Dental Caries Clinical Trial
Official title:
Miswak Versus Standard Measures to Prevent the Incidence of Caries Young Egyptian Adults: A Randomized Controlled Clinical Trial
Objectives:
Aim of the study The objective is to conduct an RCT to evaluate the effectiveness of miswak
in comparison with standard caries preventive measures for the prevention of new carious
lesions in high caries risk patients.
-Research hypothesis (alternative hypothesis): This study will be designed to test the
alternative hypothesis that using miswak in addition to standard preventive measures will
show significant difference over using standard preventive measures alone in preventing
incidence of new carious lesions in high caries risk patients.
- General procedures The study will be announced at the Faculty of Oral and Dental Medicine,
6 October University campus to encourage interested students to participate in the study.
Interested participants will be screened at Conservative Department clinic for eligibility by
(M.M). Eligible participants will be assessed using caries risk assessment tool by (R.R.).
Eligible participants will be randomly divided into three groups 1st group will follow only
standard preventive measures(tooth brushing and tooth paste plus interdental cleaning and
mouth rinse using CHX and Fluoride) , 2nd group will use miswak for oral hygiene measures and
3rd group will use of miswak plus tooth brushing and tooth paste.
Before starting the study the eligible participants will undergo supragingival, subgingival
scaling and prophylaxis polishing, then any carious cavity, or defective restoration will be
treated and filled with resin composite restoration.
New set of manual brushes and dental floss will be given to the participants, after they are
properly trained for the correct brushing and flossing technique. The participants will be
asked to brush their teeth twice a day with fluoride tooth paste and to clean their teeth
interdentally with dental floss once a day every day till the end of the study(Group 1 and 3
only) 11b- Preparation of miswak
- Procedure of preparing Miswak:
Miswak has its own unique aspects that must be adapted prior to use for the best results. The
functional end of a thin bark piece is striped off followed by chewing. Chewing of miswak
separates fibers and giving it a brush like appearance that helps in cleaning the teeth
easily. The recommended length for a stick is about 15 cm so that it can easily be grasped
along with ease to carry around, whereas, the diameter is preferred to be <1 cm.(16) There
are two methods documented to hold the miswak. One is the three finger grip technique and the
other is five finger grip technique The aim of both techniques is to make sure that all
surfaces of the teeth are accessible and cleaned with convenience and controlled movements of
the stick in the oral cavity. In order to clean the tooth surfaces, the fibers of miswak
should be held perpendicular to the tooth surface and gently moved in up and down motions,
directed away from the gingival margins on both the buccal and lingual surfaces(17) .
11c-For the intervention group After recording the primary data, Miswak will be given to the
intervention group and they will be trained and asked to use it two times per day. The
demonstrations and instructions for chewing stick users will include the technique of
preparation of working end of chewing sticks and its appropriate brushing technique. The
sticks which are not prepared are instructed to be refrigerated. (13)(14).(group 2 and 3)
- For the control group Participants in this group will follow only the standard preventive
measures which is brushing twice a day after breakfast and before bed time and daily flossing
interdentally before bed time and mouth rinse containing CHX and fluoride.
In all study groups if any patient during the period of the study develops any carious
cavity, the affected tooth will be treated immediately and restored with resin composite
restoration.
. Outcomes: Visual inspection to detect presence or absence of new caries lesions will be
done according to WHO guidelines by using CPI Probe (15).
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