Key Takeaway
Salvadora persica mouthwash showed comparable effectiveness to chlorhexidine for reducing plaque and improving gingival health in a meta-analysis of clinical trials.
Summary
This systematic review and meta-analysis compared the periodontal health effects of Salvadora persica (miswak) extract mouthwash against chlorhexidine gluconate, the gold-standard antimicrobial mouthwash in dentistry. The authors searched multiple databases and pooled data from clinical trials that directly compared the two mouthwash formulations.
The meta-analysis found that Salvadora persica mouthwash demonstrated comparable effectiveness to chlorhexidine for reducing plaque index and improving gingival index scores. While chlorhexidine showed slight numerical advantages in some outcomes, the differences were not statistically significant in the pooled analysis, suggesting clinical equivalence between the two products.
Importantly, Salvadora persica mouthwash may offer practical advantages over chlorhexidine, which is associated with side effects including tooth staining, taste alteration, and mucosal irritation with prolonged use. The natural miswak extract mouthwash showed a more favorable side-effect profile while delivering similar antimicrobial and anti-inflammatory benefits. These findings extend the evidence for miswak beyond the traditional chewing stick format, demonstrating that the plant bioactive compounds retain their effectiveness in mouthwash formulations.