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VOLUME 21 , ISSUE 12 ( December, 2020 ) > List of Articles


Caries Preventive and Antibacterial Effects of Two Natural Mouthwashes vs Chlorhexidine in High Caries-risk Patients: A Randomized Clinical Trial

Dina Kamal, Hassan Hassanein, Mai Akah, Mostafa A Abdelkawy, Heba Hamza

Keywords : Antibacterial effect, Caries preventive effect, Gum Arabic, Licorice, Natural mouthwashes, Oral side effects, Randomized clinical trial

Citation Information : Kamal D, Hassanein H, Akah M, Abdelkawy MA, Hamza H. Caries Preventive and Antibacterial Effects of Two Natural Mouthwashes vs Chlorhexidine in High Caries-risk Patients: A Randomized Clinical Trial. J Contemp Dent Pract 2020; 21 (12):1316-1324.

DOI: 10.5005/jp-journals-10024-2986

License: CC BY-NC 4.0

Published Online: 13-04-2021

Copyright Statement:  Copyright © 2020; Jaypee Brothers Medical Publishers (P) Ltd.


Aim and objective: To evaluate the caries preventive and antibacterial effects of Gum Arabic and Licorice mouthwashes vs chlorhexidine in high caries-risk patients. The prevalence of oral side effects from using the mouthwashes was also assessed. Materials and methods: Total 63 participants categorized as high caries-risk according to the CAMBRA caries-risk model were recruited. They were randomly allocated to three groups (n = 21) according to the mouthwash used: G1 (Gum Arabic), G2 (Licorice), and G3 (Chlorhexidine). Baseline DMF scores and saliva samples were obtained. DMF scores, salivary Streptococcus mutans (SM) and Lactobacillus acidophilus (LA) counts, and any reported oral side effects were recorded after 3, 6, 9, and 12 months. The obtained results were subjected to the statistical analysis and the significance level was set at p ≤ 0.05. Results: Regarding DMF scores, no statistically significant difference was found between the three groups at baseline, after 3, 6, and 9 months. After 12 months, a statistically significant difference was found between G3 and each of G1 and G2 where G3 showed significantly higher DMF scores (p < 0.001). No statistically significant difference was found between G1 and G2. Regarding antibacterial activity, after 6 months, all mouthwashes showed statistically significant antibacterial effect against SM and LA with no statistically significant difference between them (p < 0.001). After 9 and 12 months, G1 and G2 showed a statistically significant reduction in SM and LA counts (p < 0.001). However, G3 showed a statistically significant increase in SM and LA counts indicating bacterial resistance (p < 0.001). No oral side effects were reported in G1 and G2. On the other hand, several oral side effects were reported in G3. Conclusion: Gum Arabic and Licorice mouthwashes show promising caries preventive and antibacterial effects with no oral side effects reported. Clinical significance: Natural mouthwashes can serve as substitutes to chemical agents as chlorhexidine, providing effective caries control and safe long-term use.

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