Findings

What do systematic reviews say?

592 questions · 793 findings · 32 reviews · Periodontology

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No studies found 148 · 18.7%GRADE not reported 429 · 54.1%Very low 137 · 17.3%Low 53 · 6.7%Moderate 14 · 1.8%High 12 · 1.5%

Salvadora persica (miswak) mouthrinse vs Chlorhexidine mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

When usual mechanical plaque control continued, Salvadora persica and chlorhexidine did not differ significantly for plaque; not GRADE-rated.

8 findings from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Did not refrain from mechanical plaque control
MD 0.17 [-0.08, 0.42]
11 studies · 594 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Duration of mouthwash use: >=3 weeks
MD 0.24 [-0.11, 0.60]
7 studies · 420 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity)
MD 0.19 [0.01, 0.37]
18 studies · 902 participants
GRADE not reported

Show 5 more findings

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Refrained from mechanical plaque control
MD 0.22 [0.05, 0.39]
7 studies · 308 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Study quality: moderate-quality studies
MD 0.19 [-0.11, 0.50]
10 studies · 616 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Duration of mouthwash use: <3 weeks
MD 0.15 [0.01, 0.29]
11 studies · 482 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Chlorhexidine concentration: 0.12%
MD 0.52 [0.35, 0.69]
5 studies · 396 participants
GRADE not reported
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Study quality: high-quality studies
MD 0.19 [0.06, 0.31]
8 studies · 286 participants
GRADE not reported

Rubber/elastomeric cleaning stick plus toothbrushing vs Interdental brushing plus toothbrushing

Plaque · Adults, 16 years and older (dentate)

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes plaque compared with interdental brushing plus toothbrushing (very low certainty).

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
4 to 6 weeks
SMD 0.08 [-0.33, 0.49]
2 studies · 92 participants
Very low

Wooden cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Plaque · Adults, 16 years and older (dentate)

It is very uncertain whether wooden cleaning stick plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
3 months
MD 0.02 [-0.06, 0.10]
1 study · 24 participants
Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Side effects · Adults, 16 years and older (dentate)

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
Five studies assessed adverse events. One did not report findings, but the others reported either no adverse events or minor adverse events that did not significantly differ between interventions.
5 studies
GRADE not reported

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Periodontitis (probing pocket depth) · Adults, 16 years and older (dentate)

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
One study measured periodontitis but the data were not usable (Smith 1988 measured PPD but data unusable).
1 study
GRADE not reported

Flossing plus toothbrushing vs Toothbrushing alone

Side effects · Adults, 16 years and older (dentate)

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
Adverse effects were assessed and reported in seven studies. Three reported no adverse events on the oral hard or soft tissues. Four reported sporadic adverse events with mild severity, with no evidence of a difference…
7 studies
GRADE not reported

Interdental brushing plus toothbrushing vs Flossing plus toothbrushing

Plaque · Adults, 16 years and older (dentate)

It is very uncertain whether interdental brushing plus toothbrushing changes plaque compared with flossing plus toothbrushing (very low certainty).

3 findings from 2 reviews · compare the 2 reviews

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
1 month (4 to 6 weeks)
SMD -0.47 [-0.84, -0.11]
5 studies · 290 participants
Very low
Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
1 month (4 to 6 weeks)
SMD 0.10 [-0.13, 0.33]
7 studies · 326 participants
Low
Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
3 months (12 weeks)
SMD -2.14 [-5.25, 0.97]
2 studies · 107 participants
Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Interdental brushing plus toothbrushing

Gingivitis · Adults, 16 years and older (dentate)

It is very uncertain whether rubber/elastomeric cleaning stick plus toothbrushing changes gingivitis (proportion of bleeding sites) compared with interdental brushing plus toothbrushing (very low certainty).

2 findings from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
1 month
MD -0.02 [-0.10, 0.06]
1 study · 31 participants
Very low
Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
4 to 6 weeks
MD 0.10 [-0.32, 0.52]
1 study · 61 participants
Very low

Salvadora persica (miswak) mouthrinse vs Chlorhexidine 0.2% mouthrinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica was less effective than 0.2% chlorhexidine at reducing plaque (favours chlorhexidine); not GRADE-rated.

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity) · Chlorhexidine concentration: 0.2%
MD 0.12 [0.03, 0.21]
12 studies · 566 participants
GRADE not reported

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Lactobacillus count (CFU/mL) · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Lactobacillus counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-treatment · In vivo clinical trial (human oral cavity)
MD -1.12 [-1.45, -0.79]
2 studies · 60 participants
GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

Plaque · Adults, 16 years and older (dentate)

Oral irrigation plus toothbrushing showed no clear difference in plaque compared with toothbrushing alone (low certainty).

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
1 month
SMD -0.16 [-0.41, 0.10]
3 studies · 235 participants
Low

Salvadora persica (miswak) mouthrinse vs Pre-treatment (baseline, same group)

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts relative to baseline; not GRADE-rated.

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Pre- vs post-treatment · In vivo clinical trial (human oral cavity)
MD 1.82 [1.03, 2.62]
5 studies · 71 participants
GRADE not reported

Rubber/elastomeric cleaning stick plus toothbrushing vs Flossing plus toothbrushing

Interproximal caries · Adults, 16 years and older (dentate)

The review found no eligible studies for this question.

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
No included study assessed caries as an outcome.
0 studies
No studies found

Interdental brushing plus toothbrushing vs Toothbrushing alone

Interproximal caries · Adults, 16 years and older (dentate)

The review found no eligible studies for this question.

2 findings from 2 reviews · compare the 2 reviews

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
No included study assessed caries as an outcome.
0 studies
No studies found
Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults 2013 · Cochrane All outcomes
Not estimable. No included study assessed caries as an outcome. (See comment)
0 studies
No studies found

Placebo rinse vs Pre-treatment (baseline, same group)

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Placebo rinse did not significantly change plaque relative to baseline; not GRADE-rated.

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Pre- vs post-treatment · In vivo clinical trial (human oral cavity)
MD -0.19 [-0.39, 0.02]
7 studies · 152 participants
GRADE not reported

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Streptococcus mutans count · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced Streptococcus mutans counts more than placebo (favours Salvadora persica); not GRADE-rated.

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-treatment · In vivo clinical trial (human oral cavity)
MD -1.42 [-2.08, -0.76]
5 studies · 142 participants
GRADE not reported

Oral irrigation plus toothbrushing vs Toothbrushing alone

Side effects · Adults, 16 years and older (dentate)

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
Three studies reported that there were no adverse events, one reported one incidence of aphthous ulcer in irrigator group, one reported oral lacerations but found no difference between the interventions, and one did…
5 studies
GRADE not reported

Salvadora persica (miswak) mouthrinse vs Placebo rinse

Plaque · Medically healthy individuals (adults and children, 6-60 years)

Salvadora persica rinse reduced plaque more than placebo (favours Salvadora persica); certainty not GRADE-rated (Shekelle grade Ia).

1 finding from 1 review

The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of… 2019 All outcomes
Post-intervention · In vivo clinical trial (human oral cavity)
MD -0.59 [-0.82, -0.35]
12 studies · 452 participants
GRADE not reported

Flossing plus toothbrushing vs Toothbrushing alone

Plaque · Adults, 16 years and older (dentate)

It is very uncertain whether flossing plus toothbrushing changes plaque compared with toothbrushing alone (very low certainty).

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
1 month
SMD -0.42 [-0.85, 0.02]
7 studies · 542 participants
Very low

Rubber/elastomeric cleaning stick plus toothbrushing vs Toothbrushing alone

Side effects · Adults, 16 years and older (dentate)

The review found no eligible studies for this question.

1 finding from 1 review

Home use of interdental cleaning devices, in addition to toothbrushing, for preventing and controlling periodontal… 2019 · Cochrane All outcomes
Harms and adverse outcomes: Not reported (neither study reported on adverse effects).
0 studies
No studies found