Efficacy of Miswak toothpaste and mouthwash on cariogenic bacteria

OBJECTIVES To evaluate the efficacy of Salvadora persica (Miswak) products on cariogenic bacteria in comparison with ordinary toothpaste.  METHODS The study was conducted in Zakho city, Kurdistan region, Iraq during the period from October 2013 to January 2014. A randomized controlled clinical trial of 40 students randomly allocated into 4 groups. They were instructed to use Mismark toothpaste, Miswak mouthwash, and ordinary toothpaste with water or with normal saline. Salivary samples were collected at 3-time intervals: before, immediately after use, and after 2 weeks of use. The effect of each method on Streptococcus mutans and Lactobacilli was evaluated by using caries risk test.  RESULTS One-way repeated measure analysis of variance (ANOVA), one-way ANOVA, and least significant difference tests were used. Miswak wash has a significant reduction effect on both bacteria immediately and after 2 weeks of use. Miswak paste has a similar effect on Lactobacilli, while Streptococcus mutans showed a significant decrease only after 2 weeks of use. Ordinary paste showed a non significant effect on both bacteria at both time intervals; while the addition of normal saline showed a significant effect on both bacteria only after 2 weeks of use.  CONCLUSION Miswak products, especially mouth wash, were more effective in reducing the growth of cariogenic bacteria than ordinary toothpaste.