Year : 2009 | Volume
: 20 | Issue : 4 | Page : 480--482
The efficacy of a herbal-based toothpaste in the control of plaque and gingivitis: A clinico-biochemical study
Jacob George, Shashikant Hegde, KS Rajesh, Arun Kumar
Department of Periodontics, Yenepoya Dental College, Mangalore, India
Department of Periodontics, Yenepoya Dental College, Mangalore
Objective: A double-blinded controlled clinical trial with parallel groups was designed to investigate the effectiveness of a herbal-based toothpaste in the control of plaque and gingivitis as compared with a conventional dentifrice. The efficacy of Colgate Herbal over Colgate tooth paste was assessed in this study.
Materials and Methods: Thirty subjects with gingivitis participated in the study. All participants had at least 20 natural teeth with no probing depths greater than 3 mm and a plaque index score of 2 or more at baseline. At baseline, the clinical parameters like gingival index, plaque index and salivary pH were estimated. Paired t-test was used to compare the difference within the groups and unpaired t-test was used to compare the difference between the groups at baseline and on the 30 th day.
Results: At the end of the study, there were statistically significant reductions in the gingival index and the plaque index scores within the test group. However, there were no statistically significant differences between the test and the control groups. The salivary pH changes were not statistically significant in the test group but were displaced more toward the acidic range in the control group.
Conclusion: It was however concluded that the herbal-based toothpaste was as effective as the conventionally formulated dentifrice in the control of plaque and gingivitis.
|How to cite this article:|
George J, Hegde S, Rajesh K S, Kumar A. The efficacy of a herbal-based toothpaste in the control of plaque and gingivitis: A clinico-biochemical study.Indian J Dent Res 2009;20:480-482
|How to cite this URL:|
George J, Hegde S, Rajesh K S, Kumar A. The efficacy of a herbal-based toothpaste in the control of plaque and gingivitis: A clinico-biochemical study. Indian J Dent Res [serial online] 2009 [cited 2021 Jun 17 ];20:480-482
Available from: https://www.ijdr.in/text.asp?2009/20/4/480/59460
Self-performed mechanical plaque removal is one of the most accepted methods of controlling plaque and gingivitis. It has been estimated that less than one-third of the population of developed nations can be expected to practice mechanical plaque removal.  Mechanical plaque control is time consuming and some individuals may lack motivation for these procedures.  There has been a search for years for chemical agents that could supplant patient- dependent mechanical plaque control and thus reduce or prevent oral disease.  Colgate herbal toothpaste (Colgate- Palmolive India Limited, Mumbai, India) containing calcium carbonate, chamomile, sage, myrrh eucalyptus and sodium monoflurophosphate was used in this study against a conventional Colgate toothpaste containing calcium carbonate, sodium monoflurophosphate, triclosan and silicate. Chamomile is said to have antiinflammatory properties.  Sage is believed to have antibacterial, antifungal and antiviral effects.  Myrrh is reputed to have antiseptic properties and a strong cleaning and healing action.  Eucalyptus adds on as an aromatic stimulant and antiseptic.  The aim of this study was to compare the efficacy of a herbal-based product with a conventionally formulated toothpaste in the control of plaque and gingivitis.
Materials and Methods
A convenient sample size of 30 subjects aged between 18 and 65 years was selected for the study. Selected subjects had to have at least 20 natural teeth and no periodontal pockets greater than 3 mm, with a gingival index ≥1 at more than 60% of the sites examined. At baseline, all the subjects had to have a plaque index of greater than 2, as measured by Turesky et al. in 1970 (modification of the Quigley Hein plaque index, 1962). No subjects had a history of known sensitivity or oral mucosal tissue reaction to toothpaste. All subjects were medically fit and none were undergoing antibiotic or antiinflammatory therapy or had undergone such therapy in the past 6 months.
The study was designed as a randomized double-blinded clinical trial. The subjects were randomly assigned to either the test or the control group by the random number table. The random allocation sequence was generated and was concealed from the main investigator. The investigator and the study subjects were unaware of the contents of each toothpaste.
Volunteers in the test group received a tube containing 150 gm of Colgate herbal-based toothpaste and subjects in the control group were given 150 gm of a conventional non herbal dentifrice. All the subjects were given tooth brushes at the beginning of the study (Plakoff-4; ICPA Health Products Ltd., Mumbai, India) and were instructed to brush twice daily with the assigned toothpaste for 30 days.
No prophylaxis was undertaken before the commencement of the study and no attempt was made to modify the volunteers' oral hygiene habits. Gibson et al. had shown that effective tooth cleaning is not achieved by detailed instructions at a single visit, including demonstration by the subject. Repetition of the instructions after 3 weeks also did not achieve a higher standard of plaque removal. 
Unstimulated salivary samples were collected at baseline, with the patient sitting with the head down and the mouth open to allow the saliva to drip from the lower lip into a beaker or a similar receptacle  for 2 min to collect about 2 ml of saliva over a given time and the pH was measured using a salivary pH meter (CL-51B; Systronics New Delhi, India).
The plaque index and the gingival index were recorded. Salivary pH, plaque index (Turesky et al. (1970) modification of the Quigley Hein plaque index) and gingival index (Loe and Sillness) were recorded at baseline and on the 30 th day.
The data were found to be normally distributed and comparisons were analysed by the t-test. Data obtained from the study are represented in [Table 1] and [Figure 1].
Intragroup comparisons in the test group using students t-test for plaque index, gingival index and salivary pH showed a statistically significant difference in the plaque and gingival scores but, for the salivary pH values, no statistically significant difference was found [Table 2].
Intragroup comparisons in the control group using students t-test showed no statistically significant difference in the plaque and gingival scores but there was a significant difference in the salivary pH, which was found to be displaced more toward the acidic range [Table 3].
When a comparison was made, using the unpaired t-test, between the test and the control groups for the plaque index, gingival index and salivary pH, no statistically significant difference was obtained [Table 4].
Lately, there has been a growing interest in natural products. The principal ingredients of the toothpaste used in this study may possess many medicinal properties. However, data pertaining to the substantivity of these products is sparse. It is imperative that clinical trials verify the efficacy of any new product, and the present study was carried out in this context. Studies by Saxer et al.  and Mullaly et al.  have shown that there is a significant reduction in both plaque index and gingival index within the group but no significant difference between the groups when herbal toothpastes were used. Likewise, in this study, the plaque index and gingival index were significantly reduced in the test group but not so in the control group and no statistically significant difference was found between the groups. Farsi et al.  had reported that periodontal disease increased with reduced salivary flow rate and increased salivary pH and that the high pH value may be associated with supersaturation of saliva with calcium and phosphate salts.
Willerhausen et al.  have shown that the pH of the total saliva was significantly displaced into the alkaline range by the use of herbal products whereas in this study, there was no statistically significant difference in the salivary pH range in the test group. Salivary pH in the control group was found to be displaced more toward the acidic range. The results of this investigation show that the herbal toothpaste is an effective agent in the control of plaque and gingivitis. However, it seems to have no significant clinical advantage over a traditionally formulated dentifrice. It can be inferred from the above results that the herbal dentifrice is as efficacious as the conventionally formulated dentifrice and could be used as an alternative for people interested in natural products. Future studies may be carried out to compare the split mouth technique using both toothpastes. It may be suggested that clinical trials should verify the efficacy of any new product instead of just assuming that the product is efficient based on laboratory studies.
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