Comparative evaluation of guava leaf extract and chlorhexidine mouthwash in plaque-induced gingivitis: A clinical and computational approach

Background Gingivitis can be found in up to 90% of the population with dental plaque being the primary cause and chemical approaches such as antimicrobial mouth washes, for eliminating plaque, are suggested for either supplementing the mechanical removal of plaque or, in some instances, substituting for it. Aim This study aimed to evaluate the efficacy of a mouthwash containing guava leaf extract and compare it with standard chlorhexidine mouthwash as adjuncts to professional scaling for plaque-induced gingivitis among young adults. Methods This study was performed as a triple-blinded, randomized controlled trial and study participants were allocated into two groups, with one receiving 0.15% hydro-ethanolic guava mouthwash, and the other receiving 0.12% chlorhexidine, of 10 ml each for 30 s, twice daily, for two weeks as adjuncts to professional scaling along with appropriate tooth brushing. Results The analysis showed that both 0.15% guava and 0.12% chlorhexidine mouthwashes demonstrated significant reductions in median plaque and gingival scores from baseline to 28 th day (p < 0.001). But no significant difference was noted between the guava and chlorhexidine mouthwashes at the end of the 28 th day in median plaque and gingival scores (p > 0.05). In addition, the computational study revealed strong binding by docking with Prolyl Tripeptidyl Aminopeptidase and consistent binding through dynamics simulations, elucidating that the Ellagic acid present in the guava could be a potent compound against P. gingivalis . Conclusion The present study concluded that 0.15% hydro-ethanolic guava mouthwash could be an adjunct to professional scaling for plaque-induced gingivitis on par with chlorhexidine mouthwash when appropriate tooth brushing techniques are followed.