Anti-Caries Effect of a Mouthwash Containing Sambucus williamsii var. coreana Extract: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Abstract

This study was performed to verify the clinical effect of a mouthwash containing Sambucus williamsii var. coreana extract on the acid production of oral bacteria and bacteria involved in dental caries. A randomized, double-blind, and placebo-controlled trial was conducted on 66 patients of the following groups: a Sambucus williamsii var. coreana extract gargle group (n = 34) and a saline solution gargle group (n = 32). According to the application time of a mouthwash (before gargle application, immediately after gargle application, and five days after gargle application), we examined the emergence of dental caries-causing bacteria by PCR analysis and changes in the amount of acid production in dental plaque through a Cariview test. As a result of verifying the effect of inhibiting and preventing dental caries in the oral environment, the dental caries-causing bacteria decreased in the Sambucus williamsii var. coreana extract gargle group compared to the saline gargle group. In particular, Streptococcus mutans showed a marked decrease from immediately after application of gargle to 5 days after application. In addition, the mouthwash containing Sambucus williamsii var. coreana extract did not cause acid production and had low dental caries activity. A mouthwash containing Sambucus williamsii var. coreana extract, a natural substance, can be used as an anti-dental caries agent and be commercialized as an effective dental caries prevention agent that is safe for teeth and has an excellent antibacterial effect.

Effects of a mouthwash containing Lespedeza cuneata extract on risk of dental caries: a randomized, placebo-controlled clinical trial

“…Compared to dental clinical studies on Glycyrrhiza uralensis extract 17 and Sambucus williamsii var. coreana extract 18 for S. mutans, which are the most common cause of dental caries, S. mutans was not detected at all in the mandibular from immediately after gargle of Lespedeza cuneate extract used in this study. It was also not detected even after 5 days of use since the antibacterial effect persisted.…”

“…In addition, a study by Kim and Nam reported that a natural mouthwash containing Sambucus williamsii var. coreana extract has excellent antibacterial activity against caries-causing bacteria in the oral cavity 18 . As such, clinical efficacy is being verified using natural antibiotics instead of chemical mouthwashes.…”

Comparison of halitosis according to herbal mouthwash containing Glycyrrhiza uralensis extract and saline mouthwash: A randomized, double‐blind, placebo‐controlled study

“…Also, as the duration of using the mouthwash containing G. uralensis extract was extended, the level of halitosis was reduced at ‘Treatment’ and ‘After 5 Days’. This study is considered significant in a practical aspect of maintaining oral health as no research has been conducted on the effectiveness of halitosis removal and improvement, whereas the antibacterial effect of G. uralensis was reported in many studies 31–39 …”

“…Up to 70 BBV was classified as ‘Perceive halitosis all the time’, up to 90 BBV was classified as ‘Clearly perceive halitosis’, and up to 100 BBV was classified as ‘Perceive intense halitosis’. A result of ≥50 BBV was determined as requiring treatment 36 …”

Ingredients in Commercially Available Mouthwashes

“… 4 , 5 , 6 Analogous to toothpaste, mouthwashes encompass a repertoire of antibacterial, antimalodour, and antioxidant components, which have demonstrated their efficacy in controlling plaque buildup as well as in preventing periodontal disease and dental caries. 7 , 8 , 9 , 10 However, it is noteworthy that a few constituents present in mouthwashes, such as paraben, sodium lauryl sulphate, chlorhexidine (CHX), and ethanol, have been associated with potential side effects including discolouration of tooth-coloured restorations, 11 taste disturbances, 12 and allergic reactions. 13 Notably, claims linking certain types of mouthwash to an increased risk of oral cancer 14 have been proposed, although these assertions lack substantial support from epidemiologic evidence.…”