Comparison of Antimicrobial Effects of Stevia Rebaudiana Extract and Xylitol on Dental Biofilm: An In Vitro Study

Objectives This study aimed to assess the antibacterial effects of xylitol and Stevia rebaudiana (S. rebaudiana) ethanolic extract on oral biofilm. Methods A total of 96 acrylic discs were divided into two main groups for inoculation with Streptococcus mutans (S. mutans) and Streptococcus sobrinus (S. sobrinus). Each group consisted of 6 subgroups including a positive control subgroup and 5 subgroups of discs immersed in 1% or 3% xylitol solutions, 2 or 4 mg/mL S. rebaudiana, or a combination of 3% xylitol and 4 mg/mL S. rebaudiana. After incubation, the discs were rinsed and transferred to fluid universal medium. The solutions were cultured on specific culture media and incubated. The colony-forming units (CFUs) were counted for each disc. The structure of biofilm in each group was evaluated under a scanning electron microscope (SEM). Results ANOVA revealed significant differences between the subgroups in both S. mutans and S. sobrinus groups (P=0.03 and P=0.01, respectively). In S. mutans group, the logarithmic mean of colony count in the positive control subgroup was 6.75 while this value was significantly lower in 2 mg/mL (5.81) and 4mg/mL (5.92) S. rebaudiana subgroups using the post hoc Dunnett's test (P=0.01 and P=0.04, respectively). The three other subgroups did not show significant differences. In S. sobrinus group, all five experimental subgroups demonstrated significantly lower colony count than the positive control group (P<0.05). Conclusion S. rebaudiana extract appears to be more potent than xylitol against dental biofilm.