Abstract
Objective: The objective of the study was to determine the ability of toothpaste containing Salvadora persica (Siwak) to reduce the accumulation of dirt in the oral cavity compared to ordinary toothpaste users in fixed orthodontic users.
 Methods: It was conducted on 40 subjects, divided into two groups of A and B. Group A uses Siwak, while Group B uses ordinary toothpaste. The research subjects were students that utilized fixed appliances for at least 6 months and without periodontal disease. Data were obtained by measuring the plaque level before and after using the toothpaste.
 Results: A significant relationship between the use of Siwak and ordinary toothpaste by reducing its accumulation in patients using fixed orthodontic appliances and a Chi-square statistical test value of 0.018.
 Conclusion: The use of Siwak is more effective in reducing plaque accumulation in fixed orthodontic appliance users compared to ordinary toothpaste.
Highlights
The maintenance of regular and oral hygiene is an important factor in the prevention of dental disease
A total of 182 plant species have been used as chewing sticks, but the most commonly used in East Asia is Siwak (Salvadora persica) [4]
The respondents were divided into two groups of 20, with those using toothpastes containing Siwak and the control group using ordinary toothpaste (Table 1)
Summary
The maintenance of regular and oral hygiene is an important factor in the prevention of dental disease This led to the inception of several hygiene tools such as toothbrushes, dental floss, and mouthwash. Before the development of toothbrushes, the Babylonians used chewing sticks (3500 BC) to clean their teeth They chewed branches, stems, or roots from various plant species which they believed had the ability to clean and refresh the mouth. This act was conducted by biting the stick until it becomes smooth like a brush and the other end is made to be tapered to pick food stuck between the teeth [1,2,3]. S. persica as a tool for cleaning the teeth and mouth has the advantage in mechanical cleaning from the fibers produced and its pharmacological effects [1]
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