Validation of the anti-bacteremic efficacy of an essential oil rinse in a Brazilian population: a cross-over study

Abstract

This cross-over study was conducted to assess the germ-killing efficacy of an essential oil mouthrinse (EOM) by determining the blood levels of microorganisms associated with induced bacteremia and investigating the prevalence of this event in Brazilians with mild-to-moderate gingivitis. Thirty four (31.19%) subjects positive for bacteremia induced by chewing a ration of apple were enrolled out of 109 screened subjects (50 males and 59 females). A difference of at least 10 colony forming units between the pre-and post-insult blood samples was defined as a positive result. For the following two weeks patients underwent a toothbrush plus fluoride dentifrice normalization period, and were then scheduled for the Phase I protocol as follows. At baseline I, subjects were instructed to chew a new apple ration, had new blood samples taken before and after this oral stimulus, and were randomly assigned to an experimental essential oil (n = 17) or placebo (P) mouthrinse (n = 17) treatment for 2 weeks. These procedures were repeated at the end of Phase I and then followed by a two-week wash-out period (tooth brushing with fluoride dentifrice). Bacteremia was again induced at baseline and at the end of Phase II, when subjects were crossed-over to the other EOM or placebo groups. Bacterial count differences between baseline and 2-week post-treatment (EOM versus P) in the blood samples collected were assessed by analysis of covariance. Mean aerobic counts decreased by 45.8%, whereas mean anaerobic counts decreased by 63.3% after EOM treatment. After the P treatment, aerobic bacteria increased by 28.4% and anaerobic bacteria decreased by 18.5%. This study validated this novel methodology and showed that the germ-killing action of EOM significantly reduced bacteremia.

Listerine® Products: An Update on the Efficacy and Safety

“…Using the term 'essential oil mouthwash', 13 studies were identified (Charles et al, 2012(Charles et al, , 2015Cortelli et al, 2012aCortelli et al, , 2012bCortelli et al, , 2013Cortelli et al, , 2014Cosyn et al, 2013;Parikh-Das et al, 2013;Pizzo et al, 2013;Samuels et al, 2012;Singh et al, 2013;Wikén Albertsson et al, 2013) and one study on safety (Ros-Llor and Lopez-Jornet, 2014). A manual search revealed another clinical study (Al Habashneh et al, 2014) and a further study on safety (Zamora-Perez et al, 2013).…”

Effects of chlorhexidine preprocedural rinse on bacteremia in periodontal patients: a randomized clinical trial

“…The sample size calculation was determined based on a previous study 6 and adjusted after the pilot study (n = 2 per group) that included the processing of realtime PCR. Volunteers from the pilot study did not participate in the main study.…”

“…Periodontal diseases contribute to systemic disorders that involve inflammatory mediators in the bloodstream and the migration of microorganisms and their products throughout the body 14 , 15 . Bacteremia can be induced by simple daily habits such as oral hygiene 14 , 16 and mastication 6 , 9 or by more invasive procedures such as dental scaling 13 , 14 , 20 , 30 . The intensity of injury, microbiota profile, severity of inflammation, and local infection affect bacteremia 27 .…”

Impact of Dental Plaque Biofilms in Periodontal Disease: Management and Future Therapy

“…It has been shown that mouthwash with essential oils (EO) might be a reliable alternative to chlorhexidine (CHX) for controlling gingival inflammation, dental plaque development, bacteremia with anaerobic bacteria in patients with mild-to-moderate gingivitis and oral malodor [144,145]. Moreover, the diluted EO displayed no detectable detrimental effects on human gingival and periodontal ligament fibroblasts, while diluted CHX reduced both cell migration and long-term survival [146].…”

“…Moreover, the diluted EO displayed no detectable detrimental effects on human gingival and periodontal ligament fibroblasts, while diluted CHX reduced both cell migration and long-term survival [146]. The regular long-term use of the EO-based mouth rinse improved the efficacy of a 0.05% cetylpyridinium chloride-and fluoride-containing mouth rinse [144]. Linalool and α-terpineol exhibited strong antimicrobial activity against periodontopathic and cariogenic bacteria [147].…”