Efficacy of green tea mouth wash as an adjunct to non-surgical periodontal treatment in patients with chronic periodontitis

Abstract

Background and objectives: Periodontal disease is the most common disease associated with microbial infection with the destruction of supporting structures. This study was carried out to evaluate the effectiveness of green tea as a mouthwash in the management of chronic periodontitis in comparison to chlorhexidine mouthwash. Patients and methods: A randomized controlled trial on 45 healthy humans with mild to moderate localized chronic periodontitis. They were randomly assigned into 3 equal groups (15 patients each), and they all received scaling and root surface debridement treatments. Group A used prepared green tea 5% as mouth wash for 2 weeks, group B used chlorhexidine mouthwash 0.12% for 2 weeks and group C did not use any mouth wash. Intra-oral clinical examination and blood samples collection were done for all patients for estimating the biochemical parameters C-reactive protein, alkaline phosphatase, Malondialdehyde at baseline and 30 days after periodontal therapy. For statistical analysis, SPSS program was used. Results: The study groups showed significant reduction in clinical periodontal parameters and inflammatory markers after 30 days of periodontal therapy (P<0.001). A significant difference was seen between group A and group B in relation to clinical periodontal parameters and inflammatory markers after periodontal therapy P<0.05, while the difference between group B and group C was non-significant in relation to gingival index, clinical attachment level, C-reactive protein, alkaline phosphatase, and Malondialdehyde. Conclusion: Green tea as a mouthwash could be an appropriate and effective choice as an adjunctive measure in the treatment of chronic periodontitis.

Clinical Effectiveness of Herbal Oral Care Products in Periodontitis Patients: A Systematic Review

“…All included studies were published between 2003 and 2022 [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and the majority of them were randomized clinical trials [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 54 , 55 , 56 , 58 , 59 , 60 , 61 , 62 , 63 , 64 ] and conducted in India [ 43 , 45 , 46 , 47 , 48 , 51 , 52 , 53 , 55 , 63 , 64 ], while the rest of them were from Iran [ 44 , 49 , 59 ], Iraq […”

“…None of the included eligible investigations tested herbal gels. Various herbal products were tested in the included investigations including 1% Matricaria chamomilla [ 43 ], triphala ( Emblica officinalis , Terminalia chebula , and Terminalia belerica ) [ 45 , 52 , 53 ], Saussurea lappa extracts [ 46 ], 4% Ocimums anctrum [ 47 ], green tea [ 48 , 49 , 50 ], Nigella sativa [ 54 ], liquorice [ 57 ], Stuckenia striata [ 59 ], lemongrass oil [ 63 ], red ginseng [ 64 ], or combinations of different herbs [ 44 , 51 , 55 , 56 , 58 , 60 , 61 , 62 ].…”

“…SRP was completed in conjunction with the use of herbal products in 13 studies [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 52 , 53 , 54 , 55 , 57 ], whereas the rest of them performed SRP prior to the initiation of the study [ 51 , 56 ], or included SPD only [ 57 , 58 , 60 , 62 , 63 , 64 ], or no treatment [ 59 , 61 ]. All examined patients were diagnosed with chronic periodontitis.…”

“…Five studies included patients with “generalized chronic periodontitis” [ 43 , 45 , 53 , 55 , 64 ], while “chronic periodontitis” was reported in the inclusion criteria of eleven included investigations [ 44 , 46 , 47 , 51 , 52 , 54 , 56 , 57 , 59 , 60 , 61 ]. Other diagnoses included “mild to moderate periodontitis” [ 48 ], “generalized moderate chronic periodontitis” [ 49 ], “localised mild to moderate chronic periodontitis” [ 50 ], “slight and moderate chronic periodontitis” [ 58 ], “moderate or severe periodontitis” [ 62 ], “generalized severe periodontitis” [ 63 ]. The follow-up time ranged between 1 week and 6 months.…”

“…All included studies reported significant differences favoring the herbal products when compared to placebos or no adjuncts [ 43 , 44 , 46 , 50 , 53 , 62 , 63 , 64 ], apart from a comparative non-randomized clinical trial that reported no difference between SRP + liquorice mouthwash and SRP only [ 57 ]. When herbal oral care products were compared to CHX, comparable outcomes were found for 1% Matricaria chamomilla (MTC) [ 43 ], Saussurea lappa extracts [ 46 ], Triphala [ 53 ], polyherbal mouthwash HiOra ® [ 55 ], lemongrass [ 63 ] and red ginseng [ 64 ].…”