Comparing the effectiveness of probiotic, green tea, and chlorhexidine- and fluoride-containing dentifrices on oral microbial flora: A double-blind, randomized clinical trial

Introduction: Oral cavity harbors wide variety of microorganisms; these are considered crucial for the dental caries initiation and progression. Plaque-induced caries is a local disease; therefore, dentifrices are the most ideal vehicle for the daily delivery of antibacterial agents. In recent years, alternatives to fluorides such as green tea, probiotic, and chlorhexidine (CHX) toothpastes have been proposed to possess antiplaque and anticariogenic properties. Aim: To compare the effectiveness of probiotic, green tea, and CHX- and fluoride-containing dentifrices on oral microbial flora. Materials and Methods: A double-blinded, parallel group, randomized controlled clinical trial was conducted among healthy adults. Fifty-two individuals were randomly allocated to four groups (n = 13): Group I - green tea dentifrice, Group II - fluoridated dentifrice, Group III - CHX dentifrice, and Group IV - probiotic dentifrice. Plaque and saliva samples were evaluated for Streptococcus mutans and Lactobacillus at baseline and 15(th) and 30(th) days of follow-up. Paired t-test and one-way ANOVA were used to compare the mean differences of plaque and salivary S. mutans counts at two and three time periods. Wilcoxon signed-rank and Kruskal-Wallis tests were used to compare the mean Lactobacillus count in plaque and saliva samples at two and three time periods, respectively. Results: The mean S. mutans and Lactobacillus counts in plaque and saliva samples were significantly reduced by all the treatment groups at the 30(th) day of follow-up. However, Group III showed the highest reduction and was found to be statistically significant (P < 0.05). Conclusion: All the four groups exhibited antimicrobial activity by bringing about a significant reduction in the mean S. mutans and Lactobacillus colony counts at the 30(th) day of follow-up. Among all the preventive modalities, Group III (CHX dentifrice) showed better results compared to other groups.