Anti-plaque and anti-gingivitis effect of Papain, Bromelain, Miswak and Neem containing dentifrice: A randomized controlled trial

Background: Patients undergoing fixed orthodontic therapy may have difficulty in maintaining a good oral hygiene due to the difficulty posed by the appliances in accessing such areas. This study aimed to compare anti-plaque and anti-gingivitis efficacy of dentifrice containing Papain, Bromelain, Miswak and Neem with a standard dentifrice among patient's undergoing fixed orthodontic treatment. Material and Methods: single center, single blind, parallel arm, randomized controlled clinical trial with an allocation ratio of 1:1 was conducted. Evaluation of plaque and gingivitis was done using Williams modification of Silness and Loe Plaque Index (PI) for use in orthodontic subjects and Loe and Silness's Gingival Index (GI) at baseline and one month. Results: Inter-group comparison showed there was significantly lower mean plaque index in test (0.88 ±0.05) than in control group (1.17 ±0.05) after adjusting for the baseline plaque index (p < 0.001). Similarly, there was significantly lower mean gingival index in test (0.87 ±0.04) than in control group (1.14 ±0.04) after adjusting for the baseline gingival index (p < 0.001). Conclusions: The efficacy of the test dentifrice in limiting plaque and gingivitis suggests that it can be used as a home based adjunct to clinical therapy in orthodontic patients.