Types Of Mouthwashes Research Articles

Production and Evaluation the Pharmacokinetic Effects of Probiotic Mouthwashes and Their Impacts on Periopathogenic Bacteria in Vitro

Background: In this study, the pharmacokinetic effects of Lactobacillus rhamnosus (L.rh) and Lactobacillus reuteri (L.r) mouthwashes were investigated and the effects of these two bacteria on the Aggregatibacter actinomycetemcomitans (A.a) and Purofiromonas gingivalis (P.g) were compared. The results indicated which of the following probiotics has the inhibitoriest effect on priopathogens. Materials and Methods: Two types of mouthwash containing two probiotics; L. reuteri and L. rhamnosus, were produced. To evaluate the pharmacokinetics of each of the probiotic strains in the mouthwashes, tests for hydrogen peroxide resistance, lysozyme resistance, quantitative calculation of organic acids, and disk diffusion were performed. The Antipathogenic test was also performed to determine the extent of growth inhibition of the mouthwashes against the periopathogens of Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis. Results: L. rhamnosus probiotic was more resistant to hydrogen peroxide but less resistant to lysozyme enzyme than L. reuteri. The production of organic acids after 72 hours of incubation at 37 ͦ C in the L. reuteri strain was significantly higher than the L. rhamnosus. The amount of growth inhibition zone formed by the periopathogenes was detected. Both strains of lactobacilli used in the mouthwashes had good resistance to antibiotics. Conclusion: L. reuteri had a higher resistance to the enzyme lysozyme. However, due to the higher production of organic acids and the possibility of its negative impact on the structure of tooth enamel, the use of this bacteria is not ultimately desirable to maintain oral hygiene. According to the data of this study, due to the high resistance of L. rhamnosus to hydrogen peroxide and antibiotics and its greater effect on periopathogenic strains, the use of this bacteria in comparison with L. reuteri in the laboratory environment has more advantages.

Impact of chlorine dioxide and chlorhexidine mouthwashes on friction and surface roughness of orthodontic stainless steel wires: an in-vitro comparative study

Objectives Good oral hygiene measures are important for successful orthodontic treatment. They involve various types of mouthwashes which have been reported to cause alteration of mechanical properties of archwires. This study aimed to evaluate the effects of a new kind of chlorine-dioxide-containing mouthwash on the mechanical properties and surface morphology of stainless steel orthodontic archwires against the already prevalent chlorhexidine mouthwash in the market. Method Group A – Chlorhexidine mouthwash 0.2% (study), Group B – Chlorine Dioxide mouthwash (study), and Group C – Artificial Saliva (control). 42 specimens of 5 cm long 19x25 inch SS archwires were immersed in each group equally. Post immersion, the frictional force was analyzed in the universal testing machine for each group using custom-made acrylic jigs for 10 specimens. The remaining 4 specimens from each group were sent for surface morphology evaluation using an atomic force microscope. Results Friction resistance evaluation for the archwires revealed a mean friction of 0.011 ± 0.0056 in Group A, 0.015 ± 0.0052 in Group B, and 0.010 ± 0.0067 in Group C. Results suggested that the static friction of Group C (control group) was found to be the least when compared with the experimental groups, although not producing statistically significant values. Surface roughness of archwires compared at a 10μm range revealed a mean roughness of 19.38 ± 0.82 in Group A, 25.39 ± 7.01 in Group B, and 16.65 ± 3.07 in Group C which shows there wasn’t any statistically significant difference in the mean roughness midst the three sets. Conclusion Chlorine dioxide and Chlorhexidine mouthwashes caused an increase in the frictional resistance of the archwires when compared to the control group. This increase was statistically insignificant. When measured at a range of 10μm the mean surface roughness did not statistically differ across the control and the experimental groups.

Comparative Evaluation of Efficacy of Chitosan and Chlorhexidine Mouthwash in Plaque Control and Gingivitis: An Observational Study.

Mouth rinse is a highly effective chemical solution for managing plaque and gingivitis. This study evaluated and compared the efficacy of chitosan (CH)-rich mouthwash with standard chlorhexidine (CHX) mouthwash in reducing gingivitis, plaque, halitosis, and stains. This retrospective, observational study was conducted on the clinical case records of 60 patients who were treated with CH mouthwash (formulated and dispensed from the department) as group 1 and CHX mouthwashas group 2 for at least three months. Indices such as the plaque index (PI), gingival index (GI), stain index (SI), and halitosis index (HI) were obtained at baseline (T0) and the end of three months of mouthwash use (T1) from the case records. The data were subjected to statistical analysis. Both groups effectively reduced all indices from T0 to T1; however, group 1 was more effective than group 2 in reducing gingival, plaque, and stain scores. The results were statistically significant (p<0.05) for all indices, and both groups were equally effective in reducing halitosis. Male sex showed a significant positive correlation with PI, GI, and SI, whereas female sex showed a positive correlation with PI and HI. Based on the findings of the present study, it was concluded that the CH mouthwash was more effective in reducing plaque, gingival, and staining scores than the CHX mouthwash. Both types of mouthwash were equally effective in reducing halitosis scores.

Influence of different types of mouthwashes on force decay of elastomeric chain recommended in SARS-COV-2 pandemic.

This study aimed to compare the force decay of the power-chain elastics after exposure to anti-coronavirus 2019 (COVID-19) antiseptic mouthwashes at different intervals. A total of 300 power-chain pieces were used from American Orthodontics (AO) and Dentaurum (D) brands. Each piece composed of five loops that were selected to simulate canine retraction distally. The samples were randomly grouped according to immersion in the tested mouthwashes 0.2% povidone-iodine (PVP-I), 1% hydrogen peroxide (H2O2), and 0.2% chlorhexidine (CHX) and cetylpyridinium chloride (CPC). The maximum tensile load failure testing (MTLT) was assessed at six time points (zero, one hour, 24 hours, 1, 2 and 4 weeks). Analysis of variance (ANOVA) and Tukey's post hoc tests were used to analyse the data, where P < 0.05. Significant differences in MTLT of power-chain elastics used at different immersion intervals were observed. MTLT, in each tested group, decreased significantly as the immersion time increased with significant differences among the tested mouthwashes at each time point. H2O2 group displays a maximum force decay throughout the time intervals for both brands, in contrast to CPC group, which shows less degradation over time. Both brands are decade over time during exposure to the tested mouthwashes. CPC mouthwashes is a good option to be described for orthodontic patient during COVID-19 pandemic, whereas H2O2 mouthwashes should be avoided.

Advancements in Herbal Mouthwash

Several herbal/chemical-based types of mouthwash are accessible to us nowadays. Selection of suitable mouthwash can be done by conferring the risk and benefits and conditions of the oral cavity. As written in the literature, nature offers us many medicinal materials with antimicrobial and antibacterial properties. Herbal mouthwashes are in high demand as they are effective in combating oral germs and in the treatment of many other oral diseases of the human body. Plaque management is essential for maintaining good oral hygiene. Herbal medicine can be used as an alternative to treat oral diseases with little or no side effects. Recently, herbal mouthwashes are formulated according to the different needs of the customers which has led to different manufacturing processes and techniques for the development of mouthwash. The market revenue of herbal mouthwash has been set to eventually grow in the coming years. An increase in technological advancements paved a way for innovative formulations and new patented products. This review will discuss intimately the benefits and advancements of herbal mouthwash in contrast to chemical mouthwash.

A longitudinal assessment of major mouthwashes used in alleviating pain and xerostomia among advanced nasopharyngeal carcinoma patients receiving chemoradiotherapy.

This longitudinal study aimed to evaluate the overall efficacy of mouthwashes in oral mucositis pain and mucositis xerostomia in advanced nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemoradiotherapy (CCRT) at different phases throughout treatment. A longitudinal study enrolled 79 advanced NPC subjects receiving CCRT. The subjects were interviewed prospectively three times over 7 weeks for pain and xerostomia scores based on the various types of mouthwash used. The median pain score difference and median xerostomia score difference were utilised to determine mouthwash superiority. Participants completed three interviews, during which 480 instances of mouthwash use were observed throughout different phases of the treatment period. The results showed that the median pain scores between mouthwashes differed significantly, H-Stat(3) = 30.0, 25.7 and 26.0, respectively, with p < 0.001 for all three interviews. The pain score reductions of lidocaine mouthwash (median = 2, interquartile range (IQR) = 3, 2 and 2.75 over the three interviews, respectively) were significantly higher than those of benzydamine and sodium bicarbonate mouthwashes. There were no significant differences between the studied mouthwashes in their xerostomia score reductions. Lidocaine mouthwash was superior in managing oral mucositis pain at all phases throughout the entire chemoradiotherapy treatment for advanced NPC patients. There was insufficient evidence to determine the preferred mouthwash for treating oral mucositis xerostomia.

Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study.

Herbal medicines are both promotive and preventive in inhibiting dental caries. Most commonly used natural plant extracts like mango (Mangifera indica) and pudina (Mentha arvensis) as an entire or together are scientifically well proven to be safe and effective against various oral health problems, especially in preventing dental caries and periodontal diseases. The present study aims to comparatively evaluate the effect of Mangifera indica, Mentha arvensis, and Chlorhexidine (CHX) (0.2%) mouthwashes on Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) in children. By random allocation, 45 healthy children were selected between the age-group of 7 and 10 years of both genders from a residential school. They were divided into three study groups of 15 in each; group I-CHX (control group), group II-Mangifera indica mouthwash, and group III-Mentha arvensis mouthwash. Stimulated whole saliva sample collected for the amount of colony forming units and cultured for S. mutans and C. albicans. The data was tabulated, and statistical analysis was done with one-way variance analysis of the variance (ANOVA), Tukey's post hoc honestly significant difference (HSD) test, and Bonferroni and Kruskal-Wallis test. Mangifera indica (group II) and Mentha arvensis (group III) showed a significant reduction of salivary counts at baseline, 14th day, and 21st day period and minimal effect on C. albicans for Mangifera indica. Among the three types of mouthwash, the CHX was the most superior; it showed a statistically significant reduction overall. When compared to Mangifera indica with Mentha arvensis, Mentha arvensis showed a statistically significant reduction in S. mutans and C. albicans and had an almost equivocal effect like CHX. Both herbal mouthwashes had a significant reduction in the S. mutans and C. albicans in children. So, it can be considered an active ingredient in mouthwashes. It may serve as a natural antimicrobial mouthwash with no adverse effects. Kajjari S, K VB, Janardhanan S, et al. Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S78-S83.

Comparative efficacy of Moringa oleifera and coconut oil-based mouthwashes versus chlorhexidine in reducing human oral microbial populations in healthy adults: a single blind clinical trial

IntroductionDentists have considered chlorhexidine as the gold standard antimicrobial solution against oral microbes for decades. The side effects of chlorhexidine and our historical reliance on natural remedies create the need for herbal alternative. This study evaluated the effectiveness of chlorhexidine, coconut oil, and moringa on the prevalence of human oral bacteria using a single-blind, randomised, clinical trial method. MethodsA total of 90 oral swabs were collected from consenting human participants on day 0 of the clinical trial. The participants were given either chlorhexidine (group A), coconut oil (group B), or Moringa oleifera (group C) mouthwashes and instructed to rinse for 14 days, twice daily. The participants were sampled again on day 14. Total plate count (TPC) and differential plate count (DPC) were done on both samples of each participant collected on day 0 and day 14. Bacteria were identified by standard biochemical tests. ResultsStreptococcus mitis, Veillonella parvula, Klebsiella aerogenes, Streptococcus mutans, Bacteroides fragilis, Aggregatibacter actinomycetecomitans, Streptococcus pneumoniae, and Staphylococcus aureus were isolated from the plaque. All 3 types of mouthwash exhibited statistically significant differences in TPC and DPC of day 0 and day 14 when compared using a paired t-test (P value = 0.03, 0.01, and <0.01 respectively). No statistically significant difference was noted in the antimicrobial activity of the three mouthwashes when compared using one-way ANOVA, post-hoc Tukey’s test. ConclusionOur results show that M. oleifera and coconut oil have a bactericidal effect on oral microbial populations associated with caries and periodontal disease, comparable to chlorhexidine.

A Comparison of the Effects of Chlorhexidine and Sodium Bicarbonate Mouthwashes on COVID-19–Related Symptoms

Abstract Background: Some studies have reported that mouthwashes can decrease the viral load in the mouth, but there is not much information about the effectiveness of mouthwashes on coronavirus disease 2019 (COVID-19). This study was conducted to compare the impact of using two types of mouthwash, chlorhexidine and sodium bicarbonate, on COVID-19 symptoms and infection. Materials and Methods: The present three-group, double-blind clinical trial examined 116 operating room nurses and anesthesia personnel of certain hospitals of Isfahan University of Medical Sciences, Isfahan, Iran. The participants were randomly assigned to three groups: intervention group 1 (chlorhexidine mouthwash), intervention group 2 (sodium bicarbonate mouthwash), and the control group (placebo). Mouthwash was used twice a day (morning and night) for 2 weeks. The participants were monitored in terms of COVID-19–related symptoms for 4 weeks, from the first day of mouthwash use. Results: Fisher’s exact test indicated a significant difference between the chlorhexidine and control groups in terms of the onset of COVID-19–related symptoms (p = 0.02). There was no significant difference in the symptoms of COVID-19 between the groups, but the groups were significantly different in terms of all symptoms at a 4-week interval (p = 0.04). Furthermore, headache was less observed in the chlorhexidine (p = 0.007) and sodium bicarbonate (p = 0.03) groups compared to the control group. Conclusions: The use of 0.2% chlorhexidine mouthwash can decrease the onset of COVID-19–related symptoms in health-care workers. In addition, this mouthwash can partially reduce the symptoms of this disease in comparison to the control and sodium bicarbonate groups.

Impact of chlorine dioxide and chlorhexidine mouthwashes on friction and surface roughness of orthodontic stainless steel wires: an in-vitro comparative study.

Good oral hygiene measures are important for successful orthodontic treatment. They involve various types of mouthwashes which have been reported to cause alteration of mechanical properties of archwires. This study aimed to evaluate the effects of a new kind of chlorine-dioxide-containing mouthwash on the mechanical properties and surface morphology of stainless steel orthodontic archwires against the already prevalent chlorhexidine mouthwash in the market. Group A - Chlorhexidine mouthwash 0.2% (study), Group B - Chlorine Dioxide mouthwash (study), and Group C - Artificial Saliva (control). 42 specimens of 5 cm long 19x25 inch SS archwires were immersed in each group equally. Post immersion, the frictional force was analyzed in the universal testing machine for each group using custom-made acrylic jigs for 10 specimens. The remaining 4 specimens from each group were sent for surface morphology evaluation using an atomic force microscope. Friction resistance evaluation for the archwires revealed a mean friction of 0.011 ± 0.0056 in Group A, 0.015 ± 0.0052 in Group B, and 0.010 ± 0.0067 in Group C. Results suggested that the static friction of Group C (control group) was found to be the least when compared with the experimental groups, although not producing statistically significant values. Surface roughness of archwires compared at a 10μm range revealed a mean roughness of 19.38 ± 0.82 in Group A, 25.39 ± 7.01 in Group B, and 16.65 ± 3.07 in Group C which shows there wasn't any statistically significant difference in the mean roughness midst the three sets. Chlorine dioxide and Chlorhexidine mouthwashes caused an increase in the frictional resistance of the archwires when compared to the control group. When measured at a range of 10μm the mean surface roughness did not differ across the control and the experimental groups.

In vivo efficacy of 2% povidone iodine, chlorhexidine gluconate, and herbal extract mouthwash on SARS-CoV-2 viral load in saliva: A randomized clinical trial.

One of the major techniques to reduce the transmission rate of COVID-19 would be to decrease the viral titers of SARS-CoV-2 in the saliva of infected patients and it is particularly useful in a dental setting. The present study evaluated the change in salivary viral load of COVID-19 patients using povidone iodine (PI), chlorhexidine (CHX), and an herbal extract (RightSure®) oral antiviral herbal mouthwash (HM) at clinically recommended duration and concentrations. Thirty individuals with SARS-CoV-2 were randomly allocated to three groups: (1) Group 1, PI mouthwash; (2) Group 2, CHX mouthwash; and (3) Group 3, HM mouthwash. A baseline salivary throat sample was collected from all the participants who were later instructed to rinse with their respective mouthwash for 30 s. A second salivary sample was collected 30 min after rinsing. The SARS-CoV-2 viral load was analyzed using real-time reverse-transcription polymerase chain reaction wherein the cyclic threshold (Ct) values were evaluated. Independent t-test analysis reported a statistically significant difference concerning the PI group (before-after comparison) (P < 0.05). The rest of the two study groups failed to report any significant difference in the nucleocapsid gene and open reading frame 1a gene levels. While all three types of mouthwash increased the Ct values, a statistically significant difference was observed with PI mouthwash, indicating that it might potentially reduce the spread of the SARS-CoV-2 virus, especially via aerosol but further studies with larger sample size and longer follow-up periods are required to investigate this relationship.

The Effects of Antimicrobial Mouthwashes on Systemic Disease: What Is the Evidence?

The potential association between antimicrobial mouthwash use and systemic health has gained attention in recent years with reports highlighting how some common systemic conditions are influenced by the use of different types of mouthwashes. In this context, links between mouthwash use and cardiovascular disease, diabetes mellitus, oral cancer, Alzheimer’s disease, and preeclampsia have been proposed, albeit with limited levels of evidence. Chlorhexidine mouthwash in particular has been the most widely studied agent while available data on other types of over-the-counter mouthwashes are generally scarce. Furthermore, there is currently no evidence-based recommendations on the appropriate use of mouthwashes during pregnancy. This article will present the current evidence on the association between mouthwash use and the aforementioned conditions with emphasis on the mechanisms that may underlie such an association.

Treatment of shallow and deep white spot lesions with three different mouthwashes evaluated by laser fluorescence (an in vitro study)

This research aims to find how three different types of mouthwashes affect the depth of artificial white spot lesions. Teeth with various depths of white spot lesions were immersed in either splat mouthwash, Biorepair mouthwash, Sensodyne mouthwash, or artificial saliva (control)twice daily for one minute for 4 weeks and 8 weeks at 37°C. After this immersion procedure, lesion depth was measured using a diagnosed pen score. A one-way analysis of variance, Dunnett T3 and Tukey's post hoc α = .05 were used to analyze the testing data. Splat mouthwash enhanced the WSL remineralization and made the lowest ΔF compared with other mouthwashes in shallow and deep enamel after 4 and 8 weeks of treatment. In the repair groups, after 4 weeks of treatment, significant recovery was observed in shallow enamel. Further improvement in shallow WSL after 8 weeks of treatment with biorepair mouthwash was observed compared to Sensodyne and the control group. Splat mouthwash is more effective than other mouthwashes in remineralizing two depths of WSLs at different time points. Keywords: DIAGNOdent pen, Shallow enamel, Deep enamel, white spot lesion.

Effect of mouthwashes on the microhardness of aesthetic composite restorative materials.

Mouthwashes are increasingly being used worldwide. However, these preparations are known to have a negative impact on composite resin dental restorations. In this study, we aim to evaluate the effect of mouthwashes on the microhardness of such restorations. Thirty specimens of Tetric N-Ceram composite were prepared. Each composite specimen was cured for 40 seconds and kept in saline solution for 24 hours at 37 °C. Baseline microhardness of each specimen was recorded using an Innovatest Vickers Micro Hardness Tester. Composite specimens were randomly placed in 20 mL of the selected mouthwashes (Colgate® Plax, Listerine® Teeth & Gum Defence, and Closeup® Antibacterial Mouthwash Cool Breeze) and stored in an incubator for 24 hours at 37 °C. Next, microhardness values were rechecked. pH measurements were recorded for each type of mouthwash using a digital pH meter. Due to the acidic nature of Colgate® and Listerine®, the microhardness of the restorations decreased with these mouthwashes; Listerine® caused the greatest decrease in microhardness and had the lowest pH reading (4.34). For Closeup®, with a neutral pH (7.02), no negative effect on microhardness was found; on the contrary, due to the presence of zinc in this latter mouthwash, an increase of the microhardness was found. We confirm the negative effect of acidic mouthwashes on the microhardness of composite dental restorations.

Effects of bedtime mouthwash use on sleep: A field sleep study using wristwatch‐type heart rate monitoring devise

AbstractThis study aimed to test the efficacy of a mint‐flavored mouthwash when it is used at bedtime for subsequent sleep in a field study setting, using a wristwatch‐type heart rate (HR) monitoring devise. Using a within‐subject experimental design, twenty healthy adults used three types of mouthwash having a different intensity of mint sensation (or water as a control) per one experiment night just before going to bed at their home environment, in a counterbalanced order. As for results, irrespective of the intensity of mint‐flavored mouthwashes, the subjective score for “fatigue” and “refreshing” before sleep was decreased and increased, respectively. In addition, although a significant inhibition of HR decline in the sleep initiation period (0–30 min after bedtime) was observed with the use of mint‐flavored mouthwashes compared with the control, the trend reversed subsequently as HR trended lower than for the control during 2–6 h after the bedtime. These findings suggest that the using mint‐flavored mouthwashes at bedtime induces a positive mood before sleep and may improve physiological sleep. Moreover, this study illustrated the possible application and significant advantage of the use of wristwatch‐type HR monitoring devise in a context of field study.

Comparative Evaluation of Antibacterial Efficacy of Cetylpyridinium Chloride and Chlorhexidine Gluconate Mouthwashes after Periodontal Surgery - A Randomized Clinical Study

Background: Periodontitis affects 20-50 percent population is and has various systemic interrelationship. Treatment of periodontal disease requires a holistic approach. Prevention of bacterial accumulation at surgical site is crucial to minimize post-operative complications. The principal cause of post-surgical infection is bacterial colonization due to the wicking effect of the sutures. Despite numerous factors, pathogenic biofilm formation continues to play a crucial role in disease progression. Hence, a comprehensive approach with the goals of infection control, periodontal tissue regeneration, and function restoration becomes a necessity. In this study, we assessed the antibacterial efficacy of Chlorhexidine (CHX) and Cetylpyridinium Chloride (CPC) mouthwashes after periodontal surgery. Material and Methods: In this single-centric, prospective, randomized study, patients undergoing various periodontal surgeries including flap procedures, crown lengthening, resective osseous surgeries, implant placement and periodontal plastic procedures following placement of simple interrupted sutures using monofilament PTFE sutures to reduce the wicking effect. Patients included were &gt;18 years of age, while those with any systemic diseases, pregnant and lactating women, smokers or any other deleterious habits, immune and mental disorders, unwilling to participate were excluded from the study. A total of 46 patients were randomized using envelope method to either one of the two types of mouthwashes CHX or CPC for 10 days post-periodontal surgeries and the sutures were removed after 10 days for CFU analysis. Results: Out of total 46 participants more than half were males (26) and the mean age of participants was 32.53 years (range 18-65 years). Maximum periodontal surgeries were flap procedures (21) and crown lengthening (15) while remaining included osseous surgery (5), perioplastic procedures (3) and implant procedures (2). There was a statistically significant difference seen for the values between the groups. Group I CPC had average CFU count (Mean 1.2x1010) Group II CHX had (Mean 1.2x108) The p value of Mann-Whitney U test was &lt;0.01. Conclusion: Though the bacterial load was reduced by both types of mouthwashes, our study observed better antibacterial effectivity with CHX as compared to CPC. The findings of the study also highlighted the importance of careful adjuvant therapies regardless of the type of periodontal surgery. Keywords: Periodontal surgery, Cetylpyridinium chloride, Chlorhexidine gluconate, mouthwashes, periodontitis, biofilm, Plaque, Wound healing.

A Randomized Double-Blind Clinical Trial Evaluates the Efficacy of Alternative Herbal Mouthwashes.

The removal of dental plaque is the primary step in achieving good oral hygiene. Mechanical plaque removal measures have questionable efficacy in inaccessible areas and proximal aspects of the oral cavity. Out of the several types of mouthwash available, chlorhexidine (CHX) is regarded as the gold standard, but considering its adverse effects, herbal alternatives are being sought after. So, the aim of the study was to evaluate the efficacy of alternative herbal mouthwashes. In this randomized, double-blind study, 125 selected patients were divided into five groups. Group 1: negative control - distilled water (DW); group 2: positive control - hexidine mouthwash (ICPA, Gujarat, India); group 3: FeelFresh Herbal Mouthcare Gargle (Able Exports, Gujarat, India); group 4: HiOra mouthwash (Himalaya Wellness Company, Bengaluru, India); group 5: Colgate MaxFresh Fresh Tea mouthwash (Colgate-Palmolive, India). Plaque index (PI), gingival index (GI), and microbial count (CFU) were evaluated before and after the intervention. The difference among the three types of herbal mouthwash was statistically non-significant. The lowest PI, GI, and CFU values were obtained in the subjects of group 4. Herbal mouthwashes are a promising alternative and are effective in maintaining oral hygiene.

Investigation of Cajuput and Lemongrass Essential Oils Supplemented in Alcohol-Free Mouthwash: Anti-Inflammation on Human Gingival Fibroblast Cells In Vitro

Alcohol-free mouthwash containing essential oils is a helpful adjunct to self-performed oral hygiene of patients with periodontal disease due to its antimicrobial and anti-inflammatory properties. This study aimed to investigate the anti-inflammatory activity of cajuput and lemongrass essential oils supplemented in alcohol-free mouthwash on human gingival fibroblast cells and RAW 264.7 macrophages, which were incubated in a complete medium. In the current in vitro study, 3 types of mouthwash, including 12 % (v/v) alcohol-free mouthwash, 0.8 % (v/v) cajuput essential oil and 0.4 % (v/v) lemongrass essential oil supplemented in alcohol-free mouthwash, and 0.12 % chlorhexidine mouthwash, were evaluated. All 3 types were determined for cytotoxicity by MTT assay. The sub-IC50 concentration of each mouthwash was calculated to investigate anti-inflammatory activities via the inhibition of lipopolysaccharide-activated nitric oxide production, cyclooxygenases-2, interleukin-1β and interleukin-6 gene expression. The wound healing rate was determined by scratch assay. The results demonstrated that the sub-IC50 concentrations of essential oils in 0.8 % (v/v) cajuput essential oil and 0.4 % (v/v) lemongrass essential oil supplemented in alcohol-free mouthwash significantly inhibited nitric oxide production in lipopolysaccharide-activated RAW 264.7 macrophages and reduced the gene expression of cyclooxygenases-2, interleukin-1β and interleukin-6 in lipopolysaccharide-activated human gingival fibroblast cells, while stimulating the migration of human gingival fibroblast cells, similar to the sub-IC50 concentration of 0.12 % chlorhexidine mouthwash. These findings suggested that essential oils contained in this mouthwash formula exhibited an anti-inflammatory effect and promoted oral wound healing, which might be used as an alternative agent for patients with periodontal disease. HIGHLIGHTS Cajuput and lemongrass essential oils supplemented in alcohol-free mouthwash expressed anti-inflammatory activity by inhibiting nitric oxide production in LPS-activated RAW 264.7 macrophages and reducing COX-2, IL-6 and IL-1β expression in LPS-activated HGFs, as well as by promoting oral wound healing, similar to chlorhexidine mouthwash, which is a common, well-known agent in dental treatment Our findings suggested that this novel mouthwash may be an alternative agent in preventing oral inflammatory diseases, especially periodontal disease GRAPHICAL ABSTRACT

Effects of Bedtime Mouthwash Use on Sleep: A Field Sleep Study using Wristwatch-type Heart Rate Monitoring Devise

This study aimed to test the efficacy of a mint-flavored mouthwash when it is used at bedtime for subsequent sleep in a field study setting, using a wristwatch-type heart rate (HR) monitoring devise. Using a within-subject experimental design, twenty healthy adults used three types of mouthwash having a different intensity of mint sensation (or water as a control) per one experiment night just before going to bed at their home environment, in a counterbalanced order. As for results, irrespective of the intensity of mint-flavored mouthwashes, the subjective score for “fatigue” and “refreshing” before sleep was decreased and increased, respectively. In addition, although a significant inhibition of HR decline in the sleep initiation period (0-30 minutes after bedtime) was observed with the use of mint-flavored mouthwashes compared with the control, the trend reversed subsequently as HR trended lower than for the control during 2-6 hour after the bedtime. These findings suggest that the using mint-flavored mouthwashes at bedtime induces a positive mood before sleep and may improve physiological sleep. Moreover, this study illustrated the possible application and significant advantage of the use of wristwatch-type heart rate monitoring devise in a context of field study.

Nondrug Intervention for Opportunistic Infections in Individuals With Hematological Malignancy: Systematic Review.

Hematological malignancies disturb the blood, lymph nodes, and bone marrow. Taking medications for treating opportunistic infections (OIs) in these individuals may enhance the risk of medication interaction as well as adverse drug reactions. This review aims to evaluate the effectiveness of nondrug interventions in reducing OIs among patients with hematological cancers. The PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Embase databases were searched on December 26, 2022, for all randomized controlled trials (RCTs). The primary endpoint was OIs. The quality of included studies was assessed by the Cochrane Risk-of-Bias tool. A total of 6 studies were included in this review with 4 interventions: (1) types of mouthwash received, (2) presence of coating on central venous catheters (CVCs), (3) use of well-fitted masks, and (4) types of diet consumed. The results were presented in 8 different comparisons: (1) chlorhexidine-nystatin versus saline mouth rinse, (2) chlorhexidine versus saline mouth rinse, (3) nystatin versus saline mouth rinse, (4) chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters, (5) well-fitted masks versus no mask, (6) amine fluoride-stannous fluoride versus sodium fluoride mouthwash, (7) low-bacterial diet versus standard hospital diet, and (8) herbal versus placebo mouthwash. No clear differences were reported in any of the outcomes examined in the first 3 comparisons. There were also no clear differences in the rate of catheter-related bloodstream infection or insertion site infection between the use of chlorhexidine silver sulfadiazine-coated CVCs versus uncoated catheters in the patients. Further, no significant differences were seen between patients who used a well-fitted mask and those without a mask in the incidence of OI. The all-cause mortality and mortality due to OI were similar between the 2 groups. There was no clear difference in all-cause mortality, although common adverse effects were reported in patients who used sodium fluoride mouthwash compared with those using amine fluoride-stannous fluoride mouthwash. There was no evidence of any difference in the incidence of possible invasive aspergillosis or candidemia between patients who consumed a low-bacterial diet and a standard diet. For the last comparison, no significant difference was seen between patients who received herbal and placebo mouthwash. Very limited evidence was available to measure the effectiveness of nondrug interventions in hematological cancers. The effectiveness of the interventions included in this review needs to be evaluated further in high-quality RCTs in a dedicated setting among patients with hematological malignancies. PROSPERO International Prospective Register of Systematic Reviews CRD42020169186; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=169186.