Are Mouthwashes Really Effective against Candida spp.?

Area of Science:

• Oral Medicine
• Mycology
• Pharmacology

Background:

• Oral candidiasis, caused by Candida species, is an opportunistic infection.
• Increasing antifungal drug resistance limits the effectiveness of traditional treatments like nystatin, fluconazole, and miconazole.
• There is a growing need for alternative and supportive therapies for oral candidiasis.

Purpose of the Study:

• To evaluate and compare the in vitro antifungal efficacy of mouthwashes available on the European market against Candida species.
• To identify potential alternative or adjunctive treatments for oral candidiasis.

Main Methods:

• A systematic literature review was conducted using PRISMA 2020 guidelines.
• Bibliographic searches were performed on PubMed and ScienceDirect databases.
• Twenty-one eligible studies published over a 27-year period were included.

Main Results:

• Mouthwashes containing chlorhexidine digluconate, cetylpyridinium chloride, hexetidine, fluorine compounds, and natural antimicrobials (menthol, thymol, eucalyptol, Glycyrrhiza glabra extracts) demonstrated antifungal activity.
• Methodological variations across studies created ambiguity in comparing the efficacy of different mouthwash formulations.
• Despite variations, several European mouthwashes exhibited potential anti-Candida effects.

Conclusions:

• Certain commercially available European mouthwashes possess antifungal properties against Candida species.
• These mouthwashes may serve as valuable tools for the prevention and treatment of oral candidiasis, especially in the context of rising antifungal resistance.
• Further standardized research is needed to definitively compare the efficacy of various mouthwash formulations.