Research from the University of Sharjah reveals that garlic extract may serve as a powerful alternative to chlorhexidine, a widely-used antimicrobial mouthwash. A systematic review published on December 8, 2025, in the Journal of Herbal Medicine indicates that higher concentrations of garlic mouthwash can effectively eliminate bacteria, sometimes outperforming chlorhexidine while providing a more natural solution.
Medical researchers conducted a comprehensive review of clinical studies to assess garlic’s efficacy against chlorhexidine. The study’s findings suggest that garlic mouthwash could be a viable substitute, although it may cause more discomfort than its synthetic counterpart. “Chlorhexidine is recognized as a gold standard in mouthwash formulations but carries potential side effects and raises concerns regarding antimicrobial resistance,” the authors noted. “Garlic (Allium sativum), known for its natural antimicrobial properties, has emerged as a potential alternative.”
Systematic Review Highlights Garlic’s Potential
The researchers based their conclusions on a systematic review that adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. They employed the PICO framework to structure their clinical research questions. Initially, the team identified 389 articles from six electronic databases in January 2024 and included an additional 13 articles through manual citation searching. After filtering for duplicates and applying strict inclusion and exclusion criteria, only five articles remained for analysis.
The selected studies comprised randomized controlled trials and clinical investigations with varying designs and low-to-moderate risks of bias. The review found that higher concentrations of garlic extract demonstrated antimicrobial performance comparable to chlorhexidine. “Effectiveness varied based on mouthwash concentration and duration of application,” the review stated. “Some studies favored chlorhexidine for maintaining higher plaque and salivary pH, while others indicated that garlic extract was more effective at specific concentrations.”
Side Effects and Future Research Directions
Although garlic extract can produce side effects, they are generally milder than those associated with synthetic mouthwashes. Reported issues include a burning sensation and an unpleasant odor, which may deter patients from transitioning to garlic-based options. Nonetheless, the review underscores significant reductions in bacterial counts, suggesting that garlic mouthwash might serve as a viable alternative in certain contexts.
The authors advocate for further clinical trials with larger participant samples and extended follow-up periods to validate garlic’s effectiveness and enhance its applicability in dental care. Despite current findings, chlorhexidine remains the gold standard for antimicrobial mouthwashes.
Garlic has long been recognized for its potent antibacterial and antifungal properties. Scientific interest has particularly focused on allicin, a compound within garlic known for its strong antimicrobial activity. In 2024, global garlic consumption reached approximately 30 million metric tons, with China accounting for nearly 80 percent of worldwide consumption and production. Furthermore, the global garlic extract market was valued at over $15 billion that same year.
As interest grows in herbal alternatives for oral care, garlic extracts are increasingly available in over-the-counter health products. In contrast, synthetic agents like chlorhexidine typically require a prescription from healthcare professionals. The review emphasizes the importance of antimicrobial mouthwashes as essential adjuncts for managing oral diseases caused by bacteria, fungi, or viruses.
While the review highlights numerous studies demonstrating garlic’s antimicrobial effects, it also notes a significant gap in clinical research. Most existing studies are in vitro, vary in methodology, and lack standardization, indicating a pressing need for additional research to confirm garlic’s efficacy in dental practices.
