# Nano-Hydroxyapatite-Based Mouthwash for Comprehensive Oral Care: Activity Against Bacterial and Fungal Pathogens with Antioxidant and Anti-Inflammatory Action

## TL;DR

A new mouthwash with nano-hydroxyapatite shows strong antimicrobial, antioxidant, and anti-inflammatory effects, especially against bacteria and fungi on dental materials.

## Contribution

A novel nano-hydroxyapatite-based mouthwash is introduced with demonstrated efficacy against biofilms and multiple oral pathogens.

## Key findings

- The mouthwash KWT0000 showed strong antimicrobial activity against S. aureus and C. albicans with MICs of 0.2–1.6%.
- It significantly disrupted biofilms on titanium and zirconia surfaces and exhibited superior antioxidant and anti-inflammatory activity.
- The formulation outperformed a fluoride-based comparator in antioxidant and anti-inflammatory effects.

## Abstract

Background/Objectives: The growing demand for biocompatible and fluoride-free alternatives in oral care has led to the development of formulations containing nano-hydroxyapatite (nanoHAP). This study aimed to evaluate the antimicrobial, antibiofilm, antioxidant, and anti-inflammatory properties of a novel mouthwash containing nanoHAP, zinc lactate, D-panthenol, licorice extract, and cetylpyridinium chloride, with particular focus on its efficacy against Staphylococcus aureus and its biofilm on various dental materials. Methods: The antimicrobial activities of the mouthwash KWT0000 and control product ELM were assessed via minimal inhibitory concentration (MIC) testing against selected Gram-positive and Gram-negative bacteria and Candida fungi. Antibiofilm activity was evaluated using fluorescence and digital microscopy following 1-h exposure to biofilms of Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. The efficacy was compared across multiple dental materials, including titanium, zirconia, and PMMA. Antioxidant capacity was determined using the 2,2-diphenyl-1-picrylhydrazyl radical (DPPH) assay, and anti-inflammatory potential via hyaluronidase inhibition. Results: KWT0000 exhibited strong antimicrobial activity against S. aureus and C. albicans (MICs: 0.2–1.6%) and moderate activity against Gram-negative strains. Fluorescence imaging revealed significant biofilm disruption and bacterial death after 1 h. On metallic surfaces, especially polished titanium and zirconia, KWT0000 reduced S. aureus biofilm density considerably. The formulation also demonstrated superior antioxidant (55.33 ± 3.34%) and anti-inflammatory (23.33 ± 3.67%) activity compared to a fluoride-based comparator. Conclusions: The tested nanoHAP-based mouthwash shows promising potential in antimicrobial and antibiofilm oral care, particularly for patients with dental implants. Its multifunctional effects may support not only plaque control but also soft tissue health.