Comparative evaluation of effectiveness of miswak mouthwash and chlorhexidine mouthwash in treating gingivitis: A randomized clinical trial

Introduction: Mouth rinses are used in dentistry for both preventive and curative purposes. Chlorhexidine is regarded as gold standard in dentistry for plaque control. Most commercial mouth rinses are alcohol-based and have significant adverse-effects. Miswak is natural, safe, and alternative for promoting oral health. Miswak has been used for centuries due to its therapeutic properties, including antiplaque, antibacterial, antifungal and anticariogenic effects, making it beneficial for various oral diseases.Thus, the current study is proposed to evaluate the effectiveness of miswak mouthwash and chlorhexidine mouthwash in treating gingivitis.Objective: The objective of the study is to compare the efficacy of miswak mouthwash in comparison to chlorhexidine mouthwash in prevention of gingivitis and plaque formation.Materials and Methods: It is a randomized controlled clinical trial. A total of 30 undergraduate students who had undergone full-mouth scaling and received oral hygiene instructions were included in the study. The participants were randomly divided into two groups: Group A, Chlorhexidine mouthwash & Group B, Miswak mouthwash. Plaque, Debris, Calculus and Gingival indices were recorded over a period of 28 days.Results: In terms of statistics, both the groups showed nearly equal reduction in gingivitis score. The mean gingival bleeding, and plaque index scores recorded with miswak mouthwash and 0.12% chlorhexidine were (PI: p=0.852; GI: p=0.679; OHI-S: p=0.344), stating miswak mouthwash to be nearly equal to chlorhexidine mouthwash in terms of the tested indices.Conclusion: Miswak mouthwash demonstrated non-inferior efficacy to chlorhexidine in reducing plaque and gingival inflammation, suggesting it as a safe, natural, and cost-effective alternative for routine oral hygiene, with potential for long-term use.