Non-Cochrane · intervention · PM42421793
Biodegradable vs. conventional toothbrushes for biofilm control: a systematic review and meta-analysis of randomized trials.
Mayta-Tovalino Frank, Espinoza-Carhuancho Fran, Mauricio-Vilchez Cesar, et al. · Frontiers in oral health · 2026 · PubMed · doi:10.3389/froh.2026.1846306
Findings
6 findings
| Population | ||||
|---|---|---|---|---|
| Children and adults with natural dentition | Biodegradable or natural oral hygiene tools (bamboo toothbrush, miswak) | Conventional plastic manual toothbrush | Plaque index (PI) Immediately after brushing to 12 weeks · Overall estimate shown in subgroup forest plots (Figure 4) | MD -0.09 [-0.36, 0.18] GRADE not reported 5 studies · 292 participants |
| Children and adults with natural dentition | Biodegradable or natural oral hygiene tools (bamboo toothbrush, miswak) | Conventional plastic manual toothbrush | Plaque index (PI) Follow-up 4 weeks to 12 weeks (SoF); immediate to 12 weeks across trials Unresolved: the two extractors disagree on this row. | MD -0.09 [-0.47, 0.29] -0.09 [-0.47, 0.29] plaque index units (MD) Very low Downgraded: risk of bias, imprecision, inconsistency, indirectness 5 studies · 292 participants |
| Adolescents and adults using miswak | Miswak (chewing stick) | Conventional plastic manual toothbrush | Plaque index (PI) Immediately after brushing to 12 weeks · Toothbrush type = Miswak (Azizan 2023; Abdellatif 2024) | MD 0.08 [-0.13, 0.28] GRADE not reported 2 studies · 112 participants |
| Children and adults using bamboo toothbrush | Bamboo toothbrush (biodegradable) | Conventional plastic manual toothbrush | Plaque index (PI) Immediately after brushing to 12 weeks · Toothbrush type = Bamboo (Fageeh 2024; Kariya 2024; Ranwa 2025) | MD -0.21 [-0.62, 0.19] GRADE not reported 3 studies · 180 participants |
| Adults | Biodegradable or natural oral hygiene tools (bamboo toothbrush, miswak) | Conventional plastic manual toothbrush | Plaque index (PI) Immediately after brushing to 12 weeks · Population = Adult (Azizan 2023; Fageeh 2024; Abdellatif 2024) | MD 0.08 [-0.05, 0.21] GRADE not reported 3 studies · 132 participants |
| Children | Biodegradable or natural oral hygiene tools (bamboo toothbrush, miswak) | Conventional plastic manual toothbrush | Plaque index (PI) Immediately after brushing to 12 weeks · Population = Children (Kariya 2024; Ranwa 2025) | MD -0.37 [-0.81, 0.07] GRADE not reported 2 studies · 160 participants |
Included primary studies 5
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Abdellatif 2024 Comparative Effectiveness of Miswak and Toothbrushing on Dental Plaque and Gingivitis: A Randomized Controlled Trial. PMID:39517363 | 2024 | this review only | Plaque index (PI) | not extracted yet |
| Azizan 2023 Effectiveness of Salvadora persica toothbrush and Salvadora persica chewing stick in plaque and gingivitis control: a randomized control… PMID:38098022 | 2023 | this review only | Plaque index (PI) | not extracted yet |
| Fageeh 2024 Plaque Removal and Gingival Bleeding Using Biodegradable Toothbrushes: Salvadora persica, Bamboo, and Nylon: A Comparative Study. PMID:39511862 | 2024 | this review only | Plaque index (PI) | not extracted yet |
| Kariya 2024 Comparing plaque removal efficacy of biodegradable toothbrush and nonbiodegradable toothbrush in children of 8-10 years of age: A… PMID:38957908 | 2024 | this review only | Plaque index (PI) | not extracted yet |
| Ranwa 2025 A Comparative Study on the Efficacy of Plaque Removal Using Conventional Toothbrushes, Bamboo Toothbrushes, and Neem Toothbrushes among… PMID:40469829 | 2025 | this review only | Plaque index (PI) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Participants of any age with natural dentition, without systemic conditions | Children 8-12 years and adolescents/adults 15-50 years (n=408; 292 analyzed) |
| Intervention | Biodegradable or natural oral hygiene tools (bamboo toothbrushes, miswak) | Miswak (n=3 RCTs); bamboo/neem/biodegradable toothbrush (n=2 RCTs) |
| Comparison | Conventional plastic manual toothbrush | Conventional plastic toothbrush |
| Outcomes | Plaque index (validated indices) | Plaque index (5 RCTs); gingival index, bleeding index, PISA reported in single trials, not pooled |
| Study designs | RCTs | RCTs (n=5) |
| Timing | Not specified | Immediate to 12 weeks |