Comparative Evaluation of the Effects of Black Tea Extract Mouthrinse and Chlorhexidine Mouthwash on Salivary Streptococcus Mutans Load

Background- Dental caries is one of the most frequent oral health problems. The present study shows the antibacterial effect of black tea extract on salivary Sterptococcus Mutans load. Materials & Methods- The study was conducted on 125 individuals. The differences in the Colony Forming Units and count-scores of S.mutans were analyzed in salivary samples collected from individuals before and after administration of 2% black tea extract mouth-rinse and chlorhexidine mouthwash(CM). Results- There was a statistical difference in mean salivary S. mutans colony count and mean count- score before and after administration of black tea extract mouth-rinse (p = 0.0003) and chlorhexidine mouthwash (p = 0.0002) respectively. Hence, it was found that there is no statistically significant difference in the fall of S.mutans load due to black tea mouth-rinse and chlorhexidine mouthwash. Conclusions- A 2% black tea extract mouth-rinse significantly reduces salivary S.mutans load, irrespective of age and gender. Also, it is an effective natural anti-cariogenic agent with no known implicated side effects.

Evaluation of Nanocurcumin Mouthwash as an Adjunctive Plaque Control Agent: A Clinical Pilot Study

The use of adjunctive plaque control methods such as mouthwashes has shown to be effective in prevention of plaque accumulation. The gold standard for mouthwashes is 0.2% chlorhexidine, however, various side effects compels researchers to divert towards herbal alternatives. Curcumin has been enhanced with nanotechnology to enhance its efficacy and water solubility. The aim of study was to compare the efficacy of 0.1% nanocurcumin mouthwash to 0.2% chlorhexidine gluconate as an adjunct to scaling and root planning in localized chronic periodontitis patient. In this randomized controlled clinical study, a total of 30 patients having localized mild to moderate periodontitis were included. The study population was divided into 2 groups by randomization protocol; Group A (n=15) was given 0.1% nanocurcumin mouthwash whereas Group B (n=15) was given 0.2% CHX mouthwash. Clinical parameters including Plaque index (PI), Modified Gingival Index (mGI) being recorded at baseline, 30th day and 45th day and Sulcular Bleeding Index (SBI), Periodontal Probing Depths (PPD), Clinical attachment levels (CAL) were recorded at baseline and 45th day. Subjective criteria included taste acceptability, burning sensation and dryness whereas objective criteria including ulcer formation, tongue and teeth staining were analyzed. Statistically significant improvement was observed in all clinical parameters when compared to baseline in both groups and difference was statistically non-significant on intergroup comparison. No adverse reaction was observed in both groups in terms of subjective and objective criteria. Within the limitations, it can be concluded that nanocurcumin can be a viable alternative to chlorhexidine to formulate a mouthwash

Effect of Dentoxol® in the treatment of recurrent mild aphthous ulcers. A prospective observational pilot study

ABSTRACT: Background: Recurrent aphthous stomatitis (RAS) is the most common oral ulceration. Its prevalence in the general population varies between 5% and 60%, and during the acute period, it causes pain and interferes with basic activities, such as eating, swallowing and talking. Dentoxol® is a medical mouthrinse that cleans, moisturizes and lubricates the mouth, mechanically stimulating local epithelial regeneration. The aim of this study was to evaluate the efficacy of Dentoxol® in improving the general state of patient with minor RAS using two different treatment schemes. Material and methods: Thirty-nine patients with RAS were recruited in a prospective observational pilot study. Two dosing regimens, 5 ml of Dentoxol® twice daily and 5 ml of Dentoxol® three times daily were evaluated. Results: Efficacy to improve the general state was significant superior in "Three time daily" group compared with "twice daily" at 72 h (66% vs 33% respectively). No pain was reported in approximately 90% of cases at 96 h of use in both group without significant differences between the groups in any evaluation time-point. Conclusion: Despite the limitations of these preliminary data, Dentoxol® shows promising beneficial properties for the management of minor RAS.

Antibacterial Effect of Commercial Mouthwashes on Streptococcus mutans: An in vitro study

ABSTRACT: The aim of this study was to compare the antibacterial effect of eight different commercial (MWs) on two Streptococcus mutans (SM) strains by using the agar well diffusion method. Eight commercial MWs were selected, all of them combined several ingredients in different concentrations, the main active ingredients were: Chlorhexidine gluconate, cetylpyridinium chloride, sodium fluoride, zinc lactate, vitamin B5 and super-oxidized water. The SM strains were extracted from Cultiloops® and incubated for 24 hours at 37 °C. The antimicrobial activity was evaluated using the agar well diffusion method. The inhibition zones were measured using an electronic digital caliper. The R© software was used to perform the statistical analysis using Kruskall-Wallis test and Dunn's multiple comparisons test. Seven commercial formulas demonstrated inhibitory effect over both SM strains. Only the MW containing super-oxidized water did not exhibit antibacterial activity. Higher inhibitory effect was observed in the chlorhexidine gluconate formula (27.38 ± 0.98 mm and 31.52 ± 0.64 mm). No statistically significant differences were observed when comparing formulas containing chlorhexidine gluconate in combination with other active ingredients. Seven MWs showed antibacterial activity except super-oxidized water formula. MWs containing chlorhexidine gluconate demonstrated the best effect against SM. However, no statistically significant differences were found when comparing formulas using exclusively chlorhexidine gluconate or combined with other antiseptics. Future research must be performed, focused on developing new MWs with similar antibacterial effects to chlorhexidine, but free of side effects, particularly in long-term treatments.

RESUMEN: El objetivo de este estudio fue comparar el efecto antibacteriano de ocho colutorios comerciales en la proliferación de dos cepas de Streptococcus mutans (SM) mediante el método de difusión de pozos de agar. Se seleccionaron ocho colutorios comerciales, todos ellos combinados con varios ingredientes en diferentes concentraciones, los principales ingredientes activos fueron: gluconato de clorhexidina, cloruro de cetilpiridinio, fluoruro de sodio, lactato de zinc, vitamina B5 y agua superoxidada. Las cepas SM se extrajeron de Cultiloops® y se incubaron durante 24 horas a 37 °C. La actividad antimicrobiana se evaluó mediante el método de difusión de placa de agar. Las zonas de inhibición se midieron utilizando un calibre digital electrónico. Se utilizó el software R © para realizar el análisis estadístico mediante la prueba de Kruskall-Wallis y la prueba de comparaciones múltiples de Dunn. Siete fórmulas comerciales demostraron efecto inhibidor sobre ambas cepas SM. Solo el colutorio que contenía agua superoxidada no mostró actividad antibacteriana. Se observó un mayor efecto inhibidor en las fórmulas congluconato de clorhexidina (27,38 ± 0,98 mm y 31,52 ± 0,64 mm). No se observaron diferencias estadísticamente significativas al comparar fórmulas que contienen gluconato de clorhexidina en combinación con otros ingredientes activos. Siete MW mostraron actividad antibacteriana excepto la fórmula de agua superoxidada. Los colutorios que contienen gluconato de clorhexidina mostraron el mejor efecto contra SM. Sin embargo, no se encontraron diferencias estadísticamente significativas al comparar fórmulas que combinaron con otros principios activos. Se deben realizar investigaciones, enfocadas en el desarrollo de nuevos colutorios con efectos antibacterianos similares a la clorhexidina, pero libres de efectos secundarios, particularmente en tratamientos a largo plazo.

Anti-plaque And Anti-gingivitis Agents In The Control Of Supragingival Plaque

This review considers the main agents which have been used as anti-plaque and anti-gingivitis agents in mouthwashes and other vehicles to inhibit the growth of supragingival plaque. The agents are classified into first generation, second generation and third generation agents. Bisguanide antiseptics, hexetidine, povidone iodine, triclosan, delmopinol, salifluor, metal ions, sanguinarine, propolis and oxygenating agents are included. The anti-plaque and antigingivitis properties of these agents are considered along with their substantivity, safety and possible clinical usefulness. A number of product forms are available to deliver anti-plaque agents (i.e., mouthrinses, dentrifices, aqueous gels, chewing gum and lozenges) and should facilitate optimal bioavailability at the site of action and patient compliance.

Estudio del Efecto de un Enjuagatorio de Rosmarinus officinalis (Romero) en la Cicatrización de Heridas de Mucosa / Oral Study of the Effect of Rosmarinus officinalis (Rosemary) Mouthrinse on Healing Wounds of the Oral Mucosa

RESUMEN: El objetivo de este estudio fue evaluar el efecto de un enjuague oral de extracto acuoso de Rosmarinus Officinalis (romero) sobre la cicatrización de heridas de mucosa oral en sujetos sanos. Veintiocho estudiantes, de sexo masculino, edad promedio de 22 años, fueron reclutados para un estudio de doble ciego en la Facultad de Odontología de la Universidad de Concepción, Chile. Se creó una herida estándar de 3 mm de diámetro en la mucosa palatina, que fue fotografiada durante un período de 21 días para determinar su tamaño por fotoplanimetría. Los voluntarios recibieron enjuagues orales para ser utilizados a diario desde el día de creación de la herida, 3 veces al día, y fueron divididos en grupo control (enjuague placebo) y grupo experimental (enjuague de extracto de romero). El extracto acuoso de Romero fue analizado por HPLC, mostrando un alto contenido de carnosol (83 %) y ácido rosmarínico (65 %). Se observó una disminución significativa en el tamaño de la herida del grupo tratado con enjuague de romero comparado con el tratado con enjuague placebo al día 3 de cicatrización (20 %, p=0,046, Mann-Whitney). Posteriormente no se encontraron diferencias, completándose la cicatrización antes del día 21 para ambos grupos. Los resultados sugieren que el enjuagatorio de extracto acuoso de romero favorece la cicatrización temprana de las heridas, lo que puede deberse a su alto contenido de carnosol y ácido rosmarínico que han demostrado estimular la cicatrización y poseer actividad antimicrobiana.

ABSTRACT: The objective of the study was to evaluate the effect of a mouthrinse containing an aqueous extract of Rosmarinus officinalis (rosemary) on healing wounds of the oral mucosa in healthy subjects. Twenty Eight healthy, non-smoking male students, mean age 22 years, were recruited for a double-blind study at the School of Dentistry of the University of Concepción, Chile. A standard 3mm wound was created on the palate with a punch biopsy. The wounds were photographed to assess healing for 21 days. The subjects were instructed to use a mouthrinse 3 times daily for 21 days, starting the day of wounding, and were divided into a control group (placebo) and an experimental group (rosemary extract). The aqueous rosemary extract used for the mouthrinse had a high content of carnosol (83 %) and rosmarinic acid (65 %) as determined by HPLC. We observed a 20 % reduction in wound size by day 3 in the rosemary mouthrinse group as compared to the placebo mouthrinse group (p=0.04, Mann Whitney). Thereafter, no significant differences in wound closure were observed. Healing was completed by day 21 in both groups. The results suggest that the mouthrinse containing the aqueous rosemary extract stimulates early healing of mucosal wounds. This could be due to the high content of carnosol and rosmarinic acid, which are known for their healing and antimicrobial properties.

Acción Inmediata de los Enjuagues Orales en la Saliva / Immediate Action of Mouthwashes on Whole Saliva

RESUMEN: Numerosos estudios confirman la efectividad de los enjuagatorios orales sobre la viabilidad de los microorganismos que producen gingivitis y halitosis, pero poco se conoce sobre la influencia de los mismos en el medio ambiente oral. El objetivo del siguiente trabajo fue analizar In vivo e In vitro el efecto de enjuagatorios orales sobre la saliva total no estimulada. Se trabajó con saliva de individuos sanos. Para el estudio in vivo se recogieron las muestras antes y después del enjuague oral a diferentes tiempos (1, 5, 10, 15, 30, 45 y 60 minutos). Para el ensayo in vitro, se incubó la saliva con igual volumen de la solución enjuagatoria a 37 ºC con agitación a diferentes tiempos (1, 5, 10 y 15 minutos). Se determinó pH inmediatamente recogidas las muestras. Posteriormente fueron centrifugadas y determinados flujo salival y proteínas totales. La separación de proteínas por electroforesis en SDS-PAGE se realizó solo en el ensayo in vivo. Los resultados mostraron que los enjuagatorios fluorurados poco alteran la fisiología oral a través de flujo salival, pH y proteínas totales. La combinación fluoruro de sodio/xilitol produjo mayor estimulación del flujo salival. La mezcla de aceites esenciales provocó un incremento del flujo salival y de pH, redujo el contenido de proteínas totales, evidenciando por SDS-PAGE que las comprometidas fueron particularmente las de mediano y bajo peso molecular. Clorhexidina debido a su elevada sustantividad, incrementó significativamente flujo salival y pH in vivo. In vitro, fuera del medioambiente oral, los enjuagatorios estudiados ejercieron un efecto similar sobre proteínas totales. Los enjuagatorios de uso frecuente alteraron parámetros salivales, por lo que podría estudiarse la acción que ejercen sobre otros componentes de la saliva con actividad biológica importante en cavidad oral.

ABSTRACT: Numerous studies confirm the effectiveness of mouthwashes on the viability of microorganisms that produce gingivitis and halitosis, but little is known about their influence on the oral environment. The objective of the following work was to analyze In vivo and In vitro the effect of mouthwashes on total non-stimulated saliva. We worked with saliva from healthy individuals. For In vivo study, samples were collected before and after oral rinsing at different times (1, 5, 10, 15, 30, 45 and 60 minutes). For the In vitro assay, the saliva was incubated with equal volume of the rinse solution at 37 ° C with shaking at different times (1, 5, 10 and 15 minutes). PH was determined immediately collected samples. Subsequently they were centrifuged and determined salivary flow and total proteins. Separation of proteins by SDS-PAGE electrophoresis was performed only in the In vivo assay. The results showed that fluoridated rinses hardly alter oral physiology through salivary flow, pH and total proteins. The combination of sodium fluoride / xylitol produced greater stimulation of salivary flow. The mixture of essential oils caused an increase in salivary flow and pH, reduced the total protein content, evidencing by SDS-PAGE that those involved were particularly those of medium and low molecular weight. Chlorhexidine due to its high substantivity, significantly increased salivary flow and pH In vivo. In vitro, outside the oral environment, the rinses studied had a similar effect on total proteins. Rinses used frequently altered salivary parameters, so that the action they exert on other components of saliva with important biological activity in the oral cavity could be studied.

The antiplaque and bleeding control effects of a cetylpyridinium chloride and tranexamic acid mouth rinse in patients with gingivitis

PURPOSE: This study aimed to evaluate the effects of a cetylpyridinium chloride (CPC) and tranexamic acid (TXA) mouth rinse on patients with gingivitis. METHODS: This randomized, placebo-controlled, double-blind, parallel-group, clinical trial included 45 healthy adults with gingivitis, who were randomized into 2 groups. The experimental group used a 0.05% CPC and 0.05% TXA mouth rinse, and the control group used a placebo mouth rinse. The following clinical indices were assessed at baseline, at 3 weeks, and at 6 weeks: the Turesky-Quigley-Hein plaque index (QHI), the Löe-Silness gingival index (GI), and bleeding on marginal probing (BOMP). The subjects used the mouth rinse during the experimental period for 20 seconds, 4–5 times daily (10 mL each time). RESULTS: There were no significant differences in the clinical indices between the groups at baseline. In the experimental group (CPC+TXA), a statistically significant improvement was evident in the QHI, GI, and BOMP at 3 and 6 weeks. These results were similar to those observed in the control group at 3 and 6 weeks, although the change in BOMP was not statistically significant in that group. At 6 weeks, the experimental group had a significantly lower mean score for the QHI than the control group. CONCLUSIONS: This study demonstrated that a CPC and TXA mouth rinse exhibited significant antiplaque and anti-gingivitis efficacy, and had a positive effect on bleeding control when used daily for 6 weeks.

Investigations on the effects of mouthrinses on the colour stability and surface roughness of different dental bioceramics

PURPOSE: In this study, three bioceramic materials, [IPS Empress CAD (Ivoclar), IPS e.max CAD (Ivoclar), and Lava Ultimate CAD (3M ESPE)] were treated with three commercial mouthrinses [Listerine, Tantum Verde, and Klorhex]; and changes in colour reflectance and surface roughness values were then quantitatively assessed. MATERIALS AND METHODS: One hundred and twenty ceramic samples, with dimensions of 2 × 12 × 14 mm, were prepared and divided into nine sample groups, except three control samples. The samples were immersed in the mouthrinse solutions for 120 hrs, and changes in colour reflectance and surface roughness values were measured by UV light spectrophotometry (Vita Easyshade; VITA Zahnfabrik) and by profilometer device (MitutoyoSurftest SJ-301), respectively. The change of surface roughness was inspected by Scanning Electron Microscopy (SEM) and Atomic Force Microscopy (AFM). RESULTS: There was a positive correlation between the ΔE and increase in the surface roughness. Two of the ceramic materials, IPS Empress and Lava Ultimate, were affected significantly by the treatment of the mouthrinse solutions (P<.05). The most affecting solution was Tantum Verde and the most affected material was Lava Ultimate. As expected, the most resistant material to ΔE and chemical corrosion was IPS e max CAD among the materials used. CONCLUSION: This work implied that mouthrinse with lower alcohol content had less deteriorating effect on colour and on the surface morphology of the bioceramic materials.

Comparative effects of aqueous single-phase and oil-water two-phase mouthrinses containing bamboo salt, magnolia bark and Centella asiatica extracts on reducing gingivitis: a randomized clinical trial / 대한구강보건학회지

OBJECTIVES: The aim of this study was to assess the antiplaque and antigingivitis effectiveness of aqueous single-phase and oil-water two-phase mouthrinses, containing bamboo salt, magnolia bark, and Centella asiatica extracts, in Korean adults. METHODS: In this double-blinded clinical trial, a total of thirty-four participants aged over 19 years were randomly allocated to three experimental groups: 1) control group; 2) aqueous single-phase mouthrinse (ASM) group, and; 3) oil-water two-phase mouthrinse (OTM) group. The experimental mouthrinses all contained sodium fluoride, and the ASM and OTM contained additional ingredients of bamboo salt, magnolia bark, and Centella asiatica extracts. For the OTM, 50% essential oil was added to create an oil-water two-phase mouthrinse. A two-week randomized crossover design with a two-week washout period was applied. Following a complete dental prophylaxis, participants were instructed to use the prescribed mouthrinse twice daily for two weeks as an adjunct to their usual mechanical oral hygiene procedures. Pre- and post-experiment clinical examinations were performed to measure the plaque index (PI) and bleeding on probing (BOP) for the full mouth. Paired t-test was applied to compare the intergroup differences for all clinical variables. RESULTS: Compared to the control group, ASM showed a significantly reduced BOP (P<0.05). However, there was no statistically significant difference in the effects of the three mouthrinses on reducing the PI. CONCLUSIONS: The results of this study indicate that the use of an aqueous, single-phase mouthrinse containing bamboo salt, magnolia bark and Centella asiatica extracts could help alleviate gingivitis.

Malodor reductions and improved oral hygiene by toothbrushing and mouthrinsing.

Objective: This clinical study compared the effects of an antibacterial regimen, comprising a triclosan toothpaste and a 0.075% cetylpyridinium chloride (CPC) mouthrinse, on malodor, self‑reported malodor, and oral hygiene measures such as dental plaque, gingivitis, and bleeding relative to brushing with a fluoride toothpaste. Materials and Methods: At baseline, 36 subjects were evaluated for malodor (9‑point organoleptic scale [OLT]), dental plaque (Turesky modification of Quigley‑Hein; PI), gingivitis (Löe‑Silness; GI) and bleeding (Ainamo and Bay; BI) and randomized to (1) tooth brushing with fluoride toothpaste, or (2) a regimen comprising tooth brushing with a triclosan toothpaste and mouth rinsing with CPC mouthrinse. After the first use of assigned treatments, subjects were evaluated for malodor 2 h after breakfast (OLT‑2 h) and used provided treatments for the next 14 days. On the 7th and 14th days, subjects refrained from oral hygiene for 12 h before evaluations (OLT, PI, GI, and BI) and then performed oral hygiene at the dental clinic. Subjects were evaluated for malodor 2 h after breakfast (OLT‑2 h) and self‑assessed their malodor on a 100 mm visual analog scale (VAS). Results: Treatment groups demonstrated no significant differences in OLT, PI, GI, BI at baseline (P > 0.05). OLT‑2 h scores after the first use of regimen and after tooth brushing alone were 5.94 and 6.21, respectively, and were statistically significantly different (P < 0.05). Correspondingly, the regimen demonstrated progressive reductions in OLT and OLT‑2 h on the 7th and 14th day evaluations (5.81, 4.88, and 5.09, 4.20, respectively) and were significantly lower than after tooth brushing alone (6.49, 6.18, and 6.35, 5.99, respectively) (P < 0.05). From the 7th to 14th days, the regimen also demonstrated progressively lower PI, GI, BI, and self‑reported malodor (VAS scores) which were significantly lower than tooth brushing alone (P < 0.05). Conclusions: Results from this study demonstrated that a regimen comprising a triclosan toothpaste and CPC mouthrinse demonstrated significant malodor reductions 2 h after the first use and progressively increasing reductions in malodor, dental plaque, gingivitis, bleeding and self‑reported malodor from the 7th to 14th days than tooth brushing alone.

Short-term evaluation of a green tea extract-based mouthrinse / Avaliação de curto prazo de um enxaguatório bucal à base de extrato de chá verde

Introduction: mechanical hygiene is still the best method forthe maintenance of oral health and prevention of biofilm formation. However, mouthrinses have been increasingly used as an adjunct support especially for post-operatory conditions or when periodontal conditions require. In this way, a number of mouthrinses are available, presenting different active ingredients with predominant antimicrobial action. Objectives: the aim of the present study was to evaluate the topical action of a green-tea extract-based mouthwash on gingival tissue. Materials and Methods: a longitudinal double-blind comparison was performed with two groups of patients clinically evaluated and diagnosed as suffering from gingivitis (n= 40). The patients were divided into two groups, according to the mouthrinse used: GT - green tea (concentration of 20mg/ml), and P - placebo, 0.9% saline solution. Clinical examination of the mucosa, tooth staining, plaque and gingival indices were peformed before and 15 days after the continuous use of the products twice a day. Results: no mucosal or tasting alterations were found, neither tooth staining regardless the mouthrinse used. Statistical assessment did not detect differences on gingival indexes between the groups before and after mouthrinses use; however, plaque indexes were significant lower in patients of GT group, compared to the P group. Conclusions: the use of phytotherapic products with active ingredients should be investigated for biofilm control, responsible for the onset and progression of periodontal disease, as well as other various oral pathologies. Considering the period of evaluation pro-posed in this study, relevant decrease in initial phase of plaque for-mation could be observed with the green tea mouthrinse. Further long-term evaluation studies should be carried-out in order to eluci-date its continuous effects on oral structures.

Introdução: higiene mecânica ainda é o melhor método para a manutenção da saúde bucal e prevenção da formação de biofilmes. No entanto, enxagues têm sido cada vez mais usado como um suporte auxiliar especialmente para as condições pós-operatórias ou quando as condições periodontais exigem. Desta forma, um número de bochechos estão disponíveis, apresentando diferentes ingredientes ativos com predominante ação antimicrobiana. Objetivos: o objetivo do presente estudo foi avaliar a ação tópica de um bochecho à base de extrato de chá verde no tecido gengival. Materiais e Métodos: a comparação longitudinal, duplo-cego, foi realizada com dois grupos de pacientes clinicamente avaliados e diagnosticados como portadores de gengivite (n = 40). Os pacientes foram divididos em dois grupos, de acordo com o enxaguatório oral usado: CV - chá verde (concentração de 20 mg / ml), e P - placebo, solução salina a 0,9%. O exame clínico da mucosa, coloração dos dentes, índice de placa e índice gengival foram realizados antes e 15 dias após o uso contínuo dos produtos duas vezes por dia. Resultados: nenhuma alteração na mucosa ou de degustação foi encontrada, assim como não foi identificado modificação na coloração do dente. A Avaliação estatística não detectou diferenças no índice gengival entre os grupos antes e depois de usar enxaguatórios. No entanto, índice de placa inferior foi menor de forma significativa nos pacientes do grupo CV, em comparação com o grupo P. Conclusões: o uso de produtos fitoterápicos com ingredientes ativos deve ser investigado para o controle de biofilme, responsável pelo aparecimento e progressão da doença periodontal. Considerando o período de avaliação proposto, a redução correspondente na fase inicial da formação de placa pôde ser observada com o enxaguatório à base de chá verde. Além disso, estudos de avaliação de longo prazo devem ser realizados, a fim de elucidar seu efeito contínuo em longo prazo sobre as estruturas orais.

Effect of mouthrinses with different active agents in the prevention of initial dental erosion.

Introduction: Hydrochloric acid (HCl) from the gastric juice is the only source of intrinsic acid, which can reach the oral cavity in cases of gastroesophageal reflux or chronic vomiting, enhancing the risk of dental erosion. Aim: Compare the effects of mouthrinses with different active agents in the prevention of initial dental erosion caused by HCl. Subjects and Methods: Casein (CAS at 0.2%), sodium hexametaphosphate (HMP at 0.02%), titanium tetrafluoride (TiF4 at 0.34%), and stannous fluoride (SnF2 at 0.87%) were individually added to an experimental mouthrinse. The mouthrinse without additives was used as the negative control (C) and a commercially available mouthrinse for erosion (ELM – Elmex®) as the reference product. Enamel specimens were exposed to human saliva and randomly assigned to 6 experimental groups (n = 8). Specimens were submitted to erosion in HCl for 10 s, followed by to the experimental mouthrinses for 30 s, and artificial saliva for 60 min. This cycle was repeated 3 times. The total amounts of calcium and phosphorus released by the specimens in the 2nd and 3rd erosive challenges were evaluated by atomic emission spectrometry. Statistical analysis used Shapiro–Wilks and Hartley tests, followed by one‑way ANOVA and Tukey tests. Results: When compared with C, ELM and HMP presented significantly less calcium in solution, with no difference between them. All the groups showed similar and significantly less phosphorus than C, except CAS. Conclusions: HMP was the only agent that could match the protection against initial erosion of the commercially available mouthrinse in both analyses.

The Effects of S-solution and A-solution on Oral Health in Preschool Children

PURPOSE: This study aimed to evaluate the effects of gargling with S-solution and gargling with A-solution on salivary pH, coated tongue, and dental plaque index in preschool children. METHODS: Non-equivalent control group pretest-posttest design was used to select the participants. 99 preschool children were divided into three groups. Dependent variables were recorded at baseline, 30 minutes, and 7 days after the first treatment was given. The data were analyzed using chi2-test, ANOVA, and repeated measures of ANOVA. RESULTS: There were no significant differences in dependent variables in pre-test. However, the salivary pH in the S-solution group had significantly increased after 30 minutes (p<.05) and then again 7 days (p<.01) after the first treatment. Also, the S-solution and A-solution groups had greater decrease in dental plaque index after 30 minutes and again 7 days after the first treatment (p<.001) than the control group. With respect to coated tongue, there were no significant differences among the three groups. CONCLUSION: The results of this study indicate that essential oil gargling after brushing is helpful in improving oral health due to auxiliary oral hygiene effects with natural products. Specifically, gargling with S-solution is more effective than A-solution on oral health in preschool children by neutralizing salivary pH and reducing dental plaque index.

Effect of various commercially available mouthrinses on shear bond strength of orthodontic metal brackets: An in vitro study.

Context: Alcohol is known to degrade and dissolve the bisphenol A glycidyl methacrylate present in the composite resin. The effect of alcohol containing mouthrinses on the shear bond strength of orthodontic metal brackets bonded with composite resin has not been verified until date and is the purpose of this study. Aims: The aims and objectives of the present study were to evaluate (1) Whether there is a significant difference in the shear bond strength of metal orthodontic brackets after the 1 year (12 h) and 2 years simulation (24 h) of mouth rinsing with 4 different commercially available mouthrinses (2 alcoholic and 2 alcohol-free mouthrinses) when compared to the control. (2) Whether alcohol containing mouthrinses have more adverse effect on the shear bond strength when compared with alcohol-free mouthrinses. (3) To assess the site of bond failure using adhesive remnant index. Setting and Design: Experimental - laboratory based. Materials and Methods: A total of 100 upper premolars extracted for orthodontic purpose were collected immediately after extraction, cleared soft-tissue debris and blood and immediately stored in distilled water with 0.1% thymol crystals added to inhibit bacterial growth. Two alcohol containing mouthrinses and two alcohol-free mouthrinses were used and the bonded teeth were placed in the mouthrinses for a stipulated period of time (1 year simulation and 2 years simulation) and shear bond strength were tested using Lloyd Universal Testing Machine. Statistical Analysis Used: The data were analyzed using analysis of variance and paired samples t-test. Results: After the 1 year and 2 years simulation time, samples stored in alcohol containing mouthrinses showed lower bond strength (P < 0.05) when compared to samples stored in alcohol free mouthrinses and distilled water (control). Conclusion: Alcohol containing mouthrinses affect the shear bond strength of the metal orthodontic brackets bonded with composite resin (Transbond XT in the present study), more when compared with alcohol-free mouthrinses. It is, therefore, highly advisable to avoid alcohol containing mouthrinses in patients undergoing orthodontic treatment and use alcohol-free mouthrinses as adjuncts to regular oral hygiene procedures for maintaining good enamel integrity and periodontal health, without compromising the shear bond strength of the bonded metal brackets.

Clinical applicability of natural product(s)-containing mouthwashes as adjunctive treatment of biofilm-induced gingivitis: a systematic review / Aplicabilidade clínica de colutórios à base de produtos naturais como tratamento adjuvante da gengivite induzida por biofilme: uma revisão sistemática

Natural products have emerged as an effective and low-cost alternative for treating various diseases of the oral cavity. This study aimed to evaluate, through a systematic literature review, if there is scientific evidence ensuring the safe and effective use of natural product(s)-containing mouthwashes as adjunctive treatment of biofilm-induced gingivitis. Searches were conducted in the databases Medline, SciELO, LILACS and Cochrane Library, by using combinations of the key words gingivitis/natural products/phytotherapy/mouthwash, in English, Portuguese and Spanish. Studies published until September 2010 were considered. Four examiners analyzed independently: study design and phase, methodological quality (Jadad scale - JE), experimental product and its concentration, dosing interval and time of usage, as well as employed statistical analysis and clinical outcome of interest. From the 503 articles found, 08 were included in the final review as phase II, controlled, randomized and blind clinical trials, scoring 4 (25%) and 5 (75%) in JE. The main natural products assessed were: Azadirachta indica, Garcinia mangostana, Lippia sidoides, Salvadora persica and Sesamum indicum whose concentration, dosing interval, time of usage and adverse effects varied according to each study. The Plaque and Gingival Index were most employed, as well as α = 5% and paired t, Student's t, Wilcoxon and Mann-Whitney tests. A total of 62.5% and 50% of the products significantly reduced supragingival biofilm and gingivitis, respectively. Mouthwashes containing the essential oil from the leaves of L. sidoides (1%) and the extract from the leaves of A. indica (25%) can be indicated as adjunctive treatment of biofilm-induced gingivitis.

Os produtos naturais têm surgido como alternativa eficaz e de baixo custo para o tratamento de várias doenças da cavidade oral. Objetivou-se avaliar, a partir de revisão sistemática da literatura, se há evidências científicas garantindo a utilização segura e eficaz de antissépticos bucais contendo produto(s) natural(is) como tratamento adjuvante da gengivite induzida por biofilme. Foram realizadas buscas nas bases de dados Medline, SciELO, LILACS e Cochrane Library, através de combinações usando as palavras-chave gengivite/produtos naturais/ fitoterápicos/bochechos, em Inglês, Português e Espanhol. Consideraram-se os estudos publicados até setembro de 2010. Quatro examinadores analisaram separadamente: desenho e fase do estudo, qualidade metodológica (escala de Jadad - EJ), produto experimental e a concentração, intervalo de administração e tempo de uso, bem como a análise estatística empregada e os resultados clínicos de interesse. Foram encontrados 503 artigos dos quais 08 foram incluídos na revisão final como sendo ensaios clínicos fase II, controlados, randomizados e cegos, marcando 4 (25%) e 5 (75%) na EJ. Os principais produtos naturais avaliados foram Azadirachta indica, Garcinia mangostana, Lippia sidoides, Salvadora persica e Sesamum indicum, cuja concentração, intervalo de administração, tempo de uso, e efeitos adversos, variaram de acordo com cada estudo. Índice de placa e Índice Gengival foram os mais utilizados, bem como α=5% e testes t-pareado, t-Student, Wilcoxon e Mann-Whitney. 62,5% e 50% dos produtos reduziram significativamente a presença de bioflme supragengival e gengivite, respectivamente. Os colutórios contendo o óleo essencial das folhas de L. sidoides (1%) e o extrato das folhas de A. indica (25%) podem ser indicados como tratamento adjuvante da gengivite induzida por biofilme.

Antiplaque and antigingivitis effects of a mouthrinse containing cetylpyridinium chloride, triclosan and dipotassium glycyrrhizinate

PURPOSE: The goal of this study was to evaluate the clinical anitplaque and antigingivitis effects of a mouthrinse containing cetylpyridinium chloride (CPC), triclosan and dipotassium glycyrrhizinate (DPZ) in patients with gingivitis and mild periodontitis. METHODS: Thirty-two subjects were randomized into 2 groups. The test group used a mouthrinse containing 0.05% CPC, 0.02% triclosan and 0.02% DPZ, while the control group used a placebo mouthrinse. At baseline, 2 weeks and 4 weeks, the papillary bleeding index (PBI), Turesky-Quigley-Hein plaque index (PI) and Loe-Silness gingival index (GI) were assessed. During the experimental period, the patients used the mouthrinse for 30 seconds, 4 to 5 times/day (10 mL/time) within 30 minutes after toothbrushing. RESULTS: No adverse effects appeared in either the experimental or the control group. Regarding PBI, PI and GI values, statistical significance was detected between values at baseline and 2 weeks for both groups (P<0.05). In the experimental group, statistically significantly lower values were detected at 4 weeks compared to at 2 weeks. However, in the control group, no statistically significant difference was detected between the values at 2 weeks and 4 weeks. Additionally, the mean value after 4 weeks for the control group was slightly higher than the mean value after 2 weeks for the control group. CONCLUSIONS: This study for 4 weeks demonstrated that mouthrinses containing CPC, triclosan and DPZ may contribute to the reduction of supragingival plaque and gingivitis.

Antiplaque and antigingivitis effects of a mouthrinse containing cetylpyridinium chloride, triclosan and dipotassium glycyrrhizinate

PURPOSE: The goal of this study was to evaluate the clinical anitplaque and antigingivitis effects of a mouthrinse containing cetylpyridinium chloride (CPC), triclosan and dipotassium glycyrrhizinate (DPZ) in patients with gingivitis and mild periodontitis. METHODS: Thirty-two subjects were randomized into 2 groups. The test group used a mouthrinse containing 0.05% CPC, 0.02% triclosan and 0.02% DPZ, while the control group used a placebo mouthrinse. At baseline, 2 weeks and 4 weeks, the papillary bleeding index (PBI), Turesky-Quigley-Hein plaque index (PI) and Loe-Silness gingival index (GI) were assessed. During the experimental period, the patients used the mouthrinse for 30 seconds, 4 to 5 times/day (10 mL/time) within 30 minutes after toothbrushing. RESULTS: No adverse effects appeared in either the experimental or the control group. Regarding PBI, PI and GI values, statistical significance was detected between values at baseline and 2 weeks for both groups (P<0.05). In the experimental group, statistically significantly lower values were detected at 4 weeks compared to at 2 weeks. However, in the control group, no statistically significant difference was detected between the values at 2 weeks and 4 weeks. Additionally, the mean value after 4 weeks for the control group was slightly higher than the mean value after 2 weeks for the control group. CONCLUSIONS: This study for 4 weeks demonstrated that mouthrinses containing CPC, triclosan and DPZ may contribute to the reduction of supragingival plaque and gingivitis.

Effect of mouthrinse with low pH on the surface microhardness of artificial carious enamel / 대한구강보건학회지

OBJECTIVES: The aim of the present study was to evaluate the effect of fluoride mouthrinse with low pH on the surface microhardness of artificial incipient carious enamel. METHODS: Firstly, the concentration of sodium fluoride and pH values were measured in commercially available mouthrinse. Secondly, DOCTOR Clean & Fresh(R) (Jang In Pharm, co., LTD. KOREA) with 0.02% sodium fluoride and pH value below pH 4.0 was selected as the experimental group, 0.02% sodium as the positive control group and distilled water as the negative control group. Enamel samples of n vine teeth (n=36) were divided into the three groups respectively and treated with the mouthrinse solutions for 3 and 20 minutes. The surface microhardness (Vickers hardness number, VHN) was measured with microhardness tester before and after the treatments. RESULTS: The average pH of DOCTOR Clean & Fresh(R) was 3.45+/-0.00, and it was acidic enough to cause tooth erosion. The difference of surface microhardness (DeltaVHN) before and after the 20 minute treatment was statistically significant among the groups: DOCTOR Clean & Fresh(R) (12.77+/-2.25 DeltaVHN), distilled water (0.24+/-0.75 DeltaVHN), 0.02% sodium fluoride solution (-0.62+/-1.62 DeltaVHN) (P<0.05). The DOCTOR Clean & Fresh(R) group with low pH showed greater changes on the surface microhardness of the carious enamel than those of other groups (P<0.05). CONCLUSIONS: It is suggested that the mouthrinse with low pH can reduce the surface microhardness of incipient carious enamel.

Efficacy of xylitol and fluoride mouthrinses on salivary mutans streptococci

To evaluate the level of salivary Mutans streptococci (MS) after rinsing with xylitol, fluoride, and a combination of xylitol and fluoride solutions, compared with distilled water. Methods: Eighty healthy 8-9 years old subjects with high level of MS (> 105 CFU/mL) were equally divided into 4 groups. Subjects rinsed their mouths for 1 min with 10 mL of 0.05% (w/v) sodium fluoride (NaF), 12.5% (w/v) xylitol or 0.05% (w/v) NaF + 12.5% (w/v) xylitol 3 times daily over 10 weeks. Distilled water rinsed group served as a control. Paraffin-stimulated whole saliva samples were collected at baseline, 5 weeks, and 10 weeks after rinsing to determine the level of salivary MS by culturing on Mitis Salivarius Bacitracin agar. The statistical significance was calculated by Kruskal Wallis, Mann Whitney U, and Wilcoxon signed-rank tests at a significant level ofP< 0.05. Results: Significant reductions in MS count were observed in subjects using 0.05% NaF+ 12.5% xylitol over other groups within 5 weeks and after 10 weeks and 12.5% xylitol alone after 10 weeks compared with baseline. Conclusions: The present study provides evidence for the inhibitory effect of xylitol, used in combination with fluoride, delivered in the form of mouthrinse, on salivary MS in the group of schoolchildren.