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The Inhibitory and Antibacterial Effects of Peppermint Essential Oil on Periodontal Photogenes
Objectives/Aims
To evaluate the antimicrobial activity of a newly developed foam mouthwash containing a modified lactoperoxidase system in vitro.
Materials and methods
Biofilms of five bacterial species were developed on hydrophobic and hydrophilic surfaces whilst salivary-based biofilm was grown on tooth enamel. Each surface was exposed to the foam mouthwash or saline in vitro. Optical density and scanning electron microscopy (SEM) was used to determine retention of the biofilm following 5 or 30 s exposure time.
Results
The foam mouthwash was active against biofilms formed by S. aureus, K. rhizophila, M. thailandicus, E. coli, and C. violaceum and eliminated significant amount of biofilm from each surface; immature 4 h biofilm was less resistant than 24 h biofilm. A 30 s rinse showed best performance, with removal of up to 66% of biofilm from the hydrophilic surface. SEM imaging confirmed oral biofilm removal from the enamel surface after a 5 s rinse with the foam mouthwash.
Discussion
Foam mouthwash demonstrated a significant impact on growing biofilm when compared against saline solution. Growing biofilms were more susceptible to the action of the foam mouthwash, which justifies after-meal use of the mouthwash when traditional dentifrices may not be accessible.
Conclusions
Foam mouthwash can be a convenient on-the-go format of oral care products that can be used after meals or when needed to reduce the risk of biofilm-associated oral conditions.
Despite many discoveries over the past 20 years regarding the etio-pathogenesis of periodontal and peri-implant diseases, as well as significant advances in our understanding of microbial biofilms, the incidence of these pathologies still continues to rise. This review presents a general overview of the main protagonists and phenomena involved in oral health and disease. A special emphasis on the role of certain keystone pathogens in periodontitis and peri-implantitis is underlined. Their capacity to bring a dysregulation of the homeostasis with their host and the microbial biofilm lifestyle are also discussed. Finally, the current treatment principles of periodontitis and peri-implantitis are presented and their limits exposed. This leads to realize that new strategies must be developed and studied to overcome the shortcomings of existing approaches.
The oral cavity harbors hundreds of microbial species that are present either as planktonic cells, or incorporated into biofilms. The majority of the oral microbes are commensal organisms. Those that are pathogenic microbes can result in oral infections, and at times initiate systemic diseases. Biofilms that contain pathogens have been challenging to control. Many conventional antimicrobials have proven to be ineffective. Recent advances in science and technology are providing new approaches for pathogen control and containment and methods to characterize biofilms. This perspective provides: 1) A general understanding of biofilm development; 2) A description of emerging chemical and biological methods to control oral biofilms; 3) An overview of high-throughput analytical approaches to analyze biofilms.
The chemical composition of the essential oils was influenced by many factors including extraction methods. In this study, the effect of extraction methods; hydrodistillation, microwave assisted hydrodistillation and solvent free microwave extraction of Mentha piperita L. growing in Taif, KSA, on the yield and chemical composition of their essential oils were investigated. Furthermore, the oils were in vitro investigated as antimicrobial and anticancer agents. The results showed no great difference between the oil yields obtained by the three different methods but the methods which used microwave were rapid, saving time and energy than classical hydrodistillation. The qualitative chemical compositions of the oils were similar with little quantitative differences of some compounds between the three methods. All oils consists mainly of monoterpenes and sesquiterpenes in which carvone is the main component of M. piperita (carvone chemotype). All essential oils showed moderate in vitro anticancer activity and high antimicrobial activity. In conclusion, this considered to be the first study represented the effect of microwave extraction on the essential oil chemical composition of M. piperita growing in Taif, KSA. The authors recommended the usage of microwave method in the extraction of essential oils because it is energy and time saving, in addition to environment friendly. © 2018 Oriental Scientific Publishing Company. All rights reserved.
Periodontal diseases are prevalent both in developed and developing countries and affect about 20-50% of global population. High prevalence of periodontal disease in adolescents, adults, and older individuals makes it a public health concern. Several risk factors such as smoking, poor oral hygiene, diabetes, medication, age, hereditary, and stress are related to periodontal diseases. Robust evidence shows the association of periodontal diseases with systemic diseases such as cardiovascular disease, diabetes, and adverse pregnancy outcomes. Periodontal disease is likely to cause 19% increase in the risk of cardiovascular disease, and this increase in relative risk reaches to 44% among individuals aged 65 years and over. Type 2 diabetic individuals with severe form of periodontal disease have 3.2 times greater mortality risk compared with individuals with no or mild periodontitis. Periodontal therapy has been shown to improve glycemic control in type 2 diabetic subjects. Periodontitis is related to maternal infection, preterm birth, low birth weight, and preeclampsia. Oral disease prevention strategies should be incorporated in chronic systemic disease preventive initiatives to curtail the burden of disease in populations. The reduction in the incidence and prevalence of periodontal disease can reduce its associated systemic diseases and can also minimize their financial impact on the health-care systems. It is hoped that medical, dental practitioners, and other health-care professionals will get familiar with perio-systemic link and risk factors, and need to refer to the specialized dental or periodontal care.
Background
Plant extracts mixture (PEM) and its individual constituent plant extracts(Psidium sp., Mangifera sp., Mentha sp.) are known to have an anti-adhering effect towards oral bacteria in the single-species biofilm. To date, the adhering ability of the early and late plaque colonisers (Streptococcus sanguinis and Streptococcus mutans) to PEM-treated experimental pellicle have not been investigated in dual-species biofilms.
Methods
Fresh leaves of these plants were used in the preparation of the respective aqueous extract decoctions. The minimum inhibitory concentration (MIC) of the extracts towards S. sanguinis ATCC BAA-1455 and S. mutans ATCC 25175 was determined using a two-fold serial microdilution method. The sum of fractional inhibitory concentration (ΣFIC) index of PEM and its constituent plant extracts was calculated using the MIC values of the plants. The minimum bactericidal concentration (MBC) of the plant extracts was also determined. The anti-adherence effect of the plant extracts (individually and mixed) was carried out by developing simulated S. sanguinis and S. mutans respectively in single- and dual-species of biofilms in the Nordini’s Artificial Mouth (NAM) model system in which the experimental pellicle was pretreated with the plant extract before bacterial inoculation. The bacterial population in the respective biofilms was quantified using ten-fold serial dilutions method and expressed as colony forming unit per ml (CFU/ml). The bacterial population was also viewed using Scanning Electron Microscope (SEM). All experiments were done in triplicate.
Results
The PEM compared with its respective constituent plants showed the lowest MIC towards S. sanguinis (3.81 mg/ml) and S. mutans (1.91 mg/ml) and exhibited a synergistic effect. The Psidium sp. (15.24 mg/ml) and, PEM and Psidium sp. (30.48 mg/ml) showed the lowest MBC towards S. sanguinis and S. mutans respectively. The anti-adherence effect of the PEM and its respective constituent plants (except Psidium sp.) was different for the two bacteria in the single-species biofilm. In the dual-species biofilms, PEM demonstrated similar anti-adherence effect towards S. sanguinis and S. mutans. The proportions of the bacterial population viewed under SEM appeared to be in agreement with the quantified population.
Discussion
The combination of the active constituents of the individual plant extracts in PEM may contribute to its low MIC giving rise to the synergistic effect. The different anti-adherence effect towards S. sanguinis and S. mutans in both single- and dual-species biofilms could be due to the different proportion of the active constituents of the extracts and the interaction between different bacteria. The better adhering ability of S. sanguinis towards the PEM-treated pellicle when present together with S. mutans in the dual-species biofilms may suggest the potential of PEM in controlling the balance between the early and late colonisers in biofilms.
Various plant extracts have great potential against infectious agents and can be used for therapeutic purposes. This study was carried out to evaluate the antimicrobial activities of peppermint (Mentha piperita) extracts against 10 multidrug resistant (MDR) pathogenic bacterial clinical isolates.The antibacterial activities of ethanol, methanol, ethyl acetate and chloroform peppermint extracts were assessed using the standard minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) methods. Overall, the ethyl acetate extract of peppermint had strong growth inhibitory effects on the tested pathogens, followed by the chloroform, ethanol and methanol extracts. The inhibitory activity of the ethyl acetate extract against all Gram-negative pathogens was higher than that of chloroform (10-80. mg/ml), methanol (10-(>80. mg/ml) and ethanol (40-(>80. mg/ml). The lowest MIC value was seen for . Streptococcus pyogenes (1.25. mg/ml for ethyl acetate extract), followed by methicillin-resistant . Staphylococcus epidermidis (MRSE) and . Enterococcus faecalis (2.5. mg/ml for ethyl acetate extract).The MBC values of all extracts were higher than the corresponding MIC values for the majority of pathogens. This study highlights the potential antibacterial activity for . M. piperita extracts, especially the ethyl acetate extract, against MDR . S. pyogenes, E. faecalis, methicillin-resistant . Staphylococcus aureus (MRSA), MRSE and carbapenem-resistant . E. coli, and . Klebsiella pneumonia clinical isolates. Further . in vitro and . in vivo studies on a large number of clinical isolates of MRSA, . Acinetobacter baumannii and . Stenotrophomonas maltophilia are necessary to further investigate and standardize the inhibitory effect of peppermint extracts against these emerging pathogens.
For decades, physicians and dentists have paid close attention to their own respective fields, specializing in medicine pertaining to the body and the oral cavity, respectively. However, recent findings have strongly suggested that oral health may be indicative of systemic health. Currently, this gap between allopathic medicine and dental medicine is quickly closing, due to significant findings supporting the association between periodontal disease and systemic conditions such as cardiovascular disease, type 2 diabetes mellitus, adverse pregnancy outcomes, and osteoporosis. Significant effort has brought numerous advances in revealing the etiological and pathological links between this chronic inflammatory dental disease and these other conditions. Therefore, there is reason to hope that the strong evidence from these studies may guide researchers towards greatly improved treatment of periodontal infection that would also ameliorate these systemic illnesses. Hence, researchers must continue not only to uncover more information about the correlations between periodontal and systemic diseases but also to focus on positive associations that may result from treating periodontal disease as a means of ameliorating systemic diseases.
Although Streptococcus mutans has been implicated as a major etiological agent of dental caries, our cross-sectional preliminary study indicated that 10%
of subjects with rampant caries in permanent teeth do not have detectable levels of S. mutans. Our aims were to use molecular methods to detect all bacterial species associated with caries in primary and permanent teeth
and to determine the bacterial profiles associated with different disease states. Plaque was collected from 39 healthy controls
and from intact enamel and white-spot lesions, dentin lesions, and deep-dentin lesions in each of 51 subjects with severe
caries. 16S rRNA genes were PCR amplified, cloned, and sequenced to determine species identities. In a reverse-capture checkerboard
assay, 243 samples were analyzed for 110 prevalent bacterial species. A sequencing analysis of 1,285 16S rRNA clones detected
197 bacterial species/phylotypes, of which 50% were not cultivable. Twenty-two new phylotypes were identified. PROC MIXED
tests revealed health- and disease-associated species. In subjects with S. mutans, additional species, e.g., species of the genera Atopobium, Propionibacterium, and Lactobacillus, were present at significantly higher levels than those of S. mutans. Lactobacillus spp., Bifidobacterium dentium, and low-pH non-S. mutans streptococci were predominant in subjects with no detectable S. mutans. Actinomyces spp. and non-S. mutans streptococci were predominant in white-spot lesions, while known acid producers were found at their highest levels later
in disease. Bacterial profiles change with disease states and differ between primary and secondary dentitions. Bacterial species
other than S. mutans, e.g., species of the genera Veillonella, Lactobacillus, Bifidobacterium, and Propionibacterium, low-pH non-S. mutans streptococci, Actinomyces spp., and Atopobium spp., likely play important roles in caries progression.
Unmet dental needs and untreated dental decay represent a significant disease burden for children and adults.
Background:
Through a systematic literature review, the authors evaluated the use of chlorhexidine (CHX) mouthwash as an adjunct to mechanical periodontal therapy for chronic periodontitis.
Types of studies reviewed:
The authors performed a systematic search by using PubMed (MEDLINE), Scopus, Scientific Electronic Library Online, and Cochrane Central Register of Controlled Trials. The authors selected randomized controlled clinical trials in which the investigators evaluated the probing depth (PD) and clinical attachment level (CAL) in test groups by using CHX as an adjuvant and in control groups and subject to mechanical periodontal therapy (scaling and root planing [SRP] 4-6 visits or 24 hours).
Results:
The literature search resulted in 8 articles, which the authors then assessed for quality. After testing for heterogeneity, the authors performed a meta-analysis only in the SRP group with 4 to 6 visits. Results were positive for both PD and CAL with use of CHX. However, the summary measure was significant (P < .05) only for PD at 40 to 60 days (0.33 millimeters; 95% confidence interval, 0.08 to 0.58 mm) and 180 days (0.24 mm; 95% confidence interval, 0.02 to 0.47 mm) of follow-up, showing positive results for the use of CHX at those times. Although those differences were statistically significant, they could be interpreted as clinically slight.
Conclusions and practical implications:
Adjunctive use of CHX mouthrinse with mechanical SRP resulted in slightly greater PD reduction than did SRP alone. Clinicians must consider the small additional gain in PD reduction, negligible effect on CAL, and potential for tooth staining when using CHX as an adjunct to SRP in treating chronic periodontitis.
Link to full-text:
https://authors.elsevier.com/a/1Ux4k_46QvsIY
The use of oral gargle has gained popularity recently. Despite being either alcohol-based or plant-based, the main purpose for the usage of oral gargle is to prevent the accumulation of heavy plaque or oral malodour, that usually caused by the growth of oral biofilm. In this study, the antimicrobial effect of Psidium guajava, Mangifera sp. and Mentha sp. was tested against the single-species biofilm consisting of Streptococcus sanguinis and Streptococcus mitis. The biofilms were allowed to grow on the saliva-coated glass beads in Nordini’s Artificial Mouth (NAM) model to represent the oral cavity for 24 hours. The saliva would form the experimental pellicle on the glass beads. The results obtained showed that biofilm of Streptococcus mitis displayed a maximum adherence (11.53%) compared to Streptococcus sanguinis (1.83%) on the untreated experimental pellicle. When the aqueous extraction of plant extract was applied on the experimental pellicle, the bacterial adherence was significantly reduced to 1.54% (Streptococcus mitis) and 0.21% (Streptococcus sanguinis). This result indicates that the selected plant extracts can be used to inhibit the heavy growth of oral biofilm.
Background:
With the increasing incidence of periodontal diseases and development of antibiotic resistance, the global need for alternative treatment modalities, safe, effective, and economical products is the need of time. Aloe vera is a medicinal plant which has the greater medicinal value and enormous properties for curing and preventing oral diseases disease.
Aim:
The aim of the study was to access the effect of Aloe vera mouthwash on the dental plaque and gingivitis and comparing it with the bench mark control chlorhexidine and placebo.
Material and methods:
345 healthy subjects were randomly allocated in 3 groups to the test group (n=115) - mouthwash containing Aloe vera, Control group (n=115) -chlorhexidene group, Distilled water - Placebo (n=115) . Plaque Index (PI) and Gingival Index (GI) were assessed at days 0, 15 and 30. Subjects were asked to rinse their mouth with the stated mouthwash, twice a day, during a 30-day period.
Results:
Our result showed that Aloe vera mouthrinse is equally effective in reducing periodontal indices as Chlorhexidine. The results demonstrated a significant reduction of gingival bleeding and plaque indices in both groups over a period of 15 and 30 days as compared to placebo group. There was a significant reduction on plaque and gingivitis in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them (p>0.05). Aloe vera mouthwash showed no side effects as seen with chlorhexidine.
Conclusion:
The results of the present study indicate that Aloe vera may prove to be an effective mouthwash owing to its ability in reducing periodontal indices.
The effects of the, essential oils of peppermint (Mentha piperita L.), spearmint Mentha spicata L.) and Japanese mint (Mentha, arvensis L.), of four major constituents of the esssential oil of peppermint, and of three major constituents of the essential oil of spearmint, on the proliferation of Helicobacter pylori, Salmonella enteritidis, Escherichia coli O157:H7, methicillin-resistant Staphylococcus aureus (MRSA) and methicillin sensitive Staphylococccus aureus (MSSA) were examined. The essential oils and the various constituents inhibited the proliferation of each strain in liquid culture in a dose-dependent manner. In addition, they exhibited bactericidal activity in phosphate-buffered saline. The antibacterial activities varied among the bacterial species tested but were almost the same against antibiotic-resistant and antibiotic-sensitive strains of Helicobacter pylori and S. aureus. Thus, the essential oils and their constituents may be useful as potential antibacterial agents for inhibition of the growth of pathogens.
The interaction between saliva-coated tooth surfaces and pathogenic bacteria is partly governed by electrostatic and hydrophobic interactions, providing a solid rationale for using chemical agents as part of a plaque-control routine. Chlorhexidine works in several ways. For example, it binds to salivary mucins on the bacterial cell membrane, and penetrates the plaque biofilm. Essential oil (EO) mouthwashes kill micro-organisms by disrupting their cell walls and inhibiting their enzymic activity. They prevent bacterial aggregation, slow multiplication and extract endotoxins. Recent studies have shown that bacterial phenotypes are altered when organisms change from a planktonic to a sessile state. This suggests that an effective mouthwash must also penetrate the plaque biofilm. Two studies have demonstrated the ability of an EO mouthwash to penetrate the plaque biofilm.
Between 3-12 weeks after the beginning of supragingival plaque formation, a distinctive subgingival microflora predominantly made up of gram-negative, anaerobic bacteria and including some motile species, becomes established. In order to establish in a periodontal site, a species must be able to attach to one of several surfaces including the tooth (or host derived substances adhering to the tooth), the sulcular or pocket epithelium, or other bacterial species that are attached to these surfaces (Socransky and Haffajee 1991). Bacterial adhesion has demonstrated specificity in the mechanisms involved and studies have shown that there is a diversity of receptors on tooth surfaces, epithelial or other host cells and other bacteria. Recent studies have described bacterial complexes that are present in subgingival plaque and these studies are likely to help in current understanding of the complex ecology observed in dental plaque biofilm (Socransky, Haffajee et al. 1998). Bacterial interactions play important roles in species survival. Some interspecies relationships are favourable, in that one species produces growth factors for, or facilitates attachment of, another species. Other relationships are antagonistic due to competition for nutrients and binding sites, or to the production of substances that limit or prevent the growth of another species (Socransky and Haffajee 1991). A number of different bacterial interactions within plaque biofilm have been discussed. In the last 30-40 years, a vast amount of evidence has been published to suggest that bacteria are the primary aetiological agents of periodontal diseases. In the 1950s and early 1960s, periodontal treatment was based on the non-specific plaque hypothesis. However, the non-specific plaque hypothesis gave way after studies suggested that not all organisms in plaque are equally capable of causing destructive periodontal disease. Thus the concept of specificity re-emerged. Criteria for defining periodontal pathogens have been developed and include association, elimination, host response, virulence factors, animal studies and risk assessment (Haffajee and Socransky 1994). Until recently there were few consensus periodontal pathogens and trying to discriminate pathogenic from non-pathogenic species has been a difficult task for dental researchers for a variety of reasons. A discussion of the specific microbiota associated with gingivitis, chronic and aggressive periodontitis, NUG, HIV-associated periodontitis and implantitis has been presented. The bacteria associated with periodontal diseases are predominantly gram-negative anaerobic bacteria and may include A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus, C. rectus, E. nodatum, P. micros, S. intermedius and Treponema sp. The bacterial numbers associated with disease are up to 10(5) times larger than those associated with health.
The periodontal diseases are highly prevalent and can affect up to 90% of the worldwide population. Gingivitis, the mildest form of periodontal disease, is caused by the bacterial biofilm (dental plaque) that accumulates on teeth adjacent to the gingiva (gums). However, gingivitis does not affect the underlying supporting structures of the teeth and is reversible. Periodontitis results in loss of connective tissue and bone support and is a major cause of tooth loss in adults. In addition to pathogenic microorganisms in the biofilm, genetic and environmental factors, especially tobacco use, contribute to the cause of these diseases. Genetic, dermatological, haematological, granulomatous, immunosuppressive, and neoplastic disorders can also have periodontal manifestations. Common forms of periodontal disease have been associated with adverse pregnancy outcomes, cardiovascular disease, stroke, pulmonary disease, and diabetes, but the causal relations have not been established. Prevention and treatment are aimed at controlling the bacterial biofilm and other risk factors, arresting progressive disease, and restoring lost tooth support.