The Efficacy of Sesewanua (Clerodendrum Fragrans Wild) Mouthwash in Reducing Oral Bacteria Growth: A Quasi-Experimental Study in Nursing Practice

Poltekkes Kemenkes Manado100 enrolled

Overview

Background and Objectives: This study investigated the antibacterial efficacy of Sesewanua (Clerodendrum fragrans Wild) extract as a mouthwash alternative to mitigate oral bacteria, particularly Streptococcus mutans. Materials and Methods: A quasi-experimental design was employed with a cohort of 100 female students, divided into four groups to assess varying concentrations (1%, 2%, and 4%) of Sesewanua extract, along with a purified water control. The extraction process involved mechanical grinding followed by maceration with 70% ethanol to maximize the extraction of bioactive compounds. Microbiological analysis was conducted post-intervention to measure the reduction in bacterial counts.

Study Type

INTERVENTIONAL

Allocation

Purpose

TREATMENT

Masking

NONE

Enrollment

100

Conditions

Oral Bacteria Levels in the Mouth

Interventions

Eligibility

Sex: FEMALE

Medical Language ↔ Plain English

Inclusion Criteria 1. Female students registered as residents of the female dormitory at the Manado Ministry of Health Polytechnic during the study period. 2. Age ≥17 years. 3. Willing to sign written informed consent. 4. Good oral and general health status based on initial screening (no acute oral infections, severely inflamed gums, or other oral conditions requiring immediate treatment). 5. Not currently using medications or therapies that could modulate oral flora (e.g., systemic antibiotics, therapeutic oral antiseptics) in the past 2 weeks. 6. Able to follow standardized oral hygiene protocols (able to brush and rinse as instructed). Exclusion Criteria 1. Pregnancy or breastfeeding. 2. History of allergy to ingredients in mouthwash formulations (e.g., fragrances, parabens, sorbitol). 3. Use of antibiotics, antifungals, systemic steroids, or immunosuppressive medications in the 2 weeks before or during the study. 4. Invasive dental treatment or oral surgery in the past 1 month. 5. Systemic diseases that can affect saliva composition (e.g., uncontrolled diabetes, severe xerostomia, oral autoimmune diseases). 6. Active smoking or use of other tobacco products. 7. Non-compliance with protocols (e.g., failure to show up for sample collection).

Outcomes

Primary Outcomes

Change in Streptococcus mutans colony counts (CFU/ml) in participants' oral samples between pre-intervention and post-intervention. Secondary Outcome

Outcome Measure 1 (Primary; continuous; CFU/mL): Change in Streptococcus mutans colony counts (CFU/mL) in oral samples from baseline (pre-intervention) to end of treatment (post-intervention within 12 weeks). For each group (1%, 2%, 4%, placebo), within-group change will be evaluated using paired t-tests; results will be reported as mean (SD) CFU/mL at each time point and mean (SD) change.

Time frame: Research timeline for a quasi-experimental study on the effectiveness of Sesewanua (Clerodendrum fragrans Wild) mouthwash in reducing the growth of Streptococcus mutans. Total duration: 12 weeks (3 months).

Outcome Measure 2 (Secondary A; continuous; %):

Participant-level percent reduction in S. mutans CFU/mL. Between-group differences in mean percent reduction will be tested using one-way ANOVA (with appropriate post-hoc comparisons if overall p\<0.05).

Outcome Measure 3 (Secondary B; categorical; proportion):

Clinically meaningful response rate, defined as achieving ≥50% reduction in CFU/mL from baseline to post-intervention.