NCT07409610

Miswak (Salvadora Persica) Versus a Toothbrush in Plaque Removal

Effectiveness of a 45°-Cut Miswak (Salvadora Persica) Versus a Toothbrush in Plaque Removal Among Children: A Randomized Split-Mouth Clinical Trial

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 82 (actual)
• Sponsor: King Abdulaziz University · Academic / Other
• Sex: All
• Age: 6 Years – 14 Years
• Healthy volunteers: Accepted

Summary

The study investigates the effectiveness of a 45°-cut miswak for plaque removal compared to a toothbrush in children and assesses their preferences for these tools. Conducted at King Abdulaziz University Dental Hospital, it employs a split-mouth randomized controlled trial design to measure plaque levels and gather feedback through a questionnaire.

Detailed description

Miswak provides both mechanical and chemical cleaning. Its fibrous structure enables mechanical removal of debris from tooth surfaces and interdental areas, while naturally occurring compounds (e.g., fluoride, silica, and calcium) may contribute to its anticariogenic effects. Studies have reported that miswak exhibits antibacterial, antifungal, antiviral, anti-cariogenic, and antioxidant effects, and molecular docking studies have suggested potential anti-COVID-19 activity. One of the studies has shown that miswak can reduce oral bacterial load, in some cases more effectively than conventional toothpaste particularly against Streptococcus mutans and Lactobacilli, key contributors to dental caries. Miswak-based toothpaste and mouthwash have also been associated with significant reductions in plaque levels and improved gingival health, suggesting that miswak could be a viable and affordable oral hygiene option, especially for children in underserved or resource-limited communities Methods: This research employs a split-mouth randomized controlled trial (RCT) design that compared the effectiveness of a 45-degree cut Miswak stick versus a manual toothbrush in reducing dental plaque among children aged 6 to 14 years. The study focused on evaluating intra-individual differences in plaque accumulation by assigning each child to use Miswak on one side of the mouth and a toothbrush on the opposite side. This split-mouth approach aims to minimize variability and enhance statistical reliability. This design supported intra-individual comparison and enhanced the study's internal validity. * Group A (n=36) used a manual toothbrush on the left upper and lower quadrants and a 45-degree cut Miswak on the right quadrants. * Group B (n=36) followed the reverse assignment, using the toothbrush on the right and Miswak on the left

Conditions

• Dental Caries
• Dental Plaque Accumulation

Interventions

Type	Name	Description
OTHER	Miswak	Miswak is a traditional oral hygiene tool made from the twigs of the Salvadora persica tree. It's used for cleaning teeth and has natural antibacterial properties. Miswak is popular in many cultures, particularly in the Middle East and parts of Africa, and is valued for its effectiveness in promoting oral health.
OTHER	Toothbrush	A toothbrush is a small, handheld device used for cleaning teeth and maintaining oral hygiene. It typically consists of a handle and a head with bristles that help remove plaque, food particles, and bacteria from the teeth and gums, often used in conjunction with toothpaste.

Timeline

• Start date: 2025-09-12
• Primary completion: 2025-12-12
• Completion: 2026-01-19
• First posted: 2026-02-13
• Last updated: 2026-02-13

Locations

1 site across 1 country: Saudi Arabia