A Comparison of Antibacterial Efficacy of 0.5% Sodium Fluoride Impregnated Miswak and Plain Miswak Sticks on Streprococcus mutans - A Randomized Controlled Trial

Introduction: Miswak (Salvadora persica) is a tooth cleaning stick made from the Salvodora Persica tree. It serves as a natural dentifrice with anti-bacterial, anti-plaque and antifungal properties. Fluoride, impregnated in chewing sticks will bestow comparable safety against dental caries as the fluoride containing dentifrice. Aim: The aim of the present study was to assess and compare the anti-bacterial effect of 0.5% sodium fluoride impregnated miswak and plain miswak sticks on Streptococcus mutans. Materials and Methods: A randomized controlled concurrent parallel triple blind clinical trial was conducted for a period of 8 days. The trial included 30 subjects aged 20–23 years, who were randomly allocated in 1:1 ratio to Group A [0.5% Sodium Fluoride (NaF) impregnated Miswak sticks) and Group B (Plain Miswak sticks) respectively. The participants were instructed to chew miswak sticks for 6 minutes in the morning before breakfast. Unstimulated saliva was collected at baseline and after chewing miswak sticks to estimate S. mutans count using Mitis Salivarius Bacitracin agar. Data was statistically analyzed using paired and unpaired t-test. Results: A statistically significant reduction in S. mutans Colony Forming Units (CFU) count in saliva was observed after using fluoridated miswak sticks compared to the baseline count (p=0.001). There was no significant difference in anti-bacterial effect of fluoridated miswak sticks and plain miswak sticks on S. mutans count (p=0.58). Conclusion: The efficacy of miswak impregnated with 0.5% NaF and plain miskaw sticks in reducing S. mutans counts in saliva is analogous.