Comparative In Vitro Evaluation of the Antimicrobial Efficacy of Tulsi, Triphala, and Aloe Vera against Streptococcus mutans Relative to Chlorhexidine

Abstract

Aim and background: Long-term use of chlorhexidine as an antibacterial mouthwash has been associated with several adverse effects. 80% of the population in developing countries relies on traditional medicines and natural products to meet their primary healthcare needs. This study aimed to evaluate the antibacterial efficacy of herbal extracts and to compare their effectiveness with that of 0.2% chlorhexidine mouth rinse. Methods: The herbal extracts used were Ocimum sanctum (tulsi), a mixture of Emblica Officinalis, Terminalia chebula, and Terminalia belericia (triphala), and Aloe Barbadensis Miller (aloe vera). Blood agar plates were inoculated with Streptococcus mutans, and inhibition zones were measured after 24 hours of incubation at 37°C. Results: Chlorhexidine exhibited the highest antibacterial activity, followed by tulsi, triphala, and aloe vera. The mean inhibition zone diameters (in mm) were 22.33 ± 0.8, 11 ± 0.603, 8.6 ± 0.77, and 8 ± 0.6, respectively. Intergroup comparison revealed statistically significant differences (p = 0.00), favoring chlorhexidine over the herbal extracts. Intragroup analysis also showed significant differences (p = 0.00), with tulsi demonstrating the highest antibacterial activity among the herbal extracts, followed by triphala and aloe vera. Conclusion: Within the limitations of this in vitro study, all tested herbal extracts exhibited antibacterial properties against S. mutans. However, chlorhexidine showed the highest efficacy. Among the herbal extracts, tulsi demonstrated the most potent antibacterial activity, followed by triphala, while aloe vera exhibited the least effectiveness. Clinical significance: As the plant extracts demonstrated a notable efficacy in inhibiting the proliferation of oral bacteria, this suggests that these extracts could be formulated into an herbal antibacterial mouth rinse option suitable for individuals seeking herbal alternatives. ©TheAuthor(s). 2025OpenAccess.