Synsepalum dulcificum (S. dulcificum) commonly known as “miracle fruit” because its berries have the capability to modify sour taste to the sweet taste when eaten. Beside the berries, S. dulcificum leaves were also known to possess biological properties such as antioxidant, antimutagenic and antidiabetic activities. However, the study of its antimicrobial activity against oral pathogen is still lacking. Thus, this study aimed to evaluate the antibacterial activity of its leaves against cariogenic bacteria and to analyse its phytochemical compounds. The samples of S. dulcificum leaves were collected in Kelantan, the east coast region of Peninsular Malaysia and extracted with distilled water using a Soxhlet technique. The antibacterial activity of the S. dulcificum leaves aqueous extract against Streptococcus mutans (S. mutans), Streptococcus sobrinus (S. sobrinus) and Lactobacillus salivarius (L. salivarius) was evaluated using the broth microdilution assay. The identification of the phytochemical compounds was performed using gas chromatography-mass spectrometry (GC-MS). The antibacterial study showed the minimum inhibitory concentration of S. dulcificum leaves aqueous extract against S. mutans and S. sobrinus were 16 mg/mL and 8 mg/mL, respectively. Interestingly, there was no inhibitory effect of S. dulcificum leaves aqueous extract against L. salivarius. A total of 42 chemical compounds were identified and major identified bioactive compounds groups were heterocyclic and phenolic compounds. Our results suggested S. dulcificum leaves aqueous extract has antimicrobial properties against S. mutans and S. sobrinus, but no inhibitory activity against oral normal flora, with the presence of bioactive compounds has potential in oral care products application.

Introduction: Chronic kidney disease (CKD) is associated with periodontal disease due to its hyperinflammatory state. Limited studies have explored the prevalence of periodontal disease among CKD patients in Malaysia. Objective: To assess the periodontal status of pre-dialysis CKD patients in Hospital Universiti Sains Malaysia. Methods: A total of 46 pre-dialysis CKD patients who attended the nephrology clinic at Hospital Universiti Sains Malaysia were enrolled in this study. Periodontal examination was performed using the periodontal probing depth (PPD), clinical attachment loss (CAL) and plaque index. Results: The majority of the CKD patients were Malay (95.7%) and 80.4% were males. The mean age of the patients was 58.5 years. Using PPD measurement, 37 (74.0%) of the patients had mild periodontitis, 9 (20.0%) had moderate periodontitis and 3 (6.0%) had no periodontitis. Based on CAL measurement, 12 (26%) patients had mild periodontitis, 29 (63.0%) had moderate periodontitis and 5 (11%) had severe periodontitis. The mean (standard deviation [SD]) value of mild and moderate-to-severe periodontitis by PPD measurement were 4.26 (0.26) and 5.24 (0.36), respectively. The mean of mild and moderate-to-severe periodontitis by CAL measurement were 2.66 (0.62) and 4.98 (0.73), respectively. There was no correlation between the periodontal parameters and estimated glomerular filtration rate (PPD: r = −0.160, P = 0.914; CAL: r = −0.135, P = 0.372; plaque index: r = 0.005, P = 0.974). Conclusion: This study revealed a greater prevalence and severity of chronic periodontitis among CKD patients. Thus, the periodontal health of CKD patients’ needs to be screened and monitored.