Efficacy of alcohol-free mouthwash containing essential oil from the fruits of Zanthoxylum limonella Alston on dental biofilm, gingivitis, and Streptococcus mutans controls

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Thanyaporn Vachirarojpisan
Kanokwan Karnchanarungroj
Chinnakrij Posiri
Phraodara Hongsamsipjet
Rawiwan Charoensup
Wilairat Worapamorn


Objective: To evaluate the efficacy of mouthwash containing essential oil from the fruits of Ma-Khwaen (Zanthoxylum limonella Alston) on dental biofilm, gingival inflammation, and Streptococcus mutans controls.

Materials and Methods: The crossover clinical trial was conducted in twenty-four volunteers who were allocated into three groups according to the types of mouthwash including 0.12% chlorhexidine digluconate (CHX), 0.5% Ma-Khwaen mouthwash (Ma-Kh), and distilled water (DW). After receiving professional prophylaxis and 2 -weeks run-in period, the volunteers started to rinse with their allocated mouthwashes, immediately after brushing in the morning and at night for 14 days. Clinical parameters, plaque index (PI), gingival index (GI), as well as S.mutans colony forming unit (CFU) count from collected supragingival plaque of four molars were conducted at baseline, Day 7, and Day 14. At the end of each experimental phase, the volunteers underwent 2-weeks washout period before starting the second and third allocations.

Results: Both CHX and Ma-Kh groups demonstrated the reduction on PI and GI statistically significant difference from baseline to Day 7 and Day 14. DW had no effects on PI and GI reduction. There was statistically significant difference when compared the efficacy in PI and GI reduction between CHX and DW groups as well as Ma-Kh and DW groups, but no significant difference between CHX and Ma-Kh groups. S.mutans CFU count significantly decreased in CHX group from baseline to Day 7 and Day 14, and in Ma-Kh group from baseline to Day 7. DW had no effect on S.mutans CFU reduction.

Conclusion: The alcohol-free mouthwash formulation containing essential oil from Ma-Khwaen fruits demonstrates the clinical efficacy on dental biofilm and gingival inflammation reduction but has little effect on S.mutans control. Ma-Khwaen mouthwash seems to be possible alternative to CHX mouthwash as part of the daily oral hygiene of patients with gingivitis.


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Vachirarojpisan T, Karnchanarungroj K, Posiri C, Hongsamsipjet P, Charoensup R, Worapamorn W. Efficacy of alcohol-free mouthwash containing essential oil from the fruits of Zanthoxylum limonella Alston on dental biofilm, gingivitis, and Streptococcus mutans controls. M Dent J [Internet]. 2021 Apr. 26 [cited 2023 Dec. 3];41(1):83-90. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/247597
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