# Antibacterial and Anti-Inflammatory Potential of Mouthwash Composition Based on Natural Extracts
## 1 Introduction
It is associated with subacute bacterial endocarditis and extraoral pathologies such as cerebral microbleeding, IgA nephropathy, and severe atherosclerosis [20]. Along with _S. mutans_, _Streptococcus sobrinus_ is often observed in cautious lesions, but _S. mutans_ mainly uses pellicle-directed and specific surface antigens, while _S. sobrinus_ mainly uses glucans [21]. _Eikenella corrodens_ causes periodontal disease with severe alveolar bone loss [22]. It has been shown to cause head and neck infection, sinusitis, lung infection, arthritis, endocardiis, intraperitoneal infection, pancreatic abscess, cranial infection, and vertebral osteomyelitis [23; 24]. _Fusobacterium nucleatum_ periodically activates inflammatory cytokines, causing periodontal stiffness and tissue damage [25] and is related to periodontitis and periodontal disease. _Aggregatibacter actinomycetemcomitans_ is a periodontal pathogen known to be involved in the development of aggressive periodontitis [26]. _Porphyomonas gingivalis_ is known to be involved in the onset of periodontitis, an inflammatory disease that can lead to tooth loss by destroying the tissues that support teeth [27]. _Prerotella nigrescens_ and _Prerotella intermedia_ are the most frequently found oral bacteria in subgingival plaque [28]. While _P. intermedia_ is a member of the subgingival microbial group related to periodontitis, _P. nigrescens_ is known to be observed in children, active periodontal disease sites, and root canal infections [29]. _Streptococcus salivarius_ inhibits respiratory pathogens and, similarly to _S. mutans_, _S. sobrinus_ and _Streptococcus pyogenes_[30], it has also been reported as an antagonist of pathogens related to tooth decay, pharyngitis, and periodontitis [31]. _Lactobacillus salivarius_ inhibits growth and expression of glucosyltransferase (Gfts) for synthesis of exopolysaccharideacharides (EPS) involved in early plague adhesion, colonization, and accumulation [32], and reduces _S. mutans_ biofilm formation in a contact-independent manner [33]. Additionally, _L. salivarius_ has been shown to have strong antibacterial activity against oral pathogens [34]. Periodontitis (PT) is a chronic inflammatory disease determined by certain periodontal pathogens which, due to an inflammatory host response, can result in periodontal tissue destruction, alveolar bone resorption, and tooth loss [35]. PT has been correlated with certain systemic disorders, such as cardiovascular diseases [36], diabetes ([PERSON] et al., 2019), metabolic syndrome ([PERSON] et al., 2018), and coronary heart disease (CHD) [37]. One of the main problems of PT is the occurrence of vascular-related diseases, which may be related to oxidative stress and relative vasospasm. This, in turn, determines endothelial injury, damage of vascular endothelial cells, and, finally, periodontal tissue destruction [38]. In this regard, recent evidence suggests that the host response mediated by IL-6 may accelerate PT and endothelial damage through a specific inflammatory reaction mediated by a specific oxidative stress pathway [39]. Galectins are a family of beta-galactosidase-binding proteins physiologically expressed in fibroblasts, epithelial cells, and during active stages of inflammation [40]. Among these, galectin-3 was reported to be implicated during cell adhesion, inflammatory response, tissue fibrosis, and first immune response [41]. Galectin-3 is systemically released from fibroblasts and macrophages on active inflammation sites and is implicated during the early stages of certain systemic diseases such as endothelial dysfunction, CHD, and heart failure [42]. Some studies evaluating concentrations of galectins at different gingival conditions showed that patients with gingivitis and chronic periodontitis had lower gingival crevicular fluid (GCF) concentrations of galectin-1 compared to healthy individuals [43], and that plasma galectin-3 was demonstrated to have a moderate prognostic accuracy in acute CHD patients [44].