Efficacy of miswak on oral pathogens

Oral health status and hygiene practices among visually impaired adolescents from a school in Kenya

BACKGROUND

Visual impairment affects a significant population globally. The aim of this study was to determine the oral health status and oral hygiene practices among visually impaired adolescents from a school in Kenya.

METHODS

A descriptive cross-sectional study was carried out among 159 adolescents aged 10-19 years attending the largest public primary boarding school for the blind in Kenya. A questionnaire was used to record participants' socio-demographic variables and oral hygiene practices. Clinical examination was undertaken to assess oral health status which consisted of oral hygiene, gingival health, and dental caries. Bivariate analyses were conducted to compare dental health outcomes across socio-demographic characteristics.

RESULTS

There were 69 (43.4%) and 90 (56.6%) participants in Category I and II visual impairment respectively, 85 (53.5%) were male and 74 (46.5%) were female. Study participants were divided into three age categories: 10-12 years 48 (30.2%), 13-15 years 67 (42.1%), and 16- 19 years 44 (27.7%), with an overall mean age of 13.9 ± 2.3. All participants brushed their teeth, majority 107 (67.3%) brushed two or more times daily. Only 66 (41.5%) of the participants replaced their toothbrushes at 3 months. Sex (p =< 0.001) and age (p = 0.04) influenced frequency of toothbrush replacement. The average plaque score and gingival score index was 0.95 ± 0.45 and 0.28 ± 0.25 respectively, with gingivitis prevalence of 88.1%. Overall dental caries prevalence was 44.7%, [42.1%)] permanent dentition and [8.2%] deciduous dentition. Mean DMFT and dmft were 0.44 ± 0.60 and 0.12 ± 0.32 respectively. DMFT had a statistically significant association with sex (t = 1.82, p = 0.03). Oral hygiene practices did not influence oral hygiene and dental caries status. However, a statistically significant association was reported between frequency of toothbrush replacement and gingival score index ("p" =< 0.001).

CONCLUSIONS

The study reported general good oral hygiene, prevalent gingivitis 140 (88.1%), and almost half of the study population affected by dental caries 71 (44.7%). Most participants were unaware of using fluoridated toothpaste and of needing to change toothbrushes within 3 months. Frequency of toothbrush replacement was reported to influence gingival score index.

The effect of Salvadora persica ethanolic extract on oral tissue healing in rats: An in vivo study

Introduction

Invasive surgical procedures in the oral cavity inevitably cause trauma to the soft and hard tissues. The healing process in the oral cavity tissue occurs in a complex manner involving different types of cells, maturation process, and the time of healing. Salvadora persica (miswak) has been found to exert various positive effects on the oral cavity, including antimicrobial, anti-gingivitis, anti-cariogenic, gingival healing, and teeth whitening properties. This study aims to investigate the potential of miswak as an adjunctive therapy in promoting wound healing.

Materials and methods

30 live Sprague-Dawley rats were used in this study. The rats' mandibular first molar tooth was extracted, and an incision wound was made on the tongue. The extraction socket and incision wound were irrigated using normal saline and different concentrations of locally processed miswak plant extracts (0.05%, 10%, and 20%) for 7 days. The rats were sacrificed for gross examination of the tooth socket and tongue healing. Both soft tissue and alveolar bone were examined microscopically.

Results

Complete closure of the incision wound was observed on all rats' tongues; miswak groups showed better wound healing than control and placebo groups in the oral mucosa overlying the alveolar bones. 0.05% and 20% miswak extracts showed prominent wound healing effects in the sagittal sections of the tongue, with moderate formation of connective tissue under the wound site and notable wound contraction. The 20% miswak extract group showed the highest percentage of healed oral mucosa on the alveolar bone and higher bone deposition at the alveolar base.

Conclusion

A concentration of 20% miswak extract enhances the initial phase of wound healing both in oral soft and hard tissues. Miswak extract at this concentration was not toxic to the tissues and had potential therapeutic effects in oral tissue healing.

Utilising dentist-dental health educator skill-mix to implement oral health promotion that better supports diverse communities

Purpose

Dentists may be seen as the most prominent figures within dentistry. Yet, a number of dental care professionals make significant contributions to the profession. The dental health educator (DHE) is one prime example. This teammate is typically a dental nurse who has achieved a post-registration qualification in oral health education (OHE). Through interactions with patients, members of the community and other pertinent stakeholders, the DHE empowers people through promoting the importance of good oral health. The purpose of this paper is to cast light on the unique and invaluable roles that DHEs can play within their organisations.

Design/methodology/approach

This paper aims to share some examples of dentist-DHE collaborations, where OHE initiatives were implemented within an ethnically diverse London Borough in England.

Findings

It was found that such interprofessional, skill-mix efforts were more productive, when the dentist and DHE worked together, rather than the latter working independently.

Originality/value

There exists great potential for DHEs to act as ambassadors for their dental establishments, network and collaborate with other organisations and build worthwhile relations with other healthcare professionals and stakeholders.

Salvadora persica: Nature's Gift for Periodontal Health

Salvadora persica (SP) extract, displays very valuable biotherapeutic capacities such as antimicrobial, antioxidant, antiparasitic and anti-inflammatory effects. Numerous investigations have studied the pharmacologic actions of SP in oral disease therapies but its promising outcomes in periodontal health and treatment are not yet entirely described. The current study has been planned to analyze the reported effects of SP as a support to periodontal therapy to indorse regeneration and healing. In consort with clinical trials, in vitro investigations show the advantageous outcomes of SP adjunctive to periodontal treatment. Yet, comprehensive supplementary preclinical and clinical investigations at molecular and cellular levels are indispensable to reveal the exact therapeutic mechanisms of SP and its elements for periodontal health and therapy.

Microbial biodiversity of natural toothbrushes in Mali

Different oral hygiene practices are used to overcome endemic diseases such as dental caries and oral infections. In Mali (Africa), natural plant-based toothbrushes are used for eliminating bacterial biofilm. The repertoire of microorganisms associated with natural toothbrushes is unknown. The aim of our study is to study microbial flora in particular the methanogenic archaea associated with natural toothbrushes recently recognized as responsible for periodontitis and peri-implantitis. We investigated the methanogens and bacteria associated with 15 different natural plant toothbrushes collected in Bamako local market (Mali). Microbiological investigations consisted in culturing the bacteria on agar plates and searching archaea using molecular techniques. No archaea were demonstrated by molecular biology but 50 bacterial species, including 33 aero-anaerobic and 17 aerobic species, were isolated from natural toothbrushes. We isolated Pseudomonas sp., Staphylococcus sp. and Klebsiella pneumoniae, which are acknowledged as opportunistic human pathogens. This study has highlighted the likely impact of the use of natural toothbrushes in the spread of potentially pathogenic bacteria in the human oral cavity.

Antibacterial activity of plant species used for oral health against Porphyromonas gingivalis

Porphyromonas gingivalis is the keystone pathogen of periodontitis, a chronic inflammatory disease which causes tooth loss and deterioration of gingiva. Medicinal plants have been traditionally used for oral hygiene and health and might play a role as antibacterial agents against oral pathogens. In this work, we aimed to evaluate the antibacterial activity of plants used for oral hygiene or symptoms of periodontitis against P. gingivalis. We first reviewed the literature to identify plant species used for oral hygiene or symptoms of periodontitis. Then, we cross-checked this species list with our in-house library of plant extracts to select extracts for testing. Antibacterial activity tests were then performed for each plant extract against P. gingivalis, and their cytotoxicity was assessed on HaCaT cells. The selectivity index (SI) was then calculated. A total of 416 plant species belonging to 110 families and 305 genera were documented through our literature search, and 158 plant species were noted as being used by North American Native peoples Once cross-checked with the extracts contained in our library of natural products, 30 matches were identified and 21 were defined as high priority. Of the 109 extracts from 21 plant species selected and tested, 21 extracts from 11 plants had higher than 90% inhibition on P. gingivalis at 64 μg/mL and were further selected for MIC (Minimum Inhibitory Concentration) assays. Out of 21 plant extracts, 13 extracts (7 plant species) had a SI > 10. Pistacia lentiscus fruits showed the best MIC with value of 8 μg/mL, followed by Zanthoxylum armatum fruits/seeds with a MIC of 16 μg/mL. P. lentiscus fruits also showed the highest SI of 256. Most of the extracts tested present promising antibacterial activity and low cytotoxicity. Further testing for biofilm eradication and examination of activity against other dental pathogens and oral commensals should be performed to confirm the potential of these extracts as antibacterial agents. Future work will focus on application of a bioassay-guided fractionation approach to isolating and identifying the most active natural products in the top performing extracts. This study can serve as a basis for their future development as ingredients for oral hygiene products.

Characterization and Formulation of Miswak Film for the Treatment of Chronic Periodontitis: An In Vitro Study

Introduction:

Miswak is a tooth brushing stick that contains many ingredients that are beneficial for maintenance of oral hygiene. The aim of this study is to formulating a film containing miswak extract for treatment of chronic periodontitis.

Materials and Methods:

Here we tested the miswak raw extract invitro against Porphyromonas gingivalis and Herpes simplex virus-1 (HSV-1). The film was prepared using solvent casting method. Disintegration test was conducted to find the stability of the film.

Results:

Cytotoxicity of miswak was also tested. Minimum inhibitory concentration against P. gingivalis was 62.5 µg/mL. Therapuetic index against HSV-1 was 11.3 µg/mL. Cytotoxicity against 50% Vero cells was present at 210 µg/mL. Based on this invitro study 100 µg/mL dose was calculated to be incorporated in a film of size 0.5 mm × 0.4 mm. This film is made of polymers HPMC K 100 and Eudragit L 100. Disintegration test of the film showed that they remained stable for around 5 days.

Conclusion:

In the present study we formulated the miswak raw extract containing film that can act against P. gingivalis and HSV-1. So it can be used to treat chronic periodontitis by placing it in periodontal pockets.

Miswak users' behavior model based on the theory of planned behavior in the country with the largest Muslim population

Background

Maintaining proper oral hygiene has an influence on oral health. Religious obedience may influence individual behavior. According to Islamic religious guidance, as recommended by an Islamic role model, it is obligated to maintain oral health and the recommended tool to use is miswak.

Purpose

To describe miswak users’ behavior based on the theory of planned behavior.

Subjects and methods

The population of this study was the students of As-Salafi Al-Fitrah Islamic Boarding School who used miswak regularly and were healthy physically and mentally. One hundred and nine samples were chosen randomly and asked to complete a semi-open and a closed-ended questionnaire.

Results

Perceived behavioral control had the most dominant influence toward improving intention with β=0.211 and p<0.05. In contrast, attitude and subjective norms had less influence toward improving intention with β=0.190 and p>0.05, and β=0.164 and p<0.0001, respectively. Meanwhile, perceived behavioral control showed direct correlation toward action in model parameter with β=0.445 and p<0.0001.

Conclusion

Perceived behavioral control is the most dominant predisposing factor in increasing intention and attitude of miswak use.

Comparison the efficacy of herbal mouthwash with chlorhexidine on gingival index of intubated patients in Intensive Care Unit

Background:

Intubated patients in Intensive Care Unit (ICU) are not able to take care of their mouth health, so they are at risk of bacterial colonization and dental plaques formation that can lead to systemic diseases such as pneumonia and gingivitis.

Aims:

In randomized, double-blind clinical study, the efficacy of natural herbal mouthwash containing Salvadora persica ethanol extract and Aloe vera gel was compared with chlorhexidine on gingival index (GI) of intubated patients in ICU.

Materials and Methods:

Seventy-six intubated patients (18–64 years old with mean age 40.35 ± 13.2) in ICU were admitted to this study. The patients were randomly divided into two groups: (1) Herbal mouthwash and (2) chlorhexidine solution. Before the intervention, the GIs was measured by modified GI device into two groups. The mouth was rinsed by mouthwashes every 2–3 h for 4 days. 2 h after the last intervention, GIs were determined.

Results:

Along with mechanical methods, herbal mouthwash in reducing GI was statistically significant than that of chlorhexidine (P < 0.05).

Conclusion:

The results of this study introduce a new botanical extract mouthwash with dominant healing effects on GI (1.5 ± 0.6) higher than that of synthetic mouthwash, chlorhexidine (2.31 ± 0.73).

The antiplaque efficacy of propolis-based herbal toothpaste: A crossover clinical study

BACKGROUND

In recent years, herbal products have been suggested as an economic, safe and probably effective alternative for prevention and control of various oral diseases. But still there are some products which need to be evaluated. Of lately, Propolis is one such product. To assess and compare the efficacy of herbal dentifrice containing Propolis with Miswak and Colgate total toothpastes in controlling plaque formation.

MATERIALS AND METHODS

A double blind, randomized, crossover study design was conducted among thirty healthy dental students. After oral prophylaxis all subjects were given a washout product for one week period. Subjects were then made to brush with (washout product) for 1 minute followed by 1 minute brushing with assigned test product. The baseline MGMPI plaque scores were recorded. Subjects were then refrained from oral hygiene for 24 hours, and were recalled to be re-disclosed and re-measured for plaque formation. This procedure was repeated according to crossover design after a washout period of (2 week). Statistical tests used were Krukalwallis and Wilcoxon sign rank test.

RESULTS

There was a significant difference in 24 hour score between the test products evaluated. When the change from baseline to 24 hours was analyzed, the test product Propolis resulted in a consistently and significantly (p < 0.05) lower MGMPI mean scores than the Colgate Total and Miswak toothpastes.

CONCLUSION

Propolis was found to be safe and effective in reducing plaque accumulation when compared to Miswak and Colgate total toothpaste.