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Clinical effectiveness of tea tree oil (TTO) in plaque and gingivitis

tea tree oil in orthodonticsThis article is sponsored content brought to you by TrollDental.

Origin and properties of tea tree oil (TTO)

TTO is derived from the Australian paper bark tea tree which is part of the family Myrtaceae. Aborigines have used TTO leaves as infusion or compresses in chills, sore throats and for treatment of wounds (SALLER&REICHLING1995). Nowadays we know TTO is composed of about 100 terpines. The most effective antimicrobial components are: terpines-4-ol, pines, linalool and terpineol.

The lipophil terpines penetrate the cell membrane of the microorganisms and have a toxic effect on the membrane structure and its functions (GUSTAFSON et al. 1998, COX et al. 2000, MANN et al. 2000). TTO exhibits an antimicrobial activity against a wide range of gram-positive and gram-negative bacteria, yeasts and fungi (CARSON&RILEY 1995, HAMMER et al. 2000, MAUDSLEY&KERR 1999).

Clinical evidence of TTO in dentistry

Already at the beginning of the past century, TTO was recommended as an antiseptic in dentistry (MACDONALD 1930). Meanwhile, the positive effects of TTO products on oral microorganisms was proved (SHAPIRO et al. 1994, WALSH&LONGSTAFF 1987).

Antimicrobial activity of tea tree oil (TTO) versus Chlorhexidin (CHX)

In the study at the Institute for Preventive Dentistry and Oral Microbiology of the University in Basel, the bacteriostatic and bactericidal/fungicidal activity of a TTO-solution, of a new TTO-gel (Tebodont® Gel) and the respective placebo-gel, of a chlorhexidindigluconate-solution (CHX-solution) and of Plak-Out® (CHXgel) was tested in vitro against 10 different oral microorganisms. Minimum inhibitory concentrations were in the range from 0.0293% to 1.25% for the TTO-solution and from 0.0082% to 1.25% for the TTO-gel. The values for minimum bactericidal/fungicidal concentrations were in the range from 0,0521% to 2.5% for the TTO-solution and from <0.0098% to 3.33% for the TTO-gel.

The most susceptible microorganisms were Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum and Porphyromonas gingivalis, whereas Streptococcus mutans and Prevotella intermedia were the least susceptible ones. Both, for the CHX-solution and for Plak-Out® the values for the minimal inhibitory concentration and for the minimal bactericidal concentration were between <0.0002% and 0.0125%. This in-vitro study confirmed a 2% TTO-solution and a gel for oral application with 2% TTO (Tebodont® Gel) inhibit the growth of all the investigated 10 germs and killed 9 of them (KULIK et al. 2000).

Clinical effectiveness of tea tree oil (TTO) in plaque and gingivitis

In a randomised double-blind study a mouthrinse containing 1.5% TTO-oil and 10% Xylitol (Tebodont®) was evaluated regarding plaque and the influence on inflammation in comparison with a placebo-rinse. The TTO-mouthrinse significantly reduced the inflammation (26-32%) from the start of the application and during the following 3 months. The reduction of the inflammation was even more pronounced on the areas where the toothbrush does not reach the surface of the teeth (SAXER et al. 2003).

While applying the TTO-rinse the plaque amount was reduced significantly on all tooth surfaces but when using the placebo-rinse the plaque increased (SAXER et al. 2003). Both solutions did not influence the oral cavity regarding reactions on the oral tissue and the oral mucuosa.

Australian examinators assessed the effects of a topically applied TTO-gel (2,5%), CHX-gel (0.2%) and a placebo-gel on dental plaque and chronic gingivitis in an 8 weeks double-blind study in 49 patients with severe chronic gingivitis. The TTO group had a significant reduction in PBI (Papillary Bleeding Index) and GI (Gingival Index) scores. Although none of the groups did significantly reduce PSS (Plaque Staining Score), the reduction of the gingivitis was more pronounced in the tea tree oil group (SOUKOULIS&HIRSCH 2004).

Conclusions

TTO shares a similar range of antimicrobial activity with CHX. They both have antibacterial, antiviral and antifungal properties. The TTO oral care products are a herbal alternative in chronic gingivitis and periodontitis, which does neither discolour the teeth nor change the sense of taste. Their typical taste of TTO gives a lasting refreshing sensation in the mouth.

TrollDental identified the additional needs that orthodontic patients have between periodic check-ups and tightening. For this reason, the Tea Tree Oil based Mouthrinse and toothpaste was introduced to assist fighting inflammation and infection. Though there is no current research to support the use of TTO in orthodontics, the proven research when used against periodotitis and gingivitis suggests the rejuvenation delivered by the antibacterial, anti-fungal and anti-bacterial properties of TTO (in the correct concentrations) will deliver an environment that allows gingiva to return to a healthy state.

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Bibliography

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