MOUTHWASHES have long bragged about killing 99.9 per cent of germs in the mouth, but researchers suggest this scorched-earth approach may harm oral health by eliminating beneficial bacteria along with the bad ones.
A study in Frontiers in Oral Health from the Rutgers School of Dental Medicine found that herbal mouthwash could reduce populations of harmful bacteria in the mouth while allowing the good ones to survive.
Research has established that garlic, a widely used herb and spice, is a promising mouthwash alternative to the conventional mouthwashes.
Mouthwashes are liquid oral products that are gargled for cleaning the mouth and teeth to freshen breath. It may also kill the microorganisms in the mouth or whiten the teeth. It is used alongside mechanical oral hygiene regimens like toothbrushes in dental practice.
Chlorhexidine and Listerine are standard mouthwashes. But they showed no such selectivity, eliminating beneficial and harmful bacteria alike. Chlorhexidine is particularly aggressive, reducing some beneficial bacteria populations by a millionfold.
In a new study, University of Sharjah medical scientists confirmed that garlic extract mouthwash showed comparable efficacy to chlorhexidine, particularly at higher concentrations. Its effectiveness varied based on garlic mouthwash concentration and duration of application, contributing to differences in outcomes.
Published in the Journal of Herbal Medicine, the study suggested that while garlic-based mouthwash may cause more discomfort, such as burning sensations and unpleasant taste, than chlorhexidine, it offers longer-lasting residual effects.
This was based on a systematic analysis of studies where various researchers evaluated garlic extract’s viability as an herbal alternative by comparing its antibacterial efficiency with chlorhexidine in clinical practice.
In January 2024, 389 papers were found in six electronic databases, and 13 more articles were added by manual citation searching. Only five articles remained after duplicates were eliminated and inclusion and exclusion criteria were applied.
These articles analysed included randomised controlled trials and clinical studies, characterized by variable designs and low-to-moderate risks of bias.
Findings indicate that higher concentrations of garlic extract mouthwash demonstrated antimicrobial efficacy comparable to chlorhexidine.
Garlic extract was found to be more efficient at larger concentrations, while some research preferred chlorhexidine for maintaining higher plaque/salivary pH.
Although garlic extract is not without side effects, they are generally less severe than those associated with chemical compounds. Reported adverse reactions include a burning sensation and unpleasant odour, which may affect patients’ willingness to replace chlorhexidine with garlic-based alternatives.
Despite these drawbacks, the review provides compelling evidence of garlic extract’s clinical antimicrobial effectiveness, “with significant reductions in bacterial counts from baseline suggesting the possible use of garlic extract mouthwash as a viable alternative to chlorhexidine in certain contexts.”
However, the authors noted that additional clinical research with larger sample sizes and longer follow-up was required to confirm the “effectiveness and improve clinical applicability” of using garlic as an alternative mouthwash to the currently popular chlorhexidine, which is still the gold standard antimicrobial mouthwash.
Garlic is one of nature’s most potent antibacterial and antifungal crops, according to a study. For decades, researchers have been attempting to exploit allicin, one of its components, which has strong antibacterial properties.
Garlic extracts have been used to treat a variety of conditions, including mild to moderate periodontitis, asthma, hypertension, and metabolic syndrome. Conversely, synthetic substances such as chlorhexidine typically require a prescription from a physician or dentist.
According to the review, “Antimicrobial mouthwashes constitute an essential adjunct element in oral and dental care, acting against oral diseases. Different antimicrobial mouthwashes, whether available over-the-counter or on prescription, can be used in the management of gingivitis, dental caries, periodontal diseases, halitosis, etc.”
The review quoted a host of studies demonstrating the antimicrobial activity of garlic extracts against numerous bacteria, fungi, and viruses.
“These studies have contributed to understanding the antimicrobial role of garlic extract in comparison to synthetic agents like chlorhexidine. However, there is the need for further research to confirm garlic’s efficacy in dental practice. This uncertainty presents a significant gap in the literature on evidence-based antimicrobial therapies,” they said.
Herbs and plant materials have been used either alone or in combination for cleaning teeth and treating different diseases in the mouth by different countries; they are sources of many potent and powerful drugs, too. Such herbs include neem, guava leaf, green tea, pomegranate, clove, peppermint, and holy basil.
According to studies published in the Journal of Pharmacy and Bioresources in 2021, the herbal mouthwash made from an extract of the leaf and root bark of J. gossypiifolia, also known as black physic nut, shown enough power to be on par with Listerine in terms of both quality and efficacy.
As a strong antibacterial agent, the herbal mouthwash formulation is recommended to be both aesthetically pleasing and appropriate for usage as a mouthwash to improve patient/customer compliance.
A randomized controlled clinical trial also suggested that neem mouthwash can be used as an alternative to chlorhexidine.
In the Nigerian Journal of Pharmacy, researchers reported that neem mouthwash can serve as a mouth disinfectant. Compared to chlorhexidine mouthwash, it was more successful in reducing pain, face swelling, trismus, and poor wound healing.
Researchers had considered the effectiveness and safety of neem leaf extract in controlling postoperative complications after third molar surgeries in comparison to chlorhexidine mouthwash.
@ Nigerian Tribune
