Comparative Effects of Mouthwash Containing Trachypermum ammi Oil with Chlorhexidine on Dental Plaque Induced Gingivitis

Document Type: Original paper


1 School of Pharmacy, International Campus, Tehran University of Medical Sciences, Tehran, Iran. Department of Periodontology, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Periodontology, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.

3 Department of Health Science Educational Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.

4 Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.


Background and objectives: The primary etiology for gingivitis is dental plaque resulting in gum inflammation. Beside mechanical procedures, chemical agents in mouthwash can help in removal of plaques. Oil of Trachyspermum ammi rich in thymol may provide beneficial effect in control of gingivitis; therefore, the present study aimed to compare the effect of mouthwash containing the oil with chlorhexidine to control dental plaque and inflammation of gingivae. Methods: Essential oil of the plant was analyzed using GC-MS and amount of thymol was assayed by GC method. Herbal mouthwash was prepared and applied in an open-label non-randomized study, adult female and male suffering of gingivitis (N=30) entered in two groups after oral prophylaxis. Examining for plaque index (PI), bleeding index (BI), and modified gingival index (MGI) were conducted after two weeks administration of the herbal mouthwash. Results: The herbal mouthwash was stable for two months with no physical change and microbial contamination (0.05). Conclusion: The effect of T. ammi oil in control of inflammation was comparable with chlorhexidine, while chlorhexidine reduced risks of PI, BI, and MGI higher than those receiving the herbal mouthwash.


Main Subjects

[1] Darby ML, Walsh M. Dental hygiene-e-book: theory and practice. Ontario: Elsevier health sciences, 2009.
[2] Wiebe CB, Putnins EE. The periodontal disease classification system of the American Academy of Periodontology-an update. J Can Dent Assoc. 2000; 66(11): 594-599.
[3] Teles RP, Teles FRF. Antimicrobial agents used in the control of periodontal biofilms: effective adjuncts to mechanical plaque control? Braz Oral Res. 2009; 23(1): 39-48.
[4]  Löe H, Rindom Schiott C. The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontal Res. 1970; 5(2): 79-83.
[5] Gandomi H, Abbaszadeh S, JebelliJavan A, Sharifzadeh A. Chemical constituents, antimicrobial and antioxidative effects of Trachyspermum ammi essential oil. J Food Process Pres. 2014; 38(4): 1690-1695.
[6] Vazirian M, Hamidian K, Noorollah M, Manayi A, Samadi N. Enhancement of antibiotic activity and reversal of resistance in clinically isolated methicillin-resistant Staphylococcus aureus by Trachyspermum ammi essential oil. Res J Pharmacogn. 2019; 6(1): 1-10.
[7] Omidpanah S, Vazirian M, Hosseinkhani F, Hadjiakhondi A, Hamedani M, Manayi A. Antibacterial activity of essential oil of Trachyspermum ammi (L.) Sprague ex Turrill against isolated and standard bacteria. Am J Essent Oil Nat. 2016; 4(42): 5-11.
[8] Basch E, Ulbricht C, Hammerness P, Bevins A, Sollars D. Thyme (Thymus vulgaris L.), thymol. J Herb Pharmacother. 2004; 4(1): 49-67.
[9] Adams RP. Identification of essential oil components by gas chromatography/mass spectrometry. Carol Stream: Allured publishing corporation, 2007.
[10] López-Blanco C, Gómez-Álvarez S, Rey-Garrote M, Cancho-Grande B, Simal-Gándara J. Determination of carbamates and organophosphorus pesticides by SDME–GC in natural water. Anal Bioanal Chem. 2005; 383(4): 557-561.
[11] Rowe RC, Sheskey PJ, Owen SC. Handbook of pharmaceutical excipients. London: Pharmaceutical press, 2006.
[12] The European Agency for the Evaluation of Medicinal Products. Note for guidance on in-use stability testing of human medicinal products 2001 [Accessed 2019]. Available from:
[13] Mamgain P, Kandwal A, Mamgain RK. Comparative evaluation of triphala and ela decoction with 0.2% chlorhexidine as mouthwash in the treatment of plaque-induced gingivitis and halitosis: a randomized controlled clinical trial. J Evid Based Complement Altern Med. 2017; 22(3): 468-472.
[14] Southern EN, McCombs GB, Tolle SL, Marinak K. The comparative effects of 0.12% chlorhexidine and herbal oral rinse on dental plaque-induced gingivitis. J Am Dent Hyg Assoc. 2006; 80(1): 1-9.
[15] Silness J, Löe H. Periodontal disease in pregnancy II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964; 22(1): 121-135.
[16] Lang NP. Periodontal epidemiological indices for children and adolescents: II. Evaluation of oral hygiene; III. Clinical applications. Pediatr Dent. 1982; 4(1): 64-73
[17] Thalheimer W, Cook S. How to calculate effect sizes from published research: a simplified methodology. Work Learn Res. 2002; 1(1): 1-9.
[18] Sullivan GM, Feinn R. Using effect size-or why the p value is not enough. J Grad Med Educ. 2012; 4(3): 279-282.
[19] Kazemi M. Chemical composition and antimicrobial, antioxidant activities and anti-inflammatory potential of Achillea millefolium L., Anethum graveolens L., and Carum copticum L. essential oils. J Herb Med. 2015; 5(4): 217-222.
[20] Abdel-Hameed ESS, Bazaid SA, Al Zahrani O, El-Halmouch Y, El-Sayed MM, El-Wakil E. Chemical composition of volatile components, antimicrobial and anticancer activity of n-hexane extract and essential oil from Trachyspermum ammi L. seeds. Orien J Chem. 2014; 30(4): 1653-1662.
[21] Marchese A, Orhan IE, Daglia M, Barbieri R, Di Lorenzo A, Nabavi SF, Gortzi O, Izadi M, Nabavi SM. Antibacterial and antifungal activities of thymol: a brief review of the literature. Food Chem. 2016; 210(1): 402-414.
[22] Chapple IL, Van der Weijden F, Doerfer C, Herrera D, Shapira L, Polak D, Madianos P, Louropoulou A, Machtei E, Donos N. Primary prevention of periodontitis: managing gingivitis. J Clin Periodontol. 2015; 42(S): 71-76.
[23] James P, Worthington HV, Parnell C, Harding M, Lamont T, Cheung A, Whelton H, Riley P. Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev. 2017; Article ID CD008676.
[24] Goes P, Dutra CS, Lisboa MR, Gondim DV, Leitão R, Brito GA, Rego RO. Clinical efficacy of a 1% Matricaria chamomila L. mouthwash and 0.12% chlorhexidine for gingivitis control in patients undergoing orthodontic treatment with fixed appliances. J Oral Sci. 2016; 58(4): 569-574.
[25] Kandwal A, Mamgain RK, Mamgain P. Comparative evaluation of turmeric gel with 2% chlorhexidine gluconate gel for treatment of plaque induced gingivitis: a randomized controlled clinical trial. Ayu. 2015; 36(2): 145-150.
[26] Parikh-Das AM, Sharma NC, Du Q, Charles CA. Superiority of essential oils versus 0.075% CPC-containing mouth rinse: a two-week randomized clinical trial. J Clin Dent. 2013; 24(3): 94-99.
[27] Charles C, Mostler K, Bartels L, Mankodi S. Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial. J Clin Periodontol. 2004; 31(10): 878-884.
[28] Van Leeuwen M, Slot D, Van der Weijden G. Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review. J Periodontol. 2011; 82(2): 174-194.
[29] Pan PC, Harper S, Ricci-Nittel D, Lux R, Shi W. In-vitro evidence for efficacy of antimicrobial mouthrinses. J Dent. 2010; 38(1): 16-20.
[30] Gunsolley JC. A meta-analysis of six-month studies of antiplaque and antigingivitis agents. J Am Dent Assoc. 2006; 137(12): 1649-1657.
[31] Andrade L, de Sousa D. A review on anti-inflammatory activity of monoterpenes. Molecules. 2013; 18(1): 1227-1254.
[32] Osso D, Kanani N. Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations. J Am Dent Hyg Assoc. 2013; 87(1): 10-18.
[33] Amoian B, Omidbakhsh M, Khafri S. The clinical evaluation of Vi-one chlorhexidine mouthwash on plaque-induced gingivitis: a double-blind randomized clinical trial. Electron Physician. 2017; 9(9): 5223-5228.