Article Data

  • Views 752
  • Dowloads 242

Original Research

Open Access

Antibacterial effects of dentifrices against Streptococcus mutans in children: a comparative in vitro study

  • Kubra Tonguc-Altin1,*,
  • Senem Selvi-Kuvvetli1
  • Nursen Topcuoglu2
  • Guven Kulekci2

1Department of Pediatric Dentistry, Faculty of Dentistry, Yeditepe University, 34730 Istanbul, Turkey

2Department of Oral Microbiology, Faculty of Dentistry, Istanbul University, 34390 Istanbul, Turkey

DOI: 10.22514/jocpd.2024.035 Vol.48,Issue 2,March 2024 pp.72-81

Submitted: 08 April 2023 Accepted: 20 June 2023

Published: 03 March 2024

*Corresponding Author(s): Kubra Tonguc-Altin E-mail:


Fluoridated dentifrices have antibacterial effects on children’s teeth. On the other hand, the side effects encountered with the use of them have led researchers to look for safe alternatives. This study aimed to determine the antibacterial effect of different commercially available fluoride-free dentifrices on Streptococcus mutans (S. mutans) in comparison with different concentrations of fluoridated dentifrices. Study groups comprised of fluoride-free dentifrices, which contain Probiotic (Activated Charcoal Probiotic Dentifrice—Group P), Aloe Vera—Group AV and Salivary Proteins—Group SP. Fluoridated dentifrices containing 1450 ppm fluoride—Control Group 1 and 500 ppm fluoride—Control Group 2 served as control groups. Antibacterial activity was assessed by Minimum Inhibitory Concentrations and agar well diffusion assays on S. mutans. Biofilm inhibition assay was performed with dentifrices, which had antibacterial activities, and a negative control phosphate-buffered saline (Group PBS) on sterile hydroxyapatite discs against S. mutans. Statistical evaluation was performed. Only group AV showed an antibacterial effect on S. mutans, while control groups showed a similar antibacterial effect. The mean number of viable bacteria present in S. mutans biofilm in Control Group 1 and 2 and Group AV were statistically significantly lower than that in Group PBS, but there were no statistically significant differences between Control Groups and Group AV. Antibacterial activity of commercial dentifrices against S. mutans may be exerted by antibacterial components other than fluoride. Aloe vera-containing toothpaste showed an antibacterial effect on S. mutans, although not as much as the fluoride-containing toothpastes in the control groups. However, further in vivo and long-term studies are required.


Aloe vera; Fluoride; Antibacterial activity; Commercial; Dentifrice

Cite and Share

Kubra Tonguc-Altin,Senem Selvi-Kuvvetli,Nursen Topcuoglu,Guven Kulekci. Antibacterial effects of dentifrices against Streptococcus mutans in children: a comparative in vitro study. Journal of Clinical Pediatric Dentistry. 2024. 48(2);72-81.


[1] Adam TR, Al-Sharif AI, Tonouhewa A, AlKheraif AA. Prevalence of caries among school children in Saudi Arabia: a meta-analysis. Advances in Preventive Medicine. 2022; 2022: 7132681.

[2] Kengadaran S, Anusha D, Baskar K, Muthukrishnan K, Pooraninagalakshmi J, Prabakar J. Comparative effectiveness of herbal and conventional toothpaste on prevention of dental caries: systematic review and meta-analysis. Indian Journal of Dental Research. 2022; 33: 332.

[3] Benn AML, Heng NCK, Thomson WM, Broadbent JM. Plaque and dental caries risk in midlife. Caries Research. 2022; 56: 464–476.

[4] Fakhruddin KS, Ngo HC, Samaranayake LP. Cariogenic microbiome and microbiota of the early primary dentition: a contemporary overview. Oral Diseases. 2019; 25: 982–995.

[5] Escapa IF, Chen T, Huang Y, Gajare P, Dewhirst FE, Lemon KP. New insights into human nostril microbiome from the expanded human oral microbiome database (eHOMD): a resource for the microbiome of the human aerodigestive tract. MSystems. 2018; 3: e00187–18.

[6] Evans A, Leishman SJ, Walsh LJ, Seow WK. Inhibitory effects of children’s toothpastes on Streptococcus mutans, Streptococcus sanguinis and Lactobacillus acidophilus. European Archives of Paediatric Dentistry. 2015; 16: 219–226.

[7] Moghaddam A, Ranjbar R, Yazdanian M, Tahmasebi E, Alam M, Abbasi K, et al. The current antimicrobial and antibiofilm activities of synthetic/herbal/biomaterials in dental application. BioMed Research International. 2022; 2022: 8856025.

[8] Hattab Faiez N. An update on fluorides and fluorosis with reference to oral health status in the gulf region. Asian Journal of Dental Sciences. 2020; 11: 27–48.

[9] Munteanu A, Holban AM, Păuna MR, Imre M, Farcașiu AT, Farcașiu C. Review of professionally applied fluorides for preventing dental caries in children and adolescents. Applied Sciences. 2022; 12: 1054.

[10] Lin T, Lin C, Pan T. The implication of probiotics in the prevention of dental caries. Applied Microbiology and Biotechnology. 2018; 102: 577–586.

[11] Aden EA, Altun C, Ozmen B, Basak F. Antimicrobial effect of toothpastes containing Fluoride, Xylitol, or Xylitol-probiotic on salivary Streptococcus mutans and Lactobacillus in children. Nigerian Journal of Clinical Practice. 2018; 21: 134–138.

[12] Lynge Pedersen AM, Belstrøm D. The role of natural salivary defences in maintaining a healthy oral microbiota. Journal of Dentistry. 2019; 80: S3–S12.

[13] Inui T, Palmer Jr RJ, Shah N, Li W, Cisar JO, Wu CD. Effect of mechanically stimulated saliva on initial human dental biofilm formation. Scientific Reports. 2019; 9: 11805.

[14] Nopparat J, Khuituan P, Peerakietkhajorn S, Teanpaisan R. Probiotics of Lacticaseibacillus paracasei SD1 and Lacticaseibacillus rhamnosus SD11 attenuate inflammation and β-cell death in streptozotocin-induced type 1 diabetic mice. PLOS ONE. 2023; 18: e0284303.

[15] Marin LM, Xiao Y, Cury JA, Siqueira WL. Modulation of Streptococcus mutans adherence to hydroxyapatite by engineered salivary peptides. Microorganisms. 2022; 10: 223.

[16] Inchingolo AD, Malcangi G, Semjonova A, Inchingolo AM, Patano A, Coloccia G, et al. Oralbiotica/oralbiotics: the impact of oral microbiota on dental health and demineralization: a systematic review of the literature. Children. 2022: 9: 1014.

[17] Sivamaruthi BS, Kesika P, Chaiyasut C. A review of the role of probiotic supplementation in dental caries. Probiotics and Antimicrobial Proteins. 2020; 12: 1300–1309.

[18] Atanasov N, Evstatieva Y, Nikolova D. Antagonistic interactions of lactic acid bacteria from human oral microbiome against Streptococcus mutans and Candida albicans. Microorganisms. 2023; 11: 1604.

[19] Tanzer JM, Thompson A, Lang C, Hareng L, Garner A, Reindl A, et al. Caries inhibition by and safety of Lactobacillus paracasei DSMZ16671. Journal of Dental Research. 2010; 89: 921–926.

[20] Sharma D, Purohit N, Chaubey S, Tiwari M, Bhadauriya M, Bhasker N, et al. A review on pharmacological and therapeutic potential of aloe barbadensis miller. European Journal of Medicinal Plants. 2022; 33: 23–43.

[21] Saleem A, Naureen I, Naeem M, Murad HS, Maqsood S, Tasleem G. Aloe vera gel effect on skin and pharmacological properties. Scholars International Journal of Anatomy and Physiology. 2022; 5: 1–8.

[22] Fani M, Kohanteb J. Inhibitory activity of Aloe vera gel on some clinically isolated cariogenic and periodontopathic bacteria. Journal of Oral Science. 2012; 54: 15–21.

[23] da Silva Barboza A, Aitken-Saavedra JP, Ferreira ML, Fábio Aranha AM, Lund RG. Are propolis extracts potential pharmacological agents in human oral health?—a scoping review and technology prospecting. Journal of Ethnopharmacology. 2021; 271: 113846.

[24] Figueiredo LC, Figueiredo NF, Cruz DFD, Baccelli GT, Sarachini GE, Bueno MR, et al. Propolis, aloe vera, green tea, cranberry, calendula, Myrrha and salvia properties against periodontal microorganisms. Microorganisms. 2022; 10: 2172.

[25] Bhati N, Jaidka S, Somani R. Evaluation of antimicrobial efficacy of Aloe vera and Meswak containing dentifrices with fluoridated dentifrice: an in vivo study. Journal of International Society of Preventive and Community Dentistry. 2015; 5: 394.

[26] Rubido S, Fernandez-Feijoo J, Limeres J, Garcia-Caballero L, Abeleira M, Diz P. In vivo antiplaque effect of three edible toothpastes. Medicina Oral Patología Oral Y Cirugia Bucal. 2014; 19: e88–e92.

[27] Baffone W, Sorgente G, Campana R, Patrone V, Sisti D, Falcioni T. Comparative effect of chlorhexidine and some mouthrinses on bacterial biofilm formation on titanium surface. Current Microbiology. 2011; 62: 445–451.

[28] American Academy of Pediatric Dentistry. Fluoride therapy. The Reference Manual of Pediatric Dentistry (pp. 288–291). 2020.

[29] Saïz P, Taveira N, Alves R. Probiotics in oral health and disease: a systematic review. Applied Sciences. 2021; 11: 8070.

[30] Maden EA, Altun C, Polat GG, Basak F. The in vitro evaluation of the effect of Xyliwhite, probiotic, and the conventional toothpastes on the enamel roughness and microhardness. Nigerian Journal of Clinical Practice. 2018; 21: 306–311.

[31] Caglar E, Topcuoglu N, Cildir SK, Sandalli N, Kulekci G. Oral colonization by Lactobacillus reuteri ATCC 55730 after exposure to probiotics. International Journal of Paediatric Dentistry. 2009; 19: 377–381.

[32] Gudipaneni RK, Kumar RVGJ, Peddengatagari S, Duddu Y. Short term comparative evaluation of antimicrobial efficacy of tooth paste containing lactoferrin, lysozyme, lactoperoxidase in children with severe early childhood caries: a clinical study. Journal of Clinical and Diagnostic Research. 2014; 8: 18–20.

[33] Berto LA, Lauener A, Carvalho TS, Lussi A, Eick S. In vitro effects of arginine-containing toothpastes on cariogenic biofilms. Oral Health Preventive Dentistry. 2019; 17: 375–383.

[34] Danish P, Ali Q, Hafeez MM, Malik A. Antifungal and antibacterial activity of aloe vera plant extract. Biological and Clinical Sciences Research Journal. 2020; 2020: 1.

[35] George D, Bhat SS, Antony B. Comparative evaluation of the antimicrobial efficacy of aloe vera tooth gel and two popular commercial toothpastes: an in vitro study. General Dentistry. 2009; 57: 238–341.

[36] Bertolini PFR, Biondi Filho O, Pomilio A, Pinheiro SL, Carvalho MSD. Antimicrobial capacity of Aloe vera and propolis dentifrice against Streptococcus mutans strains in toothbrushes: an in vitro study. Journal of Applied Oral Science. 2012; 20: 32–37.

[37] Chan A, Ellepola K, Truong T, Balan P, Koo H, Seneviratne CJ. Inhibitory effects of xylitol and sorbitol on Streptococcus mutans and Candida albicans biofilms are repressed by the presence of sucrose. Archives of Oral Biology. 2020; 119: 104886.

[38] Yazdanian M, Rostamzadeh P, Alam M, Abbasi K, Tahmasebi E, Tebyaniyan H, et al. Evaluation of antimicrobial and cytotoxic effects of Echinacea and Arctium extracts and Zataria essential oil. AMB Express. 2022; 12: 75.

[39] Randall, Paul J, Seow WK, Walsh LJ. Antibacterial activity of fluoride compounds and herbal toothpastes on Streptococcus mutans: an in vitro study. Australian Dental Journal. 2015; 60: 368–374.

[40] López-García S, Pecci-Lloret MP, García-Bernal D, Guerrero-Gironés J, Pecci-Lloret MR, Rodríguez-Lozano FJ. Are denture adhesives safe for oral cells? Journal of Prosthodontics. 2021; 30: 65–70.

[41] López-García S, Pecci-Lloret MP, Pecci-Lloret MR, Guerrero-Gironés J, Rodríguez-Lozano FJ, García-Bernal D. Topical fluoride varnishes promote several biological responses on human gingival cells. Annals of Anatomy. 2021; 237: 151723.

[42] López-García S, Guerrero-Gironés J, Pecci-Lloret MP, Pecci-Lloret MR, Rodríguez-Lozano FJ, García-Bernal D. In vitro biocompatibility of CPP-ACP and fluoride-containing desensitizers on human gingival cells. Operative Dentistry. 2021; 46: E264–E275.

[43] Tabatabaei MH, Mahounak FS, Asgari N, Moradi Z. Cytotoxicity of the ingredients of commonly used toothpastes and mouthwashes on human gingival fibroblasts. Frontiers in Dentistry. 2019; 16: 450–457.

[44] Cvikl B, Lussi A, Moritz A, Gruber R. Dentifrices for children differentially affect cell viability in vitro. Clinical Oral Investigations. 2017; 21: 453–461.

[45] Birant S, Duran Y, Akkoc T, Seymen F. Cytotoxic effects of different detergent containing children’s toothpastes on human gingival epithelial cells. BMC Oral Health. 2022; 22: 66.

[46] Yadavalli T, Ames J, Agelidis A, Suryawanshi R, Jaishankar D, Hopkins J, et al. Drug-encapsulated carbon (DECON): a novel platform for enhanced drug delivery. Science Advances. 2019; 5: eaax0780.

[47] Yusuf Aliyu A, Adeleke OA. Nanofibrous scaffolds for diabetic wound healing. Pharmaceutics. 2023; 15: 986.

[48] Chen L, Shi W, Zhang T, Zhou Y, Zhao F, Ge W, et al. Antibacterial activity of lysozyme-loaded cream against MRSA and promotion of scalded wound healing. International Journal of Pharmaceutics. 2022; 627: 122200.

[49] Bayrak GD, Sandalli N, Selvi-Kuvvetli S, Topcuoglu N, Kulekci G. Effect of two different polishing systems on fluoride release, surface roughness and bacterial adhesion of newly developed restorative materials. Journal of Esthetic and Restorative Dentistry. 2017; 29: 424–434.

[50] Tonguc-Altin K, Sandalli N, Duman G, Selvi-Kuvvetli S, Topcuoglu N, Kulekci G. Development of novel formulations containing Lysozyme and Lactoferrin and evaluation of antibacterial effects on Mutans Streptococci and Lactobacilli. Archives of Oral Biology. 2015; 60: 706–714.

[51] Saddiq AA, Al-Ghamdi H. Aloe vera extract: a novel antimicrobial and antibiofilm against methicillin resistant Staphylococcus aureus strains. Pakistan Journal of Pharmaceutical Sciences. 2018; 31: 2123–2130.

[52] Bijle MNA, Ekambaram M, Lo ECM, Yiu CKY. The combined antimicrobial effect of arginine and fluoride toothpaste. Scientific Reports. 2019; 9: 8405.

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,500 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Biological Abstracts Easily discover critical journal coverage of the life sciences with Biological Abstracts, produced by the Web of Science Group, with topics ranging from botany to microbiology to pharmacology. Including BIOSIS indexing and MeSH terms, specialized indexing in Biological Abstracts helps you to discover more accurate, context-sensitive results.

Google Scholar Google Scholar is a freely accessible web search engine that indexes the full text or metadata of scholarly literature across an array of publishing formats and disciplines.

JournalSeek Genamics JournalSeek is the largest completely categorized database of freely available journal information available on the internet. The database presently contains 39226 titles. Journal information includes the description (aims and scope), journal abbreviation, journal homepage link, subject category and ISSN.

Current Contents - Clinical Medicine Current Contents - Clinical Medicine provides easy access to complete tables of contents, abstracts, bibliographic information and all other significant items in recently published issues from over 1,000 leading journals in clinical medicine.

BIOSIS Previews BIOSIS Previews is an English-language, bibliographic database service, with abstracts and citation indexing. It is part of Clarivate Analytics Web of Science suite. BIOSIS Previews indexes data from 1926 to the present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Scopus: CiteScore 2.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Submission Turnaround Time