-sectional study involving 607 children aged 12–14 years, randomly selected from schools in Kuwait Capital Region. A validated Oral Health Behaviour s and OHRQoL Child Perception Questionnaires (CPQ12-14) was used to collect the data. Chi-square, t-tests, and ANOVA were used to examine the association between oral behaviour s and children’s OHRQoL.ResultsAbout 52.2% of participants were males and the overall response rate was 93.8%. The mean ± SD for total OHRQoL impact was 3.1 ± 0.58, while the total mean for individual domains- for oral symptoms, functional limitations, emotional well-being and social well-being were 2.89 ± 0.63, 2.89 ± 0.72, 3.1 ± 0.91 and 3.4 ± 0.61, respectively. There was no significant difference in total OHRQoL impact score by frequency of last dental visit, flossing, use of mouth rinse or chewing gum (p > 0.05) but for the overall OHRQoL, frequency of soft drink intake was the only significant predictor associated with 0.2-unit decrease (B = -0.207, 95% CI, p = 0.002) in total OHRQoL scores.ConclusionsHigh frequency of soft drink consumption was related to poorer OHRQoL. Behaviour changing interventions based on OHRQoL inferences coupled with clinical intervention are needed.

Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment

BackgroundTaking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective.MethodsThis was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month).ResultsIn the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166).ConclusionsThe results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD.Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.

Effect of mouth rinses on the stainability of monolithic lithium disilicate glass-ceramics with different surface treatments: An in vitro study

Mouth rinses have been reported to cause tooth surface discoloration. However, information regarding their effect on the stainability of monolithic glass-ceramics with different surface treatments is lacking. The purpose of this in vitro study was to assess the effect of mouth rinses on the color change of milled and pressed monolithic lithium disilicate glass-ceramics with different surface treatments. Fifty-six Ø12×1.5-mm disk specimens were fabricated using 2 different processing techniques: milling and pressing. Each group was subdivided into 2 subgroups according to surface treatments: glazed and polished. Specimens were then immersed in 2 different types of mouth rinse (n=7): chlorhexidine (CHX) and Listerine (LST). Color parameters were assessed using a digital spectrophotometer. Color difference (ΔE00) was calculated and compared with perceptibility (ΔE00=0.8) and acceptability (ΔE00=1.8) thresholds. The data were analyzed using ANOVA and Tukey post hoc tests (α=.05). The color difference (ΔE00) was significantly affected by the type of processing technique, surface treatment, and mouth rinse (P<.001) and their interaction (P=.008). All ΔE00 values were below the selected clinical acceptability threshold (ΔE00=1.8). Milled groups (ΔE00=1.13) showed greater discoloration than pressed groups (ΔE00=0.86). Glazed specimens (ΔE00=0.70) were more resistant to discoloration than polished specimens (ΔE00=1.28) and immersion in CHX (ΔE00=1.09) led to more discoloration than immersion in LST (ΔE00=0.89). The color of milled and pressed monolithic lithium disilicate glass-ceramics with different surface treatments was affected by using CHX and LST mouth rinses. Glazed lithium disilicate glass-ceramics showed less staining compared with those that were polished. Specimens immersed in CHX showed more discoloration than those immersed in LST.

FRI233 Adrenal Insufficiency Due To An Unusual Culprit

Abstract Disclosure: S. Decamps: None. K.T. Yeung: None. K. McCowen: None. Background: Chronic exogenous use of glucocorticoids is the most common cause of reversible secondary adrenal insufficiency (AI). There is a significant risk of cortisol deficiency if the medication is abruptly discontinued. Chronic glucocorticoid therapy may cause hypothalamic-pituitary-adrenal (HPA) axis suppression, resulting in low ACTH, atrophy of the adrenal zona fasciculata and decreased cortisol production. Immunotherapy rarely causes reversible central AI, usually permanent. We present a case of an immunotherapy-receiving patient who presented with biochemical evidence of adrenal insufficiency after using an oral solution (swish and spit) of dexamethasone as prophylaxis for mucositis. Patient Summary: A 52-year-old woman with stage IIb triple negative breast cancer receiving neoadjuvant Datopotamab, Dertuxtecan and Durvalumab was evaluated for adrenal insufficiency. Prior to starting therapy, serum cortisol level measured 7.9 mcg/dL at 11 AM (normal 6.0-18.4 mcg/dL at 6-10 A.M). She had received a single dose of dexamethasone 10 mg IV with her first cycle, but not thereafter. As part of the immunotherapy protocol, serial cortisol levels were obtained, and 2 weeks after the baseline, noon serum cortisol was 1.0 ug/dL. Patient was asymptomatic. At no point were glucocorticoids replaced, but 1-week later serum cortisol level was 0.6ug/dL at 11:00 AM along with an ACTH of 5 pg/mL. Immunotherapy-induced AI was strongly suspected. Her only glucocorticoid exposure had been a dexamethasone oral mouth rinse (swish 10mL for 1 minute and spit out, four times daily). Cortisol level at 7AM a week later measured 3.5 mcg/dL with ACTH 18.7 pg/mL and a dexamethasone level 108.2 ng/dL (normal &amp;lt; 50 ng/dL for patients not on dexamethasone). Technique of swish and spit was reviewed with the patient, and she was not ingesting the medication. An observational approach was pursued at this time given hemodynamic stability, treatment was continued and several weeks later repeat labs showed cortisol levels of 3.3 (7AM), with a dexamethasone level of 84.3 ng/dL. Her course of therapy has been completed, so she has been off the dexamethasone solution, continues to be asymptomatic and repeat labs now show a 9AM Cortisol level of 9.5 mcg/dL and, given lack of other sources, it is most likely that these low cortisol levels along with elevated dexamethasone levels are related to the use of dexamethasone swish and spit rather than immunotherapy induced permanent HPA axis suppression. Conclusion: There is no literature on dexamethasone swish and spit being absorbed systemically possibly leading to potentially reversible HPA suppression. Our case will raise awareness of help guide clinicians expand their differential when working up these patients. Presentation: Friday, June 16, 2023

SAT563 Follicular Thyroid Cancer Masquerading as Chest Wall Mass With an Aggressive Course

Abstract Disclosure: I. Goyal: None. E. Punni: None. L. Adhikari: None. Introduction:Follicular thyroid cancers (FTC) are more aggressive than papillary thyroid cancer and usually have more advanced tumor stage at the time of presentation. Musculoskeletal metastases are rare though, but when present can cause various complications like pathological fractures and nerve compression. Clinical case:A 75-year-old female was seen in orthopedics clinic for a left infraclavicular chest wall mass. MRI chest showed a large destructive mass invading the manubrium. Biopsy showed follicular cells consistent with ectopic thyroid tissue. CT neck/chest showed 2x1.8 cm right thyroid lobe nodule and left sternoclavicular joint metastasis. She underwent total thyroidectomy and resection of portions of manubrium, left clavicle and left 1st and 2nd rib. Pathology showed FTC in right thyroid lobe, measuring 2.6 cm in greatest dimension with angioinvasion, and FTC of manubrium, adjacent connective tissue and sternoclavicular joint and ribs, measuring 6.3 cm in greatest dimension. Pathological TNM staging was pT2N0M1. Her 6-week post-op thyroglobulin (Tg) level was 28.7 ng/mL (Beckman Coulter Immunometric Assay, reference value &amp;lt;0.1 athyrotic). She was started on levothyroxine supplementation to achieve a TSH &amp;lt;0.01 uIu/mL. She was subsequently treated with 200 mCi of radio-active iodine (RAI) as adjuvant therapy. Post-therapy whole body scan showed increased activity in the right strap muscle and iodine-avid osseous metastasis in right hemisacrum. She further received radiation therapy to neck and sternal regions, and the right sacroiliac joint. Following this, patient was monitored with serial Tg panel and neck ultrasound (US). Her initial post-op US neck showed a soft tissue fullness in right thyroidectomy bed, concerning for residual disease but this was no longer seen after 3 months. Her Tg level downtrended from 28.7 ng/mL to 12.6 ng/mL and further to 1.8 ng/mL at 1-year follow-up. However, her course was complicated by development of several oral ulcers resulting from high-dose RAI therapy which were treated symptomatically with hydration, topical analgesics and Listerine mouth washes. The patient reported ongoing bowel incontinence since her initial cancer diagnosis. MRI pelvis showed rim-enhancing 4.5cm lesion centered at right sacral ala and extending into adjacent S1/S2 neural foramina. She was re-referred for palliative radiation therapy.Conclusion:This case of FTC is unique due to its uncommon initial presentation. Skeletal metastases to sacrum resulted in bowel incontinence in our patient. When present, skeletal metastases need treatment with high-dose (200 mCi) RAI. RAI therapy can cause xerostomia, hypogeusia and sialadenitis due to reductions in salivary flow. Clinicians should be aware of the early and late-onset complications of RAI therapy, discuss these with the patient before therapy and manage the complications adequately if these occur. Presentation Date: Saturday, June 17, 2023

THU442 A Case Of Early Medication Related Osteonecrosis Of The Jaw In Patient Receiving Intravenous Zoledronate For Treatment Of Osteoporosis

Abstract Disclosure: V. Ekpe: None. X. Au: None. M. Golson: None. L.E. McGuire: None. L.E. Aguirre: None. Introduction: Medication related Osteonecrosis of the jaw (MRONJ) is a rare side effect in patients receiving nitrogen-containing bisphosphonates intravenously and other anti-bone resorptive agents such as denosumab . The incidence is 0.1% in patients with metabolic bone disease1. Annual infusions of zoledronic acid have been recommended in order to improve patient compliance, optimize therapeutic effects and to minimize side effects in selected patients. Risk factors include history of malignancy, smoking, poor dental health, prior oral surgery, high dose exposure to zoledronic acid and longer duration of treatment with anti-resorptive therapy. Increasing usage of bisphosphonates and other antiresorptive drugs, have led to an increased incidence of MRONJ. Clinical Case: We report the case of a 63-year-old Caucasian female suffering from osteoporosis who developed early stage MRONJ. She has a history of several years of oral bisphosphonate treatment and three annual administrations of zoledronic acid. Patient presented with a new complaint of gum pain and a sore above her tooth. Prior routine dental exams have all been unremarkable. She was promptly referred and evaluated by a dental provider. Dental photographs showed a resorptive defect at the gumline. Patient was diagnosed with medication related osteonecrosis of the jaw (MRONJ) in the gum area above tooth number 9. Our patient was treated with oral amoxicillin 500mg twice daily and chlorhexidine gluconate mouth rinse twice daily. The intravenous zoledronic acid was discontinued. Her gum infection resolved. Discussion: Early detection of MRONJ is possible in patients potentially at risk for this rare complication. Providers should be aware of MRONJ and refer those patients on antiresorptive drugs to the dentist for frequent evaluation and assessment for any drug-related jaw changes.

The effect of zinc complex of N-isopropenylimidazole on the morphological characteristics of gum tissues in experimental endodontic-periodontal lesions in rats

Introduction: Combined inflammatory and destructive processes affecting the dental pulp and tissues of the periodontal complex are among the most problem diseases of the dental system. Current therapy with use of available pharmacological agents does not always allow achieving the expected positive result. In addition, often the lack of information about morphological processes in the tissues of the dental system, in particular the gums, with endodontic-periodontal lesion (EPL) limits the ability of dentists to carry out targeted pharmacotherapy with both traditional and, in particular, new medications. The aim of the study was to evaluate the morphological characteristics of gum tissues in a therapeutic context of N-isopropenylimidazole zinc complex derivative in experimental endodontic-periodontal lesion in rats. Materials and Methods: A simulation of EPL in rats was performed in two ways: simultaneous induction of acute periodontitis and parodontitis by pulp extraction and natural infection of the pulp cavity, as well as by ligation of the necks of lower incisors. The research protocols included 5 groups of animals: 1st – intact group (control-1); 2nd – animals with simulated EPL (control-2); 3rd – animals with simulated EPL and treated with Metrogyl Denta® gel (M-D); 4th – animals with simulated EPL and treated with N–isopropenylimidazole zinc complex derivative gel under the laboratory code Pilim-1; and 5th – animals with simulated EPL and treated with the combination of M-D + Pilim-1. The gum of the lower incisors was taken for morphological studies. Slides were stained with hematoxylin and eosin. Computer morphometry was performed using the ImageJ software. Results and Discussion: The substances M-D, Pilim-1 and, especially, the combination of M-D+Pilim-1 (against the background of chlorhexidine bigluconate used as oral rinse) for 14 days in rats with simulated EPL cause a significant improvement of the morphological structure of the gum with minimal residual dystrophy and sclerosis. The combination M-D + Pilim-1 led to a 1.3-time increase in epithelial thickness, and a 1.5-time decrease in acanthosis depth in comparison with M-D, while the number of capillaries and their diameter had no significant differences. Compared with Pilim-1, the epithelial thickness increased 1.5 times, and the acanthosis depth and the number of capillaries decreased 1.6 and 1.4 times, respectively, whereas the diameter of the capillaries did not change significantly. The pronounced protective effect of the combination M-D + Pilim-1 on the morphological structure of the gingival mucosa of rats with simulated EPL may be associated with antimicrobial, anti-inflammatory, regenerating, angioprotective and antioxidant properties of both M-D and Pilim-1 separately, and, possibly to a greater extent, of the combination M-D + Pilim-1. Conclusion: The substances M-D, Pilim-1 and, especially, the combination M-D + Pilim-1 (against the background of chlorhexidine bigluconate used as oral rinse) for 14 days in rats with simulated EPL have a protective effect on the epithelial structure and the connective tissue of the proper mucous plate, manifested in active normalization of pathological changes and significant restoration of their organotypic structure.

Comparison of the effectiveness of red ginseng herbal mouth rinse with chlorhexidine and saline in oral cancer patients: A pilot double-blinded randomized control trial.

Red ginseng is an herb with many medicinal properties and aids as a mouth rinse with fewer side effects than chlorhexidine. The study aimed to compare the efficacy of red ginseng herbal mouth rinses with those of chlorhexidine and saline in oral cancer patients. The present pilot study was a double-blinded randomized control trial with 45 histopathologically diagnosed oral squamous cell carcinoma patients divided into three groups: two intervention groups (herbal and chlorhexidine mouth rinse) and one control group (saline). Saliva samples for each patient were collected at baseline and after 14 days of using the mouth rinses. A microbiological examination of salivary samples was done by analysing total oral bacterial load along with specific counts for Porphyromonas gingivalis and Fusobacterium nucleatum at baseline and after the usage of mouth rinse. The data normality was analysed using the Shapiro-Wilk test, and following the normal distribution of data, parametric tests were employed. Paired t-test and one-way analysis of variance, followed by post hoc Bonferroni test, were used for inter-group and intra-group differences. There was a significant mean difference in total colony count, Fusobacterium nucleatum, and Porphyromonas gingivalis with oral hygiene index and gingival index improvement in the red ginseng herbal mouth rinse group when compared to the chlorhexidine and saline groups. In this study, red ginseng mouth rinse exhibited an increased antibacterial effect compared to chlorhexidine and saline. Hence, red ginseng mouth rinse can be used in oral cancer patients to maintain oral health, thereby improving the prognosis of these patients.

Treponema pallidum Detection at Asymptomatic Oral, Anal, and Vaginal Sites in Adults Reporting Sexual Contact with Persons with Syphilis.

We investigated Treponema pallidum PCR positivity at mucosal sites (oral, anal, and vaginal sites) among adults who had sexual contact with a person with syphilis (syphilis contacts). All syphilis contacts had oral rinse and swab samples collected for testing. Men who have sex with men had anal swab and women had vaginal swab samples collected for testing, regardless of the presence of lesions. Of 407 persons tested, 42 (10%) had early syphilis diagnosed; of those, 19 (45%) tested positive by PCR from any anatomic site and had a positive serologic test. T. pallidum was positive from vaginal samples in 3 women, anal samples in 3 men, and oral cavity samples in 2 women and 3 men, without symptoms at those sites. Three women had no prior syphilis serologic test. T. pallidum detection at asymptomatic mucosal sites suggests early syphilis infections, particularly in cases that would conventionally be staged as latent syphilis of unknown duration.

Quantification of oral neutrophil counts in periodontal health and disease utilising a standardised oral rinse.

Polymorphonuclear neutrophils are the most abundant leukocytes in humans and are key host cells in defence against invading microorganisms. The oral neutrophil count may be an indicator of the periodontal health status, which correlates with the severity of periodontal disease. This study attempts to quantify orogranulocytes utilising an oral rinse and to assess the usefulness of this method in evaluating the oral inflammatory load much the same way the circulating neutrophils are used to screen for patients with infection in extra-oral sites. A total of 125 participants were divided into five groups with 25 subjects in each group. The groups consisted of healthy, gingivitis, mild periodontitis, moderate periodontitis, and severe periodontitis. Participants were asked to rinse with 10 mL of 0.9% saline for 30 s and to expectorate. Samples were centrifuged at 2000 RPM for 10 min. The supernatant removed was suspended in 5 mL of Hanks's balanced salt solution. One millilitre of this suspension was mixed with 4 μL of acridine orange. A 10 μL aliquot of this suspension was then assessed on a haemocytometer, and the oral PMNs were counted using fluorescence microscopy. The mean number of oral neutrophils (100,000 cells/mL) was the lowest in the healthy group and increased in ascending order across the different groups with the highest for severe periodontitis group. The oral neutrophil counts increased with the severity of periodontal inflammation. This is an easy, safe, reliable, and non-invasive method of quantification of oral neutrophils.

Effect of herbal mouthwashes from Nimba (Azardirachta indica A. Juss) and curry leaves (Murraya Koenigii (L.) Spreng.) on dental plaque, Streptococcus mutans count, and gingival health in school-going children: An open-label, randomized trial

Abstract Background: Herbal drugs have been used since ancient times; oral rinse of Nimba (Azardirachta indica A. Juss, locally known as the Neem) and curry leaves (Murraya Koenigii (L.) Spreng., locally known as the Meethi Neem) is one of them for maintaining better oral hygiene. Aim: The study aimed at determining the effect of indigenously prepared two herbal and 0.2% chlorhexidine (control group) mouthwashes on dental plaque, Streptococcus mutans count and gingival health in school-going children. Material and methods: Trial design was parallel with an allocation ratio of 1:1:1. Total 120 included children aged 8–14 years were randomized into three groups, namely, Neem leaves (n = 40), curry leaves (n = 40), and chlorhexidine (CHX) mouthwash (n = 40) group. At the baseline examination, plaque and gingival scores were recorded and plaque samples were taken for S. mutans count estimation. The data were entered into Microsoft Excel and analysis was performed using statistical software “SPSS-22.” Descriptive statistics and analysis of variance were applied for evaluation. Tukey’s post hoc test was used to evaluate the difference between the pairs of mouthwashes. Results: Statistically significant differences were found between CHX and Neem and curry leaves in plaque index, S. mutans count, and gingival index at 14 and 21 days from baseline. Neem and curry leaves were equally effective as CHX. Conclusion: Neem and curry leaves mouthwashes are equally effective as antiplaque and anti-gingivitis agents as that of CHX mouthwash.

Evaluation of Antimicrobial Efficacy of Green Tea, Garlic with Lime, Pomegranate Extract and Chlorhexidine Mouth Rinses in a Group of Egyptian Children (A Randomized clinical trial)

Evaluation of Antimicrobial Efficacy of Green Tea, Garlic with Lime, Pomegranate Extract and Chlorhexidine Mouth Rinses in a Group of Egyptian Children (A Randomized clinical trial)

Antibacterial Effect of Alcohol-free Oral Rinses on Aspiration Pneumonia-inducing Microorganisms

Objectives: This study aimed to evaluate the antimicrobial effects of several commercial alcohol-free oral rinses on aspiration pneumonia‑inducing microorganisms. Methods: The experimental products of three commercial oral rinses (Caregargle, Listerine [coolmint mild], and Garglin [zero]) were selected for the evaluation of antimicrobial effect. Hexamedine and sterile distilled water were used as positive and negative controls, respectively. Four pneumonia‑causing microorganisms and Streptococcus mutans were treated with the experimental oral rinses for one minute, and the live cells were counted as colony-forming units (CFUs). For statistical analysis, one-way ANOVA and Tukey’s hoc test were performed using SPSS version 26.0. Results: Hexamedine and Listerine (coolmint mild) exhibited the highest antibacterial effects against all microorganisms. Caregargle and Garglin (zero) showed comparatively lower antibacterial effects than did Listerine (coolmint mild) and Hexamedine. Conclusions: Hexamedine and Listerine (coolmint mild) displayed significant antimicrobial effects on aspiration pneumonia‑inducing microorganisms. These findings suggest that Hexamedine and Listerine (coolmint mild) products for oral care in hospitalized patients or older adults may be effective in preventing aspiration pneumonia.

Antibacterial Activity Evaluation of Mouth Rinse containing Nigella sativa Extract Compared to Doxycycline 0,1% against Porphyromonas gingivalis and Agregatibacter actinomycetemcomitans

Background: Periodontal disease is characterized by host-mediated inflammation caused by microbial biofilm, predominantly by gram-negative bacteria such as Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. Nigella sativa is well-known as the "miracle herb" due to its high nutritional content and active components, the most important of which is Thymoquinone. It has been shown to have several advantages, including anti-inflammatory, antioxidant, and antibacterial effects. Purpose: To evaluate the antibacterial activity of Nigella sativa extract in the form of a mouth rinse to a low dosage of Doxycycline 0.1% against two of the most frequent bacteria in periodontitis, P. gingivalis and A. actinomycetemcomitans. Materials and Methods: P. gingivalis and A. actinomycetemcomitans bacteria sample are cultivated, then the treatment group for each bacterias was divided into 3 groups; the control group, the Doxycycline 0,1% group, and Nigella sativa mouth rinse 3% group. This experiment used the agar diffusion method and the diameter of the inhibitory zone for each treatment group was measured after 48hours of incubation time in anaerobic environment. Results: The data showed normal and homogeneous. The mean diameter of inhibition zone for Nigella sativa treatment group against P. gingivalis is 25,141mm, which is significantly higher than the Doxycyxline 0,1% group. The mean diameter of inhibition zone Nigella sativa treatment group against A. actinomycetemcomitans is 25,1mm, which is also significantly higher than the Doxycyxline 0,1% group. Conclusion: Nigella sativa mouth rinse 3% performs a better antibacterial result against A. actinomycetemcomitans and P. gingivalis bacteria compared to Doxycycline 0,1%.

Oral health effect of an oral rinse containing cetylpyridinium chloride: a randomized clinical trial

Oral health effect of an oral rinse containing cetylpyridinium chloride: a randomized clinical trial