“Comparative Evaluation of Clinical Changes and Microbial Flora Associated with Usage of Mouth Washes Containing Green Tea, Chlorhexidine (0.2%) and Essential Oils in Patients Undergoing Orthodontic Therapy”

Krishna Priya. B; Anil Melath; Anjali K; Mohammed Feroz T. P; Subair. K; Nanditha Chandran

doi:10.36437/ijdrd.2021.3.2.A

Krishna Priya. B Post-Graduate, Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Kerala, India.
Anil Melath Professor and HOD, Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Kerala, India.
Anjali K Assistant Professor, Department of Microbiology, Mahe Institute of Dental Sciences and Hospital, Kerala, India.
Mohammed Feroz T. P Reader, Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Kerala, India.
Subair. K Reader, Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Kerala, India.
Nanditha Chandran Senior Lecture, Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Chalakkara, Kerala, India.

DOI: https://doi.org/10.36437/ijdrd.2021.3.2.A

Keywords: Chlorhexidine, Essential Oil, Green Tea, Mouthwash, Supragingival Plaque.

Abstract

Introduction: Periodontal disease results from a complex interplay between the subgingival biofilm and the host immune-inflammatory events that develop in the gingival and periodontal tissues in response to the challenge presented by the bacteria 1 an increasing number of people all over the world are turning to nature by using natural herbal products in both prophylaxis and treatment of different diseases. Plants are the source of more than 25% of prescription and over-the-counter preparations and the potential of natural agents for oral prophylaxis should therefore be considered.

Objectives: To evaluate the clinical changes before and after the use of Green tea, Chlorhexidine (0.2%), and Essential oil mouthwashes in patients undergoing orthodontic therapy. To evaluate the antimicrobial properties of the three mouthwashes in patients undergoing orthodontic therapy. To compare the clinical changes and antimicrobial properties of the three mouthwashes in patients undergoing orthodontic therapy.

Methodology: Sixty patients of age group 13-35 yrs with minimal crowding were selected for this study. Subjects with minimal crowding were selected based on the Little’s Irregularity Index score range up to 3. The gingival health status and presence of bleeding on probing were assessed by Gingival index by Loe and Silness (1963) and Papillary bleeding index (PBI) by Muhleman and Saxer (1975) 64 after 2 weeks of placement of orthodontic brackets. Plaque samples were collected and sent for microbiological analysis to estimate colony-forming units. The subjects were randomly allocated to one of the following groups. Each group consisted of 20 subjects.

Group I: Green tea mouth wash (10ml to be rinsed for 30 seconds twice daily).

Group II: Chlorhexidine mouth wash (0.2%) (10ml to be rinsed for 30 seconds twice daily).

Group III: Essential oil mouth wash (10ml to be rinsed for 30 seconds twice daily).

After the 14^th day and 21^st day, the subjects were recalled and the gingival and bleeding indices were recorded. Supragingival plaque sample was collected using a sterile jaquette scaler for microbiological analysis.

Results: When the gingival index was compared on the baseline, 14^th, and 21^st day between the three groups, it was observed that the chlorhexidine group showed a decrease in the gingival index followed by green tea mouthwash and essential oil mouthwash. When the papillary bleeding index was compared between the three groups on baseline, 14^th day and 21^st day it was observed that chlorhexidine shows the least papillary bleeding index followed by green tea mouth wash and essential oil mouthwash. A comparison of the total CFU of various mouthwashes in this study revealed that 0.2% CHX mouthwash was the most effective in reducing the total microbial colony count (33.96% reduction in total bacterial colony count from baseline to 14th day and 51.42% reduction in total bacterial colony count from 14^th day to 21^st day), followed by green tea mouth wash (15.8% reduction in total bacterial colony count from baseline to 14^th day and 27.37% reduction in total bacterial colony count from 14^th day to 21^st day) and essential oil mouth wash (wash (6.39% reduction in total bacterial colony count from baseline to 14th day and 2.6% reduction in total bacterial colony count from 14^th day to 21^st day).

Conclusion: It was concluded that all three mouthwashes in this study are equally effective by showing significant clinical and microbiological changes after the usage in patients undergoing orthodontic therapy. Chlorhexidine mouthwashes showed better clinical and microbiological changes after the usage followed by green tea mouthwashes and essential oil mouthwashes. Green tea mouthwash can be recommended as a safe anti-inflammatory, antimicrobial mouthwash to control gingival inflammation and to maintain good oral hygiene during orthodontic treatment.