Ayurvedic and herbal plaque control agents in gingivitis: A systematic review and meta-analysis of randomized...

Since the effectiveness of ayurvedic and herbal plaque control agents in reducing plaque in gingivitis is inconsistent across multiple trials, we conducted a study to evaluate their overall effect on dental plaque index (PI), gingival index, and bacterial colony counts (CC) of debris in gingivitis patients.

We searched major electronic biomedical databases (PubMed/Medline, CAM-QUEST®, EBSCOhost, Google Scholar, EMBASE, Scopus, and Cochrane Central Register of Controlled Trials) from August 2004 to August 2021 for randomized control trials on gingivitis using ayurvedic, herbal plaque control agents, and oil pulling therapy as interventions. We grouped comparable outcome parameters of similar products and estimated the standard mean difference (SMD) for pooled effect size with 95% confidence intervals (CI) using RevMan 5.4.1 software. Risk-of-bias (ROB) assessment followed the Cochrane Collaboration's recommended approach.

We found 554 articles of 2,806 patients after searching of which 41 randomized clinical trials were considered for meta-analysis. Ayurvedic plaque control agents (Plaque index (PI): SMD = -0.52, 95% CI (-0.94, -0.11); CC: SMD = -1.70, 95% CI (-5.06, 1.67)), (Oil pulling therapy: PI: SMD = -0.38, 95% CI (-1.45, 0.68); CC: SMD = -1.04, 95% CI (-2.20, 0.11)), (Herbal plaque control agents: PI: SMD = -0.58, 95% CI (-1.55, 0.39)), (Triphala: PI: SMD = -0.65, 95% CI (-1.32, 0.03)) were found as good as control. Significant reduction in the gingival index and bacterial colony count was also seen.

In addition to conventional dental care, ayurvedic and herbal plaque control agents may help in plaque reduction, gingival inflammation, and bacterial growth. They are safe and may be recommended in community dentistry practices.(PROSPERO registration number: CRD42021274656).