RSUSSH 2020

IN20-130 Effect of Natural Oral Spray Products against Oral Bacteria and User Satisfaction in the Elderly Compared with Chlorhexidine Mouthwash

Presenter: Chanon Suwanprapis
Chulalongkorn University, Thailand

Abstract

          The natural oral spray is beneficial in elderly patients who become disabled to maintain their oral health because the elderly may have difficulties in using their hands. Chlorhexidine mouthwash retains unfavorable flavor, while the natural oral spray containing essential oil which tastes and smells better. Therefore, the purpose of this study is to investigate the antimicrobial activity of natural oral spray against oral bacteria compared with chlorhexidine mouthwash, and patient satisfaction when using the mouthwash. Participants had used two types of natural oral spray products, including essential oil and essential oil with mangosteen extract, and chlorhexidine mouthwash, with 2 weeks of washout period between each product. Unstimulated saliva samples were collected before and after using each product for microbial culture. Total colony forming units (CFUs) were enumerated and compared. Then, satisfaction score was recorded by questionnaire. The results demonstrated that natural oral spray products reduced the total colony forming units after continuous use for 2 weeks, similar to the antimicrobial effect of chlorhexidine, and most patients expressed better user satisfaction than chlorhexidine mouthwash. This study suggested that the oral spray with essential oil and mangosteen extract demonstrated effective antimicrobial activity and favored patient compliance.

Keywords: Antimicrobial activity; natural oral spray products; total oral bacteria; essential oil; essential oil with mangosteen extract; chlorhexidine mouthwash

Citation format:

Suwanprapis, C., Tharapiwattananon, T., & Vacharaksa, A.. (2020). Effect of Natural Oral Spray Products against Oral Bacteria and User Satisfaction in the Elderly Compared with Chlorhexidine Mouthwash. Proceeding in RSU International Research Conference, May 1, 2020. Pathum Thani, Thailand.

QUESTIONS & ANSWERS

ผศ.ทพ.ปภาตพงศ์ ศิริคุรุรัตน์ (Chairperson)

Thank you for your presentation. Is there any adverse effect of using oral spray with essential oil and mangosteen extract? How long would you suggest your patients to use in routine practice?

Promphakkon Kulthanaamondhita (Participant)

Thank you for your nice presentation. Oral spray containing essential oil  and mangosteen extract seems to performed less effective than essential oil alone in reduction of total oral bacteria. Could you discuss why? Do you think that the natural oral spray product used could perform better if the preparation are in the form of mouthrinse instead?

Dr. Nripendra Singh (Participant)

Thank you for your presentation. I have a question for you as;

What is effective concentration of your preparation?

What is side effects of your preparation.

Bhagavathi sundaram sivamaruthi (Visitor)

What is the stability of the product?

is there any effect in their taste sense ?

Chanon Suwanprapis (Presenter)

Thank you for your questions.

From Dr. Papatpong Sirikururat questions

Is there any adverse effect of using oral spray with essential oil and mangosteen extract?

In my study, there is no any adverse effect of using oral spray with essential oil and mangosteen extract occurred. Most of participants prefer oral spray with essential oil and mangosteen extract compared with chlorhexidine mouthwash especially in term of taste and burning sensation.

However, some elderly patients informed that its oral spray affect their taste sensation for only a short period of time. Maybe a short-term course (2 weeks) of using oral spray and chlorhexidine was the reason for the absence of adverse effects. Further studies with long term course maybe needed.

How long would you suggest your patients to use in routine practice?

I suggested my patients to use 2 times a day after meals for 2 weeks in routine dental regimens. Nonetheless, both natural oral spray product’s prescriptions indicated that you can spray into your mouth anytime you needed.

From Dr. Promphakkon Kulthanaamondhita questions

Oral spray containing essential oil and mangosteen extract seems to performed less effective than essential oil alone in reduction of total oral bacteria. Could you discuss why?

In my opinion I think that therapeutic outcomes of using oral spray consisting essential oil only seems to performed more effective than Oral spray containing essential oil and mangosteen extract because of environment factors that may affect antimicrobial activity such as composition of oral spray,patients behaviours and  sequences of use. Dietary habits and especially oral hygiene care in individuals that may influence the effect of oral spray products too. Further studies maybe needed.

Do you think that the natural oral spray product used could perform better if the preparation is in the form of mouthrinse instead?

In my opinion, if user used oral spray products correctly related to droplet velocity, the droplet size and to the volume flux to oral cavity. I think oral spray might be not statistically different from mouthrinse in term of type of delivery but it depends on dose administration. However, Further studies with different type of delivery and dose concentration may be needed.

From DR. NRIPENDRA SINGH questions

What is effective concentration of your preparation?

My preparations are from commercial products with fixed concentration. Each oral spray products contain 15 ml. each 1 ml. consist of Menthol 1.2 mg., thymol 0.3 mg, eucalyptol 5 ml., chamomile 35.014 mg, peppermint oil 13.808 mg., anise oil 1.26 mg., spearmint oil 0.25 mg., pine oil 0.014 mg, basil oil 0.0532 mg., bergamot oil 0.028 mg , aloe vera 10 mg., witch hazel 10 mg., sage 6.084 mg. and methyl salicylate 1 mg. xylitiol 6.5 mg.. For Mangosteen extract, they added mangosteen extract 10mg and reduced peppermint oil to 12 mg.

 

 

 

What are side effects of your preparation.

In my study, there is no any adverse effect of using oral spray with essential oil and mangosteen extract occurred for 2 weeks. Side effects that may be occurred after long term using oral spray are discoloration of tooth, burning sensation and alter taste sensation.

From BHAGAVATHI SUNDARAM SIVAMARUTHI questions

What is the stability of the product?

The stability of the commercial product indicated that is depends on individuals including pH of saliva, volume of saliva, temperature. The stability of the product is the one of my limitation of this study that lacks information regarding adhesion of each oral spray to mucosal site or how long did oral spray retain to oral cavity. If I have any information, I will inform you later.

is there any effect in their taste sense?

In my study, most of patients informed that its oral spray affect their taste sensation for a short period of time but more favored taste compared with chlorhexidine mouthwash  

 

Regards,