Objective:
Primary objective: To evaluate the effect of Miswak extract varnish on streptococcus mutans (S.mutans) counts in saliva and plaque, gingival bleeding index (GBI) and plaque index (PI) in orthodontic patients. Secondary objective: to suggest an appropriate frequency Miswak varnishes application to produce maximum efficiency.
Material and methods:
Enrolled patients (n=75) were randomly and equally divided into 3groups. Chlorhexidine varnish group, Miswak varnish group and control group. S.mutans counts in plaque and saliva, GBI and PI were evaluated at different time points; T0: before brackets bonding, T1: two weeks after brackets bonding, T2: one months after brackets bonding and T3: three months after brackets bonding.
Results:
Both chlorhexidine and Miswak varnishes reduced plaque S.mutans counts significantly at T2 compared to the controls, with no significant difference between Chlorhexidine and Miswak varnishes at this timepoint. After 3 months, chlorhexidine varnish group had the lowest S.mutans plaque counts followed by Miswak varnish group, while the control group had the highest counts. GBI was reduced significantly in both chlorhexidine and Miswak varnishes groups, when compared to the control group at both one month and 3 months timepoints with no statistically significant differences between chlorhexidine and Miswak neither at one month nor at 3 months. PI showed no statistically significant differences between the 3 study groups at different timepoints.
Conclusions:
Miswak varnish can be an acceptable natural substitute to chlorhexidine varnish as an anticariogenic agent if applied at monthly basis. Mechanical brushing is mandatory to reduce plaque accumulation and maintain proper gingival health.