Chemically, sanguinarine is a benzophenanthridine alkaloid derived from the alcoholic extraction of powdered rhizomes of the bloodroot plant, Sanguinaria Canadensis, that grow in central and south America and Canada. Sanguinarine contains the chemically reactive iminium ion which is probably responsible for its activity. It appears to be retained in plaque for several hours after use, and is poorly absorbed from the gastrointestinal tract. Several clinical studies have been carried out into its effects. A sanguinarine mouth rinse and toothpaste regime given for 6 months during orthodontic treatment reduced plaque by 57% and gingival inflammation by 60% compared with figures of 27% and 21% for the placebo control group. Reviews on antimicrobial mouth rinses including sanguinarine conclude that short-term studies have shown variable but significant plaque inhibitory effects but the effect on gingivitis appears to be equivocal. In respect of its possible modes of action, it has also been shown that sanguinarine at a concentration of 16 microgram per milliliter completely inhibited 98% of microbial isolates from human dental plaque and that sanguinarine and zinc act synergistically in suppressing the growth of various oral strains of streptococci (Eley1999).
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