title: Effectiveness of a miswak extract-containing toothpaste on gingival inflammation: a randomized clinical trial.
abstract: OBJECTIVE
  In this study, the efficacy of a miswak extract-containing toothpaste (Salvadora persica) on gingival inflammation was compared with that of a herbal and a conventional toothpaste.
  
  
  METHODS
  Non-smoking outpatients with sulcus bleeding index (SBI) ≥25% and with periodontal pocket depths ≤3 mm were randomly selected and divided into three groups: M-group, miswak extract-containing toothpaste; P-group, herbal toothpaste; and C-group, conventional toothpaste. After instructing the patients to brush their teeth twice a day for 3 weeks with the assigned toothpaste using a flat-trimmed manual toothbrush, a thorough oral examination was performed by a calibrated examiner (EH). The primary outcome was the SBI after 21 days. Furthermore, the amount of plaque was measured by approximal plaque index (API).
  
  
  RESULTS
  Sixty-six patients with a mean age of 57.8 ± 10.2 years were recruited and enrolled. After 3 weeks of brushing, all three patient groups showed a significant reduction in SBI. The P-group (SBI reduction: 17.1% ± 9.1) and the M-group (14.5% ± 8.1) showed the strongest effect followed by the C-group (9.4% ± 7.8). All three groups showed a significant reduction in API without significant differences between the groups.
  
  
  CONCLUSIONS
  The use of each of the three tested toothpastes caused a significant reduction in gingival inflammation and amount of plaque. The miswak extract-containing toothpaste showed a similar effect as the herbal toothpaste and can be safely used for domestic oral hygiene in patients with gingivitis.
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Azaripour
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Mahmoodi
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Habibi
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Willershausen
authors.affiliation: Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: I
authors.initials: I
authors.lastname: Schmidtmann
authors.affiliation: Department of Operative Dentistry and Periodontology, University Medical Centre, Johannes Gutenberg University, Mainz, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Willershausen
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005891:Gingivitis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010936:Plant Extracts / Q000627:therapeutic use*; D011446:Prospective Studies; D032121:Salvadoraceae; D014099:Toothbrushing; D014100:Toothpastes; D016896:Treatment Outcome
chemical_list: D010936:Plant Extracts; D014100:Toothpastes
keywords: gingival inflammation; herbal dentifrice; miswak; toothpaste