Antibacterial Efficacy of Different Herbal Based Irrigant Solutions in Deciduous Teeth

Endodontic infection requires the successful removal of microorganisms from the root canal system. The most effective irrigant solution is sodium hypochlorite, but possible problems due to its toxicity require the look for new alternatives. Constant increases in antibiotic resistance and side-effects caused by chemical irrigation have shifted research towards the production of herbal alternatives, especially in paediatric dentistry. Aim: To evaluate and compare the antibacterial efficacy of miswak, green tea, chamomile and 0.5% NaOCl as an endodontic irrigants against Enterococcus faecalis in primary root canals. Materials and Methods: The in-vitro study was conducted at the Department of Conservative Dentistry and Department of Microbiology, College of Dentistry, University of Duhok from January 2020 till June 2020. Seventy five freshly extracted intact human mandibular primary molars were decoronated at Cemento-Enamel Junction (CEJ) and distal roots were separated and biomechanically prepared up to F3 Protaper file and stored in normal saline. The specimens were inoculated with Enterococccus faecalis suspension and incubated for 72 hours. Specimens were divided into five groups containing fifteen teeth each (n=15). Freshly prepared alcoholic extracts of miswak, green tea and chamomile were used as an irrigant solution against E.faecalis compared to NaOCl as positive control and normal saline as negative control. Swabs were collected using F3 protaper paper points. The number of colonies was counted in suitable plate under good illumination and manual lens for magnification. Statistical analysis was performed by using Kruskal-Wallis one-way Analysis and Student-Newman-Keuls Method. Statistical Package for the Social Sciences (SPSS) version 26.0 was used. The p-values more than 0.05 were considered as statistically non significant. Results: Green Tea, among the herbal experimental groups, had the most effective antibacterial effect against E.faecalis. No significant statistical difference was detected between green tea (p=0.272) and NaOCl; however, there was significant difference between miswak, chamomile and NaOCl as well as between the rest herbal experimental groups and normal saline. Conclusion: NaOCl remains the gold standard as irrigant in primary teeth. Green tea extract may help in reducing E.faecalis inside the canals of primary teeth. Good efficacy against E.faecalis was also shown by Miswak and chamomile however the results obtained were not significant when compared with NaOCl.