The oral cavity harbors hundreds of microorganisms that may be uncontrolled and provoke several diseases. In this sense, periodontitis is a complex multifactorial disease with an essential microbial component in its etiology. Periodontal treatment involves mechanical control of the supra- and subgingival biofilm, but not all patients respond predictably to treatment. In this way, the biofilm chemical control helps in the reduction of periodontal pathogens during treatment or in the delay of bacterial re-colonization after scaling and root planning. Several products have been studied as adjunctive therapy and have shown promising results. Therefore, the present article reviews the biological effects of propolis, aloe vera, green tea, cranberry, calendula, myrrha and salvia that may support their use in the control of subgingival biofilm in patients with periodontitis. All the natural products cited above showed exciting results against microorganisms related to oral diseases, mainly periodontitis. These substances also have anti-inflammatory and antioxidant activities. The natural agents propolis, aloe vera, green tea, cranberry, calendula, myrrha and salvia demonstrated potential to be used as oral hygiene products, based on their antimicrobial and anti-inflammatory actions.

The effect of systemic antibiotics on the microbial profile of extracrevicular sites after periodontal treatment is currently the subject of research. This study evaluated the microbiological effects on different oral cavity sites of scaling and root planing (SRP) combined with antimicrobial chemical control in the treatment of periodontitis. Sixty subjects were randomly assigned to receive SRP alone or combined with metronidazole (MTZ) + amoxicillin (AMX) for 14 days, with or without chlorhexidine mouth rinse (CHX) for 60 days. Microbiological samples were evaluated by checkerboard DNA–DNA hybridization until 180 days post therapy. The adjunctive use of antibiotics plus CHX significantly reduced the mean proportions of red complex species from subgingival biofilm and saliva (p < 0.05). Furthermore, the analysis of all intraoral niches showed a significantly lower mean proportion of the red complex species in the same group. In conclusion, the concomitant use of antimicrobial chemical control (systemic and local) demonstrated a beneficial effect on the composition of the oral microbiota.

Evidence has shown the clear positive effects of nature-based products on biofilm control and improved gingival health. However, most studies have used in vitro models, have tested single natural components, or have not evaluated proteomic changes after treatment. This double-blind, parallel, randomized, and controlled clinical trial evaluated the benefits of a nature-based gel in controlling gingival inflammation and its effects on the proteomic gingival crevicular fluid (GCF) profile. Gingivitis patients were distributed into the following groups: (1) nature-based gel containing propolis, aloe vera, green tea, cranberry, and calendula (n = 10); (2) control—conventional toothpaste (n = 10). GCF was collected and evaluated by means of liquid chromatography coupled with tandem mass spectrometry (LC–MS/MS). At 3 months, the groups showed similar clinical benefits (p < 0.05). A total of 480 proteins were identified across all groups. In a pooled comparison of both groups at both time points, exclusive proteins were identified in the nature-based gel (78) and the control (21) groups. The exclusive proteins identified for the toothpaste mainly acted in wound healing, and those for the nature-based gel mainly acted on immune system processes. The nature-based gel achieved similar clinical outcomes to conventional toothpaste. However, the nature-based gel markedly changed the proteomic profile of GCF after treatment, showing a profile associated with a host response.

A periodontite é uma doença multifatorial complexa, sendo que o componente microbiano tem uma importância essencial em sua etiologia e progressão. O tratamento periodontal envolve o controle mecânico dos biofilmes supragengival e subgengival, mas nem todos os pacientes respondem de forma previsível ao tratamento. Dessa forma, o controle químico do biofilme auxilia na redução de patógenos periodontais durante o tratamento ou no retardo de recolonização bacteriana após raspagem e alisamento radicular. Vários produtos têm sido estudados para uso como terapia adjuvante e têm mostrado resultados satisfatórios. Dentre eles, os produtos naturais estão alcançando um patamar promissor. Assim, o objetivo desta revisão de literatura é avaliar o potencial antimicrobiano de extratos vegetais na microbiota bucal. Os efeitos biológicos da própolis, Aloe vera, chá verde, cranberry, calêndula, mirra e sálvia suportam o uso na cavidade bucal, com destaque a ação antimicrobiana no controle do biofilme subgengival em pacientes com periodontite. Essas substâncias também possuem atividades antiinflamatórias e antioxidantes. Apesar dos resultados encorajadores para o uso de produtos naturais na higiene bucal, novos estudos são necessários a fim de confirmarem por meio de estudos clínicos bem delineados sua aplicação clínica.