A recent study from the University of Sharjah reveals that garlic extract may serve as a formidable alternative to chlorhexidine, a widely used antimicrobial mouthwash. The findings indicate that higher concentrations of garlic mouthwash demonstrate comparable, and at times superior, efficacy in killing bacteria, making it a noteworthy contender in oral health care.
The study, published in the Journal of Herbal Medicine, highlights the antimicrobial properties of garlic (Allium sativum). While garlic mouthwash may cause more discomfort than chlorhexidine, it appears to offer longer-lasting effects. The authors of the study state, “Chlorhexidine is widely used as a gold standard mouthwash but is associated with side effects and concerns over antimicrobial resistance. Garlic, known for its natural antimicrobial properties, has emerged as a potential alternative.”
Systematic Review Confirms Garlic’s Efficacy
The researchers conducted a systematic review to compare the effectiveness of garlic extract against chlorhexidine in clinical settings. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, they reviewed a total of 389 articles from six electronic databases in January 2024. After applying inclusion and exclusion criteria, only five articles met their standards for analysis.
The selected literature included randomized controlled trials and clinical studies with variable designs and low-to-moderate risks of bias. The review concluded that higher concentrations of garlic mouthwash showed antimicrobial results on par with those of chlorhexidine. “The effectiveness varied based on mouthwash concentration and duration of application, contributing to differences in outcomes,” the authors noted.
While some studies favored chlorhexidine for maintaining higher plaque or salivary pH, others indicated that garlic extract could be more effective at specific concentrations. The review found that garlic mouthwash may lead to greater discomfort among users, which could influence patient preferences.
Considerations for Clinical Use
Although side effects associated with garlic extract are generally milder than those linked to synthetic mouthwashes, they include a burning sensation and an unpleasant odor. These factors may deter patients from switching from chlorhexidine to garlic-based options. Nonetheless, the review supports the clinical antimicrobial activity of garlic extract, reporting “significant reductions in bacterial counts from baseline,” suggesting its potential as a viable alternative to chlorhexidine in certain contexts.
The authors advocate for further clinical trials with larger participant groups and extended follow-up periods to confirm the effectiveness of garlic as an alternative mouthwash. Currently, chlorhexidine remains the gold standard in antimicrobial mouthwash options.
Garlic has long been acknowledged for its potent antibacterial and antifungal properties. Scientific interest has particularly focused on allicin, a compound known for its strong antimicrobial effects. Although referred to botanically as a vegetable, garlic is commonly used as both an herb and a spice. In 2024, global garlic usage reached about 30 million metric tons, with China accounting for nearly 80 percent of consumption and production. The global garlic extract market was valued at over $15 billion that same year.
Shifting Towards Herbal Alternatives
Garlic extracts are readily available in various over-the-counter health products, contrasting with synthetic agents like chlorhexidine, which often require a prescription. “Antimicrobial mouthwashes constitute an essential adjunct element in oral and dental care,” the review states, emphasizing their role against oral diseases caused by a range of pathogens.
The review also highlights numerous studies demonstrating the antimicrobial effects of garlic extracts against various bacteria, fungi, and viruses. Research has explored garlic’s use in areas such as denture stomatitis and intracanal medication. Despite this growing evidence, many studies remain in vitro, showcasing significant variations in methods and a lack of clinical standardization. This underscores the need for further research to establish garlic’s efficacy in dental practice and address existing gaps in the literature regarding evidence-based antimicrobial therapies.
