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Orthodontic treatment, using fixed appliances provides suitable conditions to bring about the colonization of cariogenic microorganisms. The oral pH levels and various microorganisms normally present in the oral cavity may influence the adhesion capacity of bacteria, a formation of biofilm, which increases the risk of demineralization in enamel, and caries development, particularly the bracket material. To prevent plaque formation both chlorhexidine and Nanosilver mouth washes are used to reduce the colony forming units . The aim of the study was to compare the antimicrobial effect of Nano silver containing mouthwash with chlorhexidine mouthwash in orthodontic patient. Methodology: Patients were randomly divided into two groups Group 1,patients using [0.2%]chlorhexidine mouth wash, group 2 patient using silver containing mouthwash[Nano life].Statistical analysis: Between CFUs variables within the groups was calculated and the variation significance was calculated by mann whitney u test and Wilcoxon Signed Ranks Test. The results showed that the values of CFU decreased significantly (p <0.001] as the time of use nanosilver mouth wash until reaching the highest value when the time of use was 4 weeks, that there was a definite reduction in the plaques in the CHX group from the 2nd week to the 4th week. Conclusion: Nano silver containing mouthwash had reduced the bacterial counts in orthodontic patients roughly in equal effect when compared with the gold standard Chlorhexidine mouth wash. [ABSTRACT FROM AUTHOR]

Objective: To compare the frequency of ventilator-associated pneumonia among mechanically ventilated patients with four hourly chlorhexidine mouthwash vs six hourly chlorhexidine mouthwash. Study Design: Randomized Controlled Trial. Setting: Surgical Intensive Care Unit of the Department of Anesthesia, Shifa International Hospital, Islamabad, Pakistan. Period: January 2020 to June 2020. Methods: Eighty patients admitted to ICU and mechanically ventilated for at least 48 hrs were randomly allocated, and 40 patients were treated with chlorhexidine mouthwash four-hourly per day group1, and 40 received chlorhexidine mouthwash six-hourly group2. The primary researcher followed patients for up to 7 days. Lower respiratory tract specimens were obtained on admission, and after 48 hrs of intubation, findings were entered in proforma. Results: The average age of the patients in group 1 was 37.55±10.16 years and in group 2 was a 38.65±9.25 year. There were 38(47.5%) male and 42(52.5%) female. The frequency of VAP was not significant between groups (11.25% vs 6.25%, p=.23). It was observed that the rate of VAP was not significant between groups in all age stratification. Gender stratification was performed and observed that no difference was found between groups. The frequency of VAP in females in group 1 was 7 (35%) and 4 (18.2%) in group 2, with p-value=0.21 and Chi-square=1.53. The frequency of ventilatorassociated pneumonia differed between groups for males in group 1 (35%) and 1 (5.6%) in group 2, with p-value=0.61 and Chi-square=0.25. Conclusion: Our study concludes that oral hygiene care incorporating chlorhexidine mouthwash effectively reduces the development of VAP in adults in ICU. We found no difference between the efficacy of four hourly and six-hourly chlorhexidine mouth wash in VAP frequency. [ABSTRACT FROM AUTHOR]

Background: Periodontitis is a chronic inflammatory disease affecting the oral cavity’s supportive structures, including gums and surrounding bone. Herbal mouthwashes have phytopharmacological agents such as Moringa oleifera (MO), and the use of herbal mouthwash has increased. Moringa mouthwash has potential for oral health due to its biocompatibility and anti-inflammatory effect. This study compares the effect of chlorhexidine gluconate (CHX) and moringa mouthwash on plaque and its reduction. Methodology: The in vitro tests included the determination of minimum inhibitory concentration using broth dilution and agar diffusion. This interventional study included 25 individuals with more than 1 plaque score. The study was conducted for 2 months with a washout period of 2 weeks between the use of both mouthwashes. The Quigley–Hein Plaque Index of the study subjects was recorded at the designated baseline and after 28 days of use throughout the study period. The statistical test used was the Wilcoxon signed-rank test, and the level of significance was considered to be

Background: Periodontitis is a chronic inflammatory disease affecting the oral cavity's supportive structures, including gums and surrounding bone. Herbal mouthwashes have phytopharmacological agents such as Moringa oleifera (MO), and the use of herbal mouthwash has increased. Moringa mouthwash has potential for oral health due to its biocompatibility and anti-inflammatory effect. This study compares the effect of chlorhexidine gluconate (CHX) and moringa mouthwash on plaque and its reduction. Methodology: The in vitro tests included the determination of minimum inhibitory concentration using broth dilution and agar diffusion. This interventional study included 25 individuals with more than 1 plaque score. The study was conducted for 2 months with a washout period of 2 weeks between the use of both mouthwashes. The Quigley–Hein Plaque Index of the study subjects was recorded at the designated baseline and after 28 days of use throughout the study period. The statistical test used was the Wilcoxon signed-rank test, and the level of significance was considered to be <0.05. Results: The results showed that the reduction in the mean plaque scores from baseline to day 28 was statistically significant in the moringa-based mouthwash. Similarly, the index scores showed a statistically significant reduction following the use of the moringa-based mouthwash when compared with the gold-standard chlorhexidine mouthwash with P = 0.00. The comparison showed that MO offered the same improvement as CHX. Conclusion: The current study aimed to provide an insight role of MO mouthwash as a possible adjunctive oral hygiene aid and its inhibitory effect on plaque reduction when compared to CHX. [ABSTRACT FROM AUTHOR]

Introduction: Oil pulling is old Indian natural daily practice which has been written in Ayurveda texts such as Charak and Sushruta Samhita. The act of swishing oil around the mouth removes microbes. Therefore, oil pulling reduces plaque-induced gingivitis. Naturally occurring products like coconut oil and sesame oil are enriched with antimicrobial activity. These oils are cheaper and easily available. Therefore, the aim of this article is to compare the efficacy of coconut, sesame oil, and chlorhexidine mouthwash as an adjunct to full-mouth scaling and root planing (SRP) in patients with plaque-induced gingivitis. Aim and Objectives: This study aimed to compare the efficacy of coconut oil sesame oil and chlorhexidine mouthwash as an adjunct to SRP in patients with plaque-induced gingivitis. Materials and Methods: Sixty patients of plaque-induced gingivitis were randomly divided into four groups: SRP, coconut oil, sesame oil, and chlorhexidine mouthwash. Clinical measurements included plaque index, gingival index (GI), and simplified oral hygiene index at baseline, 7 days, 15 days, 1 month, and 3 months. Microbial analysis was carried out. Results: There was a significant reduction in plaque and gingival scores from baseline to 3 months for the chlorhexidine group. Intragroup comparison shows a statistically significant reduction in plaque and GI. Conclusion: Oil pulling considers to affect microbes to treat plaque-induced gingivitis.

Introduction: Oil pulling is old Indian natural daily practice which has been written in Ayurveda texts such as Charak and Sushruta Samhita. The act of swishing oil around the mouth removes microbes. Therefore, oil pulling reduces plaque-induced gingivitis. Naturally occurring products like coconut oil and sesame oil are enriched with antimicrobial activity. These oils are cheaper and easily available. Therefore, the aim of this article is to compare the efficacy of coconut, sesame oil, and chlorhexidine mouthwash as an adjunct to full-mouth scaling and root planing (SRP) in patients with plaque-induced gingivitis. Aim and Objectives: This study aimed to compare the efficacy of coconut oil sesame oil and chlorhexidine mouthwash as an adjunct to SRP in patients with plaque-induced gingivitis. Materials and Methods: Sixty patients of plaque-induced gingivitis were randomly divided into four groups: SRP, coconut oil, sesame oil, and chlorhexidine mouthwash. Clinical measurements included plaque index, gingival index (GI), and simplified oral hygiene index at baseline, 7 days, 15 days, 1 month, and 3 months. Microbial analysis was carried out. Results: There was a significant reduction in plaque and gingival scores from baseline to 3 months for the chlorhexidine group. Intragroup comparison shows a statistically significant reduction in plaque and GI. Conclusion: Oil pulling considers to affect microbes to treat plaque-induced gingivitis. [ABSTRACT FROM AUTHOR]

Aims IImproving oral hygiene is a part of the nursing care in oncology centers. Its maintenance can also play an important role in improving Oral Health-Related Quality of Life (OHRQOL). This study investigated the effect of natural grape vinegar and rosewater solution on oral health-related quality of life in chemotherapy patients. Materials & Methods A randomized controlled trial was conducted on 60 chemotherapy patients. Patients were randomly assigned to one of two groups of intervention and control. The participants rinsed their mouths with grape vinegar and rosewater solution for one minute thrice daily for 14 days. An oral Health Impact Profile was used for data collection. Data were analyzed by SPSS 21, using descriptive statistics methods and inferential analysis tests, including an independent sample T-test. Findings The global mean score of oral health-related quality of life in the chlorhexidine group was 31.8±4.8 and19.5±4.6 for one day before and 21 days after the intervention, respectively. These values for grape vinegar and rosewater group patients were 30.8±6.3 and 14.1±4.1, respectively. The independent sample T-test showed a significant difference between the two groups at 21 days after the intervention. Conclusion Grape vinegar and rosewater combined solution improves OHRQOL in chemotherapy patients. [ABSTRACT FROM AUTHOR]

Brief Background Chemical plaque control agents act as adjuncts to conventional mechanical plaque control and interfere with biofilm composition. Chlorhexidine is the most comman chemical plaque control agent used. However, it has various side effects. Curcumin possesses a wide range of biologic activities due to which it can be used effectively in the treatment of periodontitis. Aim To evaluate and compare the effect of curcumin mouthwash with chlorhexidine mouthwash as an adjunct to scaling and root planing in the treatment of Stage II and Stage III Grade B periodontitis. Materials and Methods 46 subjects diagnosed with Stage II and Stage III Grade B periodontitis were randomly allocated into two groups, curcumin group and chlorhexidine group. Subjects were advised to rinse with 10ml of mouthwash for 1 min twice a day after 30 minutes of tooth brushing. The clinical parameters evaluated at baseline, 1 week, 2 weeks, 3 weeks of follow up were clinical attachment level, probing pocket depth, plaque index, gingival index. The microbiological parameters were evaluated at baseline and 3 weeks of follow up depending upon number of colonies formed on blood agar plate. Results Both the mouthwashes resulted in significant CAL gain and PPD, PI, GI values reduction at 1 week, 2 weeks and 3 weeks from baseline. It also resulted in significant reduction in CFU values at 3 weeks, thereby exhibiting anti-microbial activity. Summary and Conclusions Curcumin mouthwash can be effectively used as an adjunct to mechanical plaque therapy in the treatment of chronic periodontitis without any adverse effects. [ABSTRACT FROM AUTHOR]

Background: Commendable aesthetic properties of composites make it a pioneer filling material. However, discoloration of composite resin materials emerges as a major clinical problem in a long term. Aims and Objectives: Aim of the study is to evaluate the color stability of nano filled and micro hybrid dental composite resin in chlorhexidine mouthwash Materials and Methods: 20 specimens of dimension 10*2mm were prepared of A2 shade. All the prepared samples were immersed in 20 ml of distilled water in separate containers according to the group. Further incubation at 37°C for 24 h was done. After 24 h, baseline color values of each sample were recorded using a spectrophotometer. After recording the baseline color measurements, 10 specimens (random selection) from each group were placed in 20 ml of 0.2% chlorhexidine mouthwash for 24 h duration. The L*a*b* system of the Commission Internationale de l’Eclairage (CIE L*a*b* Color Scale) was used for the determination of colorimetric values of the specimens. Results: The color change was displayed by both the samples after immersion in the mouthwash but the change was not statistically significant (0.763). ΔE value for nano filled composites is 3.25 while for the micro-hybrid composites the value is 3.56. Conclusion: The colorimetric values of nano filled composite resins are more stable than the micro hybrid composite due to exposure to chlorhexidine mouthwash. [ABSTRACT FROM AUTHOR]

Abstract 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.

Background: One of the recommended methods for reducing aerosol contamination during the daily regular usage of high-speed turbine and ultrasonic scaling is the use of preprocedural mouth rinse. Several agents have been investigated as a preprocedural mouth rinse. Chlorhexidine significantly reduce the viable microbial content of aerosol when used as a preprocedural rinse. Studies have shown that cetylpridinum chloride (CPC) mouthwash is equally effective as chlorhexidine in reducing plaque and gingivitis. This study compared the effect of 0.07% CPC to 0.2% chlorhexidine gluconate (CHX) as preprocedural mouth rinses in reducing the aerosol contamination by high-speed turbine. Materials and Methods: 36 patients were divided into three groups based on the preprocedural rinse used (0.2% CHX, 0.07% CPC and distilled water). Conservative treatment was done for 20 min. (10 min before rinsing and 10 min after rinsing) in the same closed operatory for all the patients after keeping blood agar plates opened at three standardized locations (patient chest, dentist chest and at 12-inch from patient mouth). Colony forming units (CFUs) on blood agar plates were counted, after incubation at 37°C for 48 hr. Statistical analysis was done with (SPSS version 21(. Results: This study showed that the two antiseptic mouthwashes significantly reduced the bacterial colony forming units (CFUs) in aerosol samples at three plates locations. Chlorhexidine rinses were found to be superior to cetylpridinum chloride when used pre-procedurally in reducing aerolized bacteria. The number of CFUs were higher at the patient’s chest location as compared to other locations. Conclusion: 0.07% CPC and 0.2% CHX were effective as a pre-procedural rinse in reducing CFU count during dental treatment using high-speed turbine.

Introduction: Orthodontic elastomeric chain is polyurethane elastomer that is widely used among orthodontists due to its functions. Chlorhexidine (CHX) and sodium fluoride (NaF) are listed in mouthwash composition which could affect the mechanical properties of the elastomeric chain. This study was aimed to analyze the effect of sodium fluoride in chlorhexidine mouthwashes on force decay and permanent deformation of orthodontic elastomeric chains. Methods: This research is an experimental analytic laboratory with pretest-posttest control group design. 150 samples of orthodontic chains were divided into three groups. Group 1: artificial saliva (control group); Group 2: 0,1% chlorhexidine gluconate solution (CHX); Group 3: 0,1% chlorhexidine digluconate with sodium fluoride solution (CHX-NaF). The orthodontic elastomeric chain was stretched and maintained at a standardized distance equivalent to a force of 300 g. The measurement of force decay and permanent deformation were performed with digital force gauge and digital caliper (0.01mm) at intervals of the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Results: The force decay and permanent deformation of the elastomeric chain compared among three groups (control, CHX mouthwash and CHX+NaF mouthwash) showed did not have any significantly different (p-value>0,05) at the first, seventh, fourteenth, twenty-first, and twenty-eighth days, respectively. Conclusion: Sodium fluoride in chlorhexidine mouthwash showing no difference among saliva, CHX mouthwash and CHX+NaF mouthwash on force decay and permanent deformation of elastomeric chain.

Aim: To compare the effect of different preventive regimens containing fluoride toothpaste and chlorhexidine mouthwash with or without minimally invasive (MI) varnish on Cariogram parameters of high caries risk patients. Materials and Methods: A total of 66 participants were divided into three groups according to the tested regimen, A1: fluoride toothpaste with chlorhexidine mouthwash, A2: fluoride toothpaste with chlorhexidine mouthwash and MI varnish, or A3: fluoride toothpaste only (control group). All Cariogram parameters were evaluated and recorded according to Cariogram software (Cariogram, Internet Version 2.01, April 2, 2004 Copyright: D. Bratthall, Sweden) at baseline and after 3, 6, and 12 months. Clinical oral examination was carried out for recording caries experience and plaque scores. The salivary profile was generated by recording buffer capacity, salivary flow rate, and mutans streptococci count. Fluoride program was given according to each group, while the remaining parameters were kept constant. Statistical analysis was performed with significance level set at P ≤ 0.005. Results: Regarding Cariogram sectors, the green, red, and light blue sectors showed a statistically significant difference in all groups. The MI varnish group showed the best results followed by the chlorhexidine mouthwash group and finally the control group using fluoride toothpaste only. Conclusion: MI varnish with other preventive measures could be effectively applied to reduce caries risk, especially in high caries risk patients. [ABSTRACT FROM AUTHOR]

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.

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. [ABSTRACT FROM AUTHOR]

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.

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

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. [ABSTRACT FROM AUTHOR]

Burkholderia lata was isolated from 8 intensive care patients at 2 tertiary hospitals in Australia. Whole-genome sequencing demonstrated that clinical and environmental isolates originated from a batch of contaminated commercial chlorhexidine mouthwash. Genomic analysis identified efflux pump–encoding genes as potential facilitators of bacterial persistence within this biocide.

Objective: The objective of this study is to establish the difference in the salivary pH after rinsing with plain water, chlorhexidine (CHX) mouthwash, and herbal mouthwash and to compare the same. Materials and Methods: The sample size of the study is 30. Each participant will be subjected to either plain water or CHX mouthwash or herbal mouthwash rinsing. The salivary pH was measured using uncontaminated pH strips placed in the floor of the mouth for 30 s. The salivary pH was measured before rinsing and after rinsing. The results were compared and analyzed to determine the difference in the salivary pH between the use of plain water, CHX mouthwash, and herbal mouthwash. Results: P value for the analysis of variance test is as follows: After 5 min, 0.048 <0.05 and after 1 h is 0.042 <0.05. The paired t-test was done between every two of the three groups: Between CHX and plain water –0.04 <0.05; between herbal mouthwash and plain water –0.048 <0.05; between CHX and herbal mouthwash –0.045 <0.05. Conclusion: CHX mouthwash proves to have a positive effect on the salivary pH, which is also prolonged in nature. This once again proves the substantivity of CHX mouthwash. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the efficacy of 0.1% curcumin mouthwash and to compare it with 0.2% chlorhexidine gluconate as an antiplaque agent and its effect on gingival inflammation. Materials and Methods: One hundred and fifty subjects, age between 20 and 30 years were recruited. Study population were randomly divided into three groups. In Group A, 50 subjects were advised the experimental mouthwash. Group B subjects used placebo mouthrinse, and chlorhexidine mouth wash was given to Group C. The subjects were advised to use 10 ml of mouthwash for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque, gingival, and sulcus bleeding indices at day 0, 7, 14, and 28 days along with subjective assessment of taste. Results: On intragroup comparison between curcumin, chlorhexidine, and placebo mouthwash, the mean percentage reduction of the plaque index (PI) between 0 and 28 days were 0.58,0.57 and 1.17, respectively (P < 0.01), percentage reduction of gingival index (GI) between 0 and 28 days were 0.65, 0.66, and 1.09, respectively (P < 0.01) and sulcus bleeding index (SBI) showed a percentage reduction of 0.69, 0.66, and 1.13, respectively The intergroup comparison revealed chlorhexidine and curcumin mouthwash were statistically significant with P < 0.001 as compared to placebo. Conclusion: Curcumin mouthwash has shown an antiplaque and antigingivitis properties comparable to chlorhexidine mouthwash. Thus, curcumin mouthwash and chlorhexidine gluconate can be effectively used as an adjunct to scaling and root planning.

Background: Daily use of Chlorhexidine mouthwash following endotracheal intubation is done routinely in intensive care units (ICU). Matrika (Chamomile extract) has shown antibiotic activities, and several articles report it has similar preventive effect as Chlorhexidine on ventilator associated pneumonia, and also on oral cavity hygiene. Our study aimed to compare rate of VAP occurrence in two groups of intubated patients receiving Chlorhexidine and Matrika in Alzahra hospital’s ICU. Methods: In this trial 90 ICU patients who were intubated endotracheally, were randomly divided into two groups who will receive one of Chlorhexidine (group A) or Matrika (group B) mouthwash every 8 hours. Occurrence of VAP was determined in the following 5 days after intubation, using the standard VAP diagnosis criterion. Results: 8 of 45 (17%) patients experienced VAP in the first five days after intubation in the Chlorhexidine group, and, 9 of 45 (20%) patients in the Matrika group experienced the same condition. VAP rate was not significantly lower in the Chlorhexidine group (p value= 0.73). Conclusion: The results show that VAP occurs in Chlorhexidine and Matrika group approximately at a similar rate. Our findings recommend further studies on Matrika as an alternative to Chlorhexidine.

Background: The functions and use of mouthwashes are variable depending on their type. Oral care in patients with endotracheal tubes is important to prevent side effects such as pneumonia. The aim of this study was to determine the antimicrobial effects of chlorhexidine, drop of Matrica mouthwash (chamomile extract), and normal saline on hospitalized patients with endotracheal tube in an intensive care unit (ICU). Materials and Methods: In this clinical trial, 39 patients admitted to the ICU were selected by convenience sampling, were matched based on age and sex, and randomly assigned to three groups (chlorhexidine, Matrica, saline). Mouth washing was performed every 8 to 48 hours. The samples were taken at time zero (before the intervention) and 48 hours after the intervention for bacterial culture. Antibacterial activity of each mouthwash on microorganisms was measured based on the growth of Staphylococcus aureus, Pneumococcal, Enterococcus, Pseudomonas, and Escherichia coli. The obtained data were then analyzed using Chi-square and Fisher′s exact tests with the Statistical Package for the Social Sciences Package version 18. Results: Chlorhexidine mouthwash was more effective in preventing colonization of bacteria in the mouth (point probability = 0.06) in comparison with chamomile and saline mouthwashes. Nevertheless, none of the tested mouthwashes were able to remove pathogens, including Staphylococcus aureus, Pseudomonas, Klebsiella, and Acinetobacter. Conclusions: 0.2% chlorhexidine mouthwash has a significant effect on the bacterial colonization rate in comparison with Matrica and normal saline mouthwashes in ICU hospitalized patients with endotracheal tube.

Background: Punica granatum contains polyphenols and tannins which possess anti-inflammatory and antibacterial properties. The main enemy for dental caries and periodontal diseases is dental plaque. Several plaque control measures have been suggested to prevent plaque accumulation. One among them will be the use of chlorhexidine mouthwash which is considered to be gold standard plaque control measure. However, the major adverse effect of chlorhexidine will be staining and taste alteration. To overcome the adverse effects of chlorhexidine, various naturally occurring antibacterial agents have been incorporated to prevent plaque formation. One among them will be P. granatum. Hence, the present study was conducted to evaluate the antimicrobial effectiveness of P. granatum and chlorhexidine-containing mouthwash. Materials and Methods: A single-blind randomized controlled trial was conducted among twenty healthy individuals. The participants were randomly allocated into two groups: Group I (experimental group - P. granatum) and Group II (controlled group - chlorhexidine). Before conducting the trial, the study design was explained to the qualifying participant and informed consent was obtained from the voluntary patients who were willing to participate in the study. Plaque samples were evaluated for Streptococcus mutans at baseline and 15th day of follow-up. Wilcoxon signed-rank test was used to compare the mean differences before and after treatment within each group for plaque S. mutans. Mann-Whitney U-test was used to estimate differences in the mean plaque S. mutans count between the groups. Results: A statistically significant reduction in mean plaque S. mutans was observed in both Group I and Group II at baseline and 7th day follow-up. However, there was no statistically significant difference observed between the groups at 7th day of follow-up. Conclusion: To conclude, there was no statistically significant difference was observed in mean plaque S. mutans between group 1 and group 2 at 7th day of follow-up. Hence, the current study shows that P. granatum can be used as an effective alternative to chlorhexidine mouthwash against plaque S. mutans. [ABSTRACT FROM AUTHOR]

Objectives: To assess and compare the antimicrobial effect of garlic extract and chlorhexidine (CHX) mouthwash solution against oral salivary microorganisms. Materials and Methods: Thirty six salivary samples were obtained in dry plastic vials. Collected saliva samples were centrifuged. Each vial was mixed completely on a shaker after which 1 ml of saliva was added to 9 ml of ethanol by a sterile pipette and mixed. A volume of 1 ml of garlic hydro-alcoholic extract and 1 ml of mouthwash was added to 1 ml each case specimen and was transferred to culture medium of Trypticase Soy Agar. Agar plates were incubated at 37°C for 48 h to allow for microbial growth. Microbial colonies were counted by independent interpreter to evaluate the result. Statistical Analysis: Data obtained were analyzed using one-way ANOVA test. P < 0.001 was considered statistically significant. Result: Result of the study shows that mean colony count of salivary microbial population was (1984 ± 400) 1127 in saline group (negative control), (50 ± 4) 27 in (0.12%) CHX group (positive control), (700 ± 200) 469 in garlic extract (5%) group (case control). Conclusion: Mouthwash containing garlic extract can be used as an alternative to CHX mouthwash.

Aims and Objectives: The aims of the present study were to determine and compare the effects of different concentrations of Althaea officinalis extract, 0.2% chlorhexidine (CHX), and penicillin on Streptococcus mutans and Lactobacillus acidophilus in vitro. Materials and Methods: The laboratory study was done, for a period of 8 weeks. Minimum inhibitory concentration (MIC) in the test tube, minimum bactericidal concentration (MBC) in a plate culture medium, and growth inhibition zone diameter methods were used to compare the antibacterial effects of 0.2% CHX, penicillin, and different concentrations of A. officinalis root extract. The data were analyzed by SPSS version 24 using ANOVA and t-test analysis. Results: The results showed A. officinalis root extract had antibacterial effect, but significant differences were in MIC and MBC against L. acidophilus and S. mutans with penicillin and 0.2% CHX mouthwash. In addition, the mean growth inhibition zones of all the concentrations of the plant extract were less than that of the positive control group (P = 0.001). However, the difference in the maximum growth inhibition zone from that with the negative control group was significant. In addition, the antibacterial effect of the extract increased with an increase in its concentration. The extract exerted a greater antibacterial effect on S. mutans than on L. acidophilus. The plant polyphenols content is 3.7% which is equivalent to 29.93 g/ml. Conclusion: The root extract of A. officinalis exhibited antibacterial effects on S. mutans and L. acidophilus, but this effect was less than those of CHX mouthwash and penicillin. The antibacterial effect increased with an increase in the concentration of the extract. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to assess the efficacy of 0.1% curcumin mouthwash and to compare it with 0.2% chlorhexidine gluconate as an antiplaque agent and its effect on gingival inflammation. Materials and Methods: One hundred and fifty subjects, age between 20 and 30 years were recruited. Study population were randomly divided into three groups. In Group A, 50 subjects were advised the experimental mouthwash. Group B subjects used placebo mouthrinse, and chlorhexidine mouth wash was given to Group C. The subjects were advised to use 10 ml of mouthwash for 1 min twice a day 30 min after brushing. Parameters were recorded for plaque, gingival, and sulcus bleeding indices at day 0, 7, 14, and 28 days along with subjective assessment of taste. Results: On intragroup comparison between curcumin, chlorhexidine, and placebo mouthwash, the mean percentage reduction of the plaque index (PI) between 0 and 28 days were 0.58,0.57 and 1.17, respectively (P < 0.01), percentage reduction of gingival index (GI) between 0 and 28 days were 0.65, 0.66, and 1.09, respectively (P < 0.01) and sulcus bleeding index (SBI) showed a percentage reduction of 0.69, 0.66, and 1.13, respectively The intergroup comparison revealed chlorhexidine and curcumin mouthwash were statistically significant with P < 0.001 as compared to placebo. Conclusion: Curcumin mouthwash has shown an antiplaque and antigingivitis properties comparable to chlorhexidine mouthwash. Thus, curcumin mouthwash and chlorhexidine gluconate can be effectively used as an adjunct to scaling and root planning. [ABSTRACT FROM AUTHOR]

Background and Aim : Patients with complete dentures more occasionally neglect their denture and oral health by improper maintenance of dentures, resulting in bad oral and denture hygiene. This may lead to a host of multiple local and systemic problems such as stomatitis, bacterial and fungal infections, reservoirs for distant infections, denture stains and bad breath. Most denture wearers maintain their dentures with simple manual cleansing methods, which are not adequate to effectively sanitize the reservoir of microorganisms inhabiting the denture surfaces. The aim of this study was to compare the efficacy of the use of a denture cleanser and compare it with an adjunct use of chlorhexidine mouth rinse along with the denture cleanser and possibly suggest it as a suitable protocol. Materials and Methods : Two groups of complete denture patients were selected for the study. The total number of patients in each group was 12 and the total period of the study was 21 days. Three sets of microbiological samples were collected from each patient: before the start of the study, on day 8 and on day 21 of the study. The first sample was collected after an initial washover period (7 days) with plain water before the start of the study and the second set after 1 week of study initiation, where group-1 followed protocol-I (denture cleanser only) and group-2 followed protocol-II (denture cleanser and mouth rinse). A second washout period of 7 days followed and a crossover of the protocol was performed for the groups and followed for 1 week. Then, a third set of samples were collected. The colony-forming units were calculated for each patient for each sample and statistically analyzed. Friedman test for non-parametric analysis was employed for the comparison within the groups and a Mann-Whitney test was used for the statistical comparison between the groups. Results : There was a definite reduction in the bacterial numbers and a significant statistical difference after administering the protocols in both the groups (P < 0.001). However, there was little significance on comparing the samples between the groups (P=0.026) in the initial study period, and there was no statistical significance when comparing the groups after the crossover (P=0.140). Conclusion : The use of denture cleansers definitely reduced the microbial numbers as compared to plain manual cleansing methods in complete dentures. Although there was a substantial decrease in the bacterial colonies after the use of the mouthwash, it was not statistically significant.

Aim: The aim of this study is to compare the antiplaque and antigingivitis efficacy of 0.25% lemongrass oil mouthwash and 0.2% chlorhexidine mouthwash in patients undergoing fixed orthodontic treatment, who are suffering from gingivitis., Materials and Methods: A total of 60 patients undergoing fixed orthodontic treatment with mild-to-moderate gingivitis were selected for the study. The patients were randomly divided into three groups of twenty each, that is, group I: 0.25% lemongrass oil mouthwash ( n = 20); group II: 0.2% chlorhexidine mouthwash ( n = 20); and group III: oral prophylaxis ( n = 20). Baseline gingival index (GI) and plaque index (PI) were accessed followed by oral prophylaxis was done and the PI score was set to zero for all the patients. Patients were asked to swish their mouth with their respective mouthwashes and brushing (twice daily), that is, morning and before bedtime for 21 days. The PI and GI scores were recorded for all three groups on the 14th and the 21st days. The post hoc Bonferroni test was used for multiple comparisons of mean differences among variables after the application of the analysis of variance (ANOVA) test for comparison within the groups., Results: A lower PI and the GI were found in the lemongrass oil mouthwash group by the 14th and the 21st days, respectively, a statistically significant difference ( p < 0.001) compared to the chlorhexidine mouthwash group., Conclusion: The findings of the current study suggested that 0.25% lemongrass oil mouthwash has the potential to be used as a natural or herbal alternative to chlorhexidine mouthwash., Clinical Significance: It can be suggested that 0.25% lemongrass oil mouthwash may be a good herbal alternative to mouthwash containing 0.2% chlorhexidine gluconate.