OBJECTIVE: This study aims to systematically review the wide range of data and literatures related to siwak practice and its effect on periodontal health.
METHOD: The review was conducted based on scoping review techniques, searching literature in EBSCOHOST, PubMed, SCOPUS and Google scholar databases using the following search terms: "siwak' or 'miswak' or 'chewing stick" for intervention, and "periodontium or 'periodontal' or 'periodontal health' or 'periodontal disease" for outcome. Articles published between January 1990 to March 2021 and written in English language were included.
RESULTS: A total of 721 articles collected from the search and 21 of them were eligible for the final analysis. Results of this study was described based on clinical and antibacterial reporting of siwak, method of siwak practice and its adverse effect on oral health. Siwak was found effective at removing dental plaque and improving periodontal health over time although its effect on subgingival microbiota was inconclusive. Presence of gingival recession and clinical attachment loss were much more commonly reported in siwak users, attributable to variations in the methods employed for tooth cleaning using the siwak.
CONCLUSION: There is substantial evidence that the lack of standardised reporting for effective siwak use may have resulted in contradictory findings about its oral hygiene benefits and adverse effects. As such, future work on safe and effective siwak practice is to be advocated among its users.
METHODS: Databases including Medline, Embase and bibliographies were searched from inception to 1 April 2023. Randomized controlled trials (RCTs) with 7 days or longer duration of oil pulling with edible oils in comparison to chlorhexidine or other mouthwashes or oral hygiene practice concerning the parameters of plaque index scores (PI), gingival index scores (GI), modified gingival index scores (MGI) and bacteria counts were included. Cochrane's Risk of Bias (ROB) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework were employed to determine the quality of evidence. Two authors independently conducted study selection and data extraction. Meta-analyses of the effect of oil pulling on the parameters were conducted using an inverse-variance random-effects model.
RESULTS: Twenty-five trials involving 1184 participants were included. Twenty-one trials comparing oil pulling (n = 535) to chlorhexidine (n = 286) and non-chlorhexidine intervention (n = 205) were pooled for meta-analysis. More than half of the trials (n = 17) involved participants with no reported oral health issues. The duration of intervention ranged from 7 to 45 days, with half of the trials using sesame oil. When compared to non-chlorhexidine mouthwash interventions, oil pulling clinically and significantly improved MGI scores (Standardized mean difference, SMD = -1.14; 95% confidence interval [CI]: -1.31, -0.97). Chlorhexidine was more effective in reducing the PI scores compared to oil pulling, with an SMD of 0.33 (95% CI: 0.17, 0.49). The overall quality of the body of evidence was very low.
CONCLUSIONS: There was a probable benefit of oil pulling in improving gingival health. Chlorhexidine remained superior in reducing the amount of plaque, compared to oil pulling. However, there was very low certainty in the evidence albeit the clinically beneficial effect of oil pulling intervention.
MATERIALS AND METHODS: 100 smokers and 100 nonsmokers ages 18-50 years were recruited for this study in Kota Bharu, Malaysia. Oral hygiene (good/fair vs poor) was determined using the Simplified Oral Hygiene Index, and the halitosis level was measured using a Halimeter. Subjects were instructed to refrain from consuming foods containing garlic, onions, strong spices, alcohol and using mouthwashes 48 h prior to the examination. The halitosis levels were quantified by recording volatile sulphur compounds (VSCs) three times at 3-min intervals, resulting in a mean halitosis score. Various statistical analyses were performed, ranging from simple frequency analysis to multivariable modelling.
RESULTS: The proportions of subjects with poor oral hygiene and high halitosis were 24.0% and 41.5%, respectively. According to bivariate analyses, both problems were significantly less frequent among younger adults (halitosis), females, subjects with higher education, those with adequate habits to maintain good oral hygiene, those who had recent dental visits and those self-reporting fewer health problems. The percentages of poor oral hygiene and high halitosis were significantly higher in smokers (p < 0.001). However, almost all these variables failed to show significance in the multivariate analyses, with the exceptions of smoking for both poor oral hygiene and halitosis, education for poor oral hygiene, and age, self-reported health problems and time since the previous dental visit for halitosis.
CONCLUSION: These findings demonstrate a significantly higher level of halitosis and poorer oral hygiene in smokers than nonsmokers.
AIM: To assess the oral health status, related behaviours, and oral health-related quality of life (OHRQoL) among OA children in Cameron Highlands (CH), Malaysia, and to identify the predictor(s) for poor OHRQoL.
DESIGN: This was a cross-sectional study involving 249, 11-12 year old OA children from 4 OA primary schools in CH. The children completed a self-administered questionnaire comprising information on socio-demographics, oral health-related behaviours, and the Malay Child Oral Impacts on Daily Performances (Malay Child-OIDP) index followed by an oral examination. Data were entered into the SPSS version 23.0 software. Non-parametric tests and multiple logistic regression were used for data analysis.
RESULTS: The response rate was 91.2% (n = 227/249). The prevalence of caries was 61.6% (mean DMFT = 1.36, mean dft = 1.01) and for gingivitis was 96.0%. Despite the majority reported brushing their teeth ≥ 2x/day (83.7%) with fluoride toothpaste (80.2%), more than two-thirds chewed betel nut ≥ 1/day (67.4%). Majority of the children (97.8%) had a dental check-up once a year. Nearly three-fifths (58.6%) reported experiencing oral impacts on their daily performances in the past 3 months (mean score = 5.45, SD = 8.5). Most of the impacts were of "very little" to "moderate" levels of impact intensity with 90.2% had up to 4 daily performances affected. Most of the impacts were on eating (35.2%), cleaning teeth (22.0%) and relaxing activities (15.9%). Caries in primary teeth is associated with oral impacts among the OA children.
CONCLUSIONS: The 11-12 year old OA children in Cameron Highland had high prevalence of caries and gingivitis with the majority chewed betel nut regularly. Caries in primary teeth is associated with poor OHRQoL. Future programmes should target younger age group children to promote positive oral hygiene practices, reduce caries, and improve quality of life.
Materials and Methods: This randomized controlled trial was conducted on 40 healthy children aged between 10 and 12 years of age who were randomly assigned to either of the groups: Group I--Chewable Toothbrushes and Group II--Manual Toothbrushes. Following oral prophylaxis, baseline records of oral hygiene indices (Simplified oral hygiene index (OHI-S) in indexed teeth and Turesky modification of Quigley Hein plaque index (TMQHI) were taken. Baseline Saliva samples were collected and sent for Streptococcus mutans counts. Children were then instructed to use their respective toothbrush twice daily for a week. Oral hygiene indices and S. mutans counts were repeated after 1 week.
Results: Differences in pre-brushing and post-brushing plaque scores and salivary S. mutans counts were statistically significant when compared using paired-sample t test and independent-sample t test. There was a significant reduction in salivary S. mutans counts after using both chewable and manual toothbrushes. However, there was no statistically significant difference between the two groups (P = 0.08).
Conclusion: Chewable toothbrushes are equally effective in plaque control when compared to manual toothbrushes. These can be a reliable alternative for children who lack manual dexterity.