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Meta-Analysis
. 2020 Feb 11;20(1):43.
doi: 10.1186/s12906-020-2812-1.

Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis

Chandrashekar Janakiram  1 , Ramanarayanan Venkitachalam  2 , Paul Fontelo  3 , Timothy J Iafolla  4 , Bruce A Dye  5
Affiliations
Meta-Analysis

Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis

Chandrashekar Janakiram et al. BMC Complement Med Ther. .

Abstract

Background: Despite the large number of trials conducted using herbal oral care products for the reduction of dental plaque or gingivitis, results are conflicting and inconclusive.

Objective: To assess the effectiveness of herbal oral care products compared to conventional products in reducing dental plaque and gingivitis adults.

Methods: We searched the following databases for Randomised controlled trials (RCTs): MEDLINE Ovid, EMBASE Ovid etc. which yielded 493 trails. Of which 24 RCTs comparing herbal toothpaste or mouth rinse with over the counter toothpaste or mouth rinse in adults aged 18 to 65 years were included. Two authors extracted information and assessed the methodological quality of the included studies using Risk of Bias. Meta-analyses using the random-effects model were conducted for four outcomes for tooth paste and mouth rinse respectively. Mean difference (MD) or standardized mean difference (SMD) were used to estimate the effect, with 95% confidence intervals.

Results: A total of 1597 adults participated in 24 RCT studies. These were classified as herbal toothpaste (HTP) (15 trials, 899 participants) and herbal mouth rinse (HMR) (9 trials, 698 participants) compared with non-herbal toothpaste (NHTP) or non-herbal mouth rinse (NHMR). We found that HTP was superior over NHTP (SMD 1.95, 95% CI (0.97-2.93)) in plaque reduction. The long-term use of NHMR was superior in reduction of dental plaque over HMR (SMD -2.61, 95% (CI 4.42-0.80)). From subgroup analysis it showed that HTP was not superior over fluoride toothpaste (SMD 0.99, 95% CI (0.14-2.13)) in reducing dental plaque. However, HTP was favoured over non-fluoride toothpaste (SMD 4.64, 95% CI (2.23-7.05)).

Conclusion: For short-term reduction in dental plaque, current evidence suggests that HTP is as effective as compared to NHTP; however, evidence is from low quality studies.

Keywords: Dentifrices; Fluoride dental plaque; Herbal; Mouthwashes; Toothpastes.

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Conflict of interest statement

The authors have no affiliation with or involvement in any organization or entity with direct financial interest in the subject matter discussed in the manuscript.

Figures

Fig. 1
Fig. 1
Search strategy
Fig. 2
Fig. 2
Comparison of herbal toothpaste with non-herbal toothpaste (all controls) 2a. Effect on plaque reduction 2b. Effect on gingival inflammation
Fig. 3
Fig. 3
Subgroup analysis; comparison of herbal toothpaste with non-herbal toothpaste at 4 weeks follow-up 3a. Effect on plaque using fluoridated toothpaste as control 3b. Effect on plaque using non-fluoridated toothpaste as control 3c. Effect on plaque using -. Silness and Loe index scale for assessment
Fig. 4
Fig. 4
Comparison of herbal Mouth rinse vs non-herbal Mouth rinse 4a. Effect on plaque reduction 4b. Effect on gingival inflammation
See this image and copyright information in PMC

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