A new study from the University of Sharjah reveals that garlic extract may serve as a formidable alternative to chlorhexidine, the traditional leader in antimicrobial mouthwashes. Published on December 8, 2025, in the Journal of Herbal Medicine, the research indicates that higher concentrations of garlic mouthwash can match or even exceed the antibacterial effects of chlorhexidine, while offering a more natural option for consumers.
The systematic review of clinical studies conducted by the researchers found that garlic’s potent antimicrobial properties rival those of widely used antiseptics. The study highlights that while garlic mouthwash may cause more discomfort than chlorhexidine, it appears to maintain residual antibacterial activity for a longer duration.
Chlorhexidine has long been regarded as the “gold standard” in oral care due to its effectiveness against oral pathogens. However, the authors of the study outlined concerns regarding its side effects and the potential for developing antimicrobial resistance. They noted, “Garlic (Allium sativum), known for its natural antimicrobial properties, has emerged as a potential alternative.”
Comparative Analysis of Garlic and Chlorhexidine
The researchers’ conclusions stemmed from a systematic review that assessed how garlic extract performs against chlorhexidine in various clinical scenarios. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines, the authors identified a total of 389 articles from six electronic databases in January 2024. After applying specific inclusion and exclusion criteria, only five articles met the necessary standards for inclusion in the review.
The selected literature comprised randomized controlled trials and clinical studies with low to moderate risks of bias. The findings suggested that higher concentrations of garlic extract exhibited antimicrobial effects comparable to those of chlorhexidine. The effectiveness of the mouthwash varied, depending on the concentration used and the duration of application, which influenced the outcomes reported. Some studies indicated that chlorhexidine maintained a higher plaque and salivary pH, while others noted garlic extract’s superior effectiveness at specific concentrations.
Side Effects and Patient Considerations
While garlic mouthwash can cause side effects, such as a burning sensation and unpleasant odor, these are generally milder than those linked to synthetic alternatives. These factors may influence patient preferences when considering a switch from chlorhexidine to garlic-based options. Despite these potential drawbacks, the review emphasizes the significant clinical antimicrobial activity of garlic extract, noting that it can lead to “significant reductions in bacterial counts from baseline.” This suggests that garlic extract mouthwash could be a viable alternative to chlorhexidine in certain contexts.
The authors recommend further clinical trials involving larger participant cohorts and extended follow-up periods to ascertain the effectiveness and improve the clinical applicability of garlic as a substitute for chlorhexidine, which maintains its status as the benchmark antimicrobial mouthwash.
Garlic has been recognized historically as one of the most potent natural antibacterial and antifungal crops. Scientific investigations have particularly focused on allicin, a compound within garlic known for its strong antimicrobial effects. Although classified botanically as a vegetable, garlic is widely used as both an herb and a spice, with global consumption reaching approximately 30 million metric tons in 2024. Notably, China accounted for nearly 80 percent of this global use.
The global garlic extract market was valued at over $15 billion in 2024, highlighting the growing interest in natural alternatives for oral care. Garlic extracts are increasingly available in various health products without requiring prescriptions, unlike synthetic agents like chlorhexidine, which typically necessitate a dentist’s or physician’s approval.
The review underscores the importance of antimicrobial mouthwashes in oral health, particularly against diseases caused by bacteria, fungi, or viruses that can impact oral tissues. “Different antimicrobial mouthwashes, whether available over-the-counter or on prescription, can be used in managing gingivitis, dental caries, periodontal diseases, halitosis, and more,” the authors stated.
Although the review points to numerous studies demonstrating garlic’s antimicrobial effects against various pathogens, it also highlights that most research has been conducted in vitro. There is a pressing need for standardized clinical studies to confirm garlic’s efficacy in dental practice, as the current literature reflects significant gaps in evidence-based antimicrobial therapies.
As research into natural alternatives to synthetic agents continues, garlic extract stands out as a promising candidate that may reshape oral care practices in the future.
