Anticariogenic action and safety profile of a cacao bean husk extract: A systematic review and meta-analysis

Nowadays, there is not a meta-analytic synthesis of the clinical reports that used a cacao bean husk extract (CBHE) solution as an anticariogenic mouth rinse. Thus, the aim of this study was to evaluate that information through a systematic review and meta-analysis methodology, conducted in accordance with PRISMA guidelines. Scientific databases were searched for studies published up to June 2021. Inclusion and exclusion criteria were applied to studies found and then, their data was analyzed. The five selected studies were categorized with a 36.6, 58.5, and 4.9 % of a low, unclear, and high risk of bias, respectively. Under appropriate heterogeneities (I2 values from 0 to 65 %, p values > 0.09) and absent reporting bias (symmetrical funnels), the meta-analyses show that the use of a CBHE mouth rinse reduced the salivary count of Streptococcus mutans (Z values from 2.45 to 10.61, p values < 0.01), similar to the chlorhexidine rinse performance (Z value= 0.55, p value= 0.58), and produced an insignificant presence of adverse events (Z value= 0.92, p value= 0.36) in children and adults, all these effects compared with those volunteers under an ethanol rinse or their pretest conditions. In conclusion, the CBHE mouth rinse reduced a cariogenic bacterium under an acceptable safety profile, but more clinical studies with high quality and more parameters are needed.