Search Results (175)

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health. Full article

Background: Halitosis is a common condition often rooted in periodontal disease and exacerbated by systemic disorders such as obesity. This short-term clinical evaluation investigates the relationship between halitosis, obesity, and periodontitis, and assesses the efficacy of a natural essential oil mouthwash as an adjunctive oral hygiene intervention. Methods: In this randomized, placebo-controlled clinical trial, 45 obese patients with diagnosed periodontitis and self-reported halitosis were randomly assigned to either a test group (n = 30), receiving an essential oil-based mouthwash, or a control group (n = 15), receiving a placebo. Over 28 days, participants were evaluated using plaque index (PI), bleeding on probing (BOP), organoleptic scoring, and BANA test results. Both subjective and objective halitosis assessments were performed. Results: The test group showed marked improvements in all parameters compared to controls. PI decreased by 31.5% in the test group versus 9.25% in controls; BOP reduced by 34.5% versus 6.0%; BANA test positivity dropped by 38.1% in the test group. Organoleptic scores improved by 45.9% (examiner-rated) and 36.8% (self-assessed) in the test group. Conclusions: This 28-day clinical evaluation demonstrates the potential of an essential oil-based mouthwash to significantly reduce halitosis and periodontal inflammation in obese individuals with periodontitis. The necessity of future randomized trials is evident to substantiate the sustained benefits and safety of the intervention. Full article

Background/Objectives: The formation of oral biofilms in periodontal pockets and around dental implants with induction of periodontitis or peri-implantitis is an increasing problem in dental health. The intelligent design of a biofilm makes the bacteria embedded in the biofilm matrix highly tolerant to antiseptic therapy, often resulting in tooth or implant loss. The question therefore arises as to which mouthwashes have eradication potential against oral biofilm. Methods: A human oral biofilm model was developed based on donated blood plasma combined with buffy coats, inoculated with oral pathogenic bacterial species found in periodontal disease (Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus mitis, and Porphyromonas gingivalis). Over a span of 7 days, we tested different mouth rinsing and antiseptic solutions (Chlorhexidine, Listerine^®, NaOCl, Octenisept^®, and Octenident^®) covering the matured biofilm with 24 h renewal. Phosphate-buffered saline (PBS) was used as a control. Bacterial growth patterns were detected via quantitative polymerase chain reaction (qPCR) after 2, 4, and 7 days of treatment. Results: While all groups showed initial bacterial reduction, the control group demonstrated strong regrowth from day 2 to 4. Listerine showed a near-significant trend toward bacterial suppression. Additionally, strain-specific efficacy was observed, with Octenisept^® being most effective against Streptococcus mitis, Octenident^® and NaOCl showing superior suppression of Actinomyces naeslundii, and Listerine^® outperforming other solutions in reducing Fusobacterium nucleatum. Donor-specific, individual variability further influenced treatment outcomes, with distinct trends in bacterial suppression and regrowth observed across donors. Conclusions: These findings underscore the complexity of biofilm-associated infections and highlight the importance of targeted therapeutic approaches for managing bacterial biofilms. In this experiment, the donor-specific outcomes of the antimicrobial effects of the solutions may indicate that genetic predisposition/tolerance to oral infections appears to play a critical role in the control of oral biofilms. Full article

Background: Halitosis is frequently observed in patients undergoing orthodontic treatment with multibracket appliances, primarily due to volatile sulfur compounds (VSCs) produced by oral anaerobic bacteria. Cetylpyridinium chloride (CPC) is a widely used antimicrobial agent in oral care products and may help alleviate halitosis.This study aimed to evaluate the effects of 0.05% CPC mouthwash on halitosis, oral hygiene indices, and the tongue microbiota in orthodontic patients with elevated VSC levels. Methods: In this randomized, double-blind, placebo-controlled clinical trial, 30 orthodontic patients with elevated VSCs (≥150 ppb) were assigned to a CPC mouthwash group or a placebo group. Participants used the assigned mouthwash three times daily for 1 month. Halitosis was quantitatively assessed by gas chromatography (Oral Chroma™), and oral hygiene parameters including Plaque Index (PI), Gingival Index (GI), Tongue Coating Index (TCI), and unstimulated salivary flow rate were evaluated at baseline and after the intervention. The tongue microbiota was analyzed by 16S rRNA sequencing. Results: The CPC mouthwash group showed significant reductions in total VSCs, hydrogen sulfide, methyl mercaptan, PI, GI, and TCI (p < 0.05), while salivary flow rate and dimethyl sulfide remained unchanged. Microbiome analysis revealed decreases in halitosis-associated genera (Actinomyces, Corynebacterium, Tannerella) and increases in beneficial species such as Streptococcus salivarius. Conclusions: CPC mouthwash (0.05%) effectively reduced halitosis and improved oral hygiene parameters in orthodontic patients, likely through modulation of the tongue microbiota. This mouthwash may serve as a safe and practical adjunct to conventional oral hygiene practices during orthodontic treatment. Full article

Glycyrrhiza glabra (licorice) has been used as an herbal medicine for a long time due to its anti-inflammatory, antioxidant, and antimicrobial properties. Additionally, multiple reports have demonstrated its ability to promote wound healing. Several randomized controlled or clinical trials (RCTs) have demonstrated its potentially therapeutic effects in oral mucosal diseases, especially in recurrent aphthous stomatitis (RAS). This systematic review aims to summarize the evidence for Glycyrrhiza glabra in treating RAS. A systematic search was performed across five databases: PubMed (Medline), ScienceDirect, Scopus document, Cochrane Central Register of Controlled Trials (CENTRAL), and the Cochrane Library Database of Systematic Reviews. This study was reported following the PRISMA guidelines. RCT study using Glycyrrhiza glabra for treating RAS was included in this study with several reported outcomes like changes in ulcer diameter, pain, and healing periods. Seven RCTs were included, which used Glycyrrhiza glabra in the form of patches, pastes, mucoadhesive tablets, and mouthwashes for treating RAS. Glycyrrhiza glabra treatment in various regimens showed significant improvements in pain, ulcer diameter, and healing time in patients with RAS. This review suggests the potential of Glycyrrhiza glabra as an alternative treatment option for RAS. Full article

Background/Objectives: This investigation evaluated 2,6-Dichlorophenolindophenol (DCIP), a redox dye, as a colorimetric reagent for rapid quantification of oral bacteria and examined the antimicrobial effects of oral hygiene formulations. Methods/Results: Viable microbial cells reduce DCIP, resulting in a loss of its blue color which can be measured spectrophotometrically. Strains of Actinomyces viscosus, Veillonella atypica, Aggregatibacter actinomycetemcomitans, Streptococcus mutans and Candida albicans grown in the laboratory reduced DCIP. Significant correlations between increasing viable plate counts and DCIP reduction were noted for strains of oral organisms. Intact microbial cells reduced DCIP, with insignificant reductions observed by spent microbial media or bacteria free culture media. Organisms inactivated by either heat or cold demonstrated significantly lower DCIP reduction in comparison to metabolically intact organisms grown under optimal conditions. Conclusions: DCIP reduction provided a rapid and accurate method to evaluate antimicrobial effects of clinical proven mouthwashes formulated with cetylpyridinium chloride or chlorhexidine and toothpastes for a range of oral bacteria. Together, these results identify a rapid, low-cost method using common laboratory equipment to enumerate oral organisms with a visual outcome. Full article

Fluoride mouthwashes are often recommended by dental professionals due to their proven benefits for oral hygiene. However, it is vital to acknowledge that these products may have undesirable effects on orthodontic treatment outcomes, particularly by altering the biomechanical properties of orthodontic devices and their components. To gain a comprehensive understanding of this potential issue, an extensive and systematic search was conducted across seven distinct databases. PRISMA extension for scoping reviews (PRISMA ScR) guidelines were followed. Following a detailed evaluation and careful scrutiny of the available evidence, a total of seven relevant studies met the inclusion criteria and were incorporated into the current scoping review. Findings indicated that regular intraoral use of fluoride-containing mouthwashes could lead to heightened corrosion and greater release of metal ions from stainless-steel brackets and nickel–titanium (NiTi) archwires. Additionally, the mechanical properties and structural integrity of titanium–molybdenum alloy (TMA) wires were negatively influenced by exposure to fluoride mouthwashes. Although existing evidence highlights these potential drawbacks, there remains a clear necessity for additional comprehensive research. Given the possibility that fluoride mouthwashes could adversely influence orthodontic treatment effectiveness, orthodontists and dental clinicians must exercise cautious judgment and deliberate consideration when prescribing fluoride-based mouthwashes for patients undergoing orthodontic therapy. Full article

Effective local hemostasis is essential in oral surgery to prevent complications such as delayed healing, infection, and the need for re-intervention. Postoperative bleeding occurs in 4–6% of cases, increasing to 9–12% in patients receiving anticoagulant or antiplatelet therapy. This review evaluates the efficacy, safety, and clinical utility of local hemostatic agents based on 51 studies published between 1990 and 2023. Traditional agents, such as oxidized cellulose and gelatin sponges, control bleeding in over 85% of standard cases but offer limited regenerative benefits. Autologous platelet concentrates (APCs), including platelet-rich plasma (PRP) and leukocyte- and platelet-rich fibrin (L-PRF), reduce bleeding time by 30–50% and enhance soft tissue healing. Studies show the PRP may reduce postoperative bleeding in dental surgery by 30–50%, and in orthopedic and cardiac surgery by 10–30%, particularly in patients on anticoagulants. Tranexamic Acid mouthwash can reduce postoperative bleeding by up to 50–60%. Fibrin sealants achieve a 70–90% reduction in bleeding among high-risk patients, while topical tranexamic acid decreases hemorrhagic events by up to 80% in anticoagulated individuals without increasing thromboembolic risk. However, comparative studies remain limited, particularly in medically compromised populations. Additional gaps persist regarding long-term outcomes, cost-effectiveness, and the standardized use of emerging agents such as nanomaterials. Future research should prioritize high-quality trials across diverse patient groups and develop clinical guidelines that integrate both safety and regenerative outcomes. Full article

Background/Objectives: The main objective was to evaluate and compare the antifungal efficacy against Candida spp. in commercially available mouthwashes distributed in the European market. Indeed, the solution to emerging infectious diseases may no longer lie in costly new drug development but rather in unlocking the untapped potential of existing substances. Materials and Methods: Eighteen mouthwashes, chosen based on their composition, were tested in vitro against ten Candida strains, including clinical isolates of oral origin and reference strains, in both planktonic and biofilm forms. The antifungal susceptibility testing was conducted using the European Committee on Antimicrobial Susceptibility Testing (EUCAST) disc diffusion method and the evaluation of the kinetic growth in planktonic Candida. Biofilm reduction was determined by the evaluation of the minimal biofilm eradication concentration (MBEC). Scanning electron microscopy (SEM) analysis was performed to evaluate potential morphological alterations of Candida biofilms. Results: Most mouthwashes effectively reduced biomass production and colony-forming unit (CFU) count. Parodontax Extra showed the highest efficacy. In the disc diffusion assay, Gum Paroex 0.12% exhibited the largest average inhibition zone diameter. Some unusual trends in the data may be explained by a higher reaction of fungal cells and the release of excess biomass during co-incubation in higher concentration of mouthwashes. SEM images revealed significant morphological alterations. Conclusion: Mouthwashes containing chlorhexidine digluconate, either alone or in combination with cetylpyridinium chloride and other active compounds, emerged as a common factor among the most efficacious formulations. In vivo studies will be essential to validate these findings, but mouthwashes may serve as a valuable adjuvant in the treatment of oral candidiasis. Full article

Background: The declaration of COVID-19 as a pandemic by the World Health Organization in 2020 led to the widespread suspension of clinical practices, including dentistry. This study aims to evaluate the impact of these restrictions on oral health and dietary habits. Methods: A retrospective cross-sectional study was conducted at Egas Moniz University Clinic (Lisbon Metropolitan Area), covering from June 2019 to June 2021. A total of 3380 participants were included and categorized into two cohorts: pre- and post-COVID-19 restrictions. Data were collected through a structured questionnaire assessing oral health behaviors and dietary habits. Results: Of 3469 incoming patients, 3380 met the inclusion criteria. Statistically significant post-lockdown changes were observed, including increased smoking prevalence, higher coffee with sugar consumption, reduced use of dental floss and mouthwash, and redistribution in tooth brushing frequency, with fewer individuals brushing 2–3 times daily. Conclusions: COVID-19-related restrictions had a heterogeneous impact on oral health and dietary behaviors. While some individuals reported improved hygiene routines, others showed negative changes, such as increased tobacco use or decreased use of oral hygiene products. These contrasting effects call for targeted public health strategies to reduce inequalities and support vulnerable groups during crises. Full article

Background and Objectives: Halitosis is common among orthodontic patients, potentially exacerbated by plaque retention around brackets. It was hypothesized that patients using sonic toothbrushes would report lower halitosis impact scores compared to those using traditional or rotative toothbrushes. This study aimed to compare the Halitosis-Associated Life Quality Test (HALT) and Short Form (SF-36) domains among different toothbrush users and to evaluate mouthwash subgroups and “during” vs. “after” appliance removal. Methods: Based on a power calculation (effect size f = 0.30, α = 0.05, 1 − β = 0.80), 174 patients were required. A total of 174 orthodontic patients (57 traditional, 64 rotative, and 53 sonic; mean age 18.0 ± 1.5 years) completed the Halitosis-Associated Life Quality Test (HALT), SF-36, and organoleptic assessments. Results: Sonic toothbrush users reported significantly lower HALT scores (34.8 ± 5.8) vs. rotative (38.1 ± 6.0) and traditional (42.7 ± 6.2) toothbrush users. Spearman’s correlation (r = −0.49 to +0.54) demonstrated that sonic brushing had a moderate negative relationship with halitosis scores, indicating lower malodor for this technique. Patients using chlorhexidine-based mouthwash had the most favorable HALT (34.3 ± 5.7) and organoleptic (1.5 ± 0.4) scores. Those who completed orthodontic treatment showed better outcomes than active treatment patients. Conclusions: Optimized plaque control with sonic brushing and chlorhexidine-based mouthwash correlates with reduced halitosis and improved quality of life during orthodontic treatment. Full article

Objective: This study aimed to develop and characterize the physicochemical properties of a self-emulsion drug delivery system (SNEDDS) incorporating galangal extract (GE) and lemongrass oil (LGO). Then, to develop mouthwash powders containing GE- and LGO-loaded SNEDDS (GL-mouthwash powder) as a promising alternative for preventing and treating denture stomatitis. Methods: The solubility of GE in various vehicles was determined. Subsequently, pseudo-ternary phase diagrams of the different ingredients, oil (LGO), surfactant (Tween^® 80), and co-surfactant (Propylene glycol) were selected to develop the SNEDDS. Then, SNEDDS containing GE and LGO (GL-SNEDDS) were prepared and characterized. The optimized liquid GL-SNEDDS was transformed into GL-mouthwash powder by absorbing onto mannitol and blending with a sweetener. Subsequently, various evaluations including drug recovery, moisture content, emulsification time, stability, anti-Candida activity, and in vitro cytotoxicity were performed. Results: The developed SNEDDS formulation improved GE and LGO solubility. The optimized GL-SNEDDS exhibited a small droplet size of 148.2 ± 2.1 nm with a polydispersity index of 0.11 ± 0.03 and a zeta potential of 2.14 ± 0.11 mV. In addition, the GL-mouthwash powder demonstrated a high drug recovery of >80% with a low moisture of <10% and exhibited greater physicochemical stability under accelerated conditions. The developed GL-mouthwash powder rapidly formed a stable nanoemulsion within 2 min after reconstitution. Interestingly, GL-mouthwash powder exhibited strong anti-Candida activity with no toxicity to human fibroblast cells, which demonstrated superior biocompatibility relative to existing commercial products. Conclusions: These findings suggest that GL-mouthwash powder has potential as an alternative prevention and treatment of oral Candida infection. Full article

The rising incidence of oropharyngeal cancer caused by high-risk Human Papillomavirus (HPV) type 16 and HPV18 in the U.S and other developed countries is an important public health issue. This has been attributed to changes in sexual behavior, including the practice of oral sex, which may expose individuals to increased risk of acquiring oral HPV infection. The incidence of oral HPV infections highlights the role of the oral cavity as an important anatomical site in the acquisition and transmission of high-risk HPVs. Generally, the use of mouthwash/oral rinses have focused on targeting the oral bacteriome, and could additionally be formulated for managing the oral virome. Here, we examined virucidal properties of common over-the-counter antibacterial mouthwash products against native HPV16 and HPV18 virion in vitro, and downstream modification of virus infectivity. We tested oral rinses containing essential oils/alcohol, hydrogen peroxide, and cetylpyridinium chloride. Our results demonstrated greater than 90% efficacy against HPV16 inactivation, but comparatively with less efficacy against HPV18. Overall, hydrogen peroxide containing oral rinses demonstrated the best efficacy against both high-risk types, albeit with lower efficacy against HPV18. Prophylactic virucidal oral rinses targeted towards high-risk HPVs could be beneficial in reducing incidental oral HPV load, prevalence, and persistent infections. Full article

Green tea (Camellia sinensis) exhibits significant potential in oral health due to its antioxidant, anti-inflammatory, and antimicrobial properties. This review explores its role in managing periodontal disease, a common condition characterized by inflammation, microbial imbalances, and tissue destruction. The primary bioactive components, particularly epigallocatechin-3-gallate (EGCG), contribute to green tea’s therapeutic effects by inhibiting bacterial adhesion, modulating inflammatory pathways, and reducing oxidative stress. Clinical studies suggest green tea improves periodontal health by reducing pocket depth, inflammation, and bleeding. It can serve as an adjunct to conventional therapies, including scaling and root planing, and be incorporated into oral care products such as mouthwashes and dentifrices. Furthermore, green tea presents a natural alternative to chemical agents like chlorhexidine, potentially mitigating side effects and addressing concerns about antibiotic resistance. However, its efficacy remains moderate compared to established treatments, highlighting the need for further research to optimize its formulation and therapeutic applications. Green tea represents a sustainable and biocompatible approach to periodontal therapy, supporting its integration into preventive and therapeutic oral health strategies. Full article

Background/Objectives: Plaque-associated gingivitis is widely regarded as a local inflammatory condition initiated by the accumulation of a non-specific dental biofilm in the interaction with the host immune system. The initial symptom noticed by the patient is bleeding gums. The use of mouthwash can serve to supplement mechanotherapy. However, there is an increasing interest in mouthwashes comprising natural ingredients, including cannabidiol (CBD) and spilanthol. The objective of this study was to evaluate the effect of an oral rinse containing spilanthol and CBD oil compared to a rinse containing tea tree oil on the oral microbiota and the values of selected oral status indicators in patients with gingivitis. Methods: The study included 40 patients treated with a rinse containing tea tree oil (TTO)/TTO + spilanthol + CBD for a period of 42 days. Patients rinsed their mouth twice daily for 30 s. The patients’ oral microbiome was assessed before and after treatment, and bleeding on probing (BOP) and approximal plaque index (API) were assessed. The study was double-blind. Results: API and BOP were reduced in all groups, both the test and control. The most significant decrease in baseline BOP-1 scores was observed in test groups A and D (p = 0.005062 and p = 0.005062, respectively). A significant difference in API improvement was observed between the initial and final visits in the test (A, D) and control (B, C) groups (p = 0.012516, p = 0.005062, p = 0.004028, p = 0.003172, respectively). Conclusions: Firstly, the use of a mouthwash containing cannabidiol (CBD) and spilanthol was demonstrated to be efficacious in the maintenance of oral microbiota homeostasis. Secondly, the combination of TTO with spilanthol and CBD in the rinse was shown to result in a more significant reduction in selected oral health parameters (BOP and API) and anti-inflammatory effects when compared to a rinse with TTO alone. It should be noted that this is a pilot study and will continue. Full article