International Journal of Clinical Pediatric Dentistry

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VOLUME 17 , ISSUE 2 ( February, 2024 ) > List of Articles


Herbal Dentifrices for Prevention of Dental Caries in Children and Adolescents: A Systematic Review

Ankita Saikia, Abirami Sivasubramanian, Murugan Satta Muthu, Akila Ganesh, Krithika Chandrasekaran, Richard Kirubakaran

Keywords : Caries prevention, Carious primary dentin, Oral habits, Oral health, Oral health care, Systematic review and meta-analysis, Toothpaste

Citation Information : Saikia A, Sivasubramanian A, Muthu MS, Ganesh A, Chandrasekaran K, Kirubakaran R. Herbal Dentifrices for Prevention of Dental Caries in Children and Adolescents: A Systematic Review. Int J Clin Pediatr Dent 2024; 17 (2):229-236.

DOI: 10.5005/jp-journals-10005-2780

License: CC BY-NC 4.0

Published Online: 22-04-2024

Copyright Statement:  Copyright © 2024; The Author(s).


Despite a large number of trials conducted on the use of herbal oral care products to reduce dental plaque or gingivitis, the results are conflicting and inconclusive. This systematic review aimed to evaluate the effectiveness of herbal dentifrices in caries prevention in children and adolescents and to ascertain the potential of herbal dentifrices to remineralize white spot lesions, reduce halitosis, and improve gingival and periodontal health in children with special healthcare needs (SCHN) and among orthodontic patients. A comprehensive search was designed and conducted using several databases. The articles were independently screened for eligibility by two reviewers. Seven of the 6,940 studies were found to meet the eligibility criteria. A meta-analysis showed that for bacterial scores, the standard mean difference was estimated to be 0.6 [95% confidence interval (CI): −0.78, 1.99] and was statistically insignificant (p = 0.39). Herbal dentifrice is evidenced as equally effective in reducing bacterial count and altering bacterial plaque when compared to nonherbal dentifrices within the confines of the included studies. To verify the definitive use of herbal dentifrices for daily use, further research, including randomized controlled trials (RCT) of sufficient quality, would be recommended.

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  1. Herbal Toothpaste Market 2017 Key Growth Drivers, Challenges, Demand and Upcoming Trends by Forecast to 2023 – ABNewswire – Press Release Distribution Service – Paid Press Release Distribution Newswire [Internet]. Available from:
  2. Freires IA, Rosalen PL. How natural product research has contributed to oral care product development? A critical view. Pharm Res 2016;33(6):1311–1317. DOI: 10.1007/s11095-016-1905-5
  3. Janakiram C, Venkitachalam R, Fontelo P, et al. Effectiveness of herbal oral care products in reducing dental plaque & gingivitis - a systematic review and meta-analysis. BMC Complement Med Ther 2020;20(1):43. DOI: 10.1186/s12906-020-2812-1
  4. Estafan D, Gultz J, Kaim JM, et al. Clinical efficacy of an herbal toothpaste. J Clin Dent 1998;9(2):31–33.
  5. Tatikonda A, Debnath S, Chauhan VS, et al. Effects of herbal and non-herbal toothpastes on plaque and gingivitis: a clinical comparative study. J Int Soc Prev Community Dent 2014;4(Suppl 2):S126–S129. DOI: 10.4103/2231-0762.146220
  6. Nivethaprashanthi S, Kavya R, Priyanga R, et al. Comparing the efficacy of herbal and nonherbal toothpastes in controlling plaque and gingivitis: a review. J Sci Den 2020;10(1):25–27. DOI: 10.5005/jp-journals-10083-0920
  7. Willershausen B, Gruber I, Hamm G. The influence of herbal ingredients on the plaque index and bleeding tendency of the gingiva. J Clin Dent 1991;2(2):75–78.
  8. Ozaki F, Pannuti CM, Imbronito AV, et al. Efficacy of a herbal toothpaste on patients with established gingivitis–a randomized controlled trial. Braz Oral Res 2006;20(2):172–177. DOI: 10.1590/s1806-83242006000200015
  9. Pentapati KC, Kukkamalla MA, Siddiq H, et al. Effectiveness of novel herbal dentifrice in control of plaque, gingivitis, and halitosis - Randomized controlled trial. J Tradit Complement Med 2020;10(6):565–569. DOI: 10.1016/j.jtcme.2019.06.006
  10. Mullally BH, James JA, Coulter WA, et al. The efficacy of a herbal-based toothpaste on the control of plaque and gingivitis. J Clin Periodontol 1995;22(9):686–689. DOI: 10.1111/j.1600-051x.1995.tb00827.x
  11. Hosadurga R, Boloor VA, Rao SN, et al. Effectiveness of two different herbal toothpaste formulations in the reduction of plaque and gingival inflammation in patients with established gingivitis - A randomized controlled trial. J Tradit Complement Med 2018;8(1):113–119. DOI: 10.1016/j.jtcme.2017.04.005
  12. Fereidooni M, Samani MK, Amiri A, et al. Comparison of the effect of propolis and traditional toothpaste on bacterial plaque. J Babol Univ Med Sci 2014;16:17–22.
  13. Azaripour A, Mahmoodi B, Habibi E, et al. Effectiveness of a miswak extract-containing toothpaste on gingival inflammation: a randomized clinical trial. Int J Dent Hyg 2017;15(3):195–202. DOI: 10.1111/idh.12195
  14. Baeshen H, Salahuddin S, Dam R, et al. Comparison of fluoridated miswak and toothbrushing with fluoridated toothpaste on plaque removal and fluoride release. J Contemp Dent Pract 2017;18(4):300–306. DOI: 10.5005/jp-journals-10024-2035
  15. Patel K, Karkare S, Pustake B, et al. Comparative evaluation of antimicrobial efficacy of two commercially available herbal and nonherbal (fluoridated) toothpastes on salivary microbial count: an in-vivo study. Int J Pharm Sci Res 2018;9:3042–3046. DOI: 10.13040/IJPSR.0975-8232.9(7).3042-46
  16. Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021;372:n71. DOI: 10.1136/bmj.n71
  17. Johnson N, Phillips M. Rayyan for systematic reviews. J Electron Resour Librarianship 2018;30:46–48.
  18. Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011;343:d5928. DOI: 10.1136/bmj.d5928
  19. Higgins JPT, Thomas J, Chandler J, et al. Cochrane Handbook for Systematic Reviews of Interventions, 2nd edition. Chichester (UK): John Wiley & Sons; 2019.
  20. Wu-Yuan CD, Green L, Birch WX. In vitro screening of Chinese medicinal toothpastes: their effects on growth and plaque formation of mutans Streptococci. Caries Res 1990;24(3):198–202. DOI: 10.1159/000261265
  21. Kanth MR, Prakash AR, Sreenath G, et al. Efficacy of specific plant products on microorganisms causing dental caries. J Clin Diagn Res 2016;10(12):ZM01–ZM03. DOI: 10.7860/JCDR/2016/19772.9025
  22. Naqvi ZA, Salama MH. Periodontal evaluation of tooth brushing technique with and without miswak in orthodontic patients with fixed orthodontic appliances-a clinical study. Asian Pac J Health Sci S 2019;6(1):44–48.
  23. Philip N, Leishman SJ, Bandara HMHN, et al. Randomized controlled study to evaluate microbial ecological effects of CPP-ACP and cranberry on dental plaque. JDR Clin Trans Res 2020;5(2):118–126. DOI: 10.1177/2380084419859871
  24. Patil S, Venkataraghavan K, Anantharaj A, et al. Comparison of two commercially available toothpastes on the salivary streptococcus mutans count in urban preschool children—an in vivo study. Scientific 2010;12(4):72–81.
  25. Lotif MAL, Valadas LAR, Fechine FV, et al. A double-blind randomized clinical trial of Brazilian red propolis dentifrice efficacy in orthodontic patients. J Oral Sci 2022;64(1):28–32. DOI: 10.2334/josnusd.21-0270
  26. Bhati N, Jaidka S, Somani R. Evaluation of antimicrobial efficacy of aloe vera and Meswak containing dentifrices with fluoridated dentifrice: an in vivo study. J Int Soc Prev Community Dent 2015;5(5):394–399. DOI: 10.4103/2231-0762.165924
  27. Machorowska-Pieniążek A, Skucha-Nowak M, Mertas A, et al. Effects of Brazilian propolis on dental plaque and gingiva in patients with oral cleft malformation treated with multibracket and removable appliances: a comparative study. Evid Based Complement Alternat Med 2016;2016:2038407. DOI: 10.1155/2016/2038407
  28. Wong MC, Clarkson J, Glenny AM, et al. Cochrane reviews on the benefits/risks of fluoride toothpastes. J Dent Res 2011;90(5):573–579. DOI: 10.1177/0022034510393346
  29. Wright JT, Hanson N, Ristic H, et al. Fluoride toothpaste efficacy and safety in children younger than 6 years: a systematic review. J Am Dent Assoc 2014;145(2):182–189. DOI: 10.14219/jada.2013.37
  30. Twetman S, Axelsson S, Dahlgren H, et al. Caries-preventive effect of fluoride toothpaste: a systematic review. Acta Odontol Scand 2003;61(6):347–355. DOI: 10.1080/00016350310007590
  31. Shaheen SS, Reddy P, Shaheen SS, et al. Antimicrobial efficacy of ten commercially available herbal dentifrices against specific oral microflora - in vitro study. J Clin Diagn Res 2015;9(4):ZC42–ZC46. DOI: 10.7860/JCDR/2015/11127.5829
  32. Chandra Shekar BR, Nagarajappa R, Suma S, et al. Herbal extracts in oral health care - a review of the current scenario and its future needs. Pharmacogn Rev 2015;9(18):87–92. DOI: 10.4103/0973-7847.162101
  33. Dhingra K. Aloe vera herbal dentifrices for plaque and gingivitis control: a systematic review. Oral Dis 2014;20(3):254–267. DOI: 10.1111/odi.12113
  34. Löe H. The gingival index, the plaque index and the retention index systems. J Periodontol 1967;38(6):610–616. DOI: 10.1902/jop.1967.38.6.610
  35. Arweiler NB, Müller-Breitenkamp F, Heumann C, et al. Antibacterial action, substantivity and anti-plaque effect of different toothpaste slurries - a randomised controlled trial. Oral Health Prev Dent 2021;19(1):529–536. DOI: 10.3290/j.ohpd.b2182977
  36. Saimbi CS, Chanan S, Amrit N. Comparative anti-plaque activity of a plant preparation vis-a-vis modern dentifrices. J Indian Dent Assoc 1986;58(3):93–98.
  37. Moustafa MH, Sadek SI. The efficiency of miswak concentrate toothpaste. I: clinical report. Egypt Dent J 1987;33(1):75–84.
  38. Shasmitha RS, Gurunathan D, Mani G. Evaluation of antioxidant-essential toothpaste as a treatment for gingivitis in orthodontic patients. Drug Invent Today 2019;12.
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