SHARJAH, UAE: Besides the negative side effects, health experts are increasingly concerned that long-term or improper use of chlorhexidine-containing mouthwashes may contribute to antimicrobial resistance. In the ongoing search for safer alternatives, researchers at the University of Sharjah have conducted a systematic review to evaluate the potential of garlic extract as a herbal substitute.
Garlic has been widely investigated for its antibacterial and antifungal properties, including applications in oral health. The researchers highlighted previous findings indicating that garlic extract shows lower antimicrobial efficacy than chlorhexidine against some oral bacteria, such as Porphyromonas gingivalis, but may exhibit greater activity against multidrug-resistant bacteria. However, most of the evidence on garlic comes from in vitro studies with inconsistent methods and little standardisation, and consequently there is insufficient high-quality clinical evidence to confirm its effectiveness in routine dental practice.
The team thus gathered the clinical evidence comparing the antimicrobial efficacy of garlic extract-infused mouthwash with that of chlorhexidine-containing mouthwash. They found that garlic extract mouthwash demonstrated clinically relevant antimicrobial activity, producing significant reductions in bacterial counts compared with baseline levels. Mouthwash formulations containing higher concentrations of garlic extract showed greater antimicrobial efficacy, but were also associated with increased user discomfort. A university press release suggested that these side effects were generally less severe than those associated with chlorhexidine.
The authors concluded: “Garlic extract can serve as a viable alternative to chlorhexidine, especially at higher concentrations. However, side effects such as burning sensation and unpleasant taste may affect patient adherence.”
The studies included in the review reported differences between chlorhexidine and garlic extract mouthwashes in reducing Streptococcus mutans counts. Being based on a small and methodologically limited evidence base, its conclusions should be treated cautiously. Garlic extract has broad antimicrobial potential and has been studied against a range of bacteria, fungi and viruses. Its effectiveness has been researched in several dental applications, such as in the treatment of denture stomatitis and as a root canal irrigant in endodontics.
The study, titled “The clinical antimicrobial efficacy of garlic extract (Allium sativum) compared to chlorhexidine mouthwash: A systematic review”, was published in the December 2025 issue of the Journal of Herbal Medicine.
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