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Miswak (Salvadora Persica) Versus a Toothbrush in Plaque Removal

K

King Abdulaziz University

Status

Completed

Conditions

Dental Caries
Dental Plaque Accumulation

Treatments

Other: Miswak
Other: Toothbrush

Study type

Interventional

Funder types

Other

Identifiers

NCT07409610
35-03-25
institutional review board (Other Identifier)

Details and patient eligibility

About

The study investigates the effectiveness of a 45°-cut miswak for plaque removal compared to a toothbrush in children and assesses their preferences for these tools. Conducted at King Abdulaziz University Dental Hospital, it employs a split-mouth randomized controlled trial design to measure plaque levels and gather feedback through a questionnaire.

Full description

Miswak provides both mechanical and chemical cleaning. Its fibrous structure enables mechanical removal of debris from tooth surfaces and interdental areas, while naturally occurring compounds (e.g., fluoride, silica, and calcium) may contribute to its anticariogenic effects. Studies have reported that miswak exhibits antibacterial, antifungal, antiviral, anti-cariogenic, and antioxidant effects, and molecular docking studies have suggested potential anti-COVID-19 activity.

One of the studies has shown that miswak can reduce oral bacterial load, in some cases more effectively than conventional toothpaste particularly against Streptococcus mutans and Lactobacilli, key contributors to dental caries. Miswak-based toothpaste and mouthwash have also been associated with significant reductions in plaque levels and improved gingival health, suggesting that miswak could be a viable and affordable oral hygiene option, especially for children in underserved or resource-limited communities

Methods:

This research employs a split-mouth randomized controlled trial (RCT) design that compared the effectiveness of a 45-degree cut Miswak stick versus a manual toothbrush in reducing dental plaque among children aged 6 to 14 years. The study focused on evaluating intra-individual differences in plaque accumulation by assigning each child to use Miswak on one side of the mouth and a toothbrush on the opposite side. This split-mouth approach aims to minimize variability and enhance statistical reliability.

This design supported intra-individual comparison and enhanced the study's internal validity.

  • Group A (n=36) used a manual toothbrush on the left upper and lower quadrants and a 45-degree cut Miswak on the right quadrants.
  • Group B (n=36) followed the reverse assignment, using the toothbrush on the right and Miswak on the left

Enrollment

82 patients

Sex

All

Ages

6 to 14 years old

Volunteers

Accepts Healthy Volunteers

Inclusion and exclusion criteria

Inclusion criteria included:

  • Healthy children aged 6 to 14 years.
  • Children who their parents/legal guardians have approved and signed the consent form, which ensures that the participants are within the target age range and are healthy, which helps to control variables that could affect oral hygiene outcomes.

Exclusion Criteria:

  • Unhealthy children
  • Children whose ages are below 6 years or above 14 years
  • Children with orthodontic brackets because it can affect oral hygiene practices and outcomes, excluding these participants ensures a more homogeneous sample.

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

82 participants in 2 patient groups

Intervention (Miswak)
Experimental group
Description:
This arm introduces a 45° miswak technique, which aligns with the modified Bass method by angling the miswak fibers at 45° toward the gingival margin
Treatment:
Other: Miswak
Control (Tooth brushing)
Active Comparator group
Description:
Participants in this arm used the modified bass technique using normal tooth brush and tooth paste
Treatment:
Other: Toothbrush

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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