Evaluation of antimicrobial efficacy of Triphala (an Indian Ayurvedic herbal formulation) and 0.2% chlorhexidine against Streptococcus mutans biofilm formed on tooth substrate: An in vitro study.

Background: Streptococcus mutans is one of the most important cariogenic species of the human oral microbial flora. Biofilm style of microbial growth thought to resist the actions of antimicrobials. Aim: The purpose of this study was to evaluate the antimicrobial efficacy of Triphala, and 0.2% chlorhexidine against S. mutans biofilm formed on tooth substrate. Settings and Design: Randomized control trial. Methods: Extracted human mandibular premolars sectioned below the cemento‑enamel junction were placed in the tissue culture wells exposing the crown surface to S. mutans to form a biofilm. At the end of 3rd and 7th day, all groups were treated for 10 min with the test solutions and control and were analyzed qualitatively and quantitatively. Statistical Analysis Used: One‑way ANOVA. Results: Qualitative assay with 3 days biofilm showed complete inhibition of bacterial growth with Triphala, but 0.2% chlorhexidine and saline showed the presence of bacterial growth. In quantitative analysis, 0.2% chlorhexidine and Saline treated tooth samples have shown 1052 × 104 ± 15.1 × 104 CFU/ml, 141.3 × 109 ± 2.1×109 CFU/ml, respectively. Qualitative assay with 7 days biofilm on crown portion showed dense growth when treated with 0.2% chlorhexidine and saline, whereas Triphala has shown minimal growth. In Quantitative analysis, Triphala showed statistically significant result when compared with 0.2% chlorhexidine and saline. Conclusion: Triphala showed statistically significant antibacterial activity against S. mutans biofilm formed on tooth substrate. The incorporation of Triphala in mouth rinse could prove to be effective in reducing S. mutans count in the oral cavity.