Kusum Singal

PGIMER Chandigarh, India

Title: Herbal products for oral health care compared to chlorhexidine among Pediatric Population: A systematic review and network meta-analysis of randomized controlled

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Biography

Kusum Singal is a Research Fellow in Health Services Research Unit. With extensive experience in conducting systematic reviews, meta-analyses, and evidence-based syntheses, She has contributed significantly to the development of evidence-based policy and practice in public health.

Prior to joining our team, She worked as a Medical Research Scientist at a leading Cochrane Affiliate Center in India, where she conducted several high-impact studies on the effectiveness of public health interventions. She has experience of both quantitative and qualitative research methods and fieldwork experience of surveys and in-depth interviews.

Abstract

Background

Oral health is crucial for overall well-being. This study aimed to evaluate the effectiveness of herbal products compared to chlorhexidine (CHX) in children through a systematic review and network meta-analysis.

Methodology

Six databases were searched up to May 2023 for randomized controlled trials (RCTs) in children, comparing the antimicrobial, antiplaque, and anti-inflammatory effects of herbal products versus CHX. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias 2 tool. Network meta-analysis (NMA) and pairwise meta-analyses were conducted for antimicrobial properties, dental plaque, and gingival indices. The certainty of evidence was evaluated using the GRADE approach. 

Results

The initial search identified 2480 studies, with 35 included in the qualitative synthesis and 22 in the meta-analysis. Herbal products were found to be as effective as CHX in improving oral health. The evidence quality ranged from moderate to low. No significant differences were observed between herbal and CHX mouthwashes for S. mutans (-0.21 [-0.76 to 1.19], p<0.00001, I2=93%), Plaque Index (-0.09 [-0.30 to 0.12], p=0.71, I2=0%), and Gingival Index (-0.09 [-0.90 to 0.33], p<0.00001, I2=84%).

Conclusion

The evidence for the effectiveness of herbal products in oral health care is limited compared to CHX and of low quality, with most studies having small sample sizes and short follow-up periods. Some studies suggest that specific herbal products, such as mango and tea tree oil, may reduce plaque and gingivitis in children, but further research is needed.

Keywords

Oral hygiene, natural products, Plaque index, gingival index, S mutans etc.