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Published in: BMC Complementary Medicine and Therapies 1/2016

Open Access 01-12-2016 | Research article

Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial

Authors: Hayder Raad Abdulbaqi, Wan Harun Himratul-Aznita, Nor Adinar Baharuddin

Published in: BMC Complementary Medicine and Therapies | Issue 1/2016

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Abstract

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) and chlorhexidine (1.317 ± 0.344, p < 0.0167) mouthwashes. No significant difference was found between chlorhexidine and placebo (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.
Appendix
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Literature
1.
go back to reference Fvd W, Slot DE, Echeverría JJ. Lindhe J. Mechanical supragingival plaque control. In: Lang NP, Lindhe J, editors. Clinical Periodontology and Implant Dentistry. Volume 2. 6th ed. UK: John Wiley & Sons; 2015. p. 677–703. Fvd W, Slot DE, Echeverría JJ. Lindhe J. Mechanical supragingival plaque control. In: Lang NP, Lindhe J, editors. Clinical Periodontology and Implant Dentistry. Volume 2. 6th ed. UK: John Wiley & Sons; 2015. p. 677–703.
2.
go back to reference Ismail AI, Szpunar SM. The prevalence of total tooth loss, dental caries, and periodontal disease among Mexican Americans, Cuban Americans, and Puerto Ricans: findings from HHANES 1982-1984. Am J Public Health. 1990;80:66–70.CrossRefPubMedPubMedCentral Ismail AI, Szpunar SM. The prevalence of total tooth loss, dental caries, and periodontal disease among Mexican Americans, Cuban Americans, and Puerto Ricans: findings from HHANES 1982-1984. Am J Public Health. 1990;80:66–70.CrossRefPubMedPubMedCentral
3.
4.
go back to reference Strydonck DAC, Slot DE, Velden U, Weijden F. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol. 2012;39:1042–55.CrossRefPubMed Strydonck DAC, Slot DE, Velden U, Weijden F. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol. 2012;39:1042–55.CrossRefPubMed
5.
go back to reference Slot D, Berchier C, Addy M, Velden U, Weijden G. The efficacy of chlorhexidine dentifrice or gel on plaque, clinical parameters of gingival inflammation and tooth discoloration: a systematic review. Int J Dent Hyg. 2014;12:25–35.CrossRefPubMed Slot D, Berchier C, Addy M, Velden U, Weijden G. The efficacy of chlorhexidine dentifrice or gel on plaque, clinical parameters of gingival inflammation and tooth discoloration: a systematic review. Int J Dent Hyg. 2014;12:25–35.CrossRefPubMed
6.
go back to reference Li W, Wang RE, Finger M, Lang NP. Evaluation of the antigingivitis effect of a chlorhexidine mouthwash with or without an antidiscoloration system compared to placebo during experimental gingivitis. J Investig Clin Dent. 2014;5:15–22.CrossRefPubMed Li W, Wang RE, Finger M, Lang NP. Evaluation of the antigingivitis effect of a chlorhexidine mouthwash with or without an antidiscoloration system compared to placebo during experimental gingivitis. J Investig Clin Dent. 2014;5:15–22.CrossRefPubMed
7.
go back to reference Chelli-Chentouf N, Tir Touil Meddah A, Mullié C, Aoues A, Meddah B. In vitro and in vivo antimicrobial activity of Algerian Hoggar Salvadora persica L. extracts against microbial strains from children's oral cavity. J Ethnopharmacol. 2012;144:57–66.CrossRefPubMed Chelli-Chentouf N, Tir Touil Meddah A, Mullié C, Aoues A, Meddah B. In vitro and in vivo antimicrobial activity of Algerian Hoggar Salvadora persica L. extracts against microbial strains from children's oral cavity. J Ethnopharmacol. 2012;144:57–66.CrossRefPubMed
8.
go back to reference Almas K, Skaug N, Ahmad I. An in vitro antimicrobial comparison of miswak extract with commercially available non‐alcohol mouthrinses. Int J Dent Hyg. 2005;3:18–24.CrossRefPubMed Almas K, Skaug N, Ahmad I. An in vitro antimicrobial comparison of miswak extract with commercially available non‐alcohol mouthrinses. Int J Dent Hyg. 2005;3:18–24.CrossRefPubMed
9.
go back to reference Darout IA, Albandar JM, Skaug N, Ali RW. Salivary microbiota levels in relation to periodontal status, experience of caries and miswak use in Sudanese adults. J Clin Periodontol. 2002;29:411–20.CrossRefPubMed Darout IA, Albandar JM, Skaug N, Ali RW. Salivary microbiota levels in relation to periodontal status, experience of caries and miswak use in Sudanese adults. J Clin Periodontol. 2002;29:411–20.CrossRefPubMed
10.
go back to reference Cho YS, Oh JJ, Oh KH. Antimicrobial activity and biofilm formation inhibition of green tea polyphenols on human teeth. Biotechnol Bioprocess Eng. 2010;15:359–64.CrossRef Cho YS, Oh JJ, Oh KH. Antimicrobial activity and biofilm formation inhibition of green tea polyphenols on human teeth. Biotechnol Bioprocess Eng. 2010;15:359–64.CrossRef
11.
go back to reference Awadalla H, Ragab M, Bassuoni M, Fayed M, Abbas M. A pilot study of the role of green tea use on oral health. Int J Dent Hyg. 2011;9:110–6.CrossRefPubMed Awadalla H, Ragab M, Bassuoni M, Fayed M, Abbas M. A pilot study of the role of green tea use on oral health. Int J Dent Hyg. 2011;9:110–6.CrossRefPubMed
12.
go back to reference Kushiyama M, Shimazaki Y, Murakami M, Yamashita Y. Relationship between intake of green tea and periodontal disease. J Periodontol. 2009;80:372–7.CrossRefPubMed Kushiyama M, Shimazaki Y, Murakami M, Yamashita Y. Relationship between intake of green tea and periodontal disease. J Periodontol. 2009;80:372–7.CrossRefPubMed
13.
go back to reference Hrishi T, Kundapur P, Naha A, Thomas B, Kamath S, Bhat G. Effect of adjunctive use of green tea dentifrice in periodontitis patients–A Randomized Controlled Pilot Study. Int J Dent Hyg. 2016;14:178–83.CrossRefPubMed Hrishi T, Kundapur P, Naha A, Thomas B, Kamath S, Bhat G. Effect of adjunctive use of green tea dentifrice in periodontitis patients–A Randomized Controlled Pilot Study. Int J Dent Hyg. 2016;14:178–83.CrossRefPubMed
15.
go back to reference Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA. Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque. Arch Oral Biol. 2016;70:117–24.CrossRefPubMed Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA. Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque. Arch Oral Biol. 2016;70:117–24.CrossRefPubMed
16.
go back to reference Claydon N, Smith S, Stiller S, Newcombe R, Addy M. A comparison of the plaque‐inhibitory properties of stannous fluoride and low‐concentration chlorhexidine mouthrinses. J Clin Periodontol. 2002;29:1072–7.CrossRefPubMed Claydon N, Smith S, Stiller S, Newcombe R, Addy M. A comparison of the plaque‐inhibitory properties of stannous fluoride and low‐concentration chlorhexidine mouthrinses. J Clin Periodontol. 2002;29:1072–7.CrossRefPubMed
17.
go back to reference Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970;41:41–3.CrossRefPubMed Turesky S, Gilmore ND, Glickman I. Reduced plaque formation by the chloromethyl analogue of victamine C. J Periodontol. 1970;41:41–3.CrossRefPubMed
18.
go back to reference Hefti AF, Preshaw PM. Examiner alignment and assessment in clinical periodontal research. Periodontol 2000. 2012;59:41–60.CrossRefPubMed Hefti AF, Preshaw PM. Examiner alignment and assessment in clinical periodontal research. Periodontol 2000. 2012;59:41–60.CrossRefPubMed
19.
go back to reference Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefPubMed Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.CrossRefPubMed
20.
go back to reference Kandra L, Gyémánt G, Zajácz Á, Batta G. Inhibitory effects of tannin on human salivary α-amylase. Biochem Biophys Res Commun. 2004;319:1265–71.CrossRefPubMed Kandra L, Gyémánt G, Zajácz Á, Batta G. Inhibitory effects of tannin on human salivary α-amylase. Biochem Biophys Res Commun. 2004;319:1265–71.CrossRefPubMed
21.
go back to reference Soares S, Vitorino R, Osório H, Fernandes A, Venâncio A, Mateus N, Amado F, de Freitas V. Reactivity of human salivary proteins families toward food polyphenols. J Agric Food Chem. 2011;59:5535–47.CrossRefPubMed Soares S, Vitorino R, Osório H, Fernandes A, Venâncio A, Mateus N, Amado F, de Freitas V. Reactivity of human salivary proteins families toward food polyphenols. J Agric Food Chem. 2011;59:5535–47.CrossRefPubMed
22.
go back to reference Weber M-T, Hannig M, Pötschke S, Höhne F, Hannig C. Application of plant extracts for the prevention of dental erosion: an in situ/in vitro study. Caries Res. 2015;49:477–87.CrossRefPubMed Weber M-T, Hannig M, Pötschke S, Höhne F, Hannig C. Application of plant extracts for the prevention of dental erosion: an in situ/in vitro study. Caries Res. 2015;49:477–87.CrossRefPubMed
23.
go back to reference Hattab F. Meswak: the natural toothbrush. J Clin Dent. 1996;8:125. Hattab F. Meswak: the natural toothbrush. J Clin Dent. 1996;8:125.
24.
go back to reference Hannig C, Sorg J, Spitzmüller B, Hannig M, Al-Ahmad A. Polyphenolic beverages reduce initial bacterial adherence to enamel in situ. J Dent. 2009;37:560–6.CrossRefPubMed Hannig C, Sorg J, Spitzmüller B, Hannig M, Al-Ahmad A. Polyphenolic beverages reduce initial bacterial adherence to enamel in situ. J Dent. 2009;37:560–6.CrossRefPubMed
25.
go back to reference Joiner A, Muller D, Elofsson UM, Arnebrant T. Ellipsometry analysis of the in vitro adsorption of tea polyphenols onto salivary pellicles. Eur J Oral Sci. 2004;112:510–5.CrossRefPubMed Joiner A, Muller D, Elofsson UM, Arnebrant T. Ellipsometry analysis of the in vitro adsorption of tea polyphenols onto salivary pellicles. Eur J Oral Sci. 2004;112:510–5.CrossRefPubMed
26.
go back to reference Teles F, Teles R, Uzel N, Song X, Torresyap G, Socransky S, Haffajee A. Early microbial succession in redeveloping dental biofilms in periodontal health and disease. J Periodontal Res. 2012;47:95–104.CrossRefPubMed Teles F, Teles R, Uzel N, Song X, Torresyap G, Socransky S, Haffajee A. Early microbial succession in redeveloping dental biofilms in periodontal health and disease. J Periodontal Res. 2012;47:95–104.CrossRefPubMed
27.
go back to reference Zee K-Y, Samaranayake LP, Attström R. Scanning electron microscopy of microbial colonization of ‘rapid’and ‘slow’dental-plaque formers in vivo. Arch Oral Biol. 1997;42:735–42.CrossRefPubMed Zee K-Y, Samaranayake LP, Attström R. Scanning electron microscopy of microbial colonization of ‘rapid’and ‘slow’dental-plaque formers in vivo. Arch Oral Biol. 1997;42:735–42.CrossRefPubMed
28.
go back to reference Khalessi A, Pack A, Thomson W, Tompkins G. An in vivo study of the plaque control efficacy of Persica™: a commercially available herbal mouthwash containing extracts of Salvadora persica. Int Dent J. 2004;54:279–83.CrossRefPubMed Khalessi A, Pack A, Thomson W, Tompkins G. An in vivo study of the plaque control efficacy of Persica™: a commercially available herbal mouthwash containing extracts of Salvadora persica. Int Dent J. 2004;54:279–83.CrossRefPubMed
29.
go back to reference Al-Bayaty FH, AI-Koubaisi AH, Ali NAW, Abdulla MA. Effect of mouth wash extracted from Salvadora persica (Miswak) on dental plaque formation: a clinical trail. J Med Plant Res. 2010;4:1446–54. Al-Bayaty FH, AI-Koubaisi AH, Ali NAW, Abdulla MA. Effect of mouth wash extracted from Salvadora persica (Miswak) on dental plaque formation: a clinical trail. J Med Plant Res. 2010;4:1446–54.
30.
go back to reference Hambire CU, Jawade R, Patil A, Wani VR, Kulkarni AA, Nehete PB. Comparing the antiplaque efficacy of 0.5% Camellia sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children. J Int Soc Prev Community Dent. 2015;5:218–26.CrossRefPubMedPubMedCentral Hambire CU, Jawade R, Patil A, Wani VR, Kulkarni AA, Nehete PB. Comparing the antiplaque efficacy of 0.5% Camellia sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children. J Int Soc Prev Community Dent. 2015;5:218–26.CrossRefPubMedPubMedCentral
31.
go back to reference Kaur H, Jain S, Kaur A. Comparative evaluation of the antiplaque effectiveness of green tea catechin mouthwash with chlorhexidine gluconate. J Indian Soc Periodontol. 2014;18:178–82.CrossRefPubMedPubMedCentral Kaur H, Jain S, Kaur A. Comparative evaluation of the antiplaque effectiveness of green tea catechin mouthwash with chlorhexidine gluconate. J Indian Soc Periodontol. 2014;18:178–82.CrossRefPubMedPubMedCentral
Metadata
Title
Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial
Authors
Hayder Raad Abdulbaqi
Wan Harun Himratul-Aznita
Nor Adinar Baharuddin
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2016
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-016-1487-0

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