The effects of an Ayurvedic medicinal toothpaste on clinical, microbiological and oral hygiene parameters in patients with chronic gingivitis: a double-blind, randomised, placebo-controlled, parallel allocation clinical trial.

INTRODUCTION: Plant derived preparations have been essential components for maintenance of oral hygiene and the treatment of oral diseases globally since ancient times. Acacia chundra Willd, Adhatoda vasica Nees., Mimusops elengi L., Piper nigrum L., Pongamia pinnate L. Pirerre, Quercus infectoria Olivier., Syzygium aromaticum L., Terminalia chebula Retz., Zingiber offici-nale Roscoe., individually or in combination, have been used for this purpose because of their beneficial effects. OBJECTIVES: To study the efficacy of an Ayurvedic toothpaste containing these herbs in patients with chronic gingivitis. METHODS: Otherwise healthy males and non-pregnant females (n=80) aged 18-35 years with ≥20 teeth were randomly assigned to Group 1 (herbal toothpaste) and Group 2 (placebo toothpaste). Quigley Hein plaque index (PS), bleeding on probing (BOP) and probing pocket depth (PPD), were recorded for all teeth at six sites, and one ml of resting saliva was collected to ascertain anaerobic and aerobic bacterial counts at baseline, and at 4, 8, 12 and 24 weeks. Full-mouth prophylaxis was performed and instructions for brushing with the allocated toothpaste for 6 months were given at baseline. Sixty-six participants, 34 in Group 1 and 32 in Group 2 completed the study. Clinical examinations were performed by the same examiner blinded to group allocation. RESULTS: Linear mixed model analysis revealed significant reductions of PS, BOP, PPD (p<0.0001) and total salivary anaerobic counts (p<0.05) in Group 1 at all prescribed visits compared to Group 2. Moreover the reduction increased overtime. No unpleasant effects of toothpaste use were reported. CONCLUSIONS: This study provides robust evidence of the beneficial antiplaque and antigingivitis effects of the test herbal toothpaste Sudantha® on patients with chronic gingivitis.

A randomised double-blind placebo-controlled study on the effects of a herbal toothpaste on gingival bleeding, oral hygiene and microbial variables.

INTRODUCTION: Different systems of traditional medicine of the Indian subcontinent, have used Acacia chundra Willd, Adhatoda vasica Nees., Mimusops elengi L., Piper nigrum L., Pongamia pinnata L. Pirerre, Quercus infectoria Olivier., Syzygium aromaticum L., Terminalia chebula Retz., Zingiber officinale Roscoe., individually or in combinations, to cure oral diseases. OBJECTIVE: To investigate the oral hygiene and gingival health benefits of toothpaste formulated with a mixture of the above herbs (15% w/w). METHODS: Sixty participants (test n = 30, control n = 30, mean age 23.6 +/- 2.25 vs 23.9 +/- 3.2 years) who fulfilled the selection criteria and had similar plaque (1.734 +/- 0.29 vs 1.771 +/- 0.33) and percentage of sites with gingival bleeding (19.6 +/- 7 vs 20.7 +/- 8) were studied in a double blind randomised clinical trial. Brushing instructions to all and a scaling for those with calculus were provided two weeks before baseline examination. One ml of resting saliva was collected to ascertain anaerobic (SAnB) and aerobic (SAB) bacterial counts, plaque index (PI), percentage sites with bleeding on probing (BOP) and pocket depth (PD) (at 6 sites/tooth) were recorded at baseline, followed by home use of the allocated toothpaste (test or placebo) twice a day for 12 weeks. Measurements were repeated at 4, 8, and 12 weeks. RESULTS: PI, BOP and SAnB decreased significantly in the test group at 4, 8, and 12 weeks compared to baseline measurements (Wilcoxon-Signed Rank Test, p < 0.01). There was no statistically significant improvement in PI, BOP, and SAnB in the placebo group. CONCLUSIONS: Our study indicates the beneficial effects of this herbal toothpaste (Sudantha) on oral hygiene and gingival health variables when compared with the placebo. Further clinical trials using patients with gingivitis are necessary to confirm the therapeutic benefits of this herbal toothpaste.