Anti-Cariogenic Effect of Miswak and Grape Seed Extract Versus Fluorides

Objectives: To investigate the effect of miswak and grape seed extract (GSE) versus fluoride on salivary bacterial count and buffering capacity.
Methods: A total of thirty patients were included in the study. Patients were randomly divided into three groups of 10 patients each according to agent used;, Gp1 was assigned to a fluoride mouth wash, Gp2 (GSE) mouthwash and Gp3 were assigned to miswak to be used in its natural form.. 0.05% sodium fluoride and freshly prepared 6.5% GSE mouth wash and Miswak sticks were supplied to the patients with clear instructions. Patients were instructed to use the mouthwash/ miswak twice daily after regular tooth brushing for 2 minutes each time. Saliva samples were collected from patients at baseline, then after one month and three months. Saliva was collected 90 minutes after using mouth wash or miswak sticks. The saliva samples were analyzed for Bacterial count and saliva buffering capacity . Statistical analysis was performed using One Way Anova test and Kruskal-Wallis test.
Results: All groups showed a statistically significant decrease in bacterial count after 3 months (P-value = 0.048, Effect size = 0.585). Pair-wise comparisons between the groups revealed that Fluoride group showed the statistically significantly highest median Log₁₀ CFU of bacterial counts in comparison to GSE and Miswak Groups. There was no statistically significant difference between GSE and Miswak groups. For saliva buffering capacity results, GSE group, showed a statistically significant decrease in saliva buffering capacity after three months. In Miswak and Fluoride groups, there was no statistically significant change in saliva buffering capacity by time (P-value = 0.159, Effect size = 0.132).
Conclusions: This study concluded that Miswak in its natural form may provide an advantage over fluoride in caries prevention. Grapeseed mouth wash however may adversely affect salivary buffering capacity.