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 Table of Contents  
Year : 2021  |  Volume : 13  |  Issue : 5  |  Page : 212-216  

Cariostatic efficacy of cinnamon water extract on Streptococcus mutans: An In vitro study

1 Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Science and Hospital, Patna, Bihar, India
2 Department of Conservative Dentistry and Endodontics, Dr. B. R. Ambedkar Institute of Dental Sciences and Hospital, Patna, Bihar, India
3 Department of Conservative Dentistry and Endodontics, Mithila Minority Dental College, Darbhanga, Bihar, India
4 Dental Surgeon, Public Health Centre, Parwalpur, Nalanda, Bihar, India
5 Department of Microbiology, Government Medical College, Ratlam, Madhya Pradesh, India
6 Department of Dentistry, Anugrah Narayan Magadh Medical College and Hospital, Gaya, Bihar, India

Date of Submission15-Oct-2020
Date of Acceptance23-Oct-2020
Date of Web Publication05-Jun-2021

Correspondence Address:
Prafulla Songara
Department Of Microbiology, Government Medical College, Ratlam, Madhya Pradesh
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jpbs.JPBS_677_20

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Background: Dental caries is a chronic, widespread, and infectious disease affecting the large population. Anticariogenic effects of different herbs and natural products are observed, cinnamon among these, showed the ability to inhibit Streptococcus mutans biofilm. Objectives: The aim of this study was to assess the cinnamon water extract use on nicotine exposed S. mutans biolfilms. Materials and Methods: Microtiter plates having S. mutans culture were treated using varying nicotine concentration range (0–32 mg/ml). These were then either subjected to cinnamon water (2.5 mg/ml) extract or no treatment and analyzed using a spectrophotometer to see planktonic growth, total growth absorbance, and biofilm formation. Results: About 2.5 mg/ml of cinnamon water inhibits the S. mutans biofilm (nicotine-induced) considerably at various nicotine levels (0–32 mg/ml). Conclusion: Cinnamon water extract has a powerful inhibitory effect for S. mutans growth. Nicotine-induced S. mutans growth is markedly reduced by treating with cinnamon water extract.

Keywords: Biofilms, cinnamon water extract, nicotine, Streptococcus mutans

How to cite this article:
Mala N, Sonal S, Kumar A, Choudhary HV, Songara P, Ramesh K. Cariostatic efficacy of cinnamon water extract on Streptococcus mutans: An In vitro study. J Pharm Bioall Sci 2021;13, Suppl S1:212-6

How to cite this URL:
Mala N, Sonal S, Kumar A, Choudhary HV, Songara P, Ramesh K. Cariostatic efficacy of cinnamon water extract on Streptococcus mutans: An In vitro study. J Pharm Bioall Sci [serial online] 2021 [cited 2022 Dec 1];13, Suppl S1:212-6. Available from:

   Introduction Top

Dental caries is one of the most common chronic infectious diseases caused by bacterial colonization. Caries begin with the decalcification of nonorganic part followed by the organic matrix.[1] The polysaccharide-rich biofilm formation and low pH (acidification) are major factors that control caries pathogenesis.[2] Etiology of caries is related to sugar intake, diet, oral bacteria, oral hygiene practices, and protective procedures alterations. Dental caries prevalence is approximately 45.8%, according to NHANES.[3] There are various therapeutics for prevention and treating dental caries. Among those, fluoride constitutes the mainstay for caries prevention. However, additional approaches are required to improve treatment effectiveness. Despite advances in treatment measures, affected individuals experience tooth loss.[1]

Various antiplaque approaches for caries treatment are based on using broad-spectrum microbicidal such as chlorhexidine.[2] Along with mechanical plaque control agents, mouth rinses helps in reducing bacterial count including Streptococcus mutans and hence dental caries.[4]

Natural products contain substances having different biological activities such as anticaries. However, it is quite challenging because of difficult isolation of natural products.[2] Among natural anticaries agents, rosemary (Rosmarinus officinalis), and ginger rhizome (Zingiber officinale) showed antimicrobial activities and no toxicity by USFDA.[5],[6] No study to date has reported caries remineralization using natural agents. Most studies focused on the effect of herbals on bacterial growth and not on biofilms. Thus, understanding the mechanism of natural herbs as anticaries agents remain unknown. Still many natural substances have promising anticaries activity.[2]

Spices and herbs are widely used as an anticaries agent. Cinnamon is obtained from Cinnamomum species, has antimicrobial activity against pathogens such as Streptococcus faecalis, Enterococcus faecalis, S. aureus, and Enterobacter cloacae. These are the main factors responsible for pulpal and periapical diseases.[7],[8],[9] Essential oil, from cinnamomum zeylanicum leaves, is effective against Lactobacillus acidophilus and S. mutans causing caries and plaque.[10],[11]

The aim of this study was to assess the cinnamon water extract use on nicotine exposed biofilms of S. mutans. S. mutans was considered as it is the most common microorganism associated with dental caries.[12]

   Materials and Methods Top

A pilot experiment was conducted before main study to obtain an minimum biofilm inhibitory concentration (MBIC), and minimum inhibitory concentration (MIC) of the cinnamon water on S. mutans growth. Growth inhibition was assessed on TSBS. MBIC and MIC were established as 5 mg/ml in other study.[13] In this pilot study, the MIC was determined as 2.5 mg/ml.

To evaluate cinnamon water effect on S. mutans treated with nicotine, TSBS serial dilutions were made to achieve 0, 0.25, 0.5, 1, 2, 4, 8, 16, and 32 mg/ml nicotine without cinnamon water extract. The same series dilutions were prepared with cinnamon water extract MIC dilution (2.5 mg/ml as evaluated by the pilot experiment). All 96 wells were aliquoted with 190 μl TSBS followed by incubation in 5% CO2 at 37°C for 24 h. After 24 h, planktonic growth, and biofilm was measured using a spectrophotometer at 490 nm. S. mutans biofilms without nicotine and with/without cinnamon water extract (2.5 mg/ml) served as controls.

Collected data were statistically analyzed to compare the effect of cinnamon water on all nicotine concentrations of 0–32 mg/ml. Furthermore, their interactions of total, planktonic, and biofilm, growth were compared.

   Results Top

Cinnamon water extract, nicotine, and interaction in biofilm, total growth, and planktonic showed a significant effect and caused inhibition on 0–1 and 8 mg/ml nicotine concentration. Biofilm growth increase (significant) was noticed at nicotine concentration of 2 and 4 mg/ml.

A significant decrease at 8, 16, and 32 mg/ml nicotine was seen with cinnamon water. The modest decrease at 0.25 mg/ml nicotine, in biofilm growth, and increase (non-significant) at 0.5 mg/ml was seen. Concerning total S. mutans growth, increase at 0.5, 1, 2, and 4 mg/ml of nicotine were significant with cinnamon water. Conversely, at 8, 16, and 32 mg/ml of nicotine concentration, cinnamon extract liquid showed significant growth reduction compared to the zero-nicotine concentration. A very little total growth increase at a nicotine concentration of 0.25 mg/ml was also observed additionally.

Concerning biofilm, a decrease at nicotine at 16 and 32 mg/ml without cinnamon water compared to zero-nicotine concentration without cinnamon liquid was noticed. Furthermore, a nonsignificant biofilm increase at 4 and 8 mg/ml and slight decrease at 1 and 2 mg/ml was seen. At 0.25 and 0.5 mg/ml, no statistically significant growth difference was reported.

These results are depicted in [Table 1],[Table 2],[Table 3].
Table 1: Streptococcus mutans biofilm, with cinnamon water at various nicotine concentrations

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Table 2: Streptococcus mutans planktons, with cinnamon water at various nicotine concentrations

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Table 3: Streptococcus mutans (total), with cinnamon water at various nicotine concentrations

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   Discussion Top

The pilot experiment before study was carried out to determine the MBIC, MIC, and antimicrobial activity of cinnamon water extract. Aldehyde in cinnamon is responsible for biological activities and fragrance.[14],[15] Antimicrobial activity against S. mutans was established in the pilot experiment conducted. As S. mutans inhabit normal oral flora, establishing MIC and MBIC was important to not affect normal oral environment. 16 h S. mutans culture was kept in 96 wells flourished with TSBS and nicotine was added in control and experimental groups to enhance the biofilm growth.[6] Results showed that cinnamon water extracts significantly reduce S. mutans biofilm growth both at low (0.25 mg/ml, 0.5 mg/ml, and 1 mg/ml) and high nicotine concentration (8 mg/ml, 16 mg/ml, and 32 mg/ml). Reduction in colony counts was significant in ethanolic liquorice group establishing its cariostatic potential.[16]

Reduction of S. mutans growth was seen in planktonic and biofilm phase. However, more restriction was seen concerning biofilm. In nicotine group with no cinnamon water extract addition, biofilm formation increase was proportional to increase in nicotine concentration. At 16 and 32 mg/ml of nicotine concentration, significant inhibition of biofilm growth and microbial viability was observed. Similar results were interpreted by study of Huang et al. in 2012, where different S. mutans strains were treated at various nicotine concentrations.[17] Authors concluded that the anticariogenic effect of fluoride-chlorhexidine was highest among the groups. Green tea showed higher cariostatic effects than normal saline.

With cinnamon water extract of nicotine at 2 mg/ml and 4 mg/ml leads to significant bacterial growth increase. These can be attributed to the inhibitory effect of cinnamon water at these concentrations of nicotine and collaborative consequence of nicotine with cinnamon water extract at specific nicotine levels. One study compared caries inhibiting the effect of cinnamon oil and clove oil. Another study in 2011 assessed the efficacy of oral microbiota causing dental caries. This is contrary to popular belief that clove oil is effective in tooth decay and dental plaque. This study justified the present study.[18]

A study by Li et al.[19] evaluated effectiveness of ginger and rosemary, on initial enamel caries remineralization and significant differences between treatments, were observed in terms of microhardness. Compared with the positive control group (NaF dentifrice), significantly greater remineralization was observed with ginger-honey-chocolate treatments. Authors concluded that enhanced remineralization was observed with all treatment systems, with ginger-honey-chocolate being most effective, and this study was consistent with the present study.

   Conclusion Top

The cinnamon water addition to products for maintaining oral hygiene could be advantageous for smokers. As no study to date studied nicotine amount in smoker's biofilm, hence, more in-vivo studies to determine this are needed. A test to determine the cytotoxicity of cinnamon water extracts to be determined for safe use. The limitations include only single S. mutans strain consideration. No positive control such as chlorhexidine was used. Furthermore, salivary samples were not considered. In addition, single cinnamon species was used.

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Conflicts of interest

There are no conflicts of interest.

   References Top

Dean JA, Avery DR, Mc Donald RE. Dentistry for the Child and Adolescent. 9th ed. London: Mosby Co.; 2011. p. 177.  Back to cited text no. 1
Jeon JG, Rosalen PL, Falsetta ML, Koo H. Natural products in caries research: Current (limited) knowledge, challenges and future perspective. Caries Res 2011;45:243-63.  Back to cited text no. 2
Pakshir HR. Oral health in Iran. Int Dent J 2004;54:367-72.  Back to cited text no. 3
Goldstep F. Proactive intervention dentistry: a model for oral care through life. Compend Contin Educ Dent 2012;33:394-6.  Back to cited text no. 4
Bernardes WA, Lucarini R, Tozatti MG, Souza MG, Silva ML, Filho AA, et al. Antimicrobial activity of Rosmarinus officinalis against oral pathogens: relevance of carnosic acid and carnosol. Chem Biodivers 2010;7:1835-40.  Back to cited text no. 5
Ohara A, Saito F, Matsuhisa T. Screening of antibacterial activities of edible plants against Streptococcus mutans. Food Sci Technol Res 2008;14:190-3.  Back to cited text no. 6
Wijesekera RO. Historical overview of the cinnamon industry CRC Crit Rev Food Sci Nutr 1978;10:1-30.  Back to cited text no. 7
Keskin D, Toroglu S. Studies on antimicrobial activities of solvent extracts of different spices. J Environ Biol 2011;32:251-6.  Back to cited text no. 8
Gupta A, Duhan J, Tewari S, Sangwan P, Yadav A, Singh G, et al. Comparative evaluation of antimicrobial efficacy of Syzygium aromaticum, Ocimum sanctum and Cinnamomum zeylanicum plant extracts against Enterococcus faecalis: a preliminary study. Int Endod J 2013;46:775-83.  Back to cited text no. 9
Miller AB, Cates RG, Lawrence M, Soria JA, Espinoza LV, Martinez JV, et al. The antibacterial and antifungal activity of essential oils extracted from Guatemalan medicinal plants. Pharm Biol 2015;53:548-54.  Back to cited text no. 10
Lauren L. The effect of common household spices on Streptococcus mutans. SUURJ 2017;1:53-60.  Back to cited text no. 11
Caufield PW, Schön CN, Saraithong P, Li Y, Argimón S. Oral lactobacilli and dental caries: A model for niche adaptation in humans. J Dent Res 2015;94:110-8.  Back to cited text no. 12
Neelakantan P, Subbarao C, Sharma S, Subbarao CV, Garcia-Godoy F, Gutmann JL. Effectiveness of curcumin against Enterococcus faecalis biofilm. Acta Odontol Scand 2013;71:1453-7.  Back to cited text no. 13
Wong Y, Ahmad-Mudzaqqir M, Wan-Nurdiyana W. Extraction of essential oil from cinnamon (Cinnamomum zeylanicum). Orient J Chem 2014;30:37-47.  Back to cited text no. 14
Filoche SK, Soma K, Sissons CH. Antimicrobial effects of essential oils in combination with chlorhexidine digluconate. Oral Microbiol Immunol 2005;20:221-5.  Back to cited text no. 15
Jain E, Pandey R.K, Khanna R. Liquorice root extracts as potent cariostatic agents in pediatric practice. J Indian Soc Pedod Prev Dent 2013;31:46-152.  Back to cited text no. 16
Huang R, Li M, Gregory RL. Effect of nicotine on growth and metabolism of Streptococcus mutans. Eur J Oral Sci 2012;120:319-25.  Back to cited text no. 17
Gupta C, Kumari A, Garg A, Roberto C. Comparative study of cinnamon oil and clove oil on some oral microbiota. Acta bio-medica: Atenei Parmensis 2011;82:197-9.  Back to cited text no. 18
Li M, Huang R, Zhou X, Zhang K, Zheng X, Gregory RL. Effect of nicotine on dual-species biofilms of Streptococcus mutans and Streptococcus sanguinis. FEMS Microbiol Lett 2014;350:125–32.  Back to cited text no. 19


  [Table 1], [Table 2], [Table 3]

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