Comparative Evaluation of Antimicrobial Properties of Pomegranate Peel Extract Against Streptococcus Mutans And Lactobacillus - An In Vitro Study

Background: Dental caries is an infectious disease influenced by cariogenic microorganisms. Streptococcus mutans is associated with the initiation of caries, while lactobacilli with disease progression. Chlorhexidine is used as a gold standard mouthwash but with some side effects such as staining on long-term use. Nature itself is the best physician; it helps in treating oral health. Medicinal plants such as neem, tulsi, clove oil, triphala, and many more have been used in dentistry since ages to treat oral health problems such as bleeding gums, halitosis, and caries. One of them is pomegranate. It is the oldest edible fruit and considered as “a pharmacy unto itself.” Pomegranate has phenolic acids, flavonoids, and tannins in its different parts. Hydrolysable tannins called punicalagins which have free scavenging properties are the most abundant polyphenols found in pomegranate containing mouthwash. It has anticariogenic, anti-inflammatory, and antimicrobial properties. Aim: The aim of this study is to evaluate the antimicrobial efficacy of pomegranate peel extract, Hiora, and chlorhexidine. Materials and Methods: In this study, three different mouthwashes were used and divided into four groups as follows: Group A as chlorhexidine mouthwash (Hexidine), Group B as herbal mouthwash (Hiora), Group C as pomegranate peel extract 100% concentrated, and Group D as pomegranate peel extract 75% concentrated. Reference strains of S. mutans and Lactobacillus acidophilus were selected as it plays an important role in caries initiation and progression. S. mutans and Lactobacillus were grown in blood agar plates. For agar well diffusion method, wells of approximately 6-mm diameter and 4 mm in depth were made using a cork. In those wells, mouthwashes were added. Plates were incubated for 48 h at 37°C. The zone of inhibition was measured with the help of Vernier caliper. Results: The zone of inhibition of the solutions against S. Mutans and Lactobacillus shows a statistically significant P < 0.001** with f value of 1419.377 and 164.916, respectively. Conclusion: The pomegranate peel extract and Hiora show antimicrobial activities, and hence, they can be replaced for the long-term use to avoid the side effects of chlorhexidine mouthwash. Clinical significance: The pomegranate peel extract is a natural product with the antibacterial property; hence, it can be easily incorporated into oral hygiene measures such as mouthwashes or toothpastes.