Department of Conservative Dentistry, Faculty of Dentistry, Universitas Trisakti - Indonesia
ORCID: http://orcid.org/0000-0003-4065-5223
pH AND ANTIBIOFILM ANALYSIS OF ELEPHANT GINGER MOUTHWASH FORMULATIONS AGAINST Streptococcus mutans – An in vitro Study
Background: Caries is the most common oral disease. Streptococcus mutans is the main microorganism in caries etiology due to its ability to form biofilm. Biofilm can be eliminated using mouthwash. Elephant ginger (Zingiber officinale var. officinale) can be developed as a herbal mouthwash because it is able to inhibit S. mutans. This study aimed to analyze pH and antibiofilm effect in vitro of elephant ginger mouthwash formulations on S. mutans. Method: Elephant ginger was macerated with 96% ethanol, then formulated into 2.5%, 5%, 10%, and 15% mouthwash formulations, underwent pH measurement for 28 days, and their antibiofilm effect on S. mutans were measured using microplate reader for 1h (therapeutic assay) and 24h (preventive assay). Result: All formulations showed pH values ranging from 6.42-6.87, changing significantly within 28 days. All formulations were able to reduce S. mutans biofilm adherence for 1h better than commercialized herbal mouthwash and similar to 0.1% CHX. Furthermore, 5% and 10% mouthwash formulations showed similar effectivity to 0.1% CHX and commercialized herbal mouthwash in inhibiting S. mutans biofilm formation for 24h, while 15% mouthwash formulation was more effective than 0.1% CHX and similar to commercialized herbal mouthwash, and 2.5% mouthwash formulation was less effective than 0.1% CHX and commercialized herbal mouthwash. Conclusion: Elephant ginger mouthwash formulations showed pH values that were likely to decrease for 28 days and had the potential as an herbal mouthwash due to its antibiofilm effect on S. mutans.
Keywords: Biofilm, caries, herbal mouthwash, Streptococcus mutans, Zingiber officinale var. officinale
- Frencken JE, Sharma P, Stenhouse L, Green D, Laverty D, Dietrich T. Global Epidemiology of Dental Caries and Severe Periodontitis – A Comprehensive Review. J Clin Periodontol. 2017;44:S94–105.
- World Health Organization. Oral Health [Internet]. 2020. Available from: https://www.who.int/news-room/fact-sheets/detail/oral-health.
- Eriksson L, Lif Holgerson P, Esberg A, Johansson I. Microbial Complexes and Caries in 17-Year-Olds with and without Streptococcus mutans. J Dent Res. 2018;97(3):275–82.
- Oh DH, Chen X, Daliri EBM, Kim N, Kim JR, Yoo D. Microbial Etiology and Prevention of Dental Caries: Exploiting Natural Products to Inhibit Cariogenic Biofilms. Pathogens. 2020;9(7):1–15.
- Sivapathasundharam B, Raghu A. Dental Caries. In: Rajendran R, Sivapathasundharam B, editors. Shafer’s Textbook of Oral Pathology. Seventh. India: Elsevier; 2012. p. 419, 427.
- Lemos JA, Palmer SR, Zeng L, Wen ZT, Kajfasz JK, Freires IA, et al. The Biology of Streptococcus mutans. Microbiol Spectr. 2019;7(1):1–26.
- Gutiérrez-Venegas G, Gómez-Mora JA, Meraz-RodrÃguez MA, Flores-Sánchez MA, Ortiz-Miranda LF. Effect of Flavonoids on Antimicrobial Activity of Microorganisms Present in Dental Plaque. Heliyon. 2019;5(12):e03013.
- Gupta D, Nayan S, Tippanawar H, Patil G, Jain A, Momin, RK et. al. Are Herbal Mouthwash Efficacious Over Chlorhexidine on The Dental Plaque?. Pharmacogn Res. 2015;7(3):277–81.
- Parashar A. Mouthwashes and Their Use in Different Oral Conditions. Sch J Dent Sci J Dent Sci. 2015;2(2B):186–91.
- Renuka S, Muralidharan NP. Comparison in Benefits of Herbal Mouthwashes with Chlorhexidine Mouthwash: A Review. Asian J Pharm Clin Res. 2017;10(2):3–7.
- Sykes L, Comley M, Kelly L. Availability, Indications for Use and Main Ingredients of Mouthwashes in Six Major Supermarkets in Gauteng. J Dent Assoc South Africa / die Tydskr van die Tandheelkd Ver van Suid-Afrika. 2016;71(7):308–13.
- Cai H, Chen J, Perera PNK, Liang X. Effects of Herbal Mouthwashes on Plaque and Inflammation Control for Patients with Gingivitis: A Systematic Review and Meta-Analysis of Randomised Controlled Trials. Evidence-based Complement Altern Med. 2020;2020.
- Bagchi S, Saha S, Jagannath G, Reddy V, Sinha P. Evaluation of Efficacy of A Commercially Available Herbal Mouthwash on Dental Plaque and Gingivitis: A Double-blinded, Parallel, Randomized, Controlled Trial. J Indian Assoc Public Heal Dent. 2015;13:222–7.
- Alibasyah ZM, Andayani R, Farhana A. Potensi Antibakteri Ekstrak Jahe (Zingiber officinale Roscoe) Terhadap Porphyromonas gingivalis Secara In Vitro. J Syiah Kuala Dent Soc. 2016;1(2):147–52.
- Aryanti I, Bayu E, Kardhinata E. Identifikasi Karakteristik Morfologis Dan Hubungan Kekerabatan Pada Tanaman Jahe (Zingiber Officinale Rosc.) Di Desa Dolok Saribu Kabupaten Simalungun. J Agroekoteknologi Univ Sumatera Utara. 2015;3(3):963–75.
- Setyaningrum H, Saparinto C. Jahe [Internet]. Jakarta: Penebar Swadaya; 2013. Available from: https://books.google.co.id/books?hl=en&lr=&id=-NvtCQAAQBAJ&oi=fnd&pg=PP1&dq=jahe+indonesia&ots=rCZE9ahTEf&sig=0-0ZZDP7IbAaUeM5aDRhOFtn4Fs&redir_esc=y#v=onepage&q=jahe indonesia&f=false
- Beristain-bauza SDC, Hernández-carranza P, Cid-pérez S, Ãvila-sosa R, Ruiz-lópez II, Enrique C, et al. Antimicrobial Activity of Ginger (Zingiber Officinale) and Its Application in Food Products. Food Rev Int. 2019;00(00):1–20.
- Wibowo DP, Mariani R, Hasanah SU, Aulifa DL. Chemical Constituents, Antibacterial Activity and Mode of Action of Elephant Ginger (Zingiber officinale var. Officinale) and Emprit Ginger Rhizome (Zingiber officinale var. Amarum) Essential Oils. Pharmacogn J. 2020;12(2):404–9.
- Saptiwi B, Sunarjo L, Rahmawati H. Perasan Jahe Merah (Zingiber officinale var. Rubrum) terhadap Daya Hambat Bakteri Aggregatibacter actinomycetemcomitans. J Ris Kesehat. 2018;7(2):61–5.
- Purwakusumah ED, Rafi M, Syafitri UD, Nurcholis W, Adzkiya MAZ. Identifikasi dan Autentikasi Jahe Merah Menggunakan Kombinasi Spektroskopi FTIR dan Kemometrik. J Agritech. 2014;34(01):82–7.
- Fibryanto E, Stefani R, Winaldy B. Pengaruh Ekstrak Jahe Gajah (Zingiber officinale var. Officinarum) Terhadap Jumlah Koloni Streptococcus mutans (in vitro). J Ked Gigi Univ Padjadjaran. 2022;34(2):136142.
- Anshula D, Rameshwari R, Poonacha KS, Seema B, Monika K, Neha P. Evaluation of the Stability, pH, Density and Sedimentation of Green Tea and Green Tea Plus Ginger Mouthwash: A Phytochemical Study. J Oral Heal Dent Sci. 2018;2(1):4–7.
- Baitariza A, Ghazali A, Rosmiati. Formulasi Larutan Obat Kumur Pencegah Plak Gigi Ekstrak Kulit Nanas (Ananas comosus L. Merr). J Sabdariffarma. 2020;6(1):33–42.
- Fibryanto E, Santoso L. Mouthwashes: A Review on Its Efficacy in Preventing Dental Caries. J Ked Gigi Terpadu. 2023;5(1):91–6.
- Stanisiere J, Mousset P, Lafay S. How Safe Is Ginger Rhizome for Decreasing Nausea and Vomiting in Women during Early Pregnancy? Foods. 2018;50(7):1–29.
- Sharif M, Bennett M. The Effect of Different Methods and Solvents on The Extraction of Polyphenols in Ginger (Zingiber officinale). J Teknol. 2016;78(11–2):49–54.
- Liu M, Xia X, Chou G, Liu D, Zuberi A, Ye J, et al. Variations in The Contents of Gingerols and Chromatographic Fingerprints of Ginger Root Extracts Prepared by Different Preparation Methods. J AOAC Int. 2014;97(1):50–7.
- Cretescu I, Horhat R, Munteanu O, Caprita R. Evaluation of Physical-Chemical Characteristics of Commercially Available Fluoride Mouth Rinses. Rom J Biophys. 2017;27(3):0–7.
- Nurdianti L, Cahyalaelani D, Wulandari WT, Setiawan F. Uji Aktivitas Antibakteri Sediaan Obat Kumur Ekstrak Etanol Daun Mangga Harumanis (Mangifera indica L) Terhadap Streptococcus mutans Penyebab Karies Gigi. 2020;3(1):15–23.
- Estima AS, Coelho C. Chlorhexidine Mouthwash as An Anticaries Agent: A Systematic Review. Quintessence Int (Berl). 2017;48(7):585–91.
- Kawarai T, Narisawa N, Yoneda S, Tsutsumi Y, Ishikawa J, Hoshino Y, et al. Inhibition of Streptococcus mutans Biofilm Formation Using Extracts from Assam Tea Compared to Green Tea. Arch Oral Biol. 2016;68:73–82.
- Khalid GS, Hamrah MH, Ghafary ES, Hosseini S, Almasi F. Antibacterial and Antimicrobial Effects of Xanthorrhizol in The Prevention of Dental Caries: A Systematic Review. Drug Des Devel Ther. 2021;15:1149–56.
- Gartika M, Pramesti HT, Kurnia D, Satari MH. A Terpenoid Isolated from Sarang Semut (Myrmecodia pendans) Bulb and Its Potential for The Inhibition and Eradication of Streptococcus mutans Biofilm. BMC Complement Altern Med. 2018;18(1):1–8.
- Kim D, Hwang G, Liu Y, Wang Y, Singh AP, Vorsa N, et al. Cranberry Flavonoids Modulate Cariogenic Properties of Mixed-species Biofilm Through Exopolysaccharides-matrix Disruption. PLoS One. 2015;10(12):1–13.
- Nijampatnam B, Nadkarni DH, Wu H, Velu SE. Antibacterial and Antibiofilm Activities of Makaluvamine Analogs. Microorganisms. 2014;2(3):128–39.
- Schestakow A, Hannig M. Effects of Experimental Agents Containing Tannic Acid or Chitosan on The Bacterial Biofilm Formation in situ. Biomolecules. 2020;10(9):1–17.
- Sudhakar M, Venkata Ra B. Bactericidal and Anti-biofilm Activity of Tannin Fractions Derived from Azadirachta against Streptococcus mutans. Asian J Appl Sci. 2020;13(3):132–43.
- Hasan S, Danishuddin M, Khan AU. Inhibitory Effect of Zingiber officinale Towards Streptococcus mutans Virulence and Caries Development: In vitro and in vivo studies. BMC Microbiol. 2015;15(1):1–14.
- Faria TRB, Furletti-Goes VF, Franzini CM, de Aro AA, de Andrade TAM, Sartoratto A, et al. Anti-inflammatory and Antimicrobial Effects of Zingiber officinale Mouthwash on Patients with Fixed Orthodontic Appliances. Am J Orthod Dentofac Orthop. 2021;159(1):21–9.
- He Z, Huang Z, Jiang W, Zhou W. Antimicrobial Activity of Cinnamaldehyde on Streptococcus mutans Biofilms. Front Microbiol. 2019;10(September):1–11.
- Pandit S, Song KY, Jeon JG. Withania somnifera Attenuates Acid Production, Acid Tolerance and Extra-cellular Polysaccharide Formation of Streptococcus mutans Biofilms. Am J Chin Med. 2014;42(1):157–71.
- Nalawade T, Bhat K, Sogi S. Bactericidal Activity of Propylene Glycol, Glycerine, Polyethylene Glycol 400, and Polyethylene Glycol 1000 Against Selected Microorganisms. J Int Soc Prev Community Dent. 2015;5(2):114–9.
- Al-Ahmad A, Wiedmann-Al-Ahmad M, Auschill TM, Follo M, Braun G, Hellwig E, et al. Effects of Commonly Used Food Preservatives on Biofilm Formation of Streptococcus mutans in vitro. Arch Oral Biol. 2008;53(8):765–72.
- Ashrafi B, Rashidipour M, Marzban A, Soroush S, Azadpour M, Delfani S, et al. Mentha Piperita Essential Oils Loaded in A Chitosan Nanogel with Inhibitory Effect on Biofilm Formation Against S. mutans on The Dental Surface. Carbohydr Polym. 2019;212:142–9.
- Loimaranta V, Mazurel D, Deng D, Söderling E. Xylitol and Erythritol Inhibit Real-time Biofilm Formation of Streptococcus mutans. BMC Microbiol. 2020;20(1):1–9.