Mouthwash Research Articles

In Vitro Model to Evaluate the Development of Discolorations on Human Enamel Caused by Treatment with Mouth Rinses and Black Tea Considering Brushing.

The study aimed to develop and test an in vitro model to investigate the staining potential of mouth rinses on human enamel, considering alternating intake of black tea and tooth brushing, thus mimicking the situation in the oral cavity more realistically. Eight mouth rinses with six different active ingredients (benzydamine hydrochloride [BNZ], polyhexamethylene biguanide hydrochloride [PHMB], chlorhexidine digluconate [CHX], hexetidine gluconate [HEX], octenidine dihydrochloride [OCT] and octenidine dihydrochloride + 2-phenoxyethanol [OCTP]) and concentrations were tested. Sets of six halved human molar crowns were initially pretreated by soaking in artificial saliva (30 min). Afterward, the cyclic treatment was started by soaking in artificial saliva (2 min), staining with black tea (1 min), brushing with toothpaste (5 s), and soaking in the mouth rinse (30 s). Samples were rinsed with distilled water after each treatment step. The cyclic treatment was repeated 30 times, mimicking the consumer behavior after 15 days. Photographic images were taken after 0, 10, 20, and 30 cycles. Color measurements were conducted after each staining and brushing step using a VITA-Easyshade spectrophotometer to determine the difference in lightness ∆L and the total color difference ∆E. Analysis of variance and post-hoc Tukey test (α = 0.05) were applied. The new testing model with included brushing sequences allowed to assess the staining behavior on human teeth and provided a clear differentiation between the different investigated products. In detail, up to cycle 10, ΔE values increased for all mouth rinses with each additional cycle number. However, while ΔE values continued to increase for 0.15% BNZ, 0.1% PHMB, and 0.2% CHX between treatment cycle 10 and 30, ΔE values only slightly increased after treatment with 0.08% OCTP, 0.1% OCTP, 0.1% OCT, and 0.1% HEX. After 20 and 30 cycles, significantly less staining was found for 0.08% OCTP, 0.1% OCT, 0.1% HEX as compared to 0.2% CHX, 0.15% BNZ, and 0.1% PHMB (p < 0.05). ΔE-values were significantly lower after treatment with 0.1% OCTP as compared to 0.2% CHX1 and 0.2% CHX2 (p < 0.05). The proposed new methodology was found to be appropriate for assessing the staining progression of mouth rinses over a simulated application period of 15 days. The model allows differentiation of products with different active ingredients and concentrations.

The commercially available oral rinse vs. curcumin photosensitizers in an artificial mouth model mimicking their use after meals on early colonizers single species biofilm: An in vitro study.

Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals. The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS). Noordini's Artifical Mouth model was used for developing the single species biofilm with early microbial colonizers of oral biofilm (A. viscosus, Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count. From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis, S.sanguinis and A.viscosus. There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p⩽ 0.05). It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora.

Clinical Study on the Effect of Sodium Fluoride Mouthrinse /Gel and Toothpaste in Combination with Chlorohexidine Mouth Wash on Plaque and Gingivitis in Orthodontic Patients

This study is to examine which one is most effective the use of NaF mouthrinse and toothpaste with chlorohexidine mouthwash or the use of NaF gel with Naf toothpaste and chlorohexidine mouth wash on the plaque and gingivitis of maxillary anterior teeth that occurs in orthodontic patients during the treatment of fixed appliance. A prospective, randomized, double-blind study with 60 orthodontic patients (16 males and 44 females, average age from 15 to 25 ) was designed . All the patients were instruct to brush with NaF tooth past three times in the day and to use chlorohexidine mouth wash at night . Visible plaque index (VPI) and gingival bleeding index (GBI) were recorded on the six maxillary anterior teeth at bonding and after one, two and three months and evaluated with t tests .Then the patients that began to have plaque and gingivi tis were divided into two groups A and B , In group A they wer e instruct to use NaF gel (1500 ppm) in addition to NaF(145 0ppm) toothpaste and 2% chlorohexidine mouth wash while gr oup B used Naf (250 ppm) mouth rinse in addition to NaF toot hpaste and chlorohexidine . There was a significant differences( P&lt;0.05) between bonding and debonding after 3 months recorded for VPI and there was also a significant difference between gr oup A and B for the VPI and for the GBI after six weeks of th e treatment . It was concluded that the combined use of an NaF toothpaste/gel and chlorohexidine mouthwash had a slightly more inhibitory effect on the development of , plaque and gingivitis on maxillary anterior teeth during fixed orthodont ic treatment compared with NaF mouth rinse / toothpaste with ch lorohexidine mouthwash .

The effect of menthol rinsing before intermittent exercise on physiological, physical, and thermo-behavioral responses of male football referees in hot and humid environment.

In the current experiment, we aimed to evaluate whether eliciting pre-exercise non-thermal cooling sensations would alter perceptual measures, and physical and physiological responses in football referees. Nine highly trained male football referees undertook two 45-minute intermittent exercise protocols in hot and humid conditions (34.2 ± 0.6°C, 62.5 ± 1.0% relative humidity). In a randomized counterbalanced crossover design, 1 of 2 beverages were given before the warm-up: a 0.01% menthol solution or a placebo noncaloric solution. Physical performance was quantified as total distance covered in each of the three 15-minute exercise blocks. Core temperature, heart rate, thermal sensation and thermal comfort were measured at rest and after each exercise block. No changes were observed between trials and over time for distance covered. No main effect of mouth rinse was observed for core temperature and heart rate, but both increased over time in all conditions (P < 0.001). Thermal sensation and thermal comfort were significantly improved with menthol after mouth-rinsing (P < 0.05), but with no differences at any other time-point. These results indicate that non-thermal cooling oral stimuli provide immediate behavioral changes but may not influence physiological or physical responses in football referees, during intermittent exercise in hot and humid environments. www.clinicaltrials.gov, identifier NCT05632692.

Use of over-the-counter mouthwashes as an additional measure in individual oral prophylaxis on adults with plaque-induced gingivitis: a double-blind, parallel, randomized controlled trial

BackgroundPlaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis.MethodsThe present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18–75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1).ResultsFor total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant.ConclusionThe daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn.Trial RegistrationACTRN12622000215729, 07/02/2022.

Effects of Carbohydrate Mouth Rinse on Gastrointestinal Disorders in Triathletes

In long-term efforts, such as triathlon, the requirement for carbohydrate intake can also work as an ergogenic strategy. However, the literature has reported and recorded gastrointestinal discomfort by athletes during the race when performing this practice, which can compromise performance. Mouth rinses with carbohydrates, followed by the disposal (spitting) of the solution, is a strategy to maintain performance, without generating side effects. Therefore, this study aimed to verify the potential side effects of carbohydrate mouth rinse in triathlon athletes during cycling practice. Twelve trained male - triathletes were subjected to two experimental situations, in which they have completed 1.5 km of swimming, followed by 40 km of cycling, within the shortest time possible and self-regulated intensity (time trial test). Throughout the cycling, blindly and crossed-wise, the volunteers rinsed their mouths using a bolus of 25 ml of 0% CHO placebo solution and 16% CHO (maltodextrin) solution, for each 12.5% of the distance to be covered. A gastrointestinal symptoms questionnaire was answered at the end of the 40 km cycling. Only one volunteer (8.33%) reported discomfort, while 91.66% of them presented no type of symptoms according to the CHO rinse protocol. Therefore, carbohydrate mouth rinse presents no gastrointestinal side effects during long-term exertion.

Evaluation of the effect of ozonated water in treatment of denture stomatitis associated with removable prosthetics

BackgroundOzone therapy is highly demarcated in the dental field owing to its efficient antimicrobial action in its gaseous and aqueous forms. One of the most common difficulties accompanied by utilizing dentures is denture stomatitis (DS) which is principally triggered by Candida albicans (C. albicans).ObjectivesAssessing and comparing the impact of ozonated water versus chlorhexidine mouthwash on healing of intra-oral inflammations associated with complete dentures.Subjects and methodsFifty middle-aged male completely edentulous patients wearing complete dentures were screened for the possibility of having any accompanied DS and/or C. albicans. Patients were randomly distributed into two groups. Group I patients were treated with chlorhexidine mouthwash and oral hygiene measures (OHM); while, Group II patients received ozonated water as a mouthwash and OHM. Evaluation of inflammation, pain grade, and oral Candidiasis count took place for all patients in all visits; from the initial day of treatment and after 7, 14, and 30 days.ResultsThe inflammation’s area and severity together with pain grade showed a significant decrease with time when using both chlorhexidine mouthwash and ozonated water. Comparing the use of chlorhexidine mouthwash and ozonated water together showed insignificant differences. Regarding the Candida forming units (CFU) there was a significant decrease in the colonies number over time, but with insignificant difference between the two groups.ConclusionsOzonated water showed favorable results in reducing the area and severity of inflammation and pain grade. Ozonated water has an antifungal effect and can be used as an alternative mouth rinse in treating denture stomatitis.

Formulation and assessment of biological properties of garcinia indica fruit extract mouthrinse as an adjunct to oral hygiene regimen: an in vitro analysis.

This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.

Development of whitening mouth rinses formulated with mushroom residues and their effect on enamel's physical properties.

This study aimed to develop whitening mouth rinses formulated with industrial mushrooms and compare them with over-the-counter whitening mouth rinses. Formulations with black shimeji mushrooms, mushroom substrates, and mushroom stalks were developed. Bovine enamel/dentin samples were divided into 7 groups (n = 10): Colgate Luminous White, Listerine Whitening Extreme (LWE), Listerine Cool Mint (LC), mushroom extract rinse (MEC), mushroom substrate rinse (MSB), mushroom stalk rinse (MTC), and artificial saliva. Samples were stained with black tea for 6 days, and then were immersed in 100 mL of each mouth rinse twice daily for 14 days. Color parameters (CIELAB [ΔE*], CIEDE2000 [ΔE00], whiteness index for dentistry [ΔWID]) and microhardness (Knoop hardness number [KHN]) were analyzed at T1 (initial), T2 (24 hours), and T3 (7 days). Mouth rinse pH was measured, and enamel was examined using a scanning electron microscope. Data were analyzed using generalized linear models, and KHN with the generalized linear mixed model for repeated measures (p ≤ 0.05). ΔE* was higher in LW and MSB groups. No significant differences were found for ΔE00 (p = 0.0982) and ΔWID (p = 0.2536). Experimental mouth rinses did not promote enamel whitening based on ΔE00 and ΔWID. LWE and LC reduced KHN and had a more acidic pH, while MEC had higher KHN at T2. MEC, MSB, and MTC had alkaline pH, not altering the tooth surface. Black shimeji mushrooms are promising for mouth rinse development due to their alkaline pH and non-altering effect on surface microhardness.

Effect of 0.2% Betel Nut Mouth Rinse on Flow Rate, pH, Bacterial Parameters of Saliva: A Clinical Trial

Background Areca nut having a sialagogue effect and antibacterial activity against several bacteria can help to reduce dental caries. In the present study Areca nut in the form of a mouth rinse was used.Aim To evaluate and compare the effect on salivary parameters and bacterial count before and after the use of betel nut mouth rinse.Method Baseline salivary sample was collected from each patient on day 1. The collected samples were then used to evaluate salivary pH salivary flow rate and total bacterial count. Subsequently 5 mL of 0.2 betel nut study solution was given to the subjects as mouth rinse for using once daily for one minute for a period of 15 days. At the end of 15 days the post rinse salivary samples were collected and evaluated for the same parameters.Results The results obtained in our study demonstrated that using 0.2 betel nut as a mouth rinse has potential to reduce the oral bacterial count significantly. Although there was a difference in flow rate before and after the intervention the values obtained were not significant.Conclusion The results of this study conclusively demonstrated that 0.2 betel nut extract when used as a mouth rinse does reduce the concentration of oral bacteria and hence can have a positive impact on the overall oral health of an individual.

Potassium oxalate-based mouth rinse for rapid relief in dentinal hypersensitivity

Abstract Dentinal hypersensitivity (DHS) affects about 1.3%–92.1% of the population globally and has a significant impact on the quality of life of the affected individuals. Desensitizing agents that directly block the dentinal tubules or cause chemical blocking of the pulpal nerve endings are commonly recommended for the management of DHS. Potassium oxalate (KO) has been used as a desensitizing agent in the management of DHS. This narrative review aimed to assess the literature related to the efficacy of KO as a desensitizing agent, with a focus on mouth rinses containing 1.4% KO. A comprehensive search of the literature was carried out using PubMed and Google Scholar with relevant keywords. The results from the retrieved articles were assessed, and the findings regarding the efficacy of KO in managing DHS were analyzed. Studies suggest that the usage of 1.4% KO mouth rinses results in the occlusion of dentinal tubules by the formation of acid-resistant calcium oxalate crystals within dentinal tubules and on the dentine surface. These calcium oxalate crystals tend to form a strong bond with the inner surface of the dentinal tubules and lower the hydraulic conductivity of the dentine. These actions of KO can ensure both rapid and long-term relief from DHS.

Menthol Mouth Rinsing Improves Cycling Performance in Trained Adolescent Males Under Heat Stress.

This study investigated the effect of menthol (MEN) mouth rinsing (MR) on cycling performance during a modified variable cycle test (M-VCT) in adolescent athletes under hot conditions (31.4 ± 0.9°C, 23.4 ± 3.7% relative humidity). Trained adolescent male cyclists (n = 11, 16.7 ± 1.3years, height 176.6 ± 8.8cm, body mass 65.8 ± 11.6kg, maximal oxygen uptake 62.97 ± 7.47ml·kg-1·min-1) voluntarily completed three trials (familiarization and two experimental) of a 30-min M-VCT, which included five 6-min laps consisting of three 6-s accelerations and three 10-s sprints throughout each lap. In a randomized crossover design, MEN (0.01%) or placebo (PLA) (crystal-light), was swilled for 5s before the start of each lap (total of 6 MR). Power output, distance (in kilometers), core temperature, heart rate, perceptual exertion, thermal stimulation (thermal comfort and thermal sensation), and blood lactate concentration were recorded. MEN MR significantly improved M-VCT mean power output by 1.81 ± 1.57% compared to PLA (MEN, 177.8 ± 31.4W; PLA, 174.7 ± 30.5W, p < .001, 95% confidence interval [1.73, 4.46], d = 1.53). For maximal intermittent sprints, 6- and 10-s mean power output was significantly higher with MEN than PLA (6s, p = .041, 95% confidence interval [0.73, 27.19], d = 0.71; 10s, p = .002, 95% confidence interval [11.08, 35.22], d = 1.29). There was no significant difference in core temperature, heart rate, blood lactate concentration, or any perceptual measure between trials (p > .05) despite significantly higher work with MEN. 64% of athletes (7/11) improved M-VCT performance with MEN. The results of this investigation suggest that a MEN MR may improve power output during a sport-specific stochastic cycling task in elite adolescent male cyclists.

Decreased GCF DEL-1 and increased GCF neutrophils with increasing probing pocket depth.

Developmental endothelial locus-1 (DEL-1) plays a role in regulating neutrophil migration within the periodontium. The objective of this study was to evaluate the levels of DEL-1 in saliva and gingival crevicular fluid (GCF), as well as the number of neutrophils in patients with periodontitis. Forty systemically healthy, non-smoking periodontitis patients participated in this study. Clinical periodontal parameters, including the plaque index, probing pocket depth (PPD), clinical attachment level, bleeding on probing, modified sulcular bleeding index, and marginal bone level, were measured. Levels of DEL-1, interleukin (IL)-1β, IL-6, and IL-8 in unstimulated saliva samples, as well as DEL-1 in the GCF of 3 teeth from each participant, were assessed. Neutrophil counts in oral rinse and GCF samples were recorded. Spearman correlation coefficients were used to examine the correlation between protein levels, clinical parameters, and neutrophil quantities. Participants were divided into 2 age groups (those under 50 years and those 50 years or older) in order to investigate potential age-related differences. DEL-1 levels in the GCF showed a negative relationship with PPD (sum). Neutrophils in oral rinse samples were positively correlated with PPD, IL-8, and IL-1β levels. Neutrophils in GCF exhibited a positive correlation with PPD (sum). Salivary DEL-1 levels showed correlations with IL-8 and IL-1β, but not with the clinical parameters of periodontitis. The negative relationship observed between PPD and GCF DEL-1 levels is consistent with the proposed protective role of DEL-1.

A study to evaluate the role of antioxidants and iron as diagnostic markers in oral cancer

Oral cavity (OC) and oropharyngeal (OP) cancers afflict about 500,000 people globally. Dental health care practitioners need to understand the causes, diagnosis, and treatment of oral cavities and oropharyngeal cancer. The constant and direct exposure of oral mucosal cells to tobacco product chemical carcinogens such as polynuclear aromatic hydrocarbons and nitrosamines causes the generation of free radicals/reactive oxygen species. Changes in salivary antioxidant and micronutrient levels may prove to be an important factor in the pathogenesis of oral premalignant and malignant disorders. The present study aimed to evaluate the levels of Vitamin C, MDA and iron levels in oral cancer, pre-malignant group and the oral cancer group. 15 oral cancer patients, 30 premalignant condition patients, and 15 normal controls were analyzed in the study. Among the 30 patients of the premalignant conditions- group (Group S1) 12 were diagnosed with oral submucous fibrosis, and 18 of them were diagnosed with oral leukoplakia. The oral cancer patients (Group S2) were segregated based on the TNM system from stages I to IV. The oral submucous fibrosis patients were subdivided into four grades. The oral leukoplakia patients were categorized into homogenous and speckled types. A detailed history was obtained from the patients. After obtaining informed consent, saliva samples will be collected from patients who have not consumed any food or any form of tobacco 2 hours before collection. Following a thorough mouth rinse using distilled water, saliva is allowed to accumulate in his or her mouth for 5 minutes. Accumulated saliva is collected by the spit method. 5ml of blood sample will also be collected from these patients, Serum was separated by Centrifugation. Collected serum and saliva were stored at -80℃ until further analysis. The serum and salivary samples were then analyzed for Vitamin C, iron, and malonaldehyde (lipid peroxidation) according to the standardized protocol. In the present study, a total of 60 samples were screened for Vitamin C, Iron, and MDA in both serum and saliva of normal control, premalignant, and oral cancer patients. We found that there was a decreased level of Vitamin C and iron in both serum and saliva of premalignant and oral cancer patients. MDA level was higher in premalignant, and oral cancer patients and there was a significant increase in the level of MDA in oral cancer patients. Understanding antioxidants can help reduce the incidence of oral cancer in its early stages. More study is needed before this supplement may be recommended as an adjuvant treatment.

Comparative evaluation of efficacy of a botanical oral rinse containing Punica granatum, grapefruit seed extract, thymol with chlorhexidine mouthwash on plaque and gingivitis

Comparative evaluation of efficacy of a botanical oral rinse containing Punica granatum, grapefruit seed extract, thymol with chlorhexidine mouthwash on plaque and gingivitis

Dynamic changes of Th1/Th2/Th17 cytokines and hBD-2/3 in erosive oral lichen planus patients saliva before and after prednisone acetate treatment

ObjectiveThis study aimed to investigate the expression of T helper 1 (Th1)/Th2/Th17- related cytokines and human beta defensins 2 and 3 (hBD-2 and -3) in the saliva of patients with erosive oral lichen planus (EOLP) and to explore their role in the pathogenesis of EOLP and the effects of glucocorticoids on EOLP. MethodsA total of 30 patients with EOLP and 20 age- and sex-matched healthy individuals were included in this study. The patients were treated with prednisone at a dose of 0.4 mg/(kg·d) for 1 week and examined before and after treatment. Unstimulated whole saliva samples were collected to determine the levels of cytokines (interleukin 1 beta [IL-1β], tumour necrosis factor alpha [TNF]-α, interferon gamma [IFN-γ], IL-4, IL-6, IL-10 and IL-17) by cytometric bead array and those of hBD-2 and -3 b y enzyme-linked immunosorbent assay. In addition, oral rinse samples were collected to detect Candida load. ResultsThe levels of salivary IL-1β, IL-6, hBD-2 and hBD-3 were higher and the IFN-γ/IL-4 and IL-1β/IL-6 ratios were lower in patients with EOLP than in healthy individuals. In patients with EOLP, hBD-2 levels were positively correlated with IFN-γ levels and negatively correlated with IL-17 levels, whereas hBD-3 levels were negatively correlated with IL-17 and IL-10 levels. In addition, the prevalence of EOLP was positively correlated with IL-6 levels and negatively correlated with the IFN-γ/IL-4 ratio. The levels of IL-1β, TNF-α, IFN-γ, IL-6, hBD-2 and hBD-3 and the IFN-γ/IL-4 ratio decreased after treatment with prednisone for 1 week. The levels of IL-6, hBD-2 and hBD-3 were significantly higher in EOLP patients than in healthy individuals; while TNF-α levels and the IFN-γ/IL-4 ratio were significantly lower in EOLP patients than in healthy individuals. Furthermore, the oral counts of Candida spp. (colony forming unit [CFU]) were negatively correlated with TNF-α levels. Numerical Rating Scale(NRS) and Sign scores decreased in EOLP patients after treatment. Approximately 80 % of patients were effectively treated. Salivary TNF-α levels were significantly higher in the treatment-ineffective group than in the treatment-effective group before treatment with prednisone, and differences in salivary IL-6 levels before and after treatment were significantly higher in the treatment-effective group than in the treatment-ineffective group. ConclusionsHigh expression of IL-1β, IL-6, hBD-2 and Th1/Th2 imbalance in saliva may be associated with the pathogenesis of EOLP. IFN-γ/IL-4 balance may serve as a protective factor for EOLP. Glucocorticoids significantly alleviate the symptoms of EOLP and inhibit the expression of Th1/Th2 cytokines.

The in vitro assessment of rheological properties and dentin remineralization of saliva substitutes containing propolis and aloe vera extracts.

Saliva substitutes with enhanced dentin remineralization properties were expected to help manage caries progression in patients with xerostomia. This in vitro study examined the rheological properties and remineralization action of experimental saliva substitutes containing propolis extract and aloe vera extract on demineralized dentin. Four experimental saliva substitutes were formulated with varying concentrations of propolis extract (P) and aloe vera extract (A) were prepared. A commercial saliva substitute (Biotene Oral Rinse) was used as a commercial comparison. The rheological properties and viscosity of these materials were measured using a strain-controlled rheometer (n = 3). The remineralizing actions of saliva substitutes on demineralized dentin after 2 weeks were determined using ATR-FTIR and SEM-EDX (n = 8). The results were expressed as a percentage increase in the mineral-to-matrix ratio. Biotene demonstrated a significantly higher viscosity (13.5 mPa·s) than experimental saliva substitutes (p<0.05). The addition of extracts increased the viscosity of the saliva substitutes from 4.7 mPa·s to 5.2 mPa·s. All formulations showed minimal shear thinning behavior, which was the viscoelastic properties of natural saliva. The formulation containing 5 wt% of propolis exhibited the highest increase in the median mineral-to-matrix ratio (25.48%). The SEM-EDX analysis revealed substantial mineral precipitation in demineralized dentin, especially in formulations with 5 wt% or 2.5 wt% of propolis. The effect of the aloe vera extract was minimal. The addition of propolis and aloe vera extracts increased the viscosity of saliva substitutes. the addition of propolis for 2.5 or 5 wt% to saliva substitutes increased mineral apatite precipitation and tubule occlusion. To conclude, the saliva substitute containing propolis extract demonstrated superior remineralizing actions compared with those containing only aloe vera extract.

Comparative Evaluation of Antimicrobial Activity of 0.2% Lemongrass Oil and 0.2% Chlorhexidine as a Preprocedural Mouth Rinse: A Randomised Controlled, Parallel Design, Split-mouth Clinical Trial

Introduction: The aerosols produced by an ultrasonic scaler contain bacteria that may enter the respiratory systems of both dental surgeons and patients. Lemongrass oil is one of the essential oils with enormous antibacterial, antifungal, antioxidant, anti-inflammatory, and antipyretic effects. Aim: To evaluate and compare the efficacy of commercially available preprocedural mouth rinses, containing 0.2% lemongrass oil mouthwash and a 0.2% chlorhexidine gluconate solution, in reducing the levels of viable bacteria in aerosols. Materials and Methods: This single-centre double-blinded randomised controlled parallel design split-mouth clinical trial was planned among patients in the Department of Periodontics attending Vishnu Dental College and Hospital in Bhimavaram, Andhra Pradesh, India. The study was conducted for 40 days, from August 2022 to October 2022. Two distinct types of preprocedural mouth rinses (lemongrass oil and chlorhexidine) were used on 56 participants with Stage II or III and Grade B periodontitis. A total of 56 subjects were randomly assigned to two groups: Group A (0.2% lemongrass oil) and Group B (0.2% chlorhexidine), using a simple coin toss method. Colonyforming units (CFUs) with and without rinsing in each group were assessed and studied. CFUs collected on blood agar plates were counted during ultrasonic scaling both with and without rinsing. International Business Machine (IBM) Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. Paired t-tests and independent t-tests were used for intragroup and intergroup comparisons for both groups. Results: The mean CFU count in the chlorhexidine group without rinsing was 259.6±26.6, and with rinsing, it was 140.7±22.6, which was statistically significant (p-value &lt; 0.001). In the lemongrass oil group, the CFU count without rinsing was 263.5±26.9, and with rinsing, it was 147.18±33.82, which was also statistically significant (p-value&lt;0.001). In the intergroup comparison, the p-values for both groups-using preprocedural rinse (Group A vs. Group B for quadrants 2 and 3) and without preprocedural rinse (Group A vs. Group B for quadrants 1 and 4)-were 0.40 and 0.58, respectively, which were not significant. Conclusion: Both preprocedural mouth rinses were equally effective in reducing microbial counts in aerosols during ultrasonic scaling.

Drug-induced Stevens-Johnson syndrome in Post traumatic facial injury.

Stevens-Johnson syndrome is a severe adverse drug reaction affecting the skin and mucous membrane. The causes include Sulfonamides, Anticonvulsants, etc. A patient developed ulcerations in the lips and oral cavity with difficulty in swallowing and rashes over the back, abdomen, and genitalia following administration of injection ceftriaxone 1 g intravenous (IV) b.i.d, injection pantoprazole 40 mg IV b.i.d, tablet aceclofenac + paracetamol 325 mg b.i.d, tablet cetirizine 10 mg b.i.d, chlorhexidine mouth wash, and injection metronidazole 500 mg IV t.i.d for the treatment of traumatic facial injury after 4 days of treatment. Injection ceftriaxone and tablet aceclofenac + paracetamol were suspected as the cause of this reaction. The two drugs were stopped. The patient was treated with corticosteroids, other antimicrobials, and oral topical anesthetics. Health-care providers should be careful about the possible adverse drug reactions even to commonly used drugs.

Salivary PH Changes after Using Fluoridated Mouth Rinse and Miswak in High Caries Risk Patients.

Salivary PH Changes after Using Fluoridated Mouth Rinse and Miswak in High Caries Risk Patients.