Efficacy of green tea and its extract, epigallocatechin-3-gallate, in the reduction of cariogenic microbiota in children: a randomized clinical trial

Abstract

Objective: This study was conducted to evaluate and compare the antimicrobial efficacy of green tea and its extract epigallocatechin-3-gallate (EGCG) as a mouthwash in children.

Design: The study group included 47 children aged 5-12 years at high caries risk and prevalence. Children selected were asked to rinse with one of the substances (EGCG, green tea, chlorhexidine and distilled water) for one min. A non-stimulated salivary sample (2 mL) was collected at baseline and after rinsing. The concentration of cariogenic microorganisms (mutans streptococci and lactobacilli) was determined before and after rinsing based on the count of colony-forming units (CFU). CFU were counted with the aid of a stereomicroscope through the perfunctory identification of the morphological characteristics of CFU. The microbial reduction percentage was then calculated.

Results: The analysis of the effectiveness of the treatments showed that there was a significant reduction in relation to the values obtained before and after the mouthwash, both for mutans streptococci (pCHX = 0.001; pEGCG = 0.001; pGreen Tea = 0.005; pDistilled Water = 0.018) and lactobacilli (pCHX = 0.001; pEGCG = 0.002; pGreen Tea = 0.008; pDistilled Water = 0.033). The percentage of microbial reduction of both cariogenic microorganisms caused by the EGCG solution was higher than green tea and distilled water, but less than CHX. The percentage of microbial reduction by the EGCG solution for mutans streptococci was 79.9%, green tea 68.3%, distilled water 50.6% and CHX 95.5%. For lactobacilli, the percentage reduction of all solutions was relatively lower when compared to mutans streptococci. For the EGCG solution it was 72.09%, followed by green tea 59.17% and distilled water 41.96%, but less than CHX 86.02%.

Conclusion: Rinsing with EGCG solution reduced the levels of mutans streptococci and lactobacilli in the oral cavity of children. Although EGCG had better antimicrobial activity than green tea, this study supports the effectiveness of both as an antibacterial mouthwash option. Both EGCG and green tea could be used as alternatives to chlorhexidine-based mouthwashes.

Keywords: antimicrobial agent; children; epigallocatechin-3-gallate; green tea; saliva.