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Source E: The Potential of Aloe vera as an Active Ingredient in Toothpaste Formulations: A Narrative Review 

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Source E: The Potential of Aloe vera as an Active Ingredient in Toothpaste Formulations: A Narrative Review 

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CSE:
Nasiri P, Malekzadeh Shafaroudi A, Moosazadeh M, Poorkazemi D, Mehrani Sabet J. The Potential of Aloe vera as an Active Ingredient in Toothpaste Formulations: A Narrative Review. Jundishapur Journal of Natural Pharmaceutical Products. 2021 [accessed 2023 Apr 3];17(2). https://brieflands.com/articles/jjnpp-117500.html#5.-Conclusions. doi:https://doi.org/10.5812/jjnpp.117500

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Dental caries and Related Oral Health Factors Among 9 to 19 Month Old Thai Children 

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Dental caries and Related Oral Health Factors Among 9 to 19 Month Old Thai Children 

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CSE: Pantuwadee P, Detsomboonrat P. 2015. DENTAL CARIES AND RELATED ORAL HEALTH FACTORS AMONG 9 TO 18 MONTH OLD THAI CHILDREN. 46(4). [accessed 2023 Jan 29]. https://www.tm.mahidol.ac.th/seameo/2015-46-4/27-64368.pdf.https://www.tm.mahidol.ac.th/seameo/2015-46-4/27-64368.pdf

This source is useful in providing background information about the dental caries in Thailand, specifically in the rural areas, where accessibility to proper dental care is limited. Systematic review showed that daily brushing with fluoride toothpaste effectively reduces dental caries. The statistics from this scientific journal is that “27.8% of subjects had never had their teeth brushed at all, and 24.5% of subjects had their teeth brushed without toothpaste.” This shows the lack of accessibility to a fluoride toothpaste and essential oral necessities. This study concluded the data and statistics of the prevalence of dental varies in Thai children in Suphan Buri Province from the age of 9-18 months. They’ve found out that 32.5% had dental caries, 15.9% had at least one cavitated caries, and 16.6% had white lesions. They’ve also analysed the significant correlations between the dmfs (Decay-filled index) score, number of erupted teeth, and toothpaste usage. According to the American Academy of Pediatric Dentistry, it is recommended for children whose first tooth is starting to erupt to use fluoridated toothpaste as it shows benefits.  Subjects who used fluoride toothpaste, who had their teeth brushed at least twice a day, were classified as being raised using good child-rearing practices. Subjects who were raised using good child-rearing practices had non-significant (p=0.435) lower DMFs scores than children who were not.

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Source G:  Characterization of Bioactive Phenolics and Antioxidant Capacity of Edible Bean Extracts of 50 Fabaceae Populations Grown in Thailand (Ultrasound-assisted extraction) 

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Source G:  Characterization of Bioactive Phenolics and Antioxidant Capacity of Edible Bean Extracts of 50 Fabaceae Populations Grown in Thailand (Ultrasound-assisted extraction) 

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CSE: Tungmunnithum, D., Drouet, S., Lorenzo, J. M., & Hano, C. (2021). Characterization of Bioactive Phenolics and Antioxidant Capacity of Edible Bean Extracts of 50 Fabaceae Populations Grown in Thailand. Foods (Basel, Switzerland), [accessed 2023 Mar 15] 10(12), 3118. https://doi.org/10.3390/foods10123118

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CSE: Siddiquee, Shafiquzzaman. “The Basic Concept of Microbiology.” 7 Sep. 2017, Practical Handbook of the Biology and Molecular Diversity of Trichoderma Species from Tropical Regions 1–15. doi:10.1007/978-3-319-64946-7_1

A brief paragraph summarizing the source, explaining its credibility and relevance to the topic

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A: Preparation of Crude Extracts (Mortar & Pestle, Solvent)

B: Preparation of De Man Rogosa Sharpe Agar Plate

C: Agar Well Diffusion (measuring the Zone of inhibition)

D: Safety & Environmental Concerns
E: Aseptic Technique

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1. Various scientific studies have shown that Thai and Chinese herbs posses strong antimicrobial activity against Streptococcus mutans.

Agree:
Source A
Source C
Source D
Source E

Disagree:
Source B

1. Discussion synthesizing the sources and elaborating on the framework. Transition to the next part of the topic.

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Provide Background/Relevant Information on:

A. Thailand Local Context of Dental Caries

B. Streptococcus lactis TISTR 457

C. Mechanism of Streptococcus mutans causing Dental Caries

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Source E: Kirby-Bauer Disk Diffusion Susceptibility Test Protocol

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Source E: Kirby-Bauer Disk Diffusion Susceptibility Test Protocol

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CSE: Hudzicki J. Kirby-Bauer Disk Diffusion Susceptibility Test Protocol. American Society for Microbiology; 8 December 2009. https://asm.org/getattachment/2594ce26-bd44-47f6-8287-0657aa9185ad/Kirby-Bauer-Disk-Diffusion-Susceptibility-Test-Protocol-pdf.pdf

The author’s purpose is to provide information so that experimenters, scientists can conduct experiments with accurate procedure and therefore obtain reliable results. The author mentions the purpose of the Kirby-Bauer disk diffusion susceptibility test is to determine the sensitivity or resistance of pathogenic aerobic and facultative anaerobic bacteria to various antimicrobial compounds in order to assist a physician in selecting treatment options for his or her patients. The pathogenic organism is grown on Mueller-Hinton agar in the presence of various antimicrobial impregnated filter paper disks. The presence or absence of growth around the disks is an indirect measure of the ability of that compound to inhibit that organism.This scientific protocol, published by the American Society for Microbiology is among the most prominent publications in the field, delivering up-to-date and authoritative coverage of both basic and clinical microbiology. This  “Kirby-Bauer disk diffusion susceptibility test protocol”was also peer reviewed at the ASM Conference for Undergraduate Educators 2009. The American Society of Microbiology conference brings together health care professionals, particularly clinical microbiologists, physicians, pharmacists and researchers to discuss the latest advances in microbiology.

This article also provides multiple diagrams such as how to measure the zone of inhibition, the pattern the swab should follow, for a clearer understanding of the procedure.

Moreover, some aspects of this article is useful for my extended essay because it provides a step by step method for the Preparation of Bacterial Suspension, Inoculation of the MH plate, and Inoculum preparation. This can be useful when writing the methodology section.

‌

A brief paragraph summarizing the source, explaining its credibility and relevance to the topic

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Source D: Evaluation of the effect of a toothpaste containing Pudilan extract on inhibiting plaques and reducing chronic gingivitis: A randomized, double-blinded, parallel controlled clinical trial    

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Source D: Evaluation of the effect of a toothpaste containing Pudilan extract on inhibiting plaques and reducing chronic gingivitis: A randomized, double-blinded, parallel controlled clinical trial    

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CSE: Cheng, L., Liu, W., Zhang, T., Xu, T., Shu, Y. X., Yuan, B., Yang, Y. M., & Hu, T. (2019). Evaluation of the effect of a toothpaste containing Pudilan extract on inhibiting plaques and reducing chronic gingivitis: A randomized, double-blinded, parallel controlled clinical trial. Journal of Ethnopharmacology, 240. https://doi.org/10.1016/j.jep.2019.111870

The author’s intention of this investigation is to evaluate the effectiveness and safety of Pudilan extract-containing toothpaste in controlling plaques and reducing chronic gingivitis. This scientific study is published by Elsevier and from the Journal of Ethnopharmacology.

In this investigation, 120 patients with chronic gingivitis were separated into two groups: Experiment and control. Patients in the experiment group used a Pudilan extract - containing toothpaste， while the patients in the control group used a toothpaste without the Pudilan extract. The author measured the que Index (PI), Gingival Index (GI), Bleeding Index (BI), and Bleeding On Probing proportion (BOP%) at baseline, 4 weeks, 8 weeks and 12 weeks after using the toothpaste.

The author of this source also dedicated a section of this article to writing about ethical considerations, since it deals with human subjects. The results that the author has obtained from this investigation is that in the experimental group, the Blood on Probing proportion (%) was significantly lower in comparison to the control group. In addition, the decline of the Plaque Index (PI), Gingival Index (GI) for the experiment group after 4,8, and 12 weeks was significantly higher than the control group, indicating that there was less dental plaque accumulation. The author has concluded that the pudilan-extract toothpaste demonstrated good effect on relieving symptoms of chronic gingivitis, inhibition of plaque formation, reduction in gingival inflammation and the degree of bleeding. From the results obtained, the author believes that Pudilan extract toothpaste has prospective application potential in the prevention and treatment of chronic gingivitis.

This source is relevant for my herb choice selection, as I can test pudilan-extract as one of my variables as it’s classified as a chinese herb. I can test its antimicrobial properties against the oral bacteria by measuring the zone of inhibition, and compare it to the results made from this investigation. Although in my extended essay, it is the zone of inhibition, it can be compared to the indexes, since in the end, both are parameters which can measure the effectiveness.

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Source C: Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study 

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Source C: Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study 

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CSE: Wong, R W K et al. “Antimicrobial activity of Chinese medicine herbs against common bacteria in oral biofilm. A pilot study.” International journal of oral and maxillofacial surgery vol. 39,6 (2010): 599-605. doi:10.1016/j.ijom.2010.02.024

The author’s main purpose of this investigation is to examine the antimicrobial activity of Chinese Medicine herbs against common oral bacteria and treat infectious symptoms (inflammation) in oral biofilm. The author explains the historical background of Traditional Chinese medicines (TCM), which have been used in China to treat infectious diseases for more than 4000 years. Moreover, the author listed the advantages of using Chinese natural products, which are they are easy to obtain and low cost. Although the author mentioned a significant point which is how some of these traditional chinese medicines come from endangered plant and animal species, which can be noted as a consideration in my Extended Essay methodology and herb choices. This article is published journal Elsevier Public Health Emergency Collection and International Journal of Oral & Maxillofacial Surgery.

The methodology of this investigation: Aliquots of suspension of each bacterial species were inoculated onto a horse blood agar plate with TCMs soaked separately on 6 mm paper disks. The plates were incubated for 48 h anaerobically and the mean diameters of growth inhibition of three different areas obtained. 0.2% (w/v) chlorhexidine was used as a positive control. Broth microdilution assay was used to determine minimum inhibitory concentration and minimum bactericidal concentration.

The author proposed that there is a need to search for alternatives from Existing antimicrobial mouth rinses, such as chlorhexidine and Listerine. Since they are inedible and may be harmful if ingested, therefore there must be an alternative for less harmful agents that also has similar antimicrobial properties.

In this investigation, Chlorhexidine gluconate, a common oral antiseptic, at a concentration of 0.2% (w/v) was used as a positive control. One advantage of this study is that it has a positive control, which serves as an indicator of acceptability of the assay, and ensures that the assay is working as intended. The researchers have found out that 2 of 20 Traditional Chinese medicine extracts tested demonstrated consistent antimicrobial activity with zones of growth against Streptococcus mutans. The average inhibition zone diameter for Cortex phellodendri (huang bai) and Fructus armeniaca mume (wu mei) to S. mutans, was 8 mm and 9 mm. The author concluded that Fructus armeniaca mume had antimicrobial resistant against S. mitis, S. sanguis, S. mutans and P. gingivalis in vitro because there might be a possibility that its acidic content (citric acid, malic acid, oxalic acid, succinic acid, fumaric acid, tartaric acid, picric acid) accounts for its wide antibacterial spectrum.

There are limitations to this study which is how it is a pilot study. A pilot study is a small-scale study conducted in preparation for larger investigation studies, therefore there are possibilities of inaccurate prediction and results, and problems with funding. This research study provides a range of oral bacterias to be tested, however this study lacks a detailed comparison between these 4 oral bacterias.

This is relevant to my extended essay as I can select Cortex phellodendri (huang bai) and Fructus armeniaca mume (wu mei) as the Chinese herbs which will be tested.

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Source B: Antimicrobial Properties of Thai Herbal Plants for Application in Root Canal Treatment (Do not agree)

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Source B: Antimicrobial Properties of Thai Herbal Plants for Application in Root Canal Treatment (Do not agree)

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CSE: Phuvoravan C, Aupaphong V, Saraban O, Uraisin P, Sukcharoenkraisri C. Antimicrobial Properties of Thai Herbal Plants for Application in Root Canal Treatment. Khon Kaen Dent J [Internet]. 2022 Jul. 11 [cited 2023 Feb. 19];25(2):113-26. https://he01.tci-thaijo.org/index.php/KDJ/article/view/250666

This scientific journal is published on the Khon Kaen Dent J website. Khon Kaen Dent J aims at fostering the knowledge advancement of clinical dentistry, as well as basic dental sciences e.g. dental biomaterial sciences, oral biology and immunology in order to uplift the insights toward patient care.They highly value the double-blinded standard to produce a consistent publication quality.

‌ In recent years, herb products are well-known in the medical industry as they possess various benefits such as combating diseases and nurturing health. Some benefits of herbs in treatments is that it has anti-inflammatory, antibacterial properties, without leaving any residues or toxins in the body. Thailand has recently been supportive of the research of Thai medicinal plants to be used in medical treatments as they aim to decrease the chemical imports from foreign countries. Thai Medicinal plants are used in dentistry, studies on treatment of periodontitis and antimicrobial activities against caries have been conducted. Root Canal Bacterias: Peptostreptococcus,Prevotella,Porphyromonas,Fusobacterium  Actinomyces Obligate anaerobe, which causes inflammation. In this research conducted by dentists from Faculty of Dentistry, Thammasat University, they have concluded that 7 types of Thai medicinal plants have shown positive results on the antimicrobial efficiency of root canal bacteria either in the form of single or mixed cultures of microorganisms. In this experiment, they used the agar diffusion method to test the efficiency of sensitivity, resistance, and zone of inhibition. Another method that they used is called the broth dilution, to determine the minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Lastly, they measured the ability of Thai Microbiological treatment of herbal extracts in the form of biofilm in the real root canal (ex vivo tooth model).

This source is relevant for my EE as it can extend my toothpaste formula, such as another toothpaste designed for adults especially for the purpose of root canal treatment as they are more prevalent in adults after their thirties.

The author argues that although these 7 herbs possess antimicrobial activity against microorganisms. However, the efficiency is not as high as the existent antimicrobial agents (Mouth wash) in the market.

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Source A: Anti-Streptococcus mutans efficacy of Thai herbal formula used as a remedy for dental caries

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Source A: Anti-Streptococcus mutans efficacy of Thai herbal formula used as a remedy for dental caries

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CSE: Joycharat N, Limsuwan S, Subhadhirasakul S, Voravuthikunchai SP, Pratumwan S, Madahin I, Nuankaew W, Promsawat A. 2012. Anti-Streptococcus mutansefficacy of Thai herbal formula used as a remedy for dental caries. Pharmaceutical Biology. 50(8):941–947. doi:10.3109/13880209.2011.649430. [ accessed 24 January 23]

The aim of this comparative study is to To test in vitro anti-Streptococcus mutans activity of Thai herbal formulas used against dental caries. After conducting the Agar disc diffusion method, the results showed that Albizia myriophylla Benth. (Leguminosae), Alpinia galanga (L.) Willd. (Zingiberaceae), Avicennia marina (Forssk.) Vierh. (Acanthaceae), and Ocimum sanctum L. (Lamiaceae) showed strongest antimicrobial activity against Streptococcus mutans. The author has also described the origin and properties of each Thai herbal ingredient.The author proposed that the awareness of rural communities in Thailand should be enhanced through the incorporation of traditional herbal medicine with the potential of antimicrobial agents. The author suggested that active ingredients in these Thai herbal plant extract can be further developed as a novel agent against dental caries in the future. This is relevant to my herb selection process, as I can select 3 herbs which showed the strongest antimicrobial activity against streptococcus mutan to be tested in my extended essay.