Effect of hydroalcoholic extract of whole pomegranate fruit on cariogenic bacteria and its clinical effect on dental plaque formation in 8–10-year-old children

Abstract

ABSTRACT Background: This study aimed to assess the effect of hydroalcoholic extract of the whole pomegranate fruit on Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) and its clinical effect on dental plaque formation in 8–10-year-old children. Materials and Methods: This study was conducted in two phases of in vitro and clinical trial. In the in vitro phase, the antibacterial effect of 50%–50% hydroalcoholic extract of whole pomegranate fruit on S. mutans and L. acidophilus was assessed by the disc diffusion test. In the double-blind cross-over clinical trial phase, 14 children between 8 and 10 years were randomly assigned to two groups of 38% pomegranate mouthwash and 0.12% chlorhexidine (CHX) after assessing their baseline dental plaque by oral hygiene index-simplified (OHI-S). The children were asked not to use any other plaque control measure during the study. Their OHI-S score was measured again after 5 and 14 days using disclosing tablets. Data were analyzed by t-test and paired t-test at 0.05 level of significance. Results: The hydroalcoholic extract of pomegranate showed a positive antibacterial effect on S. mutans and L. acidophilus. However, its inhibitory effect was significantly lower than that of 0.12% CHX (P < 0.05). None of the tested mouthwashes inhibited plaque formation, but pomegranate mouthwash and CHX decreased the OHI-S score by 34% and 36%, respectively (P < 0.05), with no significant difference between them (P > 0.05). Conclusion: The whole pomegranate fruit hydroalcoholic extract showed significant inhibitory effects on S. mutans and L. acidophilus. Furthermore, 38% pomegranate mouthwash had a comparable efficacy to CHX in the reduction of dental plaque.