Anti-plaque and anti-gingivitis effectiveness of the newly invented salvadora persica toothbrush and salvadora persica chewing stick: a randomised controlled trial

Abstract

The use of Salvadora persica (miswak) chewing sticks as a customary oral hygiene tool has been recommended by the World Health Organization (WHO). Its therapeutic effects are contributed by the mechanical cleansing action, the active chemicals released, or the combination of these two actions. However, considering the difficulty in manoeuvring the chewing stick, the newly invented S. persica toothbrush is designed to merge the ease of use with the beneficial properties of S. persica preserved in its bristle. The aim of this randomised control trial was to compare the clinical effectiveness between S. persica toothbrush, S. persica chewing stick and the standard toothbrush in plaque and gingivitis control. 78 participants were randomly divided into three different groups to either use a (i) S. persica toothbrush; or (ii) S. persica chewing stick; or (iii) standard toothbrush in a standardised manner for three consecutive weeks. The primary outcomes were the Plaque Index (oral hygiene level) and the Periodontal Inflamed Surface Area (severity of gingivitis). These outcomes were recorded at three different visits: (i) baseline i.e., two-week after professional cleaning; (ii) one week post-, and (iii) three weeks post-interventions. Secondary outcomes consisted of the patient-related outcomes measured using OHIP-14 and self-reported adverse reactions over the short-term use of the oral hygiene tools. There was a statistically significant difference (p<.001) reported on the improvement of both the oral hygiene level and the severity of gingivitis for all three groups from baseline to three-week post-intervention period. When the different types of oral hygiene tools were compared, no significant difference (p>.05) was recorded. All types of oral hygiene tools showed positive influence on the impact of OHIP-14 following three weeks of use. Following standardised and correct techniques, S. persica oral hygiene tools are as effective as the standard toothbrush in plaque control and gingival health