In vitro Activity of Oral Health Care Products on Candida Biofilm Formation.

The activity of mouthwash ingredients used in daily oral care (chlorhexidine digluconate, benzalkonium chloride, povidone iodine solution, tea tree oil) and of nystatin was evaluated not only on planktonic Candida albicans or C. glabrata, but also on the inhibition of biofilm formation. A microbroth dilution technique was used to determine the minimum inhibitory concentration of the substances against two laboratory strains and seven clinical isolates. Furthermore, a potential inhibition of biofilm formation of C. albicans or C. glabrata (single-species biofilm or mixed with two oral bacteria) was assessed. The results showed an activity of all tested substances against all C. albicans and C. glabratastrains. In the biofilm assays, a concentration-dependent effect of the substances was visible. However, a low concentration of povidone iodine solution and in particular of benzalkonium chloride seemed to increase the virulence of C. albicans. Most test substances affected both bacteria and yeasts in the mixed biofilms, only nystatin predominately reduced the yeasts. In conclusion, nystatin might be the drug of choice when exclusively preventing the colonization of Candida sp. in biofilms. The alternatives, benzalkonium chloride, povidone iodine solution, and tea tree oil, should be investigated further.