Anti-Bacterial and Anti-Inflammatory Effects of Toothpaste with Swiss Medicinal Herbs towards Patients Suffering from Gingivitis and Initial Stage of Periodontitis: From Clinical Efficacy to Mechanisms

Abstract

Objective: To distinguish clinical effects and mechanisms of sodium monofluorophosphate plus xylitol and herbal extracts of Swiss medicinal plants (Chamomilla recutita, Arnica montana, Echinacea purpurea, and Salvia officinalis). Materials and Methods: A 2-month-long comparative clinical study of toothpaste containing 1450 ppm sodium monofluorophosphate and xylitol (control, 15 patients) and toothpaste additionally containing extracts of the medicinal herbs (experiment, 35 patients) was performed on patients with gingivitis and the initial stage of periodontitis. Clinical indices of gingivitis/periodontitis were quantified by Loe & Silness’s, CPITN, OHI-S, and PMA indexes. The pro-inflammatory and anti-inflammatory interleukins, nitrites/nitrates, total antioxidant activity, and bacterial pattern characteristic for gingivitis and periodontitis were quantified in the gingival crevicular fluid and plaque. In the in vitro tests, direct anti-bacterial effects, inhibition of catalase induction in Staphylococcus aureus, in response to oxidative burst of phagocytes, and intracellular bacterial killing were determined for the toothpastes, individual plant extracts, and their mixture. Results: Experimental toothpaste was more efficient clinically and in the diminishing of bacterial load specific for gingivitis/periodontitis. Although the control toothpaste exerted a direct moderate anti-bacterial effect, herbal extracts provided anti-inflammatory, anti-oxidant, direct, and indirect anti-bacterial actions through inhibition of bacterial defence against phagocytes. Conclusions: Chemical and plant-derived anti-bacterials to treat gingivitis and periodontitis at the initial stage should be used in combination amid their different mechanisms of action. Plant-derived actives for oral care could substitute toxic chemicals due to multiple modes of positive effects.

The effect of commercial herbal toothpastes on dental wear: a comparative evaluation by Optical coherence tomography

“…Natural substances such as chlorophyll, myrrh, pomegranate, sage, eucalyptol, propolis and others, also called herbal, when incorporated in different brands of toothpaste, have proven to be effective in controlling supragingival biofilm, gingivitis and bleeding on probing, comparatively with conventional dentifrices, as well as showing inhibitory effectiveness in strains of S. mutans (Hosadurga et al, 2018;Kharaeva et al, 2020;Alshehri et al, 2019). However, there are few information about the mechanical interaction between herbal based toothpastes and dental surface.…”

Can Plant Materials Be Valuable in the Treatment of Periodontal Diseases? Practical Review

“…Combining sage with other raw materials with anti-periodontitis activity is also clinically relevant. Toothpaste with Swiss Medicinal Herbs (Chamomilla recutita, Arnica montana, Echinacea purpurea, and Salvia officinalis) diminished bacterial load specific for gingivitis/periodontitis in comparison to a control toothpaste [46]. preparations shown In Table 2 presented a variety of preparations containing sage leaves with proven efficacy in the management of periodontitis.…”

Biologically active compounds of plant origin in medicine

“…The main cause of this disease is the growth of anaerobic dental plaque-forming bacteria and prolonged exposure of connective tissue to inflammation, neutrophil infiltration, and enzymes like PGE2 as well as IL-6, IL-8, and TNF-α. It can even lead to tooth loss [Kharaeva et al 2020].…”

“…An important part of periodontitis treatment is the use of antibacterial substances. Chlorhexidine, fluorides, xylitol, triclosan, and their combinations have a proven antibacterial, anti-caries, and anti-inflammatory effect [Kharaeva et al 2020], but they can cause adverse effects like most synthetic products. Some studies suggest that herbal products can have similar efficacy with significantly fewer side effects [Geidel et al 2017].…”

“…The best results were reported in a comparative clinical study conducted by Kharaeva et al [2020], who analysed combinations of herbal compositions with classic synthetic treatment. They found that addition of herbs could enhance regular treatment and allowed reduction of the doses of potentially toxic substances.…”