Role of Kefir Mouth Wash in Oral Health Status Amelioration

NCT ID: NCT06900881

Last Updated: 2025-04-24

Basic Information

• Recruitment Status: RECRUITING
• Clinical Phase: PHASE2/PHASE3
• Total Enrollment: 60 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2025-04-06
• Study Completion Date: 2025-10-10

Brief Summary

The present research aims to evaluate the efficiency of kefir mouthwash in enhancing oral health status by employing an in vivo experimental approach. Specifically, the study will assess how kefir mouthwash influences key oral health indicators, including gingival inflammation, plaque development, oral hygiene status, and halitosis. The study will be conducted over a 28-day period, with follow-up assessments every 14 days. The study will include systemically healthy adults with moderate gingivitis. Clinical parameters such as the Gingival Index (GI), Plaque Index (PI), and Simplified Oral Hygiene Index (OHI-S) will be measured, along with inflammatory biomarkers, including Interleukin-1β (IL-1β) and Interleukin-10 (IL-10). Halitosis will be evaluated using a Hali meter device. All of these will be measured at base line and day 14 and day 28 end of the study. Chlorhexidine 0.12% will be used as a comparative control to evaluate the efficacy of kefir mouthwash in improving oral health. This research intends to provide scientific evidence supporting the use of kefir as a probiotic-based mouthwash, offering a natural alternative to chemical mouthwashes and potentially reducing the negative consequences commonly associated with their use.

Detailed Description

Due to their antibacterial qualities, conventional oral hygiene products such as chlorhexidine mouthwashes have been extensively used. However, their prolonged usage is often linked to negative effects, including taste changes, tooth discoloration, and mucosal discomfort. In response, natural and probiotic-based substitutes that provide efficient antibacterial activity with minimal adverse effects have attracted increasing attention. One such alternative gaining interest is kefir, a fermented milk product rich in antimicrobial peptides, probiotics, and bioactive components, which will be used in this study to assess the impact of kefir mouthwash on oral health.

The study will involve 60 systemically healthy adults aged 18 to 28 years, with moderate gingivitis. Participants will be selected from dental students at Bilad Al-Rafi Dain University and trained dentists from a specialist dental center in Diyala city. A triple-blind design will be used to eliminate bias, where the participants, the researchers administering the intervention, and the data analysts will all be blind to group assignments. Participants will be randomly assigned to one of two groups: the chlorhexidine 0.12% Bio Fresh group (Scirto Co for Bio Fresh LIC, P.O. Box 87218, Dubai, U.A.E.) or the kefir group (Yogourmet, France).

The research will span 28 days, with three data collection periods: baseline (Day 0), Week 2 (Day 14), and Week 4 (Day 28). Participants will use either kefir mouthwash or chlorhexidine 0.12% Bio Fresh mouthwash twice daily for one minute, 30 minutes after brushing their teeth, while refraining from eating or drinking for one hour after use. Both groups will receive mouthwashes in bottles that are identical in color and shape, labeled with random codes (A or B) to maintain blinding.

The chlorhexidine 0.12% Bio Fresh mouthwash will contain 0.12% Chlorhexidine Digluconate, purified water, sodium saccharin, Cremophor, flavoring, and glycerin, while the kefir mouthwash will be made using kefir powder containing live probiotic strains and active bacterial and yeast cultures, including Lactococcus lactis, Lactococcus cremoris, Lactococcus diacetylactis, Lactobacillus acidophilus, Saccharomyces cerevisiae, Kluyveromyces lactis, and maltodextrin, along with 3% fat milk.

The effectiveness of the mouthwashes will be assessed by evaluating the Plaque Index, Gingival Index, Simplified Oral Hygiene Index, and inflammatory cytokines (IL-1β and IL-10) at baseline, 14 days, and 28 days. Saliva samples will be collected at each follow-up to analyze the inflammatory response, and halitosis will be measured using the Hali Meter device. Participants will be monitored for compliance via daily tracking logs, electronic reminders through a WhatsApp group, and follow-up visits. Non-compliance or failure to adhere to the protocol will result in exclusion from the study.

Conditions

Plaque Induced Gingivitis; Halitosis; Oral Disease

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: TRIPLE

Study Groups

Kefir Mouth Wash

The experimental group will take 60 mL of kefir mouthwash (Yogourmet, France) which contains live probiotic strains and active bacterial and yeast cultures, including (Lactococcus lactis, Lactococcus cremoris, Lactococcus diacetylactis, Lactobacillus acidophilus, Saccharomyces cerevisiae, and Kluyveromyces lactis, and maltodextrin)mixed with milk with 3 percent fat (Pegah, Iran) .The milk will be heated to boiling point and then allow to cool to room temperature (25°C). After cooling, the kefir powder will be dissolved and culture for 24 hours, use 60 ml daily, split into 30 mL in the morning and 30 mL in the evening. To guarantee uniformity in the intervention, participants follow a set rinse technique.

Participants will be instructed to use the respective mouthwash (Kefir mouth wash) twice daily for 1 minute, 30 minutes after brushing their teeth, after the mouthwash application, participants will be advised not to eat or drink anything for one hour to ensure accurate results.

Group Type: ACTIVE_COMPARATOR

Kefir Mouth Wash

Intervention Type: COMBINATION_PRODUCT

A kefir-based mouthwash was developed with active bacterial and yeast cultures, including Lactococcus lactis, Lactococcus cremoris, Lactococcus diacetylactis, Lactobacillus acidophilus, Saccharomyces cerevisiae, and Kluyveromyces lactis, along with maltodextrin and 3% fat milk. The recipe also calls for milk from Pegah, Iran. The milk is initially heated to boiling point and then allowed to cool to room temperature (25°C). After cooling, the kefir powder will be dissolved in the cooled milk and mixed well. For every 1 liter of milk, 3g of kefir starter yogurt (Yogourmet, France) will be added. The inoculated milk will then be transferred into a clean, airtight container, and the lid will be sealed. The container will be left at room temperature for approximately 24 hours until the kefir curd forms. After 24 hours, the kefir will be refrigerated for about 8 hours to halt the fermentation process.

Chlorhexidine 0,12% Bio fresh Mouth Wash

The control group will take 30 mL of 0.12% chlorhexidine Bio fresh mouthwash (Scirto Co for Bio fresh LIC)daily, split into 15 mL in the morning and 15 mL in the evening. To guarantee uniformity in the intervention, participants follow a set rinse technique.

Participants will be instructed to use the respective mouthwash (chlorhexidine) for 28 days twice daily for 1 minute, 30 minutes after brushing their teeth, after the mouthwash application, participants will be advised not to eat or drink anything for one hour to ensure accurate results.

Group Type: OTHER

Chlorhexidine 0,12%Biofresh Mouthwash

Intervention Type: DRUG

Chlorhexidine mouthwash is used as a standard treatment (Scitra Co for Biofresh LIC, P.O. Box 87218, Dubai, U.A.E.). It contains 0.12% Chlorhexidine Digluconate, purified water, sodium saccharin, cremophor, flavor, and glycerin.

Interventions

Kefir Mouth Wash

A kefir-based mouthwash was developed with active bacterial and yeast cultures, including Lactococcus lactis, Lactococcus cremoris, Lactococcus diacetylactis, Lactobacillus acidophilus, Saccharomyces cerevisiae, and Kluyveromyces lactis, along with maltodextrin and 3% fat milk. The recipe also calls for milk from Pegah, Iran. The milk is initially heated to boiling point and then allowed to cool to room temperature (25°C). After cooling, the kefir powder will be dissolved in the cooled milk and mixed well. For every 1 liter of milk, 3g of kefir starter yogurt (Yogourmet, France) will be added. The inoculated milk will then be transferred into a clean, airtight container, and the lid will be sealed. The container will be left at room temperature for approximately 24 hours until the kefir curd forms. After 24 hours, the kefir will be refrigerated for about 8 hours to halt the fermentation process.

Intervention Type: COMBINATION_PRODUCT

Chlorhexidine 0,12%Biofresh Mouthwash

Chlorhexidine mouthwash is used as a standard treatment (Scitra Co for Biofresh LIC, P.O. Box 87218, Dubai, U.A.E.). It contains 0.12% Chlorhexidine Digluconate, purified water, sodium saccharin, cremophor, flavor, and glycerin.

Intervention Type: DRUG

Eligibility Criteria

Inclusion Criteria

• Age range 18-28 years.
• Systemically healthy people without a history of chronic illness.
• Those suffering with moderate gingivitis.
• Not using any antibiotics over three months

Exclusion Criteria

• History of systemic diseases.
• Pregnant, lactating females.
• History of antibiotic therapy in the past 3 months.
• History of oral prophylaxis within the last 6 months prior to the study as this can confound the results, making it difficult to determine the real effect of the mouthwash.
• Subjects with mouth breathing habits.
• Subjects with orthodontic and prosthodontic appliances.
• Subjects with deleterious habits such as smoking, because it may affect oral health status, causing periodontal disease, altered oral microbiota, and impaired healing. This can confound the study results, making it difficult to observe the mouthwash effect .
• Failure to follow the prescription regimen.
• Failure to follow the research protocol.

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 28 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: Yes

Sponsors

Al-Mustansiriyah University

OTHER

Sponsor Role: lead

Responsible Party

ZAHRAA HUSSEIN DAWOOD

Master's Student in Dentistry

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Zahra H Al-Tamimi, MS student

Role: PRINCIPAL_INVESTIGATOR

Department of prevention, College of dentistry , University of Mustansiriyah

Locations

Al-Mustansiriyah University/College of Dentistry

Baghdad, , Iraq

Site Status: RECRUITING

Countries

Iraq

Central Contacts

Zahra H Al-Tamimi, MS student

Role: CONTACT

Zahar94@uomustansiriyah.edu.iq

009647806462936

Zahra H Al-Tamimi, MS student

Role: CONTACT

Zahar94@uomustansiriyah.edu.iq

+964 780 031 5235

Facility Contacts

Zahra H Al-Tamimi, MS student

Role: primary

Zahar94@uomustansiriyah.edu.iq

009647806462936

Zahra H Al-Tamimi, MS student

Role: backup

Zahar94@uomustansiriyah.edu.iq

+964 780 031 5235

Other Identifiers

MUPRVOO15

Identifier Type: -

Identifier Source: org_study_id