Comparative Evaluation of the Efficacy of Probiotics and Triphala Herbal Oral Rinses against Candida Species in Denture Wearer Patients: A Randomised Clinical Study

Introduction: With increasing age, patients experience a reduction in immunity and an increase in systemic illnesses. These factors significantly contribute to the occurrence of candidiasis in the oral cavity. New approaches to treating and preventing a wide range of oral disorders may become possible through host immunity modulation. Natural agents are preferred for complete denture wearers to prevent candidiasis, which is one of the leading causes of denture stomatitis. Aim: To assess the efficacy of herbal oral rinses (Triphala) and probiotics against Candida species in denture-wearing patients. Materials and Methods: This randomised double-blinded study clinical study was conducted in the Department of Prosthodontics at MM College of Dental Sciences and Research, Mullana, Ambala, Haryana, India, from August 2022 to January 2023. Ethical clearance was obtained and 60 patients were randomly divided into two groups (n=30): Group-A (Probiotics group) and Group-B (Triphala group). Sample collection was performed at baseline and after an 8-week experimental period. The collected samples were inoculated in Sabouraud Dextrose Agar with Chloramphenicol and incubated for 48 hours at 37°C±2°C in a Biological Oxygen Demand (BOD) incubator. The number of Candida colonies was scored and counted using a Digital Colony Counter, reported as Colony-forming Units (CFU) at baseline and after eight weeks. Data analysis was conducted using the Wilcoxon matched-pair test for comparisons within groups and the Mann-Whitney U-test for pair-wise comparisons (p<0.05). Results: The mean age of patients in Group-A was 61±3 years, while in Group-B it was 60±2 years. The mean CFU for the probiotics group was 44.70±72.5 and for the Triphala group, it was 79.60±58.7 before treatment. After treatment, the mean CFU for the probiotics group was 24.70±271.4 and for the Triphala group, it was 50.67±196.4. Although no significant difference (p-value>0.05) was observed between the two groups, both rinses proved effective against Candida species in denturewearing patients. However, the mean reduction in CFUs was significantly higher for Triphala (p-value=0.021). Conclusion: Both probiotics and Triphala showed a significant reduction in CFU after eight weeks of use. However, Triphala was more effective in reducing Candida compared to probiotics. Therefore, it can be considered an efficient agent for denturewearing patients against Candida species.