Antibacterial Efficacy of Syzygium cumini-Based Mouthwash against Streptococcus mutans: A Laboratory and Clinical Study

Abstract

Aim: Syzygium cumini fruit has antibacterial activity that may offer a natural alternative in addressing the growth of Streptococcus mutans that usually causes dental caries. This study aims to determine the efficacy of herbal ingredients-based mouthwash, such as S. cumini, in controlling the growth of S. mutans in the oral cavity. Methods: This study began with phytochemical testing of S. cumini fruit extract. The use of S. cumini mouthwash involved four formulations of S. cumini juice, which were evaluated for organoleptic properties, pH, viscosity, and antibacterial activity using the disk diffusion method. The most effective formulation based on the evaluations was clinically tested with six participants. Saliva samples were collected before and after usage, and bacterial counts were assessed using trypticase soy with sucrose and bacitracin (TYS20B) media. Data were analyzed using the Wilcoxon signed-rank test with a significance level set at (P < 0.05). Stability testing of the formulations was conducted at various temperatures over 21 days. Results: The phytochemical analysis of S. cumini fruit extract indicated the presence of bioactive compounds such as flavonoids, tannins, phenols, and triterpenoids. In general, all four mouthwash formulas exhibited similar appearance and characteristics; however, the largest clear zone diameter in the antibacterial test was observed in Formula 4 (F4), leading to its selection for clinical trials. During the clinical testing, a significant difference was found in the number of S. mutans colonies before and after the use of S. cumini fruit mouthwash. The mouthwash formula showed good physical stability for 21 days of observation, with no significant changes in pH value and viscosity. Wilcoxon statistical analysis also confirmed a significant difference in the number of S. mutans colonies before and after using the mouthwash, indicating the antibacterial effectiveness of the S. cumini extract. Conclusions: The extract of S. cumini shows strong potential as an oral healthcare product, particularly for addressing dental caries caused by S. mutans. However, the findings are limited by the small sample size and the short duration of the study. Further research with larger populations and longer observation periods is needed to confirm the long-term efficacy and safety of S. cumini-based mouthwashes.