Comparative Evaluation of Antimicrobial Effects of Herbal Extracts Incorporated in Dentifrices among Adults: An In-vitro Study and a Double Blinded Randomized Control Trial

Abstract

Introduction: A positive correlation has been observed between Streptococcus mutans, Candida albicans and periodontal diseases. Several substances including synthetic chemicals and natural agents have shown promising antimicrobial activity against the S. mutans- C. albicans complex. Extracts of Aloe Vera, Triphala, Tulsi, Pomegranate, and Acacia catechu have established therapeutic effects in medicine. The aim of the study was to evaluate the antimicrobial activity and the Minimum Inhibitory Concentration (MIC) of five herbal extracts in-vitro and to compare the antibacterial effects of 5 dentifrices containing the herbal extracts and a commercially available dentifrice on the plaque sample counts of S. mutans and C. albicans in-vivo Methodology: Extracts were obtained using a standardized method. Minimum inhibitory concentration was calculated for the test microorganisms using modified agar-well diffusion and macro broth dilution technique and the inhibition zone diameters were calculated. Dentifrices containing the extracts were formulated and the in vivo antimicrobial activity was evaluated by studying the CFU count from plaque samples of 420 participants.  Results: Highest antimicrobial activity against S Mutans and C albicans was shown by Acacia catechu and Tulsi respectively and least was by pomegranate. Mean reduction in microbial counts (CFU/ml) by inoculating nutrient broth from baseline to 60 days was highest in Acacia catechu and Triphala for S Mutans and C albicans respectively. All herbal extracts performed better than the commercially available toothpaste. Conclusion: Dentifrices with herbal extracts of Aloe Vera, Triphala, Tulsi, Pomegranate, and Acacia catechu could serve as an alternative to commercially available dentifrices for treating oral diseases whose causative organisms are S. mutans and C. albicans.