Inhibition of peptidase and glycosidase activities of Porphyromonas gingivalis, Bacteroides intermedius and Treponema denticola by plant extracts

Salvadora persica L. chewing stick and standard toothbrush as anti-plaque and anti-gingivitis tool: A systematic review and meta-analysis

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.

Perilla frutescens Leaf Alters the Rumen Microbial Community of Lactating Dairy Cows

Perilla frutescens (L.) Britt., an annual herbaceous plant, has antibacterial, anti-inflammation, and antioxidant properties. To understand the effects of P. frutescens leaf on the ruminal microbial ecology of cattle, Illumina MiSeq 16S rRNA sequencing technology was used. Fourteen cows were used in a randomized complete block design trial. Two diets were fed to these cattle: a control diet (CON); and CON supplemented with 300 g/d P. frutescens leaf (PFL) per cow. Ruminal fluid was sampled at the end of the experiment for microbial DNA extraction. Overall, our findings revealed that supplementation with PFL could increase ruminal fluid pH value. The ruminal bacterial community of cattle was dominated by Bacteroidetes, Firmicutes, and Proteobacteria. The addition of PFL had a positive effect on Firmicutes, Actinobacteria, and Spirochaetes, but had no effect on Bacteroidetes and Proteobacteria compared with the CON. The supplementation with PFL significantly increased the abundance of Marvinbryantia, Acetitomaculum, Ruminococcus gauvreauii, Eubacterium coprostanoligenes, Selenomonas_1, Pseudoscardovia, norank_f__Muribaculaceae, and Sharpea, and decreased the abundance of Treponema_2 compared to CON. Eubacterium coprostanoligenes, and norank_f__Muribaculaceae were positively correlated with ruminal pH value. It was found that norank_f__Muribaculaceae and Acetitomaculum were positively correlated with milk yield, indicating that these different genera are PFL associated bacteria. This study suggests that PFL supplementation could increase the ruminal pH value and induce shifts in the ruminal bacterial composition.

Antifungal Activity of Euclea divinorum Root and Study of its Ethnobotany and Phytopharmacology

The ethnobotanical survey of Euclea divinorum Hiern (Ebenaceae) was conducted on Soqotra Island, Yemen. The root bark is used to treat mouth, dental, dermal and blood diseases in the traditional medicine of the island. The study is the first report about the effect of the plant root barks against six human pathogenic fungi. The non-polar dichloromethane extract of Euclea divinorum root bark showed stronger antifungal activities compared to polar direct and sequential methanolic extracts. These extracts showed significant broad antifungal activity against Absidia corymbifera, Aspergillus fumigatus, Candida krusei, Microsporum gypseum, Mucor sp. and Trichophyton mentagrophytes compared to the standard antibiotic drug nystatin. Thin-layer chromatography (TLC) revealed the presence of the naphthoquinones in the extracts. The results showed an extraction process to separate most antifungal naphthoquinones from the root bark by using non-polar solvent dichloromethane, while flavonoids remained in the polar methanolic extracts; therefore, the polar sequential and direct methanolic extracts recorded higher antioxidant activity than the non-polar extracts with less toxicity. The biological and chemical results identified the presence of antifungal and antioxidant constituents in the root bark and confirm its traditional use in Soqotra Island as crude powder to treat dental and dermal diseases and to clean teeth. Moreover, our results are compared with literature review on ethnobotany and phytopharmacology of the E. divinorum to present a medicinal monograph about the plant.

Streptococcus salivarius Promotes Mucin Putrefaction and Malodor Production by Porphyromonas gingivalis

Although the contribution of the oral microbiota to oral malodor is well-documented, the potential role of Gram-positive micro-organisms is unclear. In the current study, we tested the hypothesis that Gram-positive micro-organisms contribute to malodor production by deglycosylating oral glycoproteins, rendering them susceptible to subsequent proteolysis. To this end, we examined the effect of Streptococcus salivarius on Porphyromonas gingivalis-mediated putrefaction of a model glycoprotein (pig gastric mucin). Malodor was scored by two odor judges, and volatile sulfides were determined with the use of a sulfide monitor. Mucin degradation was followed by electrophoresis on SDS-PAGE. Results showed that the addition of S. salivarius or β-galactosidase promoted mucin degradation and concomitant malodor production. Addition of glycosidic inhibitors (p-APTG and glucose) inhibited this process. These results suggest that Gram-positive micro-organisms such as S. salivarius contribute to oral malodor production by deglycosylating salivary glycoproteins, thus exposing their protein core to further degradation by Gram-negative micro-organisms.

Effect of sumac extract on serum oxidative status, RANKL/OPG system and alveolar bone loss in experimental periodontitis in rats

Objectives

Sumac (Rhus coriaria L.) is widely used spice which has several properties such as antioxidant, anti-inflammatory and antimicrobial. The purpose of this animal study was to evaluate the effects of sumac extract on levels of receptor activator of nuclear factor-kappa B ligand (RANKL), osteoprotegerin (OPG) expression, serum oxidative status, and alveolar bone loss in experimental periodontitis.

Material and Methods

Twenty-four Wistar rats were separated into three groups: non-ligated (NL, n=8), ligature only (LO, n=8), and ligature and treated with sumac extract (S, n=8) (20 mg/kg per day for 11 days). A 4/0 silk suture was placed around the mandibular right first molars subgingivally; after 11 days, the rats were sacrificed, and alveolar bone loss was histometrically measured. The detection of RANKL and OPG were immunohistochemically performed. Levels of serum total antioxidant status (TAS)/total oxidant status (TOS), and oxidative stress index (OSI) were also analyzed.

Results

Alveolar bone loss was significantly greater in the LO group compared to the S and NL groups (p<0.05). The number of inflammatory cell infiltrate (ICI) and osteoclasts in the LO group was significantly higher than that of the NL and S groups (p<0.05). The number of osteoblasts in the LO and S groups was significantly higher than that of the NL group (p<0.05). There were significantly more RANKL-positive cells in the LO group than in the S and NL groups (p<0.05). OPG-positive cells were higher in S group than in LO and NL groups (p<0.05). TOS and OSI levels were significantly reduced in S group compared to LO group (P<0.05) and TAS levels were similar in S and NL group (p>0.05).

Conclusions

The present study showed that systemic administration of sumac extract may reduce alveolar bone loss by affecting RANKL/OPG balance, TOS and OSI levels in periodontal disease in rats.

Traditional Uses, Phytochemistry, and Pharmacology of Olea europaea (Olive)

Aim of the Review. To grasp the fragmented information available on the botany, traditional uses, phytochemistry, pharmacology, and toxicology of Olea europaea to explore its therapeutic potential and future research opportunities. Material and Methods. All the available information on O. europaea was collected via electronic search (using Pubmed, Scirus, Google Scholar, and Web of Science) and a library search. Results. Ethnomedical uses of O. europaea are recorded throughout the world where it has been used to treat various ailments. Phytochemical research had led to the isolation of flavonoids, secoiridoids, iridoids, flavanones, biophenols, triterpenes, benzoic acid derivatives, isochromans, and other classes of secondary metabolites from O. europaea. The plant materials and isolated components have shown a wide spectrum of in vitro and in vivo pharmacological activities like antidiabetic, anticonvulsant, antioxidant, anti-inflammatory, immunomodulatory, analgesic, antimicrobial, antiviral, antihypertensive, anticancer, antihyperglycemic, antinociceptive, gastroprotective, and wound healing activities. Conclusions. O. europaea emerged as a good source of traditional medicine for the treatment of various ailments. The outcomes of phytochemical and pharmacological studies reported in this review will further expand its existing therapeutic potential and provide a convincing support to its future clinical use in modern medicine.

Characterization of the α- and β-mannosidases of Porphyromonas gingivalis

Mannose is an important sugar in the biology of the Gram-negative bacterium Porphyromonas gingivalis. It is a major component of the oligosaccharides attached to the Arg-gingipain cysteine proteases, the repeating units of an acidic lipopolysaccharide (A-LPS), and the core regions of both types of LPS produced by the organism (O-LPS and A-LPS) and a reported extracellular polysaccharide (EPS) isolated from spent culture medium. The organism occurs at inflamed sites in periodontal tissues, where it is exposed to host glycoproteins rich in mannose, which may be substrates for the acquisition of mannose by P. gingivalis. Five potential mannosidases were identified in the P. gingivalis W83 genome that may play a role in mannose acquisition. Four mannosidases were characterized in this study: PG0032 was a β-mannosidase, whereas PG0902 and PG1712 were capable of hydrolyzing p-nitrophenyl α-d-mannopyranoside. PG1711 and PG1712 were α-1 → 3 and α-1 → 2 mannosidases, respectively. No enzyme function could be assigned to PG0973. α-1 → 6 mannobiose was not hydrolyzed by P. gingivalis W50. EPS present in the culture supernatant was shown to be identical to yeast mannan and a component of the medium used for culturing P. gingivalis and was resistant to hydrolysis by mannosidases. Synthesis of O-LPS and A-LPS and glycosylation of the gingipains appeared to be unaffected in all mutants. Thus, α- and β-mannosidases of P. gingivalis are not involved in the harnessing of mannan/mannose from the growth medium for these biosynthetic processes. P. gingivalis grown in chemically defined medium devoid of carbohydrate showed reduced α-mannosidase activity (25%), suggesting these enzymes are environmentally regulated.

Antioxidant capacity of chewing stick miswak Salvadora persica

BACKGROUND

Chewing stick (miswak Salvadora persica L.) is an effective tool for oral hygiene. It possessed various biological properties including significant antibacterial and anti-fungal effects. In the present study, we evaluated the antioxidant compounds in miswak.

METHOD

Miswak root was extracted with 80% methanol. Methanol extract as antioxidant was evaluated by using DPPH, ABTS and phosphomolybdenum complex assays and analysis by GC-MS. Peroxidase, catalase and polyphenoloxidase assays were performed for crude extract of miswak root.

RESULTS

The methanol extract of miswak contained the highest amount of crude extract among the various solvent extracts. The methanol extract showed a concentration dependent scavenging of DPPH and ABTS radicals with IC50 values 4.8 and 1.6 μg crude extract, respectively. The total antioxidant activities, based on the reduction of molybdenum (VI) to molybdenum (V), increased with increasing crude extract content. The correlation coefficients (R2) between total crude extract and DPPH, ABTS scavenging activities and the formation of phosphomolybdenum complex were 0.97, 0.99 and 0.95, respectively. The GC-MS analysis showed that the methanol extract doesn't contain phenolic and flavonoid compounds or under detected limit. After silylation of methanol extract, three compounds namely 2-furancarboxaldehyde-5-(hydroxymethyl), furan-2-carboxylic acid-3-methyl- trimethylsilyl ester and D-erythro-pentofuranose-2-deoxy-1,3,5-tris-O-(trimethylsilyl) were identified by GC-MS analysis. These furan derivatives as they contain hydroxyl groups could be possessed antioxidant activities. The antioxidant enzymes were also detected in the miswak extract with high level of peroxidase and low level of catalase and polyphenoloxidase.

CONCLUSIONS

The synergistic actions of antioxidant compounds and antioxidant enzymes make miswak is a good chewing stick for oral hygiene and food purposes.

Ethnoknowledge of Bukusu community on livestock tick prevention and control in Bungoma district, western Kenya

ETHNOPHARMACOLOGICAL RELEVANCE

To date, nomadic communities in Africa have been the primary focus of ethnoveterinary research. The Bukusu of western Kenya have an interesting history, with nomadic lifestyle in the past before settling down to either arable or mixed arable/pastoral farming systems. Their collective and accumulative ethnoveterinary knowledge is likely to be just as rich and worth documenting.

AIM OF THE STUDY

The aim of the present study was to document indigenous knowledge of the Bukusu on the effect of livestock ticks and ethnopractices associated with their management. It was envisaged that this would provide a basis for further research on the efficacy of these practices that could also lead to the discovery of useful tick-control agents.

MATERIALS AND METHODS

Non-alienating, dialogic, participatory action research (PAR) and participatory rural appraisal (PRA) approaches involving 272 women and men aged between 18 and 118 years from the Bukusu community were used.

RESULTS

Ticks are traditionally classified and identified by colour, size, host range, on-host feeding sites, and habitat preference. Tick-associated problems recognised include kamabumba (local reference to East Coast fever, Anaplasmosis or Heartwater diseases transmitted by different species of livestock ticks) and general poor performance of livestock. Traditional methods of controlling ticks include handpicking, on-host use of ethnobotanical suspensions (prepared from one or more of over 150 documented plants) to kill the ticks and prevent re-infestation, fumigation of infested cattle with smoke derived from burning ethnobotanical products, burning pastures, rotational grazing ethnopractices, and livestock quarantine.

CONCLUSIONS

The study confirms that the Bukusu have preserved rich ethnoveterinary knowledge and practices. It provides some groundwork for elucidating the efficacy of some of these ethnopractices in protecting livestock from tick disease vectors, particularly those involving the use of ethnobotanicals, which may lead to the discovery of useful ant-tick agents.

Traditional dietary additives of the Maasai are antiviral against the measles virus

Although ethnopharmacological investigations emphasize the importance of medicinal plants in developing countries, species used regularly with diet are under-investigated and potentially make greater contributions to health. Thirteen traditional plants most commonly added to milk/soups by the Maasai for perceived health benefits were tested for activity against measles virus (MV) using non-medicinal plants as controls. Antiviral effects of plant extracts were sought using a modified neutralization assay. Methanolic extracts of medicinal species exhibited significantly greater activity neutralizing MV in vitro in comparison to non-medicinal extracts (p<0.02). Four of 13 (31%) medicinal species versus 0/13 controls had measurable effects against MV in vitro. Olinia rochetiana (Olkirenyi) and Warburgia ugandensis (Osokonoi) extracts were most potent with the number of plaque forming units reduced 37- and 34-fold, respectively. Given the importance of monocytes in the dissemination of MV, we assessed the capacity of a subset of plant extracts to inhibit MV growth in monocytoid cell line, U937. MV output from U937 cells was significantly reduced by four of seven medicinal plant extracts (mean reduction 48 h: 39.0+/-26.0%, range 3.5-87%; 72 h: 56.4+/-29.5%, range 14.1-103.1%) (p<0.05). This study provides evidence that medicinal plants added to the Maasai diet may contribute to the modulation of viral infections.

Use of miswak versus toothbrushes: oral health beliefs and behaviours among a sample of Jordanian adults

OBJECTIVE

This descriptive survey aimed at determining the perceived relationship among miswak, the toothbrush, and toothbrush-plus-miswak usage on oral health beliefs and behaviours of Jordanian adults, 18-60 years old, seeking dental care in the city of Irbid, northern Jordan.

METHODS

Patients (n = 138) voluntarily completed a self-designed questionnaire prior to their dental appointments at public and private clinics.

RESULTS

Overall, the level of oral health knowledge was low; of 71 people who attempted to define dental plaque, only 26% knew the meaning of dental plaque. While 12% have never been to a dentist, and 12% visit the dentist on a regular basis, the majority (63.2%) of the respondents reported that they visit the dentist only when they have pain. The majority (72%) use the toothbrush, 20.5% use the toothbrush-plus-miswak and only 3% use miswak alone. Toothbrush users believe that using the toothbrush-plus-miswak is most effective in reducing mouth debris (chi2 = 32.069, d.f. = 16, P = 0.01); and level of education is significantly associated with the type of oral cleaning device used (chi2 = 25.817, d.f. = 12, P = 0.05). There was no significant difference between toothbrush users and toothbrush-plus-miswak users in terms of how they perceive their oral health status. About 19% of the study participants use dental floss, 60.9% use mouth rinses and 8.3% use inter-dental brushes. Educated people (baccalaureate or associate degrees) tended to use toothbrushes and toothbrush-plus-miswak. The toothbrush-plus-miswak users are most likely to spend 1-2 min each day cleaning their teeth (chi2 = 34.9, d.f. = 20, P = 0.02) than those using other devices. Respondents who use the toothbrush are most likely to visit the dentist when they have pain (chi2 = 34.02, d.f. = 12, P = 0.00) than those using other devices.

CONCLUSION

The oral health awareness level among Jordanian adults is poor and needs to be improved. Evidence-based and community-based dental health education and a philosophical change from disease-oriented and pain management care to primary preventive care are highly recommended for the Jordanian population.

Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush

BACKGROUND

The chewing stick, the miswak, is used in many developing countries as the traditional means for oral hygiene. It is prepared from the roots, twigs and stem of Salvadora persica or other alternative local plants.

OBJECTIVES

To compare the effects of the chewing stick miswak (from S. persica) and toothbrush on subgingival plaque microflora among Saudi Arabian individuals. Further, to investigate whether components extracted from S. persica may interfere with the subgingival plaque micro-organisms.

MATERIAL AND METHODS

Fifteen healthy Saudi Arabian male volunteers aged 21-36 years were included in a single-blind, randomized cross-over study. The participants were taught how to use each device properly. Plaque sampling for DNA test was performed at the baseline, 1 week after professional tooth cleaning, and after 3 weeks of either miswak or toothbrush use. Identification and quantification of microbial species were performed by the checkerboard method, using whole genomic, digoxigenin-labelled DNA probes. Inhibition zones around miswak were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analyzed in a bioassay with macrophages+/-extracts of miswak.

RESULTS

Miswak and toothbrushing had a similar influence on the levels of the subgingival microbiota. However, A. actinomycetemcomitans was significantly more reduced by miswak (p<0.05) than by toothbrushing. These results were supported by our in vitro results which, indicated that extracts from S. persica might interfere with the growth and leukotoxicity of A. actinomycetemcomitans.

CONCLUSIONS

In contrast to toothbrush use, miswak use significantly reduced the amount of A. actinomycetemcomitans in the subgingival plaque.

Salivary microbiota levels in relation to periodontal status, experience of caries and miswak use in Sudanese adults

OBJECTIVES

The purpose of the present investigation was to assess the salivary levels of 25 oral bacteria in relation to periodontal status and experience of caries, and to compare the levels of these bacteria between habitual miswak and toothbrush users in adult Sudanese subjects.

MATERIAL AND METHODS

The study subjects consisted of 56 individuals with age range 19-53 years (mean 35.2 years) and included 30 miswak and 26 toothbrush users. The periodontal status and presence of dental caries were assessed clinically. Whole saliva was collected from all subjects, and the levels of 25 selected bacterial species in saliva were assessed by the checkerboard DNA-DNA hybridization method using whole genomic DNA probes.

RESULTS

A high percentage of the subjects had detectable levels (> or = 105 bacterial cells) of several bacterial species in saliva. Between 12% and 16% of the subjects showed high (> or = 106 cells) salivary levels of the periodontitis-associated bacteria A. actinomycetemcomitans, P. melaninogenica, P. intermedia, C. rectus and E. corrodens, whereas only two (3.6%) and four (7.1%) subjects had high levels of P. gingivalis and F. nucleatum, respectively. There were no significant differences in the levels of all or most bacterial species by age group, gender or periodontal status. Presence of > or = 105 L. acidophilus bacterial cells in saliva was associated with high caries scores (p = 0.02). There were significantly higher levels of A. actinomycetemcomitans, P. melaninogenica, C. rectus, P. micros, V. parvula, S. mutans, S. anginosus, A. israelii, C. sputigena, and C. gingivalis, and significantly lower levels of P. intermedia, F. nucleatum, S. sputigena, E. corrodens, L. acidophilus, S. sanguis, S. salivarius, S. oralis, and S. mitis in the miswak than in the toothbrush group.

CONCLUSIONS

: The findings suggest that miswak may have a selective inhibitory effect on the level of certain bacteria in saliva, particularly several oral streptococci species. This is the first report that the checkerboard DNA-DNA hybridization method can be useful for assessing the levels of a wide range of bacterial taxa in saliva.

The heparin-binding domain and V region of fibronectin regulate apoptosis by suppression of p53 and c-myc in human primary cells

In apoptosis the tumor suppressor p53 and the c-myc proto-oncogene are usually up-regulated. We show a novel alternative pathway of apoptosis in human primary cells that is mediated by transcriptionally dependent decreases in p53 and c-Myc and decreases in p21. This pathway is regulated by the alternatively spliced V region and high-affinity heparin-binding domain of fibronectin. Requirements for c-Myc, p53, and p21 signals in maintaining survival and for their decreases in inducing apoptosis were demonstrated by the ability of p53, c-Myc, and p21 ectopic expression to rescue this apoptotic phenotype, and the ability of p53-deficient and c-myc antisense conditions to trigger a faster rate of apoptosis.

Antibacterial activities of extracts from Nigerian chewing sticks

Ten aqueous extracts from wooden chewing sticks widely used in Nigeria for teeth cleaning were studied for antibacterial activities against 25 different bacteria using an agar diffusion assay. The extracts from five sticks, namely Garcinia kola, Anogeissus leiocarpus, Terminalia glaucescens, Sorindeia warneckei and Vitex doniana, exhibited strong activities against a wide spectrum of bacteria including medically and dentally relevant bacteria. Notably, these five chewing stick extracts showed potent activities against methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus, and multidrug-resistant Burkholderia cepacia and Pseudomonas aeruginosa. Extracts from Vernonia amygdalina, Fagara zanthoxyloides and Massularia acuminata also showed activities against bacteria significant to periodontal disease. Methanol extracts prepared from G. kola, A. leiocarpus and V. doniana were further fractionated by solvent extraction. Results showed that the antibacterial activities were distributed into different fractions suggesting that the sticks contain different active antibacterial principles. In conclusion, the results showed that most of the Nigerian chewing sticks do contain antibacterial activities which may contribute to the reported anticaries effect of chewing sticks. These sticks may be sources for new lead antibacterial agents for therapeutic or preventive applications.

The effect of herbal extracts in an experimental mouthrinse on established plaque and gingivitis

The purpose of the present study was to establish in vitro the inhibiting effect of a herbal extract mixture on a selected number of micro-organisms and to test in vivo the effect of a mouthwash containing 6.3 mg/ml herbal extract mixture on plaque and gingivitis as compared to a minus active control mouthrinse. The herbal extract was a mixture of: Juniperus communis (juniper), Urtica dioca (nettle), Achillaea millefolium (yarrow); 1:1:1. In the study, in-vitro, the effect of pure herbal extract mixture on acid production of Streptococcus mutans was tested and the minimum inhibitory concentrations (MIC) of the following micro-organisms were tested: Streptococcus mutans, Streptococcus mitis, Actynomyces viscosus, Actynomyces naeslundii, Actinobacillus actinomycetemcomitans, Prevotella intermedia, Campylobacter rectus, Fusobacterium nucleatum, Veillonella parvula. The MIC-values for A. viscosus and P. gingivalis were 100 mg/ml. The MIC-values for A. naeslundii and A. actinomycetemcomitans were considerably lower (10 mg/ml). S. mitis was the most susceptible of the tested organisms to the extract with a MIC value of 1 mg/ml. S. mutans, C. rectus, V. parvula, and F. nucleatum were not influenced by the extracts. No inhibitory effect of the 6.3 mg/ml herbal extract mixture was observed on the acid production of S. mutans. For the study in-vivo, 45 volunteers were selected on the basis of having moderate gingival inflammation. As efficacy parameters the plaque index, modified gingival index and angulated bleeding index were assessed. The subjects were randomly divided among 3 experimental groups (2x test and 1 'minus active' control). The participants were requested to rinse with 10 ml of mouthwash twice a day for a period of three months. After 6 weeks and 3 months, the same clinical indices as at baseline were recorded. The results show no difference between the two test groups and the control group. In conclusion, the results of the present study have shown that the mixture of the 3 herbal extracts, Juniperus communis, Urtica dioca and Achillaea millefolium when used in a mouthrinse has no effect on plaque growth and gingival health.

Chewing sticks and the oral hygiene habits of the adult Pakistani population

This paper discusses the oral hygiene habits of the adult Pakistani population with special reference to chewing sticks. Information collected during the National Health Survey of Pakistan (1990-1994) showed that in the rural areas more than 50 per cent of the population used chewing sticks or miswak as a tool for oral hygiene. Conversely, in the urban population the majority use a toothbrush. About 36 per cent of the Pakistani population clean their teeth daily, irrespective of the method employed. Eight per cent of the 120 million population never clean their teeth, while 54 per cent clean their teeth either on alternate days, weekly or monthly.