Anti-inflammatory effect and inhibition of Streptococcus mutans using a Moringa oleifera based mouthwash

Abstract

Introduction: Gingivitis is an infectious inflammatory process that can occur due to oral biofilm problems. Promotion and prevention programs are based on the motivation that can be generated in individuals and populations about making changes in hygiene habits with the aim of reducing the concentration of pathogenic microorganisms such as S. mutans, which is responsible for bacterial aggregation and congregation in the mouth. Early detection of gingivitis, biofilm control through the correct brushing technique and mouthwashes can prevent periodontitis, a condition that affects other supporting tissues such as bone and ligaments, producing gingival retraction, mobility and separation of teeth, hypersensitivity, pain, halitosis, and recurrent infectious processes. Moringa oleifera is considered a plant with medicinal properties, used to treat dental diseases. However, phytotherapy in dental care is not well known and is rarely used. Research has confirmed antimicrobial, anti-plaque, analgesic, healing, antioxidant, and anti-inflammatory effects. Objective: Evaluate the anti-inflammatory effect and inhibition of Streptococcus mutans with the use of mouthwash based on Moringa oleifera (MO) and the use of an electric toothbrush. Methods: 40 first-year dentistry students participated. After signing informed consent, they were divided into groups: 20 (G1) used Moringa oleifera mouthwash (10G1A electric toothbrush, 10 G1B manual brush) and 20 (G2) without mouthwash (10 G2A electric toothbrush®, 10 G2B manual toothbrush®). Consecutively, they received oral hygiene instruction, a saliva sample was taken to determine the Streptococcus mutans load and the following clinical parameters were taken: Probing Depth, Bleeding on probing Index, Oleary Plaque Index and Löe & Silness Gingival Index. They were measured at the beginning of the study and after four weeks. Results: 52.56% of participating students were female with an average age of 20 years. There were statistically significant differences in the effectiveness of the MO mouthwash in terms of gingivitis. The means of the inflammation indices (Löe-Silness), Probing Depth and BOP Index (bleeding), (0.915, 2.14 mm, 12.9%), respectively, and after 4 weeks of using the rinse were (0.21, 1.89 mm, 6.2%), respectively. In relation to dental plaque, it decreased (23.95% to 10.02%) and S. mutans cfu/ml (860,000 to 450,000). Toothbrushing is a fundamental part of oral hygiene that allows the removal of biofilm. In this study, the electric toothbrush was slightly more effective than the manual one. Conclusions: First-year dental students presented mild, moderate, and severe gingival inflammation, which, with the use of mouthwash supplemented with brushing, had a significant effect in reducing the severity of inflammation and Streptococcus mutans. However, more research with a higher N and longer clinical evaluation is required before concrete recommendations can be made.