Efficacy of aloe vera and probiotic mouthwashes vs fluoride mouthwash on Streptococcus mutans in plaque around brackets of orthodontic patients: a randomized clinical trial.

OBJECTIVES

To compare efficacy of aloe vera and probiotic mouthwashes vs fluoride mouthwash on Streptococcus mutans (S. mutans) in the plaque of orthodontic patients and to assess patient-reported outcomes and compliance.

MATERIALS AND METHODS

This prospective randomized clinical trial included 90 patients aged 12-35 years and in permanent dentition, who were randomly allocated in a 1:1:1 ratio to three mouthwash groups: aloe vera, probiotic, or fluoride. Smartphone-based applications were used to improve patient compliance. The primary outcome was the change in S. mutans levels in plaque between two times: pre-intervention and after 30 days using real-time polymerase chain reaction (Q-PCR). Secondary outcomes were the evaluation of patient-reported outcomes and compliance.

RESULTS

Mean differences between aloe vera vs probiotic: -0.53 (95% CI: -3.57 to 2.51), aloe vera vs fluoride: -1.99 (95% CI, -4.8 to 0.82), and probiotic vs fluoride: -1.46 (95% CI: -4.74 to 1.82) were not significant, P = .467. Intragroup comparison demonstrated a significant mean difference in all three groups of -0.67 (95% CI: -0.79 to -0.55), -1.27 (95% CI: -1.57 to -0.97), and -2.23 (95% CI: -2.44 to -2.00) respectively, P < .001. Adherence was above 95% in all groups. No significant differences in frequency of responses to patient-reported outcomes were found among groups.

CONCLUSIONS

No significant difference in efficacy among the three mouthwashes in reducing S. mutans level in plaque was found. Patient-reported assessments concerning burning sensation, taste, and tooth staining found no significant differences among mouthwashes. Smartphone-based applications can help improve patient compliance.