Anticariogenic Effect of Moringa Oleifera Mouthwash Compared to Chlorhexidine Mouthwash

Summary

Moringa oleifera (MO) is an extraordinary nutritious vegetable tree with high medicinal value for its antibacterial properties. Formulation of various natural dental remedies from this plant and their testing for their effectiveness might yield promising antibacterial, antiplaque and anticariogenic agents with minimal side effects. Aim of the study: Part I: The aim of this in-vitro part of the study is to formulate a nontoxic mouthwash from MO leaves extract, having antimicrobial activity, to be used in part II of the study. Furthermore, stability and efficacy of the developed mouth wash will be evaluated. Part II: The aim of this randomized controlled trial is to evaluate the antibacterial, antiplaque and anticariogenic effect of MO mouthwash compared to chlorhexidine mouthwash.

Timeline

Start

2027-12

Primary completion

2028-11

Completion

2028-12

Publications

• Background Marsh PD. Dental plaque as a microbial biofilm. Caries Res. 2004 May-Jun;38(3):204-11. doi: 10.1159/000077756.
• Background Marsh PD, Martin MV. Oral microbiology. 5th edition. Edinburgh (UK): Churchil Livingstone; 2009. P 92-110
• Background Tanzer JM, Livingston J, Thompson AM. The microbiology of primary dental caries in humans. J Dent Educ. 2001 Oct;65(10):1028-37.
• Background Loesche WJ. Role of Streptococcus mutans in human dental decay. Microbiol Rev. 1986 Dec;50(4):353-80. doi: 10.1128/mr.50.4.353-380.1986. No abstract available.
• Background Marsh PD, Nyvad B. The oral microflora and biofilms on teeth. In: Fejerskov O, Kidd E, editors. Dental caries. The disease and its clinical management. 2nd edition. Oxford: Blackwell; 2008. p. 163-87.
• Background Marsh PD. Microbiology of dental plaque biofilms and their role in oral health and caries. Dent Clin North Am. 2010 Jul;54(3):441-54. doi: 10.1016/j.cden.2010.03.002.
• Background Silverstone LM, Hicks MJ, Featherstone MJ. Dynamic factors affecting lesion initiation and progression in human dental enamel. Part I. The dynamic nature of enamel caries. Quintessence Int. 1988 Oct;19(10):683-711. No abstract available.
• Background Al-Obaidi R, Salehi H, Desoutter A, Bonnet L, Etienne P, Terrer E, Jacquot B, Levallois B, Tassery H, Cuisinier FJG. Chemical & Nano-mechanical Study of Artificial Human Enamel Subsurface Lesions. Sci Rep. 2018 Mar 6;8(1):4047. doi: 10.1038/s41598-018-22459-7.
• Background Mini KJ, Anulekh B, Anupama G. Incipient caries: an early intervention approach. Int J Community Med Public Health 2015; 2(1):10-14
• Background Wennerholm K, Lindquist B, Emilson CG. The toothpick method in relation to other plaque sampling techniques for evaluating mutans streptococci. Eur J Oral Sci. 1995 Feb;103(1):36-41. doi: 10.1111/j.1600-0722.1995.tb00008.x.
• Background Dasanayake AP, Caufield PW, Cutter GR, Roseman JM, Kohler B. Differences in the detection and enumeration of mutans streptococci due to differences in methods. Arch Oral Biol. 1995 Apr;40(4):345-51. doi: 10.1016/0003-9969(94)00164-7.
• Background Pitts N. "ICDAS"--an international system for caries detection and assessment being developed to facilitate caries epidemiology, research and appropriate clinical management. Community Dent Health. 2004 Sep;21(3):193-8. No abstract available.
• Background Ismail AI, Sohn W, Tellez M, Amaya A, Sen A, Hasson H, Pitts NB. The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries. Community Dent Oral Epidemiol. 2007 Jun;35(3):170-8. doi: 10.1111/j.1600-0528.2007.00347.x.
• Background Braga MM, Oliveira LB, Bonini GA, Bonecker M, Mendes FM. Feasibility of the International Caries Detection and Assessment System (ICDAS-II) in epidemiological surveys and comparability with standard World Health Organization criteria. Caries Res. 2009;43(4):245-9. doi: 10.1159/000217855. Epub 2009 May 8.
• Background Almosa NA, Lundgren T, Bresin A, Birkhed D, Kjellberg H. Diagnosing the severity of buccal caries lesions in orthodontic patients at de-bonding using digital photographs. Acta Odontol Scand. 2014 Aug;72(6):474-80. doi: 10.3109/00016357.2013.865788. Epub 2013 Dec 9.
• Background Preus HR, Aass AM, Hansen BF, Moe B, Gjermo P. A randomized, single-blind, parallel-group clinical study to evaluate the effect of soluble beta-1,3/1,6-glucan on experimental gingivitis in man. J Clin Periodontol. 2008 Mar;35(3):236-41. doi: 10.1111/j.1600-051X.2007.01183.x.
• Background LOE H, THEILADE E, JENSEN SB. EXPERIMENTAL GINGIVITIS IN MAN. J Periodontol (1930). 1965 May-Jun;36:177-87. doi: 10.1902/jop.1965.36.3.177. No abstract available.
• Background Theilade E, Wright WH, Jensen SB, Loe H. Experimental gingivitis in man. II. A longitudinal clinical and bacteriological investigation. J Periodontal Res. 1966;1:1-13. doi: 10.1111/j.1600-0765.1966.tb01842.x. No abstract available.
• Background Cobb CM. Non-surgical pocket therapy: mechanical. Ann Periodontol. 1996 Nov;1(1):443-90. doi: 10.1902/annals.1996.1.1.443. No abstract available.
• Background Pradeep AR, Suke DK, Martande SS, Singh SP, Nagpal K, Naik SB. Triphala, a New Herbal Mouthwash for the Treatment of Gingivitis: A Randomized Controlled Clinical Trial. J Periodontol. 2016 Nov;87(11):1352-1359. doi: 10.1902/jop.2016.130406. Epub 2016 Jul 21.
• Background Budtz-Jorgensen E, Loe H. Chlorhexidine as a denture disinfectant in the treatment of denture stomatitis. Scand J Dent Res. 1972;80(6):457-64. doi: 10.1111/j.1600-0722.1972.tb00314.x. No abstract available.
• Background Manipal S, Hussain S, Wadgave U, Duraiswamy P, Ravi K. The Mouthwash War - Chlorhexidine vs. Herbal Mouth Rinses: A Meta-Analysis. J Clin Diagn Res. 2016 May;10(5):ZC81-3. doi: 10.7860/JCDR/2016/16578.7815. Epub 2016 May 1.
• Background Charles CH, Mostler KM, Bartels LL, Mankodi SM. Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial. J Clin Periodontol. 2004 Oct;31(10):878-84. doi: 10.1111/j.1600-051X.2004.00578.x.
• Background Rath SK, Singh M. Comparative clinical and microbiological efficacy of mouthwashes containing 0.2% and 0.12% chlorhexidine. Dent Res J (Isfahan). 2013 May;10(3):364-9.
• Background Ruiz-Linares M, Ferrer-Luque CM, Arias-Moliz T, de Castro P, Aguado B, Baca P. Antimicrobial activity of alexidine, chlorhexidine and cetrimide against Streptococcus mutans biofilm. Ann Clin Microbiol Antimicrob. 2014 Aug 20;13:41. doi: 10.1186/s12941-014-0041-5.
• Background Fischman SL. The history of oral hygiene products: how far have we come in 6000 years? Periodontol 2000. 1997 Oct;15:7-14. doi: 10.1111/j.1600-0757.1997.tb00099.x.
• Background Abd Rani NZ, Husain K, Kumolosasi E. Moringa Genus: A Review of Phytochemistry and Pharmacology. Front Pharmacol. 2018 Feb 16;9:108. doi: 10.3389/fphar.2018.00108. eCollection 2018.
• Background Khawaja TM, Tahira M, Ikram UK. Moringa oleifera: a natural gift - A review. J Pharm Sci Res. 2010; 2:775-81
• Background Mehta K, Balaraman R, Amin AH, Bafna PA, Gulati OD. Effect of fruits of Moringa oleifera on the lipid profile of normal and hypercholesterolaemic rabbits. J Ethnopharmacol. 2003 Jun;86(2-3):191-5. doi: 10.1016/s0378-8741(03)00075-8.
• Background Fahey W. J. (2005). Moringa oleifera: a review of the medical evidence for its nutritional, therapeutic, and prophylactic properties. Part 1. Trees Life J. 1, 1-24
• Background Farooq, F., M. Rai, A. Tiwari, A. Khan, S. Farooq. Medicinal properties of Moringa oleifera: An overview of promising healer. J. of Medicinal Plants Research, 2012; 6(27): 4368-4374
• Background Mahdi, HarithJameel & Yousif, EmadMuthana & Khan, NurzalinaAbdulKarim & Mahmud, Roziahanim & Murugaiyah, Vikneswaran & Asmawi, Mohd. (2016). OPTIMIZING EXTRACTION CONDITIONS OF MORINGA OLEIFERA LAM LEAF FOR PERCENT YIELD, TOTAL PHENOLICS CONTENT, TOTAL FLAVONOIDS CONTENT AND TOTAL RADICAL SCAVENGING ACTIVITY.. International Journal of Advanced Research. 4. 682-695. 10.21474/IJAR01/2133.
• Background Caceres A, Cabrera O, Morales O, Mollinedo P, Mendia P. Pharmacological properties of Moringa oleifera. 1: Preliminary screening for antimicrobial activity. J Ethnopharmacol. 1991 Jul;33(3):213-6. doi: 10.1016/0378-8741(91)90078-r.
• Background Abdull Razis AF, Ibrahim MD, Kntayya SB. Health benefits of Moringa oleifera. Asian Pac J Cancer Prev. 2014;15(20):8571-6. doi: 10.7314/apjcp.2014.15.20.8571.
• Background Elgamily H, Moussa A, Elboraey A, El-Sayed H, Al-Moghazy M, Abdalla A. Microbiological Assessment of Moringa Oleifera Extracts and Its Incorporation in Novel Dental Remedies against Some Oral Pathogens. Open Access Maced J Med Sci. 2016 Dec 15;4(4):585-590. doi: 10.3889/oamjms.2016.132. Epub 2016 Nov 28.
• Background Fajriani MS, Intania N. Effectiveness of Gargle with extract of leaf moringa (Moringa Oleifera)to plaque formation for ECC (Early Childhood Caries). Journal of Baghdad college of dentistry 2018; 23(2): 110-113
• Background Hartoyo M, Purnomo SE , Budiyati , Lestari KP, Sawab. The Effect of Mouth washing with Moringa Olivera to acidity saliva level of Diabetes Mellitus Patients. JMSCR 2017 ; 5(12): 32092-32096
• Background Pithon MM, Sant'Anna LI, Baiao FC, dos Santos RL, Coqueiro Rda S, Maia LC. Assessment of the effectiveness of mouthwashes in reducing cariogenic biofilm in orthodontic patients: a systematic review. J Dent. 2015 Mar;43(3):297-308. doi: 10.1016/j.jdent.2014.12.010. Epub 2015 Jan 6.
• Background LOE H, SILNESS J. PERIODONTAL DISEASE IN PREGNANCY. I. PREVALENCE AND SEVERITY. Acta Odontol Scand. 1963 Dec;21:533-51. doi: 10.3109/00016356309011240. No abstract available.
• Background Marsh PD, Nyvad B. The oral microflora and biofilms on teeth. In: Fejerskov O, Kidd E, editors. Dental caries. The disease and its clinical management. 2nd edition. Oxford: Blackwell; 2008. p. 163-87
• Background Zhao B. , Deng J, Li H, Yaqiang He, Tao Lan, Di Wu, Haodi Gong, Yan Zhang, and Zhicheng Chen , Optimization of Phenolic Compound Extraction from Chinese Moringa oleifera Leaves and Antioxidant Activities Beibei , Journal of Food Quality. 2019; 2019:1-14
• Background Seleshe S, Kang SN. In Vitro Antimicrobial Activity of Different Solvent Extracts from Moringa stenopetala Leaves. Prev Nutr Food Sci. 2019 Mar;24(1):70-74. doi: 10.3746/pnf.2019.24.1.70. Epub 2019 Mar 31.
• Background Vermerie N, Malbrunot C, Azar M, Arnaud P. Stability of nystatin in mouthrinses; effect of pH temperature, concentration and colloidal silver addition, studied using an in vitro antifungal activity. Pharm World Sci. 1997 Aug;19(4):197-201. doi: 10.1023/a:1008664917377.
• Background Murakami S, Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Periodontol. 2018 Jun;89 Suppl 1:S17-S27. doi: 10.1002/JPER.17-0095.
• Background Sanchez-Perez L, Acosta-Gio AE, Mendez-Ramirez I. A cluster analysis model for caries risk assessment. Arch Oral Biol. 2004 Sep;49(9):719-25. doi: 10.1016/j.archoralbio.2004.02.012.
• Background Hefti AF, Preshaw PM. Examiner alignment and assessment in clinical periodontal research. Periodontol 2000. 2012 Jun;59(1):41-60. doi: 10.1111/j.1600-0757.2011.00436.x.
• Background Chitharanjan S, Mithra N, Darshana D. Correlation between dental caries with salivary flow, pH, and buffering capacity in adult South Indian population: an in vivo study. Int. J. Res. Ayurveda Pharm 2013; 4(2): 219-223
• Background Sakeenabi B, Hiremath SS. Dental caries experience and salivary Streptococcus mutans, lactobacilli scores, salivary flow rate, and salivary buffering capacity among 6-year-old Indian school children. J Int Soc Prev Community Dent. 2011 Jul;1(2):45-51. doi: 10.4103/2231-0762.97697.
• Background Lindquist B, Emilson CG. Dental location of Streptococcus mutans and Streptococcus sobrinus in humans harboring both species. Caries Res. 1991;25(2):146-52. doi: 10.1159/000261358.
• Background SILNESS J, LOE H. PERIODONTAL DISEASE IN PREGNANCY. II. CORRELATION BETWEEN ORAL HYGIENE AND PERIODONTAL CONDTION. Acta Odontol Scand. 1964 Feb;22:121-35. doi: 10.3109/00016356408993968. No abstract available.
• Background Lobene RR. Effect of dentifrices on tooth stains with controlled brushing. J Am Dent Assoc. 1968 Oct;77(4):849-55. doi: 10.14219/jada.archive.1968.0298. No abstract available.
• Background Ainamo J, Bay I. Problems and proposals for recording gingivitis and plaque. Int Dent J. 1975 Dec;25(4):229-35.

Drugs

Indications