Studies

Naturally controlling oral microflora

Patients have become increasingly aware of the adverse effects associated with artificial substances. As a result, interest has grown considerably regarding the use of natural substances that are derived from minerals, plants and animals. Research has already shown that some plant extracts demonstrate high rates of antimicrobial activity. Scientists believe that natural agents, such as Citrox, are much safer to use than some artificial substances, making them more acceptable to patients as a key ingredient in oral healthcare products.

Derived from the bioflavonoids found in bitter oranges, Citrox has been found to be a valuable antimicrobial agent. One study has evaluated two Citrox formulations—one of which is an ingredient in some mouth rinses and toothpastes (Citrox BC30), while the other is used in a range of surface disinfection products (Citrox MDC30) [i]. Although the latter’s formula contains the same bioflavonoids as Citrox BC30, it also incorporates citric acid and choline ascorbate. The aim of the study was to assess the antimicrobial efficacy of these two Citrox formulations against various fungi and bacteria, including those associated with periodontal disease.


“This study has emphasised the importance of using natural substances to combat potentially harmful bacteria, particularly within the oral cavity.”

Results of the study showed that Citrox BC30 and Citrox MDC30 both exhibited high rates of antimicrobial activity. In particular, Citrox BC30 demonstrated the greatest antimicrobial effect, significantly inhibiting the growth of all bacterial species, as well as most of the fungi that were tested. Interestingly, Citrox MDC30 appeared to be more effective against Candida albicans and Candida dubliniensis biofilm – the latter of which is an opportunistic fungal pathogen and has the ability to colonise deep within periodontal pockets.

Citrox, a natural antiseptic sourced from bitter oranges, has vast potential as a key antimicrobial ingredient in oral health care products. (Photograph: Shutterstock/nnattalli)

The study also found that the antimicrobial activity exhibited by both Citrox formulations compared favourably to those reported for chlorhexidine, which had been tested on asimilar range of oral bacteria. Against the fungi—Candida albicans and Candida dubliniensis—Citrox MDC30 demonstrated greater efficacy than what was previously observed with chlorhexidine. Furthermore, researchers believe that natural agents such as Citrox can break up and reduce biofilm more efficiently than chlorhexidine at a concentration of 0.2%.

This study has emphasised the importance of using natural substances to combat potentially harmful bacteria, particularly within the oral cavity. Experts believe that Citrox has vast potential as a key antimicrobial ingredient in mouth rinses and other dental care products, as it is facilitates greater control over oral microflora.


[i] Hooper SJ, Lewis MA, Wilson MJ, Williams DW. Antimicrobial activity of Citrox® bioflavonoid preparations against oral microorganisms. Br Dent J. 2011 Jan 8;210(1):E22. doi: 10.1038/sj.bdj.2010.1224.

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