title: A randomised double-blind placebo-controlled study on the effects of a herbal toothpaste on gingival bleeding, oral hygiene and microbial variables.
abstract: BACKGROUND
  Different systems of traditional medicine of the Indian subcontinent, have used Acacia chundra Willd, Adhatoda vasica Nees., Mimusops elengi L., Piper nigrum L., Pongamia pinnata L. Pirerre, Quercus infectoria Olivier., Syzygium aromaticum L., Terminalia chebula Retz., Zingiber officinale Roscoe., individually or in combinations, to cure oral diseases.
  
  
  OBJECTIVE
  To investigate the oral hygiene and gingival health benefits of toothpaste formulated with a mixture of the above herbs (15% w/w).
  
  
  METHODS
  Sixty participants (test n = 30, control n = 30, mean age 23.6 +/- 2.25 vs 23.9 +/- 3.2 years) who fulfilled the selection criteria and had similar plaque (1.734 +/- 0.29 vs 1.771 +/- 0.33) and percentage of sites with gingival bleeding (19.6 +/- 7 vs 20.7 +/- 8) were studied in a double blind randomised clinical trial. Brushing instructions to all and a scaling for those with calculus were provided two weeks before baseline examination. One ml of resting saliva was collected to ascertain anaerobic (SAnB) and aerobic (SAB) bacterial counts, plaque index (PI), percentage sites with bleeding on probing (BOP) and pocket depth (PD) (at 6 sites/tooth) were recorded at baseline, followed by home use of the allocated toothpaste (test or placebo) twice a day for 12 weeks. Measurements were repeated at 4, 8, and 12 weeks.
  
  
  RESULTS
  PI, BOP and SAnB decreased significantly in the test group at 4, 8, and 12 weeks compared to baseline measurements (Wilcoxon-Signed Rank Test, p < 0.01). There was no statistically significant improvement in PI, BOP, and SAnB in the placebo group.
  
  
  CONCLUSIONS
  Our study indicates the beneficial effects of this herbal toothpaste (Sudantha) on oral hygiene and gingival health variables when compared with the placebo. Further clinical trials using patients with gingivitis are necessary to confirm the therapeutic benefits of this herbal toothpaste.
authors.affiliation: Department of Oral Medicine and Periodontology, Division of Microbiology, Faculty of Dental Sciences, University of Peradeniya, Sri Lanka.
authors.forename: S
authors.initials: S
authors.lastname: Jayashankar
authors.forename: G J
authors.initials: GJ
authors.lastname: Panagoda
authors.forename: E A P D
authors.initials: EA
authors.lastname: Amaratunga
authors.forename: K
authors.initials: K
authors.lastname: Perera
authors.forename: P S
authors.initials: PS
authors.lastname: Rajapakse
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects; D058491:Bacterial Load / Q000187:drug effects; D002327:Cariostatic Agents / Q000008:administration & dosage / Q000009:adverse effects; D003773:Dental Plaque / Q000188:drug therapy* / Q000382:microbiology; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005884:Gingival Hemorrhage / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D009055:Mouth / Q000187:drug effects / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology; D009910:Oral Hygiene; D008517:Phytotherapy; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects; D012463:Saliva / Q000187:drug effects; D014100:Toothpastes / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002327:Cariostatic Agents; D010936:Plant Extracts; D014100:Toothpastes