Efficacy of an All-Natural Polyherbal Mouthwash in Patients With Periodontitis: A Single-Blind Randomized Controlled Trial

Abstract

Aim: This study aimed to evaluate the anti-inflammatory effect and the incidence of adverse effects of an all-natural polyherbal mouthwash in patients with periodontitis, after 3 months of use. These aims were accomplished by using full mouth bleeding score (FMBS), full mouth plaque score (FMPS), probing depth (PD) clinical attachment level (CAL) and a questionnaire recording any adverse events. Methods: The present randomized controlled clinical study considered 40 patients with moderate or severe periodontitis, randomized in two groups: a test group (TG) and a control group (CG). TG was instructed to use a polyherbal mouthwash composed of Propolis resin extract, Plantago lanceolata, Salvia officinalis leaves extract, and 1.75% of essential oils and the CG was given a placebo mouthwash. Both groups were instructed to rinse for 2 min, twice daily after their routine oral home care with the different mouthwashes. Clinical measurements of FMBS, FMPS, PD and CAL were recorded at baseline (T0) and after 3 months (T1). The incidence of adverse outcomes was recorded at every follow-up. Mann–Whitney U test and Wilcoxon signed-rank test were used for the statistical analysis ( p < 0.05). Results: The final study sample consisted of 34 healthy individuals, 17 individuals in each of the two groups. TG and CG showed a statistically significant reduction in FMBS ( p = 0.001 TG; p = 0.002 CG), FMPS ( p = 0.001 TG; p = 0.003 CG), PD ( p = 0.001 TG; p = 0.011 CG) and CAL ( p < 0.001 TG; p = 0.020 CG) values from baseline to 3 months. The TG showed a statistically significant decrease in FMBS and FMPS compared with the CG. No adverse events or side effects were reported or observed in both groups. Conclusion: The use of polyherbal mouthwash in patients with moderate or severe periodontitis has proved safe and effective in reducing bleeding score and plaque accumulation, after 3 months, compared with placebo, although no difference between the two groups were reported on PD and CAL (both improving at T1).

Effectiveness of Propolis in the Treatment of Periodontal Disease: Updated Systematic Review with Meta-Analysis

“…After this, three more were removed for different reasons: one because it was a review/commentary [ 29 ], one that tested the efficacy of propolis in reducing chemotherapy-induced oral mucositis [ 30 ] and another [ 31 ] because it was study of equivalence conducted on induced gingivitis. This left a total of 13 studies: eight randomized clinical trials to be included in the meta-analysis [ 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ] and five non-randomized studies [ 32 , 33 , 34 , 35 , 36 ] ( Figure 1 , flowchart).…”

“…Meta-analysis was carried out to evaluate probing pocket depth at 3 months from the beginning of treatment with propolis or with a placebo, according to the tested group [ 21 , 22 , 23 , 25 , 26 , 28 ]. The study by Sharkawy and colleagues [ 26 ] was excluded from the meta-analysis because although it measured probing depth, it did not include numerical data.…”

“…Regarding the rest of the parameters assessed in the studies, the Oral Hygiene Index (OHI) was evaluated in 2 of the studies [ 24 , 25 ] and the Gingival Index (GI) in another 2 [ 25 , 28 ]. Although gingival bleeding was measured in most of the studies, it was tested using different indices depending on the study, which created a disparity of clinical criteria for assessment and precluded the unification of data [ 21 , 22 , 23 , 26 , 27 , 28 ]. As for plaque control, 4 studies tested it using the Plaque Index (PI) [ 23 , 24 , 25 , 26 ], although 2 of them [ 25 , 26 ] did not provide numerical data.…”

“…As for plaque control, 4 studies tested it using the Plaque Index (PI) [ 23 , 24 , 25 , 26 ], although 2 of them [ 25 , 26 ] did not provide numerical data. Concerning clinical attachment level, although it was measured in 3 of the studies [ 21 , 22 , 28 ], that by Sparabombe and colleagues [ 22 ] did not explain the measurement criterion, which means that it was discordant with the measurement units used in the other 2 studies. Because of this, it was determined that the only parameter that was tested with unity of criterion among the studies selected was probing pocket depth (PPD), measured in mm and examined in 6 of the 8 studies selected for the meta-analysis [ 21 , 22 , 23 , 25 , 26 , 28 ].…”

Can Desensitizing Toothpastes Also Have an Effect on Gingival Inflammation? A Double-Blind, Three-Treatment Crossover Clinical Trial

“…Despite this, there has been no RCT to evaluate the anti-inflammatory activity of CSPS and CHA. Our double-blind three-treatment crossover trial, therefore, aimed to compare the anti-inflammatory activity of the two test toothpastes with HB, as the active control [23][24][25][26]31]. HB has been shown to exert antiplaque and anti-inflammatory activity.…”