Efficacy of Neem and Cinnamon Extracts in Reducing Bacterial Contamination during Scaling: A Randomised Clinical Study

Introduction: Ultrasonic scaling involves the production of a high amount of aerosols, which combine with oral microbes and become a potential source of airborne contaminants. Chemical antimicrobial agents like Chlorhexidine (CHX) (the gold standard) are known to reduce microbial contamination in dental waterlines. However, natural extracts are gaining popularity as an economical yet effective means of reducing bacterial load.Aim: To compare the efficacy of neem and cinnamon extracts in reducing bacterial contamination during scaling. Materials and Methods: A single-centered, parallel multiple-arm, randomised clinical study was conducted at the Department of Periodontics and Oral Implantology, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India from September 2019 to March 2020. Scaling was performed for patients in all four groups (n=128, 32 each group) -Water, 0.2% Chlorhexidine, Neem, and Cinnamon Extract. Two blood agar petri dishes were placed on either side of the patient at a distance of 40 cm from the patient's head, and one blood agar petri dish was placed on the operator's chest. The agar plates were then incubated aerobically for 48 hours for Colony Forming Units (CFU) count. Statistical analysis was performed using one-way Analysis of Variance (ANOVA) and Tukey's posthoc test.Results: Cinnamon showed a 25.2% reduction in CFUs, whereas neem showed an 11.7% reduction compared to distilled water. However, chlorhexidine had the maximum bacterial reduction. The agar plates at the chest position had the highest bacterial growth, while the left position had comparatively fewer microbial colonies. Conclusion: Chlorhexidine exhibited the highest percentage of CFU reduction. However, when used as a Dental Unit Water Line (DUWL) coolant, herbal extracts such as cinnamon and neem caused a significant reduction in CFUs compared to distilled water, with cinnamon performing better than neem. Therefore, herbal extracts like neem and cinnamon can be considered cost-effective alternatives for minimising aerosol contamination in DUWL.