Microbicidal activity of octenidine oromucosal solution against periodontal bacteria and yeast: an in vitro study
DOI:
https://doi.org/10.18203/issn.2454-2156.IntJSciRep20261980Keywords:
Bactericidal, Mouthrinse, Octenidine dihydrochloride, Oromucosal solution, Periodontopathogens, Plaque inhibition, YeasticidalAbstract
Background: Octenidine-containing antiseptic oromucosal solution (OOS) has proven to be effective and safe for temporary bacterial reduction and plaque inhibition in the oral cavity. While its clinical outcomes are encouraging, further research is needed to assess its microbicidal activity against pathogens causing gingivitis and periodontitis.
Methods: We evaluated the in vitro microbicidal activity of different product dilutions (v/v) of a commercially available OOS (0.1% (w/v) octenidine dihydrochloride) against 10 periodontopathogen-ic bacteria and three yeast strains using the testing methodology frameworks of DIN EN 13727:2012+A2:2015 (30-s contact time) and DIN EN 13624:2022-08 (60-s contact time), respectively.
Results: The OOS showed high bactericidal activity at 80% (v/v) test concentration, as indicated by the logarithmic reduction factor (lg RF) ≥5. At 50% dilution concentration, bactericidal activity was observed against specific bacteria like Porphyromonas gingivalis, Prevotella buccalis, Parvimonas micra, Eikenella corrodens, Dialister pneumosintes, Schaalia odontolytica (Actinomyces odontolyticus), and Campylobacter rectus. Yeasticidal activity against Candida albicans was observed at 80% dilution concentration, whereas Candida auris was more susceptible to the OOS and showed lg RF ≥4 even at 50% dilution concentration.
Conclusion: The OOS may be an effective adjunct to periodontal therapy aimed at reducing pathogenic microbial load and inhibiting plaque formation, which may support plaque control strategies.
References
World Health Organisation. Oral health. 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/oral-health. Accessed on 05 March 2026.
Sanz M, D’Aiuto F, Deanfield J, Fernandez-Avilés F. European workshop in periodontal health and cardiovascular disease—scientific evidence on the association between periodontal and cardiovascular diseases: a review of the literature. Eur Heart J Suppl. 2010;12:B3-12.
Socransky SS, Haffajee AD, Cugini MA, Smith C, Kent RL. Microbial complexes in subgingival plaque. J Clin Periodontol. 1998;25:134-44.
Vieira Colombo AP, Magalhães CB, Hartenbach FA, Martins do Souto R, Maciel da Silva-Boghossian C. Periodontal-disease-associated biofilm: A reservoir for pathogens of medical importance. Microb Pathog. 2016;94:27-34.
Slazhneva E, Tikhomirova E, Tsarev V, Orekhova L, Loboda E, Atrushkevich V. Candida species detection in patients with chronic periodontitis: A systematic review and meta-analysis. Clin Exp Dent Res. 2022;8(6):1354-75.
Unniachan SA, Jayakumari KN, Sethuraman S. Association between Candida species and periodontal disease: A systematic review. Curr Med Mycol. 2020;6:63-8.
Avula H, Chakravarthy Y. Models of periodontal disease pathogenesis: A journey through time. J Indian Soc Periodontol. 2022;26:204-12.
Di Stefano M, Polizzi A, Santonocito S, Romano A, Lombardi T, Isola G. Impact of Oral Microbiome in Periodontal Health and Periodontitis: A Critical Review on Prevention and Treatment. Int J Mol Sci. 2022;23(9):5142.
Fernandes GVO, Fernandes JCH, Castilho RM. Epigenetic modifications as a biomarker for periodontitis and peri-implantitis: a review. Oral Implantol J Innov Adv Tech Oral Health. 2025;17:5-8.
Dommisch H, Schäfer AS, Kuzmanova D, Michaud DS. Epigenetic Regulation in the Pathogenesis of Periodontitis. J Periodontal Res. 2025;15:70036.
Fidyawati D, Masulili SLC, Iskandar HB, Suhartanto H, Kiswanjaya B, Li X. Clinical and Radiographic Parameters for Early Periodontitis Diagnosis: A Comparative Study. Dent J (Basel). 2024;12(12):407.
Heitz-Mayfield LJA. Conventional diagnostic criteria for periodontal diseases (plaque-induced gingivitis and periodontitis). Periodontol 2000. 2024;95(1):10-9.
Arora V, Tangade P, Tirth A, Pal S, Tandon V. Efficacy of dental floss and chlorhexidine mouth rinse as an adjunct to toothbrushing in removing plaque and gingival inflammation - a three way cross over trial. J Clin Diagn Res. 2014;8(10):ZC01-4.
Toshniwal SH, Reche A, Bajaj P, Maloo LM. Status Quo in Mechanical Plaque Control Then and Now: A Review. Cureus. 2022;14(8):e28613.
Barnett ML. The rationale for the daily use of an antimicrobial mouthrinse. J Am Dent Assoc. 2006;137:16S-21S.
Sylvie S, Catherine F, Jean-Philippe G, Christine R. In vitro Bactericidal Assay under Simulated Practical Conditions for Comparison of Chlorhexidine Mouthrinses: Chlorhexidine Concentration is only one of the In vitro Activity Criteria. Oral Health Dent Manag. 2016;15:10-20.
Jockel-Schneider Y, Schlagenhauf U, Petsos H, Rüttermann S, Schmidt J, Ziebolz D, et al. Impact of 0.1% octenidine mouthwash on plaque re-growth in healthy adults: a multi-center phase 3 randomized clinical trial. Clin Oral Investig. 2021;25(7):4681-9.
Lorenz K, Jockel-Schneider Y, Petersen N, Stölzel P, Petzold M, Vogel U, et al. Impact of different concentrations of an octenidine dihydrochloride mouthwash on salivary bacterial counts: a randomized, placebo-controlled cross-over trial. Clin Oral Investig. 2018;22(8):2917-25.
Reda B, Dudek J, Martínez-Hernández M, Hannig M. Effects of Octenidine on the Formation and Disruption of Dental Biofilms: An Exploratory In Situ Study in Healthy Subjects. J Dent Res. 2021;100:950-9.
Dudek B, Tymińska J, Szymczyk-Ziółkowska P, Chodaczek G, Migdał P, Czajkowska J, et al. In vitro activity of octenidine dihydrochloride-containing lozenges against biofilm-forming pathogens of oral cavity and throat. App Sci. 2023 25;13(5):2974.
Malanovic N, Buttress JA, Vejzovic D, Ön A, Piller P, Kolb D, et al. Disruption of the Cytoplasmic Membrane Structure and Barrier Function Underlies the Potent Antiseptic Activity of Octenidine in Gram-Positive Bacteria. Appl Environ Microbiol. 2022;88(10):e0018022.
Malanovic N, Ön A, Pabst G, Zellner A, Lohner K. Octenidine: Novel insights into the detailed killing mechanism of Gram-negative bacteria at a cellular and molecular level. Int J Antimicrob Agents. 2020;56:106146.
Grover V, Mahendra J, Gopalakrishnan D, Jain A. Effect of octenidine mouthwash on plaque, gingivitis, and oral microbial growth: A systematic review. Clin Exp Dent Res. 2021;7:450-64.
CEN (European Committee for Standardization). Chemical disinfectants and antiseptics — Quantitative suspension test for the evaluation of bactericidal activity in the medical area (Phase 2, Step 1). 2015. Available at: https://nobelcert.com/ DataFiles/FreeUpload/EN%2013727-2012%20plus %20A2-2015.pdf. Accessed on 05 March 2026.
CEN (European Committee for Standardization). Quantitative suspension test for the evaluation of fungicidal or yeasticidal activity in the medical area Test method and requirements (Phase 2, Step 1). 2022. Available at: https://nobelcert.com/DataFiles/ FreeUpload/BS%20EN%2013624-2013.pdf. Accessed on 05 March 2026.
Van Dyke TE, Bartold PM, Reynolds EC. The Nexus Between Periodontal Inflammation and Dysbiosis. Front. Immunol. 2020;11:511.
Amrita A, Agarwal P, Agarwal MC, Agarwal A, Garg J, Mehra P. Comparative Evaluation of Octenidine with Chlorhexidine Mouthwash in Gingivitis and Periodontitis Patients: A Randomized Clinical Trial. J Pharm Bioallied Sci. 2024;16:S789-91.
Rath A, Wong M, Li K, Wong A, Tan L, Tan K et al. Efficacy of adjunctive octenidine hydrochloride as compared to chlorhexidine and placebo as adjuncts to instrumentation in stage I-II periodontitis: A double-blinded randomized controlled trial. Int J Dent Hyg. 2024;22(4):802-13.
Jabri B, Iken M, Ait-Ou-Amar S, Rida S, Bouziane A, Ennibi OK. Candida albicans and Candida dubliniensis in Periodontitis in Adolescents and Young Adults. Int J Microbiol. 2022;2022:4625368.
Matic Petrovic S, Radunovic M, Barac M, Kuzmanovic Pficer J, Pavlica D, Arsic Arsenijevic V, et al. Subgingival areas as potential reservoirs of different Candida spp in type 2 diabetes patients and healthy subjects. PLoS One. 2019;14(1):e0210527.
Ionescu S, Luchian I, Damian C, Goriuc A, Porumb-Andrese E, Popa CG, et al. Candida auris Updates: Outbreak Evaluation through Molecular Assays and Antifungal Stewardship-A Narrative Review. Curr Issues Mol Biol. 2024;46(6):6069-84.
Rzycki M, Drabik D, Szostak-Paluch K, Hanus-Lorenz B, Kraszewski S. Unraveling the mechanism of octenidine and chlorhexidine on membranes: Does electrostatics matter? Biophys J. 2021;120:3392-408.
Laguera B, Golden MM, Wang F, Gnewou O, Tuachi A, Egelman EH, et al. Amphipathic Antimicrobial Peptides Illuminate a Reciprocal Relationship Between Self-assembly and Cytolytic Activity. Angew Chem Int Ed Engl. 2025;64(21):e202500040.
Brookes Z, McGrath C, McCullough M. Antimicrobial Mouthwashes: An Overview of Mechanisms-What Do We Still Need to Know? Int Dent J. 2023;73:S64-8.
Vejzovic D, Iftic A, Ön A, Semeraro EF, Malanovic N. Octenidine’s Efficacy: A Matter of Interpretation or the Influence of Experimental Setups? Antibiotics. 2022;11:1665.
Amalaradjou MAR, Venkitanarayanan K. Antibiofilm Effect of Octenidine Hydrochloride on Staphylococcus aureus, MRSA and VRSA. Pathogens. 2014;3:404-16.
Köck R, Denkel L, Feßler AT, Eicker R, Mellmann A, Schwarz S, et al. Clinical Evidence for the Use of Octenidine Dihydrochloride to Prevent Healthcare-Associated Infections and Decrease Staphylococcus aureus Carriage or Transmission-A Review. Pathogens. 2023 18;12(4):612.