The effects of a tea tree oil-containing gel on plaque and

The effects of a tea tree oil-containing gel on plaque and chronic gingivitis
S Soukoulis,* R Hirsch*, Australian Dental Journal 2004;49:(2):78-83
Abstract
Background: This clinical study assessed the effects of topically applied tea tree oil (TTO)-
containing gel on dental plaque and chronic gingivitis.
Methods: This was a double-blind, longitudinal, non-crossover study in 49 medically fit non-
smokers (24 males and 25 females) aged 18-60 years with severe chronic gingivitis. Subjects were
randomly assigned to three groups and given either TTO-gel (2.5 per cent), chlorhexidine (CHX) gel
(0.2 percent), or a placebo gel to apply with a toothbrush twice daily.
Treatment effects were assessed using the Gingival Index (GI), Papillary Bleeding Index (PBI)
and plaque staining score (PSS) at four and eight weeks.
Results: No adverse reactions to any of the gels were reported. The data were separated into subsets
by tooth (anterior and posterior) and tooth surface (buccal and lingual). The TTO group had
significant reduction in PBI and GI scores. However, TTO did not reduce plaque scores, which
tended to increase over the latter weeks of the study period.
Conclusion: Although further studies are required, the anti-inflammatory properties of TTO-
containing gel applied topically to inflamed gingival tissues may prove to be a useful non-toxic
adjunct to chemotherapeutic periodontal therapy.
REFERENCES
1. Barr A, Chapman J, Smith N, Beveridge M. Traditional bush medicines – An Aboriginal pharmacopoeia.
Victoria: Greenhouse Publications, 1988.
2. Juergens UR, Stober M, Schmidt-Schilling L, Kleuver T, Vetter H.Antiinflammatory effects of eucalyptol
(1.8-cineole) in bronchial
asthma: inhibition of arachidonic acid metabolism in human blood monocytes ex vivo. Eur J Med Res
1998;3:407-412.
3. Juergens UR, Stober M, Vetter H. Inhibition of cytokine production and arachidonic acid metabolism by
eucalyptol (1.8-cineole) in human blood monocytes in vitro. Eur J Med Res
1998;3:508-510.
4. Santos FA, Rao VS. Antiinflammatory and antinociceptive effects of 1,8-cineole a terpenoid oxide present
in many plant essential oils. Phytother Res 2000;14:240-244.
5. Williams AC, Barry BW. Terpenes and the lipid-proteinpartitioning theory of skin penetration enhancement.
Pharm Res 1991;8:17-24.
6. Hart PH, Brand C, Carson CF, Riley TV, Prager RH, Finlay-Jones JJ. Terpinen-4-ol, the main component of
the essential oil of Melaleuca alternifolia (tea tree oil), suppresses inflammatory
mediator production by activated human monocytes. Inflamm Res 2000;49:619-626.
7. Brand C, Ferrante A, Prager RH, et al. The water soluble components of the essential oil of Melaleuca
alternifolia (tea tree oil) suppress the production of superoxide by human monocytes,
but not neutrophils, activated in vitro. Inflamm Res 2001;50:213-219.
8. Carson CF, Cookson BD, Farrelly HD, Riley TV. Susceptibility of methicillin-resistant Staphylococcus
aureus to the essential oil of Melaleuca alternifolia. J Antimicrob Chemother 1995;35:421-424.
9. Carson CF, Riley TV. Antimicrobial activity of the major components of the essential oil of Melaleuca alternifolia. J Appl Bacteriol 1995;78:264-269. 10. Hammer KA, Carson CF, Riley TV. In vitro susceptibility of Malassezia furfur to the essential oil of Melaleuca alternifolia. J Med Vet Mycol 1997;35:375-377. 11. Hammer KA, Carson, CF, Riley TV. In-vitro activity of essential oils, in particular Melaleuca alternifolia (tea tree) oil and tea tree oil products, against Candida spp. J Antimicrob Chemother 1998;42:591-595. 12. May J, Chan CH, King A, Williams L, French GL. Time-kill studies of tea tree oils on clinical isolates. J Antimicrob Chemother 2000;45:639-643. 13. Moran J, Addy M, Newcombe R. A clinical trial to assess the efficacy of sanguinarine-zinc mouthrinse (Veadent) compared with chlorhexidine mouthrinse (Corsodyl). J Clin Periodontol 1988;15:612-616. 14. Ostela I, Tenovuo J. Antibacterial activity of dental gels containing combinations of amine fluoride, stannous fluoride,and chlorhexidine against cariogenic bacteria. Scand J Dent Res 1990;98:1-7. 15. Shapiro S, Meier A, Guggenheim B. The antimicrobial activity of essential oils and essential oil components towards oral bacteria.Oral Microbiol Immunol 1994;9:202-208. 16. Cox SD, Gustafson JE, Mann CM, et al. Tea tree oil causes K+ leakage and inhibits respiration in Escherichia coli. Lett Appl Microbiol 1998;26:355-358. 17. Cox SD, Mann CM, Markham J, et al. The mode of antimicrobial action of the essential oil of Melaleuca alternifolia (tea tree oil). J Appl Microbiol 2000;88:170-176. 18. Fine DH, Furgang D, Barnett ML, Drew C, Steinberg L, Charles CH, Vincent JW. Effect of an essential oil-containing antiseptic mouthrinse on plaque and salivary Streptococcus mutans levels. J Clin Periodontol 2000;27:157-161. 19. Löe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol 1967;38:610-616. 20. Fischman SL. Current status of indices of plaque. J Clin Periodontol 1986;13:371-374. 21. Hoyos DF, Murray JJ, Shaw L. The effect of chlorhexidine gel on plaque and gingivitis in children. Br Dent J 1977;142:366-369. 22. Joyston-Bechal S, Smales FC, Duckworth R. Effect of metronidazole on chronic periodontal disease in subjects using a topically applied chlorhexidine gel. J Clin Periodontol 1984;11:53-62. 23. Lie T, Enersen M. Effects of chlorhexidine gel in a group of maintenance-care patients with poor oral hygiene. J Periodontol 1986;57:364-369. 24. Meitner SW, Zander HA, Iker HP, Polson AM. Identification of inflamed gingival surfaces. J Clin Periodontol 1979;6:93-97. 25. Hirsch RS, Clarke NG, Townsend GC. The effect of locally released oxygen on the development of plaque and gingivitis in man. J Clin Periodontol 1981;8:21-28. 26. Wolff LF, Koller NJ, Smith QT, Mathur A, Aeppli D. Subgingival temperature: relation to gingival crevicular fluid enzymes, cytokines, and subgingival plaque micro-organisms. J Clin Periodontol 1997;24:900-906. 27. McGee JM, Tucci MA, Edmundson TP, Serio CL, Johnson RB. The relationship between concentrations of proinflammatory cytokines within gingiva and the adjacent sulcular depth. J Periodontol 1998;69:865-871. 28. Arweiler NB, Donos N, Netuschil L, Reich E, Sculean A. Clinical and antibacterial effect of tea tree oil – a pilot study. Clin Oral Investig 2000;4:70-73. 29. Hansen F, Gjermo P, Eriksen HM. The effect of a chlorhexidinecontaining gel on oral cleanliness and gingival health in young adults. J Clin Periodontol 1975;2:153-159. 30. Lennon MA, Davies RM. A short-term evaluation of a chlorhexidine gel on plaque deposits and gingival status.Pharmacol Ther Dent 1975;2:13-19.

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