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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 countscore 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., {"references":["1. Watt SA. Inequalities in oral health: a review of the evidence and recommendation for action. Br Dent J. 1999; 187(1):6-12. 2. Silverstone L et al. Dental caries: Aetiology, Pathology and Prevention.1st Edn.; New York : The Macmillan Press Limited 1981:pp:8. 3. Grewal H, Verma M, Kumar A. Prevalence of dental caries and treatment needs amongst the school children of three educational zone of urban Delhi, India. Ind J Dent Res. 2011; 22(4):517-519. 4. Loesche WJ. Role of Streptococcus mutans in human dentaldecay. Microbio1Rev. 1986;50(4):353-380. 5. Parmar N et al. Camellia Sinensis (Black Tea): A Review. Global Journal of Pharmacology. 2012; 6 (2): 52-59. 6. Abdulrahaem R, Garib. Effect of Different Tea in Remineralization of Artificially- Induced Initial Enamel Caries of Human Teeth (Study in Vitro). Tikrit J Dent Scien. 2011;1:19-24. 7. Douglas A et al. Current concept incariology. Dent Clin N Am.2010;54(3): 455-462. 8. Nolte WA. Oral microbiology with basic microbiology andimmunology. 4th Edn.; Mosby. 1982;pp:20326. 9. Pannu P et al. Correlation between the salivary Streptococcus mutans levels and dental caries experience in adult population of Chandigarh, India. Eur J Dent. 2013;7(2):191-195. 10. Pradopo S. The colony number of Streptococcus mutans and Lactobacillus in saliva of dental caries and free caries children. Dent. J. (Maj. Ked. Gigi) 2008; 41(2): 53–55 11. Hong X, Hu D. Salivary Streptococcus mutans level: value in caries prediction for 11-12-year-old children. Community Dent Health. 2010;27(4):248-52 12. Sakeenabi B, Hiremath S. Dental caries experience and salivary Streptococcus mutans, lactobacilli scores, salivary flow rate, and salivary buffering capacity among 6-year-old Indian school children. Journal of International Society of Preventive and Community Dentistry. 2011;1(2):45-5135. 13. Balagopal S, Arjunkumar R.Chlorhexidine: The Gold Standard Antiplaque Agent. J. Pharm. Sci & Res. 2013;5(12):270-27444. 14. Chacko S et al.Beneficial effects of black tea: A literature review. Chinese Medicine 2010, 5:13. 15. Steinmann J et al. Anti-infective properties of epigallocatechin-3-gallate (EGCG), a component of","black tea. British Journal of Pharmacology 2013;168:1059–1073 16. Venkateswara B, et al. Black tea extract for periodontal health. Journal of Indian Society of Periodontology. 2011;15(1):18-22. 17. Lin L et al. Quantitative Analysis of Major Constituents in Black Tea with Different Plucking Periods and Their Antioxidant Activity. Molecules 2014;19:9173-9186. 18. Xu X et al. The Tea CatechinEpigallocatechinGallate Suppresses Cariogenic Virulence Factors of Streptococcus mutans. Antimicrob. Agents Chemother. 2011; 55(3): 1229-1236. 19. Taheer A, Moeen R. Comparison of antibacterial activity of water and ethanol extracts of Camellia sinensis (L.) Kuntze against dental caries and detection of antibacterial components. J Medicinal Plants Res. 2011;5(18): 4504-4510. 20. Awadallaet al. A pilot study of the role of black tea use on oral health. Int J Dent Hyg. 2011;9(2):110-116. 21. Satoa S, Koga T, Inoue M. Isolation and some properties of extracellular dglucosyltransferases and dfructosyltransferases from Streptococcus mutans serotypes c, e, and f. Carbohydrate Res. 1984;134:293- 304. 22. Gloro R et al. Fulminant hepatitis during self-medication with hydroalcoholic extract of black tea. Eur J Gastroenterol Hepatol. 2005;17(10):1135-1137."]}

Purpose To compare the effect of the probiotic lozenges and chlorhexidine (CHX) mouthwash on plaque index (PI) , salivary pH and Streptococcus mutans (S. mutans) 3 count among groups of Saudi children. Methods A total of 54 participants aged 8-12 years were randomly allocated into three groups, 18 children in each group. Children in the probiotic group consumed one probiotic lozenge (Biogaia prodentis) daily, while children in the CHX group were instructed to use CHX mouthwash twice daily. The control group was only instructed to follow regular oral hygiene measures. Saliva samples were taken at baseline, 15th and 30th days. PI scores, salivary pH values and S. mutans count were evaluated. Data were statistically analyzed using the ANOVA and the Tukey post-hoc test. Results Probiotic lozenges and CHX mouthwash significantly reduced PI and S. mutans count and increased the salivary pH values. However, there were no statistical differences between the effect of probiotic lozenges and CHX mouthwash on PI (p-value= 800) and pH values (p-value= 0.927) on the 30th day. Conversely a significant difference was reported among their effects on S. mutans count (p-value=0.014) on the 30th day. Greater acceptance and compliance of children to probiotic lozenges were reported. Conclusions Probiotic lozenges could be an alternative to CHX mouthwash and encouraged to be included with the daily oral hygiene measures.

Background We report a nosocomial outbreak caused by Burkholderia cepacia that occurred among six patients admitted in the medical and surgical intensive care unit between 04 March 2019 and 02 April 2019 in Istanbul, Turkey. Methods The outbreak investigation was launched on 11 March 2019 five days after the detection of B. cepacia in four different patients. We defined potential reservoirs and started environmental screening. We sampled the liquid solutions used in patient care activities. Pulse-field gel electrophoresis (PFGE) was performed to determine the genetic relatedness of environmental and patient samples. Results Burkholderia cepacia was isolated in tracheal aspiration cultures of six patients. Three out of six patients developed healthcare-associated pneumoniae due to B. cepacia. Environmental cultures in the ICUs revealed B. cepacia growth in 2% chlorhexidine-gluconate mouthwash solution that been used in the colonized patients as well as in samples obtained from the unused products. PFGE revealed the patient and a specific batch of chlorhexidine mouthwash solution samples had a 96% similarity. Conclusion Contamination of medical solutions used in critical patient care could cause outbreaks and should be detected early by infection control teams. Graphic abstract

Introduction:This study aimed toevaluate the effect of 0.12% chlorhexidine mouthwash on microhardness and elastic modulus of dentine and cementum of healthy and periodontally involved extracted teeth. Materials and Methods: Totally, 30 teeth extracted due to chronic periodontitis and 30 healthy teeth that were removed due to orthodontics treatments or latency were examined in this cross-sectional study. In each group, half of the samples were placed in 0.12% chlorhexidine mouthwash and the other half were placed in artificial saliva for two weeks. Subsequently,1 mm slices from beneath the CEJ in parallel with the horizon were prepared and the microhardness and modulus elasticity of dentin and cementum were measured. Data were analyzed using ANOVA and t-test (α=0.05). Results: There was an interaction between group and chlorhexidine for the variable of dentin microhardness; however, the interaction between group and chlorhexidine was not significant in terms of the variables of cementum microhardness, dentin, and cementum elasticity (P=0.196, P=0.897, and P=0.829, respectively). The mean dentin microhardness in the healthy and periodontitis samples in chlorhexidine was significantly higher compared to samples without chlorhexidine. In addition, the cementum microhardness, and dentin and cementum elasticity were significantly higher in the healthy group compared to those in the periodontitis group with or without chlorhexidine. Furthermore, the mean cementum microhardness, as well as dentin and cementum elasticity in the group of samples with chlorhexidine was notably higher compared to the group of samples without chlorhexidine. Conclusion:Based on the obtained results,the application of 0.12% chlorhexidine mouthwash improved the mechanical properties of the teeth (microhardness and modulus of elasticity) in the healthy and chronic periodontitis groups compared to those without mouthwash. The mechanical properties of dentin and cementum of healthy teeth were also higher compared to those with chronic periodontitis.

Chlorhexidine gluconate is currently the most effective oral antimicrobial agent against microorganisms, but discoloration of the teeth prevents its long-term use and can reduce patient cooperation. In this study, the effect of chlorhexidine and a diluted chlorhexidine-based, fluoride, cetylpyridinium and vitamin added mouth rinse (Orthokin) on stain index in fixed orthodontic patients was compared.This study was performed as a double blind randomized controlled trial on 50 patients undergoing fixed orthodontic treatment in the age group of 14-30 years. The patients were categorized as two groups of chlorhexidine and Orthokin mouth rinses and were asked to use mouthwash for eight weeks. Groups were matched according to colouring food consumption. Extrinsic staining index was assessed by modified Loben technique. Data was analysed by SPSS software. P value was set to be 0.05.In the chlorhexidine group, the stain extent index and overall stain index were increased significantly at 8 weeks (P0.001 and P=0.002, respectively). However, the increase in stain intensity index was insignificant (P=0.07). In Orthokin group, the changes in stain extent, stain intensity and overall stain were insignificant (P=0.66, P=1.000, P=0.47, respectively).According to the results of the present study, chlorhexidine mouthwash causes more staining of teeth compared to Orthokin mouthwash. It seems that lower concentrations of chlorhexidine can be prescribed to orthodontic patients. Although these compounds are effective in sense of oral hygiene, they do not cause significant discoloration.

Purpose: To compare the effect of cinnamon extract mouthwash with chlorhexidine mouthwash on Streptococcus mutans counts in saliva of some children. Materials and methods: A total of 40 children from both sex were involved in the present study. Age of Children was between 6 and 12 years in a good physical condition. Children were distributed into 2 groups (A&B), each one consists of 20 children. Group A (Experimental group): each participant was given a new bottle of specific effective amount of cinnamon extract mouthwash (150ml) to be used. Group B (Control group): each participant was given a new bottle of specific effective amount of (150 ml) chlorhexidine mouthwash (0.12 %) to be used. Unstimulated salivary samples were collected and examined. Results: The average number of S.mutans was reduced significantly in cinnamon extract group and chlorhexidine group as well. Conclusion: Cinnamon extract mouthwash was successful as an antimicrobial agent and it can be used as a natural alternative to chlorhexidine.

Background: Our study aimed to assess the efficacy of 0.1% Octenidine mouthwash as an anti-plaque agent and to assess its effect on gingival inflammation and staining of teeth when compared to 0.2% chlorhexidine gluconate by evaluating the impact on plaque and gingival inflammation as well as on microbial load. Materials and Methods: A three week double blind study was conducted on 69 subjects, aged 20-50 years, with moderate to severe gingivitis. The study population was divided into three groups with 23 subjects in each group: Group A - control subjects received only scaling, Group B received 0.2% chlorhexidine gluconate in addition to scaling and Group C received 0.1% Octenidine mouthwash along with scaling. Clinical and microbiological parameters were recorded at baseline, on 14th day and on 21st day. Subjective and objective criteria were assessed on the 14th day and 21st day. Results: There was a statistically significant reduction in all the tested parameters within all the three groups and between the groups from baseline to 21st day. The highest mean reduction in all the parameters was seen in subjects using 0.1% Octenidine. On comparison with the control group, subjects using the mouthwashes (Group B and Group C) had better improvement in clinical and microbiological parameters from baseline to 21st day. On comparison with chlorhexidine, Octenidine mouthwash significantly reduced plaque (p

Background: Dental plaque, a microbial biofilm, is the primary etiological factor leading to the initiation of gingivitis and dental caries. It is therefore important to prevent it by taking effective plaque control measures. This research aimed at comparing the anti-plaque and anti-gingivitis effects of green tea (GT), GT plus ginger (GT + G), and chlorhexidine mouthwash (CHX) in children. Materials and Methods: This was a randomized clinical trial, with a sample size of 60 children between the age group of 10–14 years with plaque and gingivitis. They were randomly allocated in three different groups, depending upon the mouthwash used: Group A (GT mouthwash), Group B (GT plus ginger mouthwash), and Group C (CHX mouthwash). Plaque index and gingival index were recorded at baseline, then at interval of 15 days and 30 days after using mouthwash. Results: The mean gingival score and plaque showed a significant reduction from the baseline among all the three groups when compared with subsequent recall visits (15 days after using mouth-rinse and 30 days after using mouthwash) with P < 0.05. Conclusion: It can be concluded that the results of all three groups are comparable and hence herbal mouthwash can be used effectively as an alternative to CHX and as an adjunct to mechanical plaque control.

Background: Pain is one of the most common complications after tooth extraction and pain control is a crucial part of the procedure. The purpose of this study was to investigate the influence of 0.2% (w/v) chlorhexidine (CHX) gluconate mouth rinse on the severity of post-extraction pain. Methods: A prospective, randomized, double-blind trial was conducted among 170 subjects. Subjects were instructed to rinse with 15 mL of CHX mouth rinse (study group) or placebo (control group) 0.5 to 1 hour before extraction. Post-operative pain was evaluated considering the number of taken rescue analgesics and using a visual analog scale (VAS) that each case completed 6, 12, 24, and 48 hours after the surgery. The Mann-Whitney U test was performed in this regard. Results: There were no significant differences between the two groups regarding demographic variables (P>0.05). The preoperative use of CHX mouth rinse showed a better performance in mitigating the perceived pain. A significant difference in the pain level (P=0.001) was found only at the 6th hour postoperatively although there was no significant difference in the pain level between the two groups (P>0.05) at all other times (12th, 24th, 48th hours). The total number of analgesics that were taken by the study group was significantly lower compared to the control group (P=0.042). Conclusions: The preoperative CHX mouth rinse could be a beneficial choice for reducing pain after simple tooth extractions.

Background and Objectives: Miswak is the public name of Salvadora persica, which is beneficial for dental treatments and can thus be used to treat gingivitis. This study compares the therapeutic effects of miswak (S. persica), toothbrush, S. persica mouthwash, and chlorhexidine mouthwash on patients with mild to moderate gingivitis by estimating gingival index and (debris) plaque index. Patients and Methods: The study is a selective sampling, cross-sectional, clinical comparative study of 50 systemically healthy patients in Erbil city. The patients were divided randomly into five groups, with each group having 10 patients. Group 1 used S. persica chewing stick only; group 2 used toothbrush only; group 3 used both S. persica and toothbrush, group 4 used S. persica mouthwash and toothbrush; while group 5 used chlorhexidine mouthwash and tooth-brush. The patients’ mouths were examined, recording clinical indices before and after four weeks from the administration of treatments. Results: There is significant improvement observed between groups 3 and 1 and groups 3 and 2 regarding gingival index. Moreover, there is significant improvement in debris (plaque) index between groups 2 and 3 and groups 2 and 1. Conclusion: The gingival index indicates that using S. persica and toothbrush together is better than using S. persica or toothbrush alone. Meanwhile, the debris index shows that using S. persica alone or using it with toothbrush is more effective than using toothbrush alone. Keywords: Salvadora persica, gingivitis, gingival index, debris index.

Aim To evaluate clinical performance and side effects of two commercially available 0.2% chlorhexidine mouthwashes after periodontal surgery, one with (test) and one without (control) an anti‐discoloration system. Materials and methods This single‐centre, crossover clinical trial included 38 patients undergoing two sessions of periodontal flap surgery. The participants used two different 0.2% chlorhexidine products, one with and one without an anti‐discoloration system, in the 14‐day post‐operative periods. Plaque, gingival inflammation, tooth staining, side effects and patient preference were evaluated. Results The control mouthwash (without an anti‐discolouring system) produced significantly lower plaque (p = 0.02) and gingival index (p = 0.01) compared to the test mouthwash. The test mouthwash produced significantly less staining in the gingival (p = 0.002) and approximal areas (p = 0.0004), but no difference was detected in the buccal area of the teeth. The patients did not show preference for any of the mouthwashes. Conclusion Chlorhexidine mouthwash without an anti‐discoloration system resulted in significantly lowered plaque and gingival index compared to chlorhexidine mouthwash with an anti‐discoloration following periodontal surgery. No difference in patient preference was found despite less side effects produced by the chlorhexidine mouthwash with the anti‐discoloration system.

The Directorate of Dental Health (2000) sets a long-term goal of the Dental and Oral Health program, which is an optimal degree of oral health with a measure of oral hygiene in elementary school students with an Oral Hygiene Index Simplified (OHIS) range of 0.6-1.2 . Initial examination at Elementary School Batukerbuy IV Pamekasan, OHIS values were obtained with an average of 3.1. The purpose of this study was to determine the effectiveness of gargling with 20% infused of pondoh snakefruit on OHIS scores fourth students of Elementary School Batukerbuy IV Pamekasan. This research method is quasy experiment using the Pre and Post-test design with control group design. Respondents were selected by the total quota sampling method in fourth students of Elementary School Batukerbuy IV Pamekasan who were 10 years old and obtained respondents as many as 40 people. Based on the results of data analysis, there is an insignificant difference in average values between after rinsing infused pondoh snakefruit 20% by 19.03 and chlorhexidine mouthwash 0.2% with an average value of 21.98 and a difference of 2.95. Based on research that has been done, it was concluded that rinse chlorhexidine mouthwash 0.2% was more effective in reducing the OHIS value compared to rinse infused of pondoh snakefruit 20%. Keywords: OHIS; infused pondoh snakefruit; elementary school students

Purpose: This study was conducted to evaluate the effect of Thyme extract mouth rinse against Chlorhexidine mouthwash on salivary Streptococcus mutans count in a group of Egyptian children. Materials and Methods: A total of 70 Egyptian children were included in this study. Children ages ranged from 5 to 10 years old in a good physical condition. Children were randomly distributed into two groups A & B each of 35 children. In children of group A (using Thyme extract) each participant was instructed to rinse with 10ml of thyme extract for one minute. In group B (control group using Chlorhexidine mouthwash 0.2%) each participant was instructed to rinse with 10ml of CHX for one minute. Results: There was a significant reduction in Streptococcus mutans count in both groups. Conclusion: Thyme extract mouthwash was successful as an antimicrobial agent. It significantly reduced the total bacterial count in the saliva of children when compared to a potent antiseptic like Chlorhexidine.

Background and Aim: Ventilator-associated pneumonia is a common, serious and costly complication in patients of intensive care units. Oral hygiene is one of the important clinical measures to reduce the amount of pulmonary infection in these patients. Therefore, this study compares the effects of chlorhexidine and orthodontal mouthwashes on prevention of pulmonary infection in patients with endotracheal tracheal intubation under mechanical ventilation in intensive care units. Materials and Methods: This double-blind clinical trial study was performed on 60 patients undergoing mechanical ventilation in two groups of intervention (n = 30) and control (n = 30) in ICU department of Imam Reza hospital in Kermanshah. In the control group, chlorhexidine (0.2%) mouthwash and in the intervention group, Ortodontol mouthwash was used three times a day. Data on the rate of early and late pneumonia were compared based on CPIS criteria applying t-test and Chi-square. Results: The incidence of early and delay pneumonia in the intervention group was lower than that of control, but no significant difference was observed (P >0.05). The overall frequency of pulmonary infection in the intervention group was significantly lower than the control group (P = 0.03). The frequency of pneumonia causes was lower in the intervention group, but this decrease was statistically significant in Staphylococcus aureus (P = 0.03). Conclusion: According to the results of this study, orthodontol mouthwash can be effective in reducing the incidence of pulmonary infection associated with mechanical ventilation.

This single-arm open-label pilot trial in Antwerp, Belgium, was ended early in accordance with the protocol because twice-daily gargling with chlorhexidine 0.2% for 6 days failed to eradicate Neisseria gonorrhoeae from the oropharynx of asymptomatic men who have sex with men (n = 3; efficacy of 0%; 95% confidence interval, 0%-56.1%).

Objectives This study aimed to evaluate the effect of 0.12% chlorhexidine gluconate on the salivary load of SARS-CoV-2. Materials and methods A randomized, double-blind, placebo-controlled trial was performed on 100 participants positive for SARS-CoV-2. In the test group (n=50), volunteers gargled with a mouthwash containing 15 mL of 0.12% chlorhexidine gluconate for one minute, while the control group (n = 50) used a placebo. Saliva samples were obtained before (baseline) and 5 and 60 minutes after using the solutions. Real-time reverse transcription polymerase chain reaction assays (qRT-PCR) were carried out and the cycle threshold (Ct) was computed. The chi-square test and t-test were used for group comparison (p≤0.05). Results The differences in Ct values between the 5-minute evaluation and baseline (test group: 2.19±4.30; control: -0.40±3.87, p=0.002) and between 60 minutes and baseline (test group: 2.45±3.88; control: 0.76±4.41, p=0.05) were significantly greater in the test group, revealing a reduction of viral load. Furthermore, there was a reduction in the load of SARS-CoV-2 in 72% of the volunteers using chlorhexidine versus 30% in the control group (p=0.001). Conclusions Chlorhexidine gluconate (0.12%) was effective in reducing salivary SARS-CoV-2 load for at least 60 minutes.

The fast elevation of the salivary pH in orthodontic patients has acritical role to safe the teeth and encourage the orthodontic treatment after acidic challenger. As their baseline salivary pH is dropped during fixed orthodontic treatments.Aims: this study was aimed to evaluate the durability of three types of mouthwashes on the salivary buffering capacity in orthodontic patients at 0, 5, 10, 15 mints after acidic challenger using direct pH meter.Material and method: 80 orthodontic patients; age range (13-21years) were distributed into four groups; 20/ each, the salivary pH were recorded using compact pH meter (LAQUAtwin, HORIBA's, Kyoto, Japan) before and after administration of carbonated beverage (100 mm coca cola) and directly after gargling with 100 ml of the tested mouthwashes (herbal, green tea and chlorohexidine mouthwash) beside tap water as placebo control. The pH was documented again at 0, 5, 10 and 15 mins after each mouthwash gargling. One way ANOVA analysis and Duncan multiple were used for salivary pH analysis, p≤0.05.Results: non-significant differences were found at 0, 5, 10, 15 mints in comparison with baseline pH after herbal mouthwash gargling, the same result was shown with chlorohexidine mouth wash but with less defined border. Salivary pH after green tea gargling showed clear oscillatory results after the same tested periods.Conclusions: Herbal mouthwash is the best type to improve salivary pH for longer duration after acidic challenger. While Chlorohexidine mouthwash shows beneficial effects in elevation salivary pH with less duration. Green tea mouthwash fail to control salivary pH for long duration.

Objectives: Research is ongoing to find safe and effective oral hygiene aids for oral self‑care in children. Mouthwashes are used to complete the process of mechanical plaque control. Lack of affordability and side effects of most commercially available mouthwashes limit their use in children. Hence, the cost-effective and easily available essential oil, lemongrass oil, when formulated as a mouthwash, may possibly serve as an adjunct to oral hygiene maintenance. The main objective of this study was to compare the efficacy of lemongrass oil and chlorhexidine (CHX) mouthwash in children. Materials and Methods: Sixty healthy children between 9-12 years were selected. During the initial visit, the plaque pH, plaque index (PI), and gingival index (GI) were assessed, and oral prophylaxis was performed. The patients were randomized into three groups (n=20) and received 0.25% lemongrass oil mouthwash (group A), 0.2% CHX mouthwash (group B), and oral prophylaxis alone (group C). The patients were recalled after 14 and 21 days. ANOVA with post-hoc Bonferroni and paired t-test were used to analyze the results by SPSS software. Results: Intragroup comparison of PI and GI showed a significant decrease between 14 and 21 days in groups A and B (P≤0.05). Intragroup comparison of the mean plaque pH in group A showed a significant increase at day 21 compared with baseline (P=0.028). Conclusion: The results showed that the lemongrass oil mouthwash was effective in reducing PI and GI in children. Thus, it may be used as a good herbal alternative to CHX mouthwash.

Purpose: To determine whether oil-pulling with sesame or coconut oil yields a better result in reducing Streptococcus mutans count compared to conventional chlorhexidine mouthwashes. Methods: Multiple databases were used to search for articles up to and including August 2019. Studies which reported use of oil-pulling and chlorhexidine mouthwashes to reduce Streptococcus mutans bacterial count were analyzed procedurally. Studies that fulfilled the inclusion criteria were then undertaken for qualitative and quantitative analysis. Results: Five studies were included in this analysis, which used oil-pulling (test group) and chlorhexidine mouthwash (control group). The follow-up period ranged from 14 to 30 days. The oil used in oil-pulling group were either sesame or coconut oil. Quantitative analysis showed a significant reduction in oral Streptococcus mutans count with oil-pulling as compared to chlorhexidine mouthwash at follow-up (Q value = 6.61, DF = 4, I2 = 39.50%). Conclusion: Use of oil-pulling showed better result in reducing cariogenic bacterial count as compared to the gold standard chlorhexidine mouthwashes. More clinical trials, evaluating additional oral hygiene parameters, would further validate the effects of oil-pulling on the oral cavity. Clinicians may advise their patients to use oil-pulling instead of chlorhexidine mouthwashes, as it is safe, cost-effective, and easily available.

Purpose: The aim of this study was to evaluate the antimicrobial effect of Coconut oil on Streptococcus mutans count in saliva in a group of Egyptian children and Compare its effect with chlorhexidine mouth wash. Materials and Methods: A total of 60 Egyptian children were included in this study their ages ranging from (5-10) years. The children (60) were divided into two groups; each group consists of 30 children (Group A, Group B). Group A (study group) : Coconut oil consisted of thirty child, each participant was instructed to rinse with 10 ml of Coconut oil 3 times per day for two weeks with average (1minute /rinse) Group B (Control group): chlorhexidine mouthwash (0.2%) consisted of thirty child, each participant was instructed to rinse with 10 ml of chlorhexidine mouthwash, 3 times per day for two weeks with average (1minute /rinse). Results: Statistically significant reduction in Streptococcus mutans count was seen in both oil pulling and chlorhexidine groups but the reduction was found to be more in the oil pulling group than in thechlorhexidine group. Conclusion: Use of coconut oil pulling therapy may be used as preventive therapy at home to maintain oral hygiene as it is natural, safe and has no side effects

Background: Ventilator associated pneumonia (VAP) is a prevalent infection of intensive care unit(ICU) accompanied with increased rate of complications and mortality. This study is raised with the aim of comparing effects of Chlorhexidine mouthwash with Herbal Cinnamon mouthwash on prevention of ventilator associated pneumonia among patients hospitalized in ICU. Methods: Number of eighty-six patients admitted at ICU was divided into two 43-member groups. First group underwent moth washing using Chlorhexidine mouthwash2% and 2nd group underwent mouth washing using Herbal Cinnamol mouthwash. Frequency and onset of VAP incidence were compared in two groups. Results: Groups under treatment with Cinnamol and Chlorhexidine were not different considering demographic factors (P>0.05). In Cinnamol group, 25(58.13%) and in Chlorhexidine group, 27(62.79%) had pneumonia. Incidence of VAP was not different in two groups (P=0.826). In Cinnamol group, 32% of patients presented VAP prior to fifth day of ventilation and 68% after fifth day and in Chlorhexidine group 22.22% prior to fifth day and 77.77% after fifth day. VAP onset was not significantly different among two groups (P=0.536). Conclusion: Chlorhexidine mouthwash in comparison to Cinnamol mouthwash for prevention of VAP among patients admitted at ICU presented no superiority considering considering decrease in VAP incidence and onset.

Introduction: Discoloration of resin composite restorations can lead to patient dissatisfaction. 0.2% Chlorhexidine and Persica mouthwashes are among the agents that cause discoloration. The aim of this study was to investigate the degree of discoloration caused by the 0.2% Chlorhexidine and Persica mouthwashes on resin composite samples. Materials and Methods: This in-vitro experimental study was conducted in Kashan and Isfahan School of Dentistry in 2020-2021. Number of 30 disc-shaped samples were fabricated from Charisma Diamond resin composite. The initial color of samples was measured by CIE Lab system in spectrophotometer. Then samples were divided into 3 groups (A, B, and C) (n = 10).The control group (A) was placed in distilled water, group B was immersed in the 0.2% Chlorhexidine mouthwash and group C was immersed in the Persica mouthwash. The color of the samples was measured again afterwards. Data were analyzed with One-way ANOVA and t-Test (α = 0.05). Results: The amount of l, a, b and ΔE after using 0.2% Chlorhexidine and Persica mouthwashes increased. The mean of Δl, Δa, Δb and ΔE showed significant differences between groups (p value < 0.05). Conclusion: The discoloration of Persica mouthwash was more than 0.2% Chlorhexidine mouthwash and control group. Therefore, for patients with resin composite restorations, 0.2% Chlorhexidine mouthwash is better. Keywords: Composite resins, Chlorhexidine, Mouthwashes

Background: Chlorhexidine mouth rinse, a 'Gold Standard'effective in reducing plaque and gingivitis, has some drawbacks like bitter taste, light brown staining of teeth etc. limiting its long-term use. Magnetized water is alkaline and inhibits the bonding process between plaque and teeth by “magnetohydrodynamic”. Aim: To compare and evaluate effectiveness of magnetized water and 0.2% chlorhexidine as a mouth rinse in children aged 12-15 years for plaque and gingivitis inhibition during 3 weeks of supervised use. Settings and Design: This was a double blinded randomized control clinical study, carried out at a non-government high school. Methods:A total of 20 children aged 12-15 years were randomized into two groups, magnetized water and 0.2% chlorhexidine, each comprising of 10 children who were asked to rinse with the respective mouthwash. Plaque index (PI) scoresand gingival (GI) scoreswere evaluated at baseline, 2 weeks and at 3 weeksfor each child. Statistical analysis: Independent sample t test and paired sample t test were used to check the mean differences. Result: A statistically significant difference was found in reduction of mean PI and GI scores of magnetized water (p=0.0001) and Chlorhexidine groups(p=0.0001) both at 14 days (2 weeks) and at 21 days (3 weeks) with no adverse effects. Conclusion: Daily use of magnetized water as a mouth rinse was safe andeffective alternative to chlorhexidinein plaque and gingivitis reduction, which supplemented the benefits of daily toothbrushing in children.

Nitrate and nitrite molecules are involved in the synthesis of nitric oxide (NO), a gaseous vasodilatory molecule, via the nitrate-nitrite-NO pathway. Oral bacteria are responsible for the reduction of nitrate to nitrite making them important regulators in NO production and vascular control. This paper aimed to investigate whether a laboratory-made propolis mouthwash maintained the oral nitrate reducing capacity (ONRC) of commensal bacteria compared with a chlorhexidine (CHX) mouthwash and the effects of this on vascular function in healthy individuals. Twenty-eight healthy participants visited the laboratory on two occasions where anthropometric, ONRC, blood pressure and vascular function data were collected. Between laboratory visits a CHX mouthwash or a propolis mouthwash were used for seven days, twice-daily. It was found that propolis mouthwash used for seven days maintained the ONRC of commensal bacteria in healthy individuals (pre; 343.4 ±251.8μM vs post; 331.9 ±225.1μM, p=0.71) and that CHX mouthwash significantly abolished this activity, lowering levels by 67.7% in seven days (pre; 399.7 ±356.4μM vs post; 129.1 ±171.3μM, p

Background Studies have reported contradictory findings regarding the efficacy of chemical mouthwashes for chemotherapy-induced oral mucositis. Objectives This study sought to compare the effect of the combined solution of grape vinegar and rose water versus chlorhexidine mouthwash on chemotherapy-induced oral mucositis. Methods 60 patients were randomly assigned to either chlorhexidine or the vinegar and rose water solution. Fifty-three patients completed the study. Patients rinsed their mouths with mouthwash three times a day for 14 days. Findings Chlorhexidine mouthwash and the grape vinegar and rose water solution decreased chemotherapy-induced oral mucositis. The therapeutic property of the grape vinegar and rose water solution was similar to that of chlorhexidine mouthwash in treating oral mucositis.

Objective Histological features of oral inflammation include infiltration of polymorphonuclear leukocytes [PMN], however studies have not examined the effects of interventions mitigating inflammation on oral PMN. Methods: This double-blind clinical study examined the effects of rinsing with mouthwashes formulated with chlorhexidine [CHX], an ingredient widely utilized in the dental clinic in comparison to a control on oral PMN representing a novel measure of inflammation. A concurrent evaluation of dental plaque and gingival inflammation using widely accepted clinical indices was included in the study. The study enrolled adult subjects providing informed consent, met study criteria and registered gingival index scores of 1.0 or more at the screening visit. Subjects [n = 90; age range 19–58 years] completed a washout phase prior to baseline evaluations for PMN and clinical assessments for dental plaque and gingivitis. Treatments [CHX or a control mouthwash] were randomly assigned to subjects for twice-daily use for the next two weeks. Post-treatment evaluations similar to baseline were conducted after one and two week use of assigned treatment. Results: At baseline, no statistically significant differences between treatment groups for PMN or clinical indices for dental plaque or gingivitis were noted. Rinsing with CHX demonstrated significant reductions for PMN and dental plaque, gingivitis in comparison to the control group. After one and two week use of CHX, PMN demonstrated a 35.9% and 54.9% reduction respectively in comparison to the control group representing significant differences [p, Highlights • Enumeration of oral polymorphonuclear leukocytes [PMN] estimates the oral inflammatory burden. • Rinsing with chlorhexidine demonstrated progressive PMN reductions corroborating gingivitis and dental plaque evaluations. • Rapid PMN assessment provides objective assessment of treatment effects applicable for dental chair-side setting.

The present study, intended to compare the effects of immersion in herbal mouthwashes and the Chlorhexidine mouthwash on orthodontic acrylic resin, specifically with regard to alterations in its hardness, roughness and color. Seventy-two specimens of Orthodontic self-cured acrylic resin were used for the experiments. After preparation, specimens were placed in three types of mouthwash including Chlorhexidine 0.2 % (CHX), Persica and Matrica. The changes in microhardness (ΔKNH), Surface roughness (ΔRa) and color (ΔE) were evaluated prior to and following the immersion in mouthwashes. In order to analyze the data, we made use of SPSS version 22. One-Way ANOVA test was used to find the differences between groups. The Tukey test was conducted in the final stage. It was revealed that acrylic resins had lower microhardness when 12 hours after immersion had taken place. There were significant differences after 12h, 24h and 7 days between the groups in the softening of acrylic resins. The reduction in microhardness of acrylic resin with herbal mouthwashes in the three-time intervals was higher than CHX. With regard to increasing surface roughness, the disparity between herbal mouthwashes was insignificant. However herbal mouthwashes significantly increased the value of roughness more than CHX. Changes in color were significantly higher in all mouthwashes. Herbal mouthwashes caused more color variation than CHX. The color, roughness and hardness of acrylic resin undergo changes as a result of being immersed in the mouthwashes. However, the effect of herbal mouthwashes was more than that of CHX.

Purpose: Does clinical significance match with the statistical significance with respect to gingival score when herbal mouthwash is used in comparison to the chlorhexidine mouthwash? Material and Method: A systematic search of literature was conducted on two databases (PubMed and Google Scholar) for the studies published from 1st January 2006 to 31st December 2018. Cross-references were checked. Hand searching was done in the library. Studies were included if they were done among healthy, non hospitalized humans and compared chlorhexidine with herbal mouthwash for the gingivitis score.Clinical significancewas ascertained based on Loe and Sillness (1967) Gingival index interpretation. Results:A total of 22 unique clinical trials were identified and 24estimates which used Gingival index as outcome assessor. 18 estimates showed matching between clinical significance and statistical significance in the chlorhexidine group while in herbal group it was found only in 15 estimates. As per Thirthalli J, Rajkumar RP criteria none of the studies showed clinical significance. Conclusion: Statistical significance does not always mean clinical significance. Researchers should modify their study design to focus on clinical significance along with statistical significance.

Background: Chlorhexidine (CHX) is an antiseptic mouthwash widely used as the gold standard for inhibiting plaque formation. However, the bitter taste of CHX limits patient compliance. We developed a 0.12% CHX and 1.5% hydrogen peroxide (H2O2) mouthwash that masked the bitter taste of CHX. This study evaluated the antibacterial activity and subject satisfaction of the developed mouthwash. Materials and Methods: Three mouthwashes were used as follows: (1) a commercial 0.12% CHX mouthwash, (2) a prepared 0.12% CHX mouthwash containing 1.5% H2O2, and (3) a prepared 0.12% CHX mouthwash. A disc diffusion assay was performed to determine the antibacterial activity of each mouthwash against Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. To assess subject satisfaction with each mouthwash, a satisfaction questionnaire was completed immediately after rinsing with each mouthwash. Results: The antibacterial activities of the three mouthwashes were similar. Moreover, the questionnaire results revealed that the level of satisfaction was significantly higher for the 0.12% CHX/1.5% H2O2 mouthwash compared with the other mouthwashes. Conclusion: The 0.12% CHX/1.5% H2O2 mouthwash revealed a similar antibacterial activity as the CHX standard against periodontal disease pathogens. In addition, the subjects were more satisfied with the new formula compared with 0.12% CHX alone. These data suggest that the 0.12% CHX/1.5% H2O2 formulation is an alternative antibacterial mouthwash to avoid the unpleasant CHX side effects.

Background: Bleeding gums are one of the common complaints to visit a dentist. Mechanical removal of plaque alone is not sufficient for the reduction of gingival inflammation associated with plaque. Mouthwashes are supplemented to it as a homecare product. The objective of this study is to evaluate the efficacy of 0.2% sodium hypochlorite mouthwash on plaque and gingival inflammation and to assess the clinical parameters of gingivitis patients from baseline to 21 days with the use of 0.2% sodium hypochlorite and 0.2% chlorhexidine mouthwashes. Materials and Methods: This clinical trial study included 60 patients with gingival inflammation evaluated using clinical parameters such as bleeding on probing index, plaque index, and gingival index at baseline and 21 days. Group A patients were given Hi Wash mouthwash and Group B 0.2% chlorhexidine mouthwash with 30 patients in each group. Results: The scores for clinical parameters were significantly reduced after 21 days in Group A and Group B patients, and there was a reduction in plaque-associated gingival inflammation without scaling and root planning. Conclusions: 0.2% sodium hypochlorite mouthwash is as effective as 0.2% chlorhexidine for the treatment of gingivitis as it is an adjunct to mechanical plaque removal in terms of safety, less side effects, less staining and can be used as a routine mouthwash.

Objective: To evaluate the efficacy of herbal mouthwash (Himalaya Hiora Regular) against methicillin-resistant Staphylococcus aureus and Acinetobacter baumanni during ultrasonic scaling. Material and Methods: Group B (n=25) received herbal mouthwash and Group A (n=25) received 0.12% chlorhexidine mouthwash respectively as a preprocedural rinse. The aerosols produced by the ultrasonic unit were collected on MeReSa and Leeds Acinetobacter Agar plates. The experimental setting included eight different locations covering all areas of the operatory. The plates exposed to aerosols for a period of 30 minutes were incubated aerobically at 37 o C for 48hrs and the colony forming units (CFU) were statistically analyzed. Results: Herbal mouthwash (Himalaya Hiora Regular) showed a significant reduction in mean CFU of MRSA compared to 0.12% chlorhexidine. While herbal mouthwash was on par with 0.12% chlorhexidine in the reduction of A. baumannii . Conclusion: Herbal mouthwash was found to be more effective against MRSA than 0.12% Chlorhexidine mouthwash as a pre-procedural rinse. Both herbal mouthwash and chlorhexidine mouthwash was found to be effective against A. baumannii . Herbal mouthwash may be a safe alternative to chlorhexidine against nosocomial pathogens like MRSA and A. baumannii .

Chlorhexidine (CHX) is the most widely prescribed antiseptic mouthwash in Dentistry. It is used as an adjunct with mechanical plaque control to improve its efficacy. But various interactions between CHX and dentifrices have been reported, causing confusion on the mode of usage of CHX. This study was done to try out the new modality of usage of CHX, that is immediately after tooth brushing rather than its delayed use.

In 2018, NHS England released guidelines restricting the prescription of over-the-counter medicines (OTC). This was a project initially targeted at primary care, but we felt that it could also be used to improve services in secondary or tertiary care. We were interested to investigate our OTC prescribing pattern within a busy maxillofacial department and therefore carried out a service review. All outpatient prescriptions were reviewed between October 2017 and October 2018. The review was then repeated between October 2018 and October 2019. All OTC medications prescribed during these periods and their costs to the Trust were highlighted. Our aim was to improve prescribing patterns based on current guidelines and reduce the departmental spend in this area. The first year of data revealed that a total sum of £2742.75 was spent on OTC medications. Those most frequently prescribed were Difflam™ (Mylan) mouthwash and spray; chlorhexidine mouthwash, and miconazole oral gel. The findings of the service review indicated deficiencies in knowledge with regards to prescribing appropriately. Following departmental training the amount spent reduced from £2742.75 to £1312. There is a need to educate nationally to reduce spending on OTC medications, which would help to relieve financial pressures on other NHS services. As a department, we can also hope for further improvement.

Objectives: To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores. Material and methods: MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed. Results: Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [−0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [−0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [−0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [−0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [−3.98; −1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [−3.32; 3.55]). Conclusion: There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.

Chlorhexidine is one of the most widely and commonly used antiplaque and antigingivitis agent. Chlorhexidine is a potent antibacterial substance but this alone does not explain its antiplaque action. Once adsorbed, and unlike some other antiseptics, chlorhexidine shows a persistent bacteriostatic action lasting in excess of 12 hours. Materials and Methods: The present study was carried out in 40 patients to evaluate and compare the short term side effects of 0.2% and 0.12% chlorhexidine. Pain, burning sensation, taste disturbance were evaluated at first, third and Seventh day Results: No statistical significant difference was observed in two groups with respect to these side effects. Conclusion: However, the taste of 0.12% was better accepted as compared to 0.2% chlorhexidine mouthwash. Keywords: Antigingivitis, Chlorhexidine.

Background: Citrus sinesis belongs to Rutaceae family is an enriched source of vitamin C, flavonoid compounds and antioxidants are helpful in reducing inflammation. Few in-vitro studies the ethanolic extract of orange peels has successfully reduced periodontal pathogens which has influenced us to prepare a mouth wash with ethanolic extract of orange peel. Aim: To evaluate and compare the effect of indigenously prepared 4% ethanolic extract of Citrus sinseis (Orange peel) mouthwash to commercially available 0.2% Chlorhexidine mouthwash as an anti-plaque agent. Materials and Methods: Twenty subjects in the age group of 18-60 years with moderate to severe gingivitis were divided into two equal groups. Clinical parameters like Plaque Index, Sulcus Bleeding Index and Gingival Index were recorded at baseline, 7th and 14th day respectively. Following oral prophylaxis Group-I (n= 10) subjects were instructed to rinse twice daily with 10ml of 0.2% chlorhexidine mouthwash and Group-II (n= 10) subjects were instructed to rinse twice daily with 10ml of 4% ethanolic extract of Citrus sinesis mouthwash for 14 days. All the subjects were recalled on the 7th and 14th day for follow up to record the clinical parameters. Results: Citrus sinesis 4% mouthwash was seen to be as efficient as 0.2% Chlorhexidine in reducing Plaque Index and more effectively reducing gingival inflammation and gingival bleeding index. Conclusion: Citrus sinesis 4% mouthwash can be used for short term purpose without any potential side effects as an alternative to 0.2% Chlorhexidine mouthwash in reducing plaque and gingival inflammation.

Background: Orthodontist prescribe mouthwash for their patients especially since most of patients do not have a satisfactory oral hygiene and have high risk of dental caries. Stainless steel brackets that exposed by mouthwash may have nickel ion release. Corrosion and nickel ion release can induced allergic reaction and make more friction during orthodontic treatment. Purpose: This study aimed to measure nickel ion release of stainless steel bracket that immersed in chlorhexidine and Piper betle Linn mouthwash. Methods: Thirty-six stainless steel bracket immersed in artificial saliva, chlorhexidine, and Piper betle Linn mouthwash. All brackets stored in incubator for 1, 3, 5, and 7 weeks. Nickel ion release was measured by Atomic Absorption Spectrophotometry (AAS). Results: The results showed a significant differences of nickel ion release in all groups (p

Dental caries is a disease of multifactorial origin and Streptococcus mutans is considered as the chief pathogen responsible for its development. However, reduction in the number of pathogenic bacteria, particularly S. mutans, with the use of various preventive measures, can reduce dental caries to a significant level. Therefore, the present clinical study was undertaken to evaluate and compare the efficacy of toothbrushing, fluoride varnish, chlorhexidine mouthwash, and a probiotic (Yakult) in reducing the S. mutans counts in the saliva using Dentocult SM Strip Mutans kit in children. A total of 40 school students between the age group of 4 and 8 years were selected for the study and S. mutans count was taken on the first dental visit using Dentocult SM Strip Mutans test kit. After the initial scores of S. mutans were obtained, the children were divided into four groups and provided with different caries preventive regimen for 2 weeks. After 2 weeks, the scores of S. mutans were reevaluated for reduction in their counts, if any. The data thus collected were tabulated and statistically analyzed. All the groups showed a significant reduction in S. mutans counts with the highest reduction from the Fluor Protector varnish followed by chlorhexidine mouthwash, probiotic (Yakult), and toothbrushing. How to cite this article: Sharma M, Pandit IK, Srivastava N, Gugnani N, Gupta M. A Comparative Evaluation of Efficacy of Streptococcus mutans Counts in Saliva: An in vivo Study. Int J Clin Pediatr Dent 2018;11(2):94-99.

Objective: To evaluate the effects of combined and sequential consumption of chlorhexidine and listerine mouthwashes on plaque indices. Material and Methods: Sixteen dental students, both genders, were selected. After prophylaxis, four mouthwash regimens were used, such that in each period, mouthwash was used for 5 days and after each period there was 4 days of washing out. During the mouthwash period, the participants did not use any mechanical plaque control tool. The four regimens included: first regimen, first chlorhexidine then listerine; second regimen, listerine then chlorhexidine; third regimen, only listerine; fourth regimen, chlorhexidine alone. At the end of the period, individuals were evaluated for plaque indices and investigated for bleeding during probing using ANOVA variance analysis and post-hoc Tukey test. The level of significance was set at 5%. Results: Regimen 1 with a plaque mean of 0.55 ± 0.25 had significantly lower plaque than other regimens. The maximum rate of plaque was observed in regimen 3. Probing did not cause bleeding in any of the individuals who used the four mouthwash regimens. Conclusion: The use of 0.2% chlorhexidine and listerine has the highest effect on plaque reduction.

The person‐to‐person transmission of SARS‐CoV‐2 may occur directly or indirectly through saliva, and a preoperational use of antimicrobial mouthwash is considered to reduce the number of oral microbes. 1 Chlorhexidine mouthwash has been a common antiseptic agent used in dentistry, both preoperative and postoperative use reducing post‐surgical infectious complications.

Aims and Objectives: The aim of the study was to analogue and anatomize the effect of KP Namboodiri’s herbal mouthwash and 0.2% chlorhexidine mouthwash in orthodontic patients after using it for 15 days. Materials and Methods: A total of 40 patients receiving fixed orthodontic treatment were selected. The patients were divided into two groups: Group I - 20 patients were given KP Namboodiri’s herbal mouthwash for 15 days and Group II - 20 patients were given Chlorhexidine mouthwash. Supra gingival Plaque samples were collected on the day 0 (baseline), followed by day 15 for microbial analysis. Results: Microbial colonies were truncated in both the groups without significant difference between the groups after 15 days in both the groups (P Conclusions: KP Namboodiri’s mouthwash could be effectively used instead of Chlorhexidine mouthwash. Keywords: Plaque, Menthol, Thymol.

Objective The study evaluated the efficacy of tea tree oil for the treatment of gingivitis. Materials and Methods The tea tree oil was administered in the form of mouthwash and then compared with a mouthwash with chlorhexidine 0.12%. Both treatments were domestic and lasted for 14 days. Patients were chosen according to random criteria, aged between 18 and 60 years, and who showed a clinically evident gingivitis. In clinical evaluation, the following clinical criteria were taken into consideration: gingival index (GI), plaque index (PI), bleeding index (BI), probing depth (PD), the presence of dental dyschromia, and the presence of taste alteration. The subjects were evaluated before (T0) and after the treatment (T1), and the data collected for each patient were recorded on a periodontal chart. Results The comparison showed that tea tree oil offered a better improvement in the evaluation of PI, BOP, and PD; furthermore, it did not cause dental dyschromia and taste alteration. In group A, treated with tea tree oil, PI decreased from 53.25 to 5.50% and BI from 38.41 to 4.22%. In group B, treated with chlorhexidine PI decreased from 47.69 to 2.37% and BI from 32.93 to 6.28%. Instead, the subjects using chlorhexidine 0.12% blamed a distaste for the product that caused a slight taste alteration; 20% of them showed iatrogenic dental dyschromia. Conclusions The collected data showed the efficacy of both treatments. Although further research works will be necessary, this study showed that tea tree oil could be an effective nontoxic substitute for the therapy of gingivitis.