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| Date: 10-15-2015 | HC# 041562-530 |
Khairnar MR, Karibasappa GN, Dodamani AS, Vishwakarma P, Naik RG, Deshmukh MA. Comparative assessment of cranberry and chlorhexidine mouthwash on streptococcal colonization among dental students: a randomized parallel clinical trial. Contemp Clin Dent. January-March 2015; 6(1):35-39.
Dental caries (cavities), caused by plaque from oral bacterial growth, can lead to serious dental problems. Preventing caries is often done with the use of antibiotic mouthwashes, such as chlorhexidine. This agent is effective but can cause adverse side effects. Cranberry (Vaccinium macrocarpon, Ericaceae) fruit has been successfully used for the prevention of bacterial urinary tract infections,1 and recent studies have shown cranberry fruit to have antibacterial activity, specifically by inhibiting bacterial adhesion to the walls of the urinary tract and gastrointestinal system. This double-blind, parallel, clinical trial investigated a mouthwash of 0.6% cranberry extract against a 0.2% chlorhexidine mouthwash for its efficacy in preventing caries in healthy subjects.
This study took place at the Department of Public Health Dentistry, ACPM Dental College, Dhule, Maharashtra, India. All included subjects were healthy, did not seek additional dental treatment during the study, and attended clinical visits. Those with "severe" teeth misalignment and/or orthodontics, crowned teeth, or dentures; those who were currently using floss or mouthwash; and those with other health problems were excluded. The cranberry extract used in this study was from Mehta Pharmacy in Ahmedabad, India. No details about the extraction process are given. The authors prepared the cranberry mouthwash at the Department of Pharmacology, Annasaheb Ramesh Ajmera Institute of Pharmacy, Dhule, India, and it was made from 600 mg of cranberry extract in 90 ml of distilled water, 10 ml of alcohol, 0.1 g of zinc chloride, 0.1 g of sodium saccharin, 0.05 g of menthol, 0.1 g of sodium benzoate, and 3 ml of glycerine. Chlorhexidine mouthwash was obtained as Welldent; Purple Remedies; Ahmedabad, Gujarat, India.
In total, 50 subjects were enrolled in the study and randomly assigned into either the chlorhexidine mouthwash group or cranberry mouthwash group, with 25 subjects in each group. Subjects used 10 ml of the mouthwash for 30 seconds twice per day for 14 days, after breakfast and before bed. Plaque samples were taken at baseline and endpoint from premolar and molar teeth to measure bacterial growth (Streptococcus mutans) via colony-forming units (CFUs) after plating in agar.
At the end of the study, significant decreases were observed in CFUs per ml in both groups (P<0.001 for both). The average decline in CFUs was 69% or 30.4 ± 5.6 in the chlorhexidine mouthwash group, and the average decline in the cranberry mouthwash group was 27.9 ± 4.3 or 68%. There was no significant difference found between the 2 groups (P=0.07).
This study's data suggest that the cranberry extract mouthwash is as effective in reducing S. mutans CFUs as chlorhexidine. From previous studies, it is surmised that cranberry fruit extract prevents bacterial adhesion. The authors acknowledge that the cranberry mouthwash contained various ingredients, making it difficult to ascertain whether the results reported are due to cranberry or other compounds. They also state that studies with a larger sample size are necessary to clarify the mechanism of action as well as safety (no adverse side effects were reported here within the 14-day study duration). In summary, cranberry mouthwash may be an effective tool for preventative dental care.
—Amy C. Keller, PhD
Reference
1Henson S. Preventing urinary tract infections with cranberry extract. HerbClip. April 30, 2007 (No. 040371-327). Austin, TX: American Botanical Council. Review of Can a concentrated cranberry extract prevent recurrent urinary tract infections in women? A pilot study by Bailey DT, Dalton C, Daugherty FJ, Tempesta MS. Phytomedicine. 2007;14(4):237-241.
