journal article·2026-02-25Open access

Comparison of the Antimicrobial Activity of Mouthwashes Containing Tea Tree Oil, Cannabidiol (CBD), Spilanthol, and Chlorhexidine Digluconate Against Selected Bacterial and Yeast Strains: An In Vitro Study

Maksymilian Kiełbratowski, Anna Kuśka-Kiełbratowska, Małgorzata Kępa, Rafał Wiench, Agata Trzcionka, Zenon Czuba, Marta Tanasiewicz

Applied Sciences· Volume 16· Issue 5

Abstract

(1) Background: The oral cavity is a complex ecological environment that integrates elements of both the digestive and respiratory systems, contributing to its extensive microbial diversity. Despite its effectiveness, chlorhexidine is associated with undesirable effects, such as mucosal irritation and tooth staining, which have prompted research into natural alternatives. This study aimed to compare the antimicrobial activity of mouthwashes containing tea tree oil (TTO) alone and in combination with cannabidiol (CBD) and spilanthol with that of a chlorhexidine digluconate-based mouthwash (CHX) against selected oral bacterial and fungal strains. (2) Methods: To assess the antimicrobial effects of the tested mouthwashes on reference microbial strains, the agar diffusion method was applied in accordance with the guidelines of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). In addition, the microdilution method using 96-well microtiter plates was employed to determine the minimum inhibitory concentration (MIC) of the tested substances. Microbial viability was further evaluated using the WST-based colorimetric Microbial Viability Assay Kit, in which the intensity of the produced WST-formazan dye is directly proportional to the number of viable cells. (3) Results: In the disc diffusion assay, inhibition zones measured after 24 h varied among the tested microorganisms, with the largest zones observed for CHX against Candida parapsilosis (19.63 mm) and Streptococcus pyogenes (16.7 mm). In the microdilution assay against Candida albicans, the MIC50 was achieved for preparations A and B at the highest tested concentrations (column 1), whereas for chlorhexidine (CHX), it was reached at lower concentrations (column 9). (4) Conclusions: ① All tested mouthwashes containing tea tree oil (TTO), either as a single active ingredient or in combination with cannabidiol (CBD) and spilanthol, demonstrated limited bacteriostatic and antifungal activity under the experimental conditions of this study. ② The chlorhexidine digluconate-based mouthwash exhibited significantly higher antibacterial and antifungal activity against all tested microbial strains compared to both the TTO-only mouthwashes and the formulation containing TTO combined with CBD and spilanthol.
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Research context

OpenAlex topics: Pediatric health and respiratory diseases · Herbal Medicine Research Studies · Cannabis and Cannabinoid Research

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Conservative Dentistry with Endodontics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland

Department of Periodontal Diseases and Oral Mucosa Diseases, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland

Department of Microbiology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Jagiellońska 4, 41-200 Sosnowiec, Poland

Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, Poland

Funding

Medical University of Silesia

References (37)

Show source-provided references
1. Tkaczyk, M., Kuśka-Kielbratowska, A., Fiegler-Rudol, J., Niemczyk, W., Mertas, A., Skaba, D., and Wiench, R. (2025). The Prevalence and Drug Susceptibility of Candida Species and an Analysis of Risk Factors for Oral Candidiasis—A Retrospective Study. Antibiotics, 14.10.3390/antibiotics14090876 ↗
2. Oral microbiomes: More and more importance in oral cavity and whole body10.1007/s13238-018-0548-1 ↗
3. Oral microbiome: Unveiling the fundamentals10.4103/jomfp.JOMFP_304_18 ↗
4. Vila, T., Sultan, A.S., Montelongo-Jauregui, D., and Jabra-Rizk, M.A. (2020). Oral candidiasis: A disease of opportunity. J. Fungi, 6.10.3390/jof6010015 ↗
5. A review on oral Candida as commensal and opportunistic pathogen
6. Candida colonization in HIV-infected patients in Londrina-PR, Brazil: Antifungal susceptibility and virulence factors10.3855/jidc.6970 ↗
7. Opportunistic respiratory pathogens in the oral cavity of the elderly10.1111/j.1574-695X.2010.00709.x ↗
8. Development of resistance to chlorhexidine diacetate in Pseudomonas aeruginosa and the effect of a residual concentration10.1053/jhin.2000.0851 ↗
9. Staphylococcus aureus and the oral cavity: An overlooked source of carriage and infection?10.1016/j.ajic.2014.09.015 ↗
10. The virulence factors and pathogenic mechanisms of Streptococcus pyogenes10.1016/j.job.2012.02.004 ↗
11. The ecology of Staphylococcus species in the oral cavity10.1099/0022-1317-50-11-940 ↗
12. Angjelova, A., Jovanova, E., Polizzi, A., Leonardi, R., and Isola, G. (2025). Effects of antiseptic formulations on oral microbiota and related systemic diseases: A scoping review. Antibiotics, 14.10.3390/antibiotics14080815 ↗
13. Effects of chlorhexidine mouthwash on the oral microbiome10.1016/j.jdent.2021.103768 ↗
14. Tea tree oil: A promising essential oil10.1080/10412905.2016.1232665 ↗
15. Antifungal activity of the components of Melaleuca alternifolia (tea tree) oil10.1046/j.1365-2672.2003.02059.x ↗
16. Melaleuca alternifolia (tea tree) oil gel (6%) for the treatment of recurrent herpes labialis10.1093/jac/48.3.450 ↗
17. A review of human studies assessing cannabidiol’s (CBD) therapeutic actions and potential10.1002/jcph.1387 ↗
18. David, C., Elizalde-Hernández, A., Barboza, A.S., Cardoso, G.C., Santos, M.B.F., and Moraes, R.R. (2022). Cannabidiol in dentistry: A scoping review. Dent. J., 10.10.3390/dj10100193 ↗
19. Comparative evaluation of a novel herbal anesthetic gel and 2% lignocaine gel as an intraoral topical anesthetic agent in children: Bilateral split-mouth, single-blind, crossover in vivo study10.4103/JISPPD.JISPPD_226_20 ↗
20. Evaluation of antibacterial potential of medicinal plant Spilanthes acmella Murr. and its in vitro raised callus against resistant organisms especially those harbouring bla genes
21. Bioactive metabolites from Spilanthes acmella Murr10.3390/molecules14020850 ↗
22. Anti-inflammatory effects of ethanolic extract and alkamides-derived from Heliopsis longipes roots10.1016/j.jep.2009.04.060 ↗
23. Comparison of the efficacy of simple and combined oral rinses with chlorhexidine digluconate against selected bacterial and yeast species: An in vitro study10.17219/dmp/187834 ↗
24. Kępa, M., Miklasińska-Majdanik, M., Haczyk, A., Matuła, A., and Wojtyczka, R.D. (2025). Caffeic acid and erythromycin: Antibacterial and synergistic effects on staphylococci. Pharmaceuticals, 18.10.3390/ph18070964 ↗
25. The oral microbiome: Diversity, biogeography and human health10.1038/s41579-023-00963-6 ↗
26. Pathophysiological microenvironments in oral candidiasis10.1111/apm.13412 ↗
27. Feldman, M., Sionov, R.V., Mechoulam, R., and Steinberg, D. (2021). Anti-biofilm activity of cannabidiol against Candida albicans. Microorganisms, 9.10.3390/microorganisms9020441 ↗
28. Ferraz, M.P. (2025). The potential of cannabidiol in the management of oral infections. Appl. Sci., 15.10.3390/app15105736 ↗
29. Iacovelli, F., Romeo, A., Lattanzio, P., Ammendola, S., Battistoni, A., La Frazia, S., Vindigni, G., Unida, V., Biocca, S., and Gaziano, R. (2023). Deciphering the broad antimicrobial activity of Melaleuca alternifolia tea tree oil by combining experimental and computational investigations. Int. J. Mol. Sci., 24.10.3390/ijms241512432 ↗
30. Effect of cannabidiol (CBD), a cannabis plant derivative, against Candida albicans growth and biofilm formation10.1139/cjm-2024-0034 ↗
31. Antimicrobial effect of Spilanthes acmella on Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis and Candida albicans in oral cavity10.2298/SGS2501003T ↗
32. Feldman, M., Gati, I., Sionov, R.V., Sahar-Helft, S., Friedman, M., and Steinberg, D. (2022). Potential combinatory effect of cannabidiol and triclosan incorporated into sustained release delivery system against oral candidiasis. Pharmaceutics, 14.10.3390/pharmaceutics14081624 ↗
33. Kiełbratowski, M., Kuśka-Kiełbratowska, A., Mertas, A., Bobela, E., Wiench, R., Kępa, M., Trzcionka, A., Korkosz, R., and Tanasiewicz, M. (2025). Evaluation of the effectiveness of a mouthwash containing spilanthol and cannabidiol on improving oral health in patients with gingivitis—Clinical trial. J. Clin. Med., 14.10.3390/jcm14051641 ↗
34. Antifungal activity of tea tree oil, chlorhexidine, and nystatin against Candida albicans: A comparative study10.1590/pboci.2026.042 ↗
35. Anti-fungal activity of four herbal mouthwashes versus chlorhexidine against Candida albicans and C. glabrata: A preliminary study10.5812/chbs-142439 ↗
36. Kuśka-Kiełbratowska, A., Wiench, R., Mertas, A., Bobela, E., Kiełbratowski, M., Lukomska-Szymanska, M., Tanasiewicz, M., and Skaba, D. (2022). Evaluation of the sensitivity of selected Candida strains to ozonated water—An in vitro study. Medicina, 58.10.3390/medicina58121731 ↗
37. Assessment of sensitivity of selected Candida strains on antimicrobial photodynamic therapy using diode laser 635 nm and toluidine blue—In vitro research10.1016/j.pdpdt.2019.06.007 ↗