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  1. Adam FA, Mohd N, Rani H, Baharin B, Mohd Yusof MYP
    J Ethnopharmacol, 2021 Jun 28;274:113882.
    PMID: 33513418 DOI: 10.1016/j.jep.2021.113882
    ETHNOPHARMACOLOGICAL RELEVANCE: Salvadora persica L. chewing stick, commonly known as miswak is still being used as an oral hygiene tool for plaque control and prevention against gingivitis. Various studies have reported on the therapeutics and prophylactic effects particularly on periodontal disease. This review aimed to evaluate the effectiveness of S. persica chewing stick compared to the standard toothbrush for anti-plaque and anti-gingivitis.

    MATERIAL AND METHODS: A PRISMA-compliant systematic search of literature was done from the MEDLINE, CENTRAL, Science Direct, PubMed and Google Scholar. Literature that fulfilled eligibility criteria was identified. Data measuring plaque score and bleeding score were extracted. Qualitative and random-effects meta-analyses were conducted.

    RESULTS: From 1736 titles and abstracts screened, eight articles were utilized for qualitative analysis, while five were selected for meta-analysis. The pooled effect estimates of SMD and 95% CI were -0.07 [-0.60 to 0.45] with an χ2 statistic of 0.32 (p = 0.0001), I2 = 80% as anti-plaque function and 95% CI were -2.07 [-4.05 to -0.10] with an χ2 statistic of 1.67 (p = 0.02), I2 = 82%.

    CONCLUSION: S. persica chewing stick is a tool that could control plaque, comparable to a standard toothbrush. Further, it has a better anti-gingivitis effect and can be used as an alternative.

    Matched MeSH terms: Salvadoraceae/chemistry*
  2. Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA
    BMC Complement Altern Med, 2016 Dec 01;16(1):493.
    PMID: 27903262
    BACKGROUND: In the author's earlier in vitro investigation, a combination of 0.25 mg/ml green tea and 7.82 mg/ml Salvadora persica L. aqueous extracts was found to exhibit significant synergistic anti-bacterial and anti-adherence effects against primary plaque colonizers biofilm. A clinical trial was needed to support these preliminary in vitro results and to investigate its efficacy as a mouthwash in the control of dental plaque.

    METHODS: A 24 h plaque re-growth, double-blinded, randomized crossover trial was carried out. Participants (n = 14) randomly rinsed with test formulation, 0.12% chlorhexidine (control) and placebo mouthwashes for 24 h. A week before the trial, all participants received scaling, polishing and oral hygiene education. On the trial day, the participants received polishing at baseline and rinsed with 15 ml of randomly allocated mouthwash twice daily without oral hygiene measures. After 24 h, plaque index was scored and then the participants entered a 6-days washout period with regular oral hygiene measures. The same protocol was repeated for the next 2 mouthwashes.

    RESULTS: The results were expressed as mean (±SD) plaque index. The test mouthwash (0.931 ± 0.372) significantly reduced plaque accumulation when compared with placebo (1.440 ± 0.498, p  0.0167).

    CONCLUSIONS: The test mouthwash has an anti-plaque effect for a 24 h period. Longer-term clinical studies are highly encouraged to investigate its anti-plaque effect for longer periods.

    TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov as NCT02624336 in December 3, 2015.

    Matched MeSH terms: Salvadoraceae/chemistry*
  3. Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA
    Arch Oral Biol, 2016 Oct;70:117-124.
    PMID: 27343694 DOI: 10.1016/j.archoralbio.2016.06.011
    OBJECTIVE: Green tea (Gt), leafs of Camellia sinensis var. assamica, is widely consumed as healthy beverage since thousands of years in Asian countries. Chewing sticks (miswak) of Salvadora persica L. (Sp) are traditionally used as natural brush to ensure oral health in developing countries. Both Gt and Sp extracts were reported to have anti-bacterial activity against many dental plaque bacteria. However, their combination has never been tested to have anti-bacterial and anti-adherence effect against primary dental plaque colonizers, playing an initial role in the dental plaque development, which was investigated in this study.

    METHODS: Two-fold serial micro-dilution method was used to measure minimal inhibitory concentration (MIC) of aqueous extracts of Gt, Sp and their combinations. Adsorption to hexadecane was used to determine the cell surface hydrophobicity (CSH) of bacterial cells. Glass beads were used to mimic the hard tissue surfaces, and were coated with saliva to develop experimental pellicles for the adhesion of the primary colonizing bacteria.

    RESULTS: Gt aqueous extracts exhibited better anti-plaque effect than Sp aqueous extracts. Their combination, equivalent to 1/4 and 1/2 of MIC values of Gt and Sp extracts respectively, showed synergistic anti-plaque properties with fractional inhibitory concentration (FIC) equal to 0.75. This combination was found to significantly reduce CSH (p<0.05) and lower the adherence ability (p<0.003) towards experimental pellicles.

    CONCLUSION: Combination between Gt and Sp aqueous extracts exhibited synergistic anti-plaque activity, and could be used as a useful active agent to produce oral health care products.

    Matched MeSH terms: Salvadoraceae/chemistry*
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