Protective effects of mouthwash formulations of Syzygium polyantha (L.) and Piper betel (L.) on oral microbiota-induced gingivitis


Submitted: 11 September 2023
Accepted: 6 November 2023
Published: 19 December 2023
Abstract Views: 308
PDF: 84
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Authors

Using a combination of natural ingredients as a mouthwash was expected to have a synergistic effect in preventing gingivitis, a common oral disease. The objective of this study was to elucidate the anti-inflammatory effect of different proportions of mouthwash infusions: F1 (75% Syzygium polyantha and 25% Piper betle) and F2 (25% Syzygium polyantha and 75% Piper betle) on oral microbiota causing gingivitis. Twenty-four Rattus norvegicus were divided into four groups, and bacteria were injected into the periodontal sulcus. The anti-inflammatory effect was assessed by calculating the reduced number of polymorphonuclear (PMN) leukocytes. A cytotoxicity test was carried out on the normal fibroblast cell line 3T3-L1. There were no significant differences in the decreased number of PMN leukocytes (p = 0.079 > 0.05). Both F1 and F2 showed results of cell viability approaching 100% of living cells at concentrations of 0.29 ppm and 0.04 ppm, equivalent to 0.058% and 0.029%, respectively. This study concluded that both formulations of Syzygium polyantha and Piper betle have potential effects on gingivitis prevention. They had an effectiveness level almost similar to Chlorhexidine gluconate 2%. The toxicity value of formulation F1 is superior to that of formulation F2. Further studies concerning the toxicity of the mixtures and their effect on oral biofilm are needed.


Amirabadi F, Sasannejad. Evaluation of the antimicrobial effects of various methods to disinfect toothbrushes contaminated with Streptococcus mutans. Int J Med Res Health Sci 5:536–540.

Syaiful I, Widodo ADW, Endraswari PD, et al. The association between biofilm formation ability and antibiotic resistance phenotype in clinical isolates of gram-negative bacteria: a cross-sectional study. Bali Med J 2023;12:1014–20.

Visentin D, Gobin I, Maglica Ž. Periodontal Pathogens and Their Links to Neuroinflammation and Neurodegeneration. Microorganisms 2023;11:1832. DOI: https://doi.org/10.3390/microorganisms11071832

Amado PPP, Kawamoto D, Albuquerque-Souza E, et al. Oral and Fecal Microbiome in Molar-Incisor Pattern Periodontitis. Front Cell Infect Microbiol 2020;10:583761. DOI: https://doi.org/10.3389/fcimb.2020.583761

Sukhabogi JR, Shekar CBR, Hameed IA, et al. Oral health status among 12- and 15-year-old children from government and private schools in Hyderabad, Andhra Pradesh, India. Ann Med Health Sci Res 2014;4:141971. DOI: https://doi.org/10.4103/2141-9248.141971

Sitanaya R, Lesmana H, Sunariani J, et al. The role of mastication in improving TGF-β levels on the inhibition of streptococcus sanguinis and streptococcus mutans in gingivitis. J Int Dent Med Res 2022;15:268–73.

Kementrian Kesehatan Republik Indonesia. Badan Penelitian dan Pengembangan Kesehatan. Laporan-Riskesdas-2018-Nasional. 2018.

Metzemaekers M, Gouwy M, Proost P. Neutrophil chemoattractant receptors in health and disease: double-edged swords. Cellular Molecular Immunol 2020;17:433-50. DOI: https://doi.org/10.1038/s41423-020-0412-0

Koppolu P, Sirisha S, Mishra A, et al. Alkaline phosphatase and acid phosphatase levels in saliva and serum of patients with healthy periodontium, gingivitis, and periodontitis before and after scaling with root planing: A clinico-biochemical study. Saudi J Biol Sci 2021;28:380-5. DOI: https://doi.org/10.1016/j.sjbs.2020.10.016

Hernawati S, Aldianah BSS, Endah P, Irmawati A. The Effectiveness of Red Pomegranate (Punica granatum Linn) Extract Mouthwash Against the Number of Oral Bacteria Colony. Malaysian J Med Health Sci 2020; https://repository.unair.ac.id/124139/

Shin AR, Nam SH. Antimicrobial effects of various methods for the disinfection of contaminated toothbrushes. Biomed Res 2018;29:2880–4. DOI: https://doi.org/10.4066/biomedicalresearch.29-18-820

Nordin R, Roslan MA, Fathilah AR, et al. Evaluation of in vitro antifungal effects of synthetic and herbal mouth rinses on oral Candida albicans and Candida glabrata. Trop Biomed 2022;39:302–14. DOI: https://doi.org/10.47665/tb.39.3.001

Ramadhani Y, Rahmasari RRP, Prajnasari KN, et al. A mucoadhesive gingival patch with Epigallocatechin-3-gallate green tea (Camellia sinensis) as an alternative adjunct therapy for periodontal disease: A narrative review. Dent J 2022;55:114–9. DOI: https://doi.org/10.20473/j.djmkg.v55.i2.p114-119

Avriliyanti F, Suparwitri S, Alhasyimi AA. Rinsing effect of 60% bay leaf (Syzygium polyanthum wight) aqueous decoction in inhibiting the accumulation of dental plaque during fixed orthodontic treatment. Dent J 2017;50:1. DOI: https://doi.org/10.20473/j.djmkg.v50.i1.p1-5

Ermawati FU, Sari R, Putri NP, et al. Antimicrobial activity analysis of Piper betle Linn leaves extract from Nganjuk, Sidoarjo and Batu against Escherichia coli, Salmonella sp., Staphylococcus aureus and Pseudomonas aeruginosa. J Phys Conf Ser 2021;1951:012004. DOI: https://doi.org/10.1088/1742-6596/1951/1/012004

Junairiah, Rahmawati RK, Manuhara YSW, et al. Induction and identification of bioactive compounds from callus extract of Piper betle L. var. Nigra. Malaysian J Analytical Sci 2020;24:1024-34. Available from: https://mjas.analis.com.my/mjas/v24_n6/pdf/Junairiah_24_6_20.pdf

Junairiah J, Ni’matuzahroh N, Zuraidassanaaz NI, Sulistyorini L. Antifungal and antibacterial activity of black betel (Piper betle L. var Nigra) extract. Biosci Res 2017;14:750–5.

Syahidah A, Saad CR, Hassan MD, et al. in Betel Leaves, Piper betle Methanolic Extract. Pak J Biol Sci 2017;20:70–81. DOI: https://doi.org/10.3923/pjbs.2017.70.81

Atiya A, Sinha BN, Lal UR. Bioactive phenylpropanoid analogues from Piper betle L. var. birkoli leaves. Nat Prod Res 2017;31:2604–11. DOI: https://doi.org/10.1080/14786419.2017.1285297

Lee S-H, Kim W-H, Ju K-W, et al. Antibacterial and Anti-Inflammatory Potential of Mouthwash Composition Based on Natural Extracts. NATO Adv Sci Inst Ser E Appl Sci 2021;11:4227. DOI: https://doi.org/10.3390/app11094227

Murakami S, Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Clin Periodontol 2018;45:S17–27. DOI: https://doi.org/10.1111/jcpe.12937

How KY, Song KP, Chan KG. Porphyromonas gingivalis: An Overview of Periodontopathic Pathogen below the Gum Line. Front Microbiol 2016;7:53. DOI: https://doi.org/10.3389/fmicb.2016.00053

Fernandes FHA, Salgado HRN. Gallic Acid: Review of the Methods of Determination and Quantification. Crit Rev Anal Chem 2016;46:257–65. DOI: https://doi.org/10.1080/10408347.2015.1095064

Salikha K, Narmada IB, Alida A, et al. Anti-inflammatory effect of caffeic acid phenethyl ester supplementation on TNF-α and NF-κB expressions throughout experimental tooth movement in vivo. J Pharm Pharmacogn Res 2022;10:1037–45. DOI: https://doi.org/10.56499/jppres22.1479_10.6.1037

Fernandes T, Bhavsar C, Sawarkar S, D’souza A. Current and novel approaches for control of dental biofilm. Int J Pharm 2018;536:199–210. DOI: https://doi.org/10.1016/j.ijpharm.2017.11.019

Granica S, Piwowarski JP, Kiss AK. Ellagitannins modulate the inflammatory response of human neutrophils ex vivo. Phytomedicine 2015;22:1215–22. DOI: https://doi.org/10.1016/j.phymed.2015.10.004

Vyas T, Bhatt G, Gaur A, Sharma C, Sharma A, Nagi R. Chemical plaque control - A brief review. J Family Med Prim Care 2021;10:1562–8. DOI: https://doi.org/10.4103/jfmpc.jfmpc_2216_20

Manipal S, Hussain S, Wadgave U, et al. The Mouthwash War - Chlorhexidine vs. Herbal Mouth Rinses: A Meta-Analysis. J Clin Diagn Res 2016;10:ZC81-3. DOI: https://doi.org/10.7860/JCDR/2016/16578.7815

Ting M, Dahlkemper A, Schwartz JJ, et al. Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review. Biomedicines 2023;11:1694 DOI: https://doi.org/10.3390/biomedicines11061694

Vergara-Buenaventura A, Castro-Ruiz C. Use of mouthwashes against COVID-19 in dentistry. Br J Oral Maxillofac Surg 2020;58:924–7. DOI: https://doi.org/10.1016/j.bjoms.2020.08.016

James P, Worthington HV, Parnell C, et al. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev 2017;3:CD008676. DOI: https://doi.org/10.1002/14651858.CD008676.pub2

Biber A, Lev D, Mandelboim M, et al. The role of mouthwash sampling in SARS-CoV-2 diagnosis. Eur J Clin Microbiol Infect Dis 2021; http://dx.doi.org/10.1007/s10096-021-04320-4 DOI: https://doi.org/10.1101/2021.07.22.21260760

Vilhena FV, Brito Reia VC, da Fonseca Orcina B, et al. The use of antiviral Phthalocyanine mouthwash as a preventive measure against COVID-19. GMS Hyg Infect Control 2021;16:Doc24.

Kusuma IW, Kuspradini H, Arung ET, et al. Biological Activity and Phytochemical Analysis of Three Indonesian Medicinal Plants, Murraya koenigii, Syzygium polyanthum and Zingiber purpurea. J Acupuncture Meridian Stud 2011;4:75-9. DOI: https://doi.org/10.1016/S2005-2901(11)60010-1

Kusumastuti N, Jaya MKA. Activity Of Bay Leaf Extract (Eugenia polyantha) As Anti- Inflammatory In White Rat (Rattus norvegicus): Narrative Review. J Pharmaceut Sci Appl 2022;4:26–32. DOI: https://doi.org/10.24843/JPSA.2022.v04.i01.p04

Miao Z, Zhao Y, Chen M, He C. Using flavonoids as a therapeutic intervention against rheumatoid arthritis: The known and unknown. Pharmacolog Res - Modern Chinese Med 2022;3:100014. DOI: https://doi.org/10.1016/j.prmcm.2021.100014

Sousa M de M, Lima RMT de, Lima A de, et al. Antioxidant action and enzyme activity modulation by bioaccessible polyphenols from jambolan (Syzygium cumini (L.) Skeels). Food Chem 2021;363:130353. DOI: https://doi.org/10.1016/j.foodchem.2021.130353

Serafini M, Peluso I, Raguzzini A. Flavonoids as anti-inflammatory agents. Proc Nutr Soc 2010;69:273–8. DOI: https://doi.org/10.1017/S002966511000162X

Tipton DA, Lyle B, Babich H, Dabbous MK. In vitro cytotoxic and anti-inflammatory effects of myrrh oil on human gingival fibroblasts and epithelial cells. Toxicol In Vitro 2003;17:301–10. DOI: https://doi.org/10.1016/S0887-2333(03)00018-3

Guandalini Cunha B, Duque C, Sampaio Caiaffa K, et al. Cytotoxicity and antimicrobial effects of citronella oil (Cymbopogon nardus) and commercial mouthwashes on S. aureus and C. albicans biofilms in prosthetic materials. Arch Oral Biol 2020;109:104577. DOI: https://doi.org/10.1016/j.archoralbio.2019.104577

Putri, M. H., Nurjanah, N., Laela, D. S., & Sukmasari, S. (2023). Protective effects of mouthwash formulations of <i>Syzygium polyantha</i> (L.) and <i>Piper betel</i> (L.) on oral microbiota-induced gingivitis. Healthcare in Low-Resource Settings, 12(1). https://doi.org/10.4081/hls.2023.11768

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