The Antifungal Potential of Cardamom-based DenteezTM Mouthwash Against Opportunistic Fungal Infections in the Oral Cavity

Abstract

Oral candidiasis is a fungal infection of the oral cavity caused by Candida albicans. Currently used antifungal drugs fail to treat oropharyngeal candidiasis. Herbal remedies are found to be safe and effective to treat bleeding gums, halitosis, mouth ulcers, and reduce tooth decay. Cardamom is known to possess antimicrobial, antioxidant, and immunomodulatory activity. In an in vitro study, we aim to evaluate the antifungal potential of cardamom-based DenteezTM mouthwash against opportunistic fungal infections in the oral cavity. Five Candida species were included in the study: namely C. albicans, C. tropicalis, C. krusei, C. parapsilosis, and C. glabrata. Additionally, 54 clinical isolates obtained from oral cavity of healthy individuals and patients suffering from oral candidiasis were randomly selected and included. Various antifungal agents tested included fluconazole, itraconazole, ketoconazole, miconazole, and amphotericin B. Minimum inhibitory concentration (MIC) and time-kill assay were performed as per standard guidelines. The MIC obtained for fluconazole against different Candida species was 1.25 µg/ml. The MIC of azole drugs was in the range of 0.312–0.62 µg/ml. The MIC of DenteezTM mouthwash was determined as 1.25%. The clinical isolates of Candida showed major resistance to fluconazole (75.9%) and absolute susceptibility to amphotericin B. DenteezTM was found effective in inhibiting 98.2% of the clinical isolates. DenteezTM mouthwash showed time-dependent inhibition of all Candida species. The mouthwash has comparable efficacy to that of other routinely used antifungal agents. DenteezTM can be effectively used to deal with oral candidiasis and antifungal resistance.