Antimicrobial effect of garlic-based mouthwash on dental caries-related oral microorganisms: A systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#garlic #humans #mouthwashes #dental-caries #streptococcus-mutans

Antimicrobial effect of garlic-based mouthwash on dental caries-related oral microorganisms: A systematic review and meta-analysis

de et al., 2026 | Arch Oral Biol | Meta Analysis

Citation

de Oliveira Alves Renata, de Matos José Roberto Vergínio, ... Nunes Gabriel Pereira. Antimicrobial effect of garlic-based mouthwash on dental caries-related oral microorganisms: A systematic review and meta-analysis. Arch Oral Biol. 2026-Mar;183:106495. doi:10.1016/j.archoralbio.2025.106495

Abstract

OBJECTIVE: This systematic review and meta-analysis (SRM) investigated the potential of garlic (Allium sativum) against cariogenic oral microorganisms. DESIGN: The SRM was conducted following PRISMA guidelines and registered in PROSPERO (CRD420251133140). Randomized clinical trials (RCTs) evaluating garlic or garlic-derived compounds on cariogenic oral microorganisms were included. A literature search was performed in the main scientific databases. Meta-analyses were performed using RevMan software, with standardized mean difference (SMD) as the effect measure, and a random-effects model was applied with 95 % confidence intervals. Risk of bias was assessed using the Cochrane tool, and the certainty of evidence was graded according to the GRADE approach. RESULTS: Nine RCTs fulfilled the inclusion criteria, predominantly assessing S. mutans, followed by Lactobacillus spp. and C. albicans. All included trials employed garlic-based mouthwashes as the intervention and consistently demonstrated significant antimicrobial activity. In meta-analysis, compared to chlorhexidine, garlic reduced S. mutans at 1 week (SMD = -0.73, 95 % CI = -1.39 to -0.07, I² = 73 %; p = 0.03), had a slightly lower effect at 2 weeks (SMD = 1.27, 95 % CI = 0.09-2.44, I² = 90 %; p = 0.03), and showed no difference at 1 month (SMD = -0.54, 95 % CI = -2.78-1.70, I² = 96 %; p = 0.64). Compared to sodium fluoride, it demonstrated superior activity at 2 weeks (SMD = -0.79, 95 % CI = -1.22 to -0.36, I² = 0 %; p = 0.0003). Most studies had a low risk of bias, and the certainty of the evidence was rated low. CONCLUSIONS: Garlic-based mouthrinses show significant antimicrobial activity against cariogenic microorganisms, supporting their potential as a phytotherapeutic strategy for biofilm control. However, the evidence remains limited, demonstrating the need for further high-quality clinical trials to confirm long-term efficacy.

Key Findings

Nine RCTs fulfilled the inclusion criteria, predominantly assessing S. mutans, followed by Lactobacillus spp. and C. albicans. All included trials employed garlic-based mouthwashes as the intervention and consistently demonstrated significant antimicrobial activity. In meta-analysis, compared to chlorhexidine, garlic reduced S. mutans at 1 week (SMD = -0.73, 95 % CI = -1.39 to -0.07, I² = 73 %; p = 0.03), had a slightly lower effect at 2 weeks (SMD = 1.27, 95 % CI = 0.09-2.44, I² = 90 %; p = 0.0

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Garlic
  • Humans
  • Mouthwashes
  • Dental Caries
  • Streptococcus mutans
  • Candida albicans
  • Chlorhexidine
  • Lactobacillus
  • Randomized Controlled Trials as Topic
  • Anti-Infective Agents
  • Mouth

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Systematic Review, Meta-Analysis, Review
  • Vertical: garlic

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09