# Propolis as Natural Product in the Oral Cavity Bacterial Infections Treatment: A Systematic Review
## 4 Results
### Antibacterial Activity of Propolis in Oral Cavity Bacterial Infections
#### 4.2.2 In Vivo Studies
The aim of the study was to assess their antibacterial activity. The researchers found out that propolis and pomegranate mouthwashes could constitute an alternative to chlorhexidine mouthwash. The results were obtained based on the study of eighty patients who were divided into four groups: the I group (used propolis mouthwash), the II group (used chlorhexidine mouthwash), and the IV group (used saline). The sample of saliva was collected at baseline, immediately after the application of mouthwash, and after seven days. pH values of the saliva samples and _S. mutans_ bacterial count were estimated. No statistically significant difference between the total percentage reduction in bacterial counts was observed in all groups. However, the lowest values were recorded immediately after the use [108]. [PERSON] et al. [109] studied the effect of topical application of an oral gel containing propolis on radiotherapy-related oral complications caused by _P. gingialis_. The authors confirmed that propolisis is not only effective in decreasing the number of _P. gingialis_ but also relieves oral pain. The results were obtained based on the study of twenty-seven patients who were divided into five groups: the I group (six patients used an oral gel with placebo), the II group (five patients used an oral gel with chloroseidine), the III group (five patients used an oral gel with curry leaf), the IV group (six patients used an oral gel with propolisis), and the V group (five patients used an oral gel with turmeric). The participants of the study were informed about the procedures during the first visit and gave their consent. Then, samples were collected before and after the treatment, during the second and fourth visit. Each subject used gel once every night after brushing their teeth for 1 month during the study. They were asked to collect saliva themselves before brushing their teeth in the morning during the second and fourth visit. Propolis was used at the concentration of 100 \(\upmu\)g/mL and inhibited both the growth and biofilm formation of _P. gingialis_. At the baseline visit, 92% of subjects felt dryness in the oral cavity, and 52% of subjects had pain in the oral cavity. Each intervention was examined on bacteria clearance in saliva by species-specific real-time PCR analysis. For propolisis, the amount of _P. gingialis_ in saliva was reduced from 100 to 20% [109]. [PERSON] et al. [110] analyzed _in vivo_ the effects of Brazilian red propolisis and xylitol chewable tablets. The obtained results suggest that the tablets can be not only an effective alternative, but they cost less. Moreover, they are natural adjuncts which could be applied to prevent dental caries and other periodontal diseases. The results were obtained based on the study of twelve participants who were divided into three groups: the I group (used placebo) and the II group (used the tested tablets). The analysis of saliva showed a decrease in the CFU of _S. mutans_. The log10 CFU/mL values were 2.74 and 2.52, respectively, for before and after treatment for the II group. For the placebo group, the log10 CFU/mL values were 2.20 and 2.29, respectively, for before and after treatment [110]. [PERSON] et al. [111] evaluated tea tree essential oil (TTO) toothpaste with natural and ethanolic extract of propolisis (EEP). They focused on the effect on microflora and certain oral health indicators. The study group included the patients who used removable acrylic partial dentures. The study proved that toothpaste with natural antimicrobial substances significantly decreased the number of oral microbiota. Therefore, the antimicrobial and antifungal activity of those natural antimicrobial substances, i.e., TTO and EEP, was confirmed. The results were obtained based on the study of fifty patients who were divided into three groups: the I group (which used the toothpaste with TTO and EEP) and the II group (which used the same toothpaste but without TTO and EEP). Control visits took place 7 and 28 days later and were compared to baseline.