title: Short term clinical effect of active and inactive Salvadora persica miswak on dental plaque and gingivitis.
abstract: BACKGROUND
  Salvadora persica shrub has been used traditionally in folk medicine for different medical condition treatments. The habitual use of Salvadora persica roots (chewing sticks) for dental hygiene is still wildly spread throughout parts of Asia, Africa, and Middle. It is one of the most important species with its reported strong antibacterial, antifungal, and antiviral effects. Mechanical removal of dental plaque is regarded as an effective mean of controlling progression of periodontal disease.
  
  
  OBJECTIVE
  To evaluate the effect of active and inactive miswak on dental plaque, subgingival microbiota and gingival inflammation in patients with gingivitis.
  
  
  METHODS
  In this double blinded randomized controlled trial 68 gingivitis patients were randomly assigned to either active or inactive miswak group, and were instructed to use only issued miswaks for oral hygiene during 3 weeks experimental period. Registration of plaque, gingival inflammation, and plaque samples were taken at baseline and on completion of the study. Plaque samples were analyzed by DNA-DNA hybridization technique.
  
  
  RESULTS
  Active miswak significantly reduced dental plaque (p = 0.007). There were no differences between active and inactive miswak in reduction of approximal plaque and composition of subgingival microbiota.
  
  
  CONCLUSIONS
  Miswak has an overall effect on dental plaque and gingival inflammation scores. Similar results were achieved by active and inactive miswak in difficult to reach areas, indicating miswak has limited chemical effects on this study population. Therefore, miswak can be used as a dental hygiene method in conjunction with interproximal cleaning aides.
authors.affiliation: Periodontology Department, Institute of Odontology, PO Box 4064, S-141 04 Huddinge, Stockholm, Sweden. asofrata@gmail.com
authors.forename: Abier
authors.initials: A
authors.lastname: Sofrata
authors.forename: Fernanda
authors.initials: F
authors.lastname: Brito
authors.forename: Meshari
authors.initials: M
authors.lastname: Al-Otaibi
authors.forename: Anders
authors.initials: A
authors.lastname: Gustafsson
mesh_terms: D000293:Adolescent; D000328:Adult; D003773:Dental Plaque / Q000382:microbiology / Q000628:therapy*; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005881:Gingiva / Q000382:microbiology; D005891:Gingivitis / Q000382:microbiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D009910:Oral Hygiene / Q000379:methods*; D010512:Periodontal Index; D018517:Plant Roots; D010946:Plants, Medicinal; D032121:Salvadoraceae; D012529:Saudi Arabia; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult