Antimicrobial Effect of Miswak Sticks and 0.5% Sodium Fluoride Impregnated Miswak Sticks on Streptococcus Mutans and Lactobacilli - a Randomized Controlled Trial

Purpose: To assess and compare the invivo antibacterial property of Miswak sticks and 0.5% Sodium Fluoride (NaF) impregnated Miswak sticks against Streptococcus mutans (S.mutans) and Lactobacillus. Materials and methods: A randomized controlled clinical trial (parallel group design) was conducted involving 20 subjects who were randomly allocated to Group A (0.5% NaF impregnated Miswak sticks) and Group B (Plain Miswak sticks). Subjects were instructed not to use any oral hygiene aids containing fluoride for one week before the test and not to eat or drink two hours before they chewed either plain or fluoride impregnated miswak sticks for 6 minutes in the morning before breakfast. Pooled saliva was collected at baseline and after chewing miswak sticks and analysed for antimicrobial activity against Lactobacilli and Streptococcus mutans. Results: Microbiological results showed significant reduction in the salivaryS.mutans count after using fluoridated miswak stick compared to baseline saliva sample [ p=0.006 ]. A reduction in the lactobacillus count was seen in both the groups compared to the baseline levels but, the difference was not statistically significant. Conclusion: A significant reduction between pre-test and post-test was found only for salivary S.mutans count (p=0.006) in 0.5%NaF impregnated miswak sticks group but not for salivary Lactobacilli count. Sodium fluoride when impregnated to miswak sticks did not significantly add to the antimicrobial efficacy.