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Abstract : One way to prevent dental and oral diseases that many people use is to control plaque chemically using mouthwash. Anti-bacterial mouthwash, both chemical and herbal, has the ability to reduce the number of pathogenic bacteria in the mouth. From previous research, the use of 0.20% Chlorhexidine mouthwash twice a day for 7 consecutive days causes disruption of the balance of the oral microbiome. This situation reduces the production of Nitric Oxide in saliva which involves nitrate reducing bacteria, resulting in an increase in blood pressure of 2-3.5 mmHg. The aim of this study was to prove the side effects of mouthwash on changes in the oral microbiome which disrupt the Nitrite Pathway and cause changes in blood pressure. This research involved 12 adult samples divided into two groups, namely six people using Chlorhexidine and six people using betel leaf herbal mouthwash. All samples involved were aged 17-30 years, healthy and had no history of hypertension. Samples were asked to gargle twice a day for 21 consecutive days. The Two Way Anova test produced a p value of <0.05 indicating an effect on blood pressure from the use of Chlorhexidine mouthwash and Betel leaf herbs. The highest systolic increase occurred on day 3rd, from each sample group, with Standard Deviation DS=5.34 & CHX=8.52. The average sample experienced an increase in blood pressure of ± 3-5 mmHg. These results show that Chlorhexidine mouthwash and betel leaf herbs have an effect on the balance of the microbiome in the oral cavity, weakening nitrate-reducing bacteria so that it can cause an increase in blood pressure.