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Plaque ControlNCT06575335

Triphala Tooth Wipes in Reduction of Streptococcus Mutans Colonies

A study testing Triphala Tooth Wipe and Chlorhexidine Tooth Wipe in people with Plaque Control, run by Dow University of Health Sciences at 1 site in Pakistan.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This double-blind randomized clinical trial will be conducted among differently abled institutionalized children. Sixty participants aged 6-12 years with mild intellectual disability (ID) will be enrolled in the study and divided into two treatment groups. Read more about this study

Who is it for?
Ages 6 to 12 years
Conditions the study is for
Plaque Control
What is being tested?
Triphala Tooth Wipe and Chlorhexidine Tooth Wipe
Could I receive a placebo?
No, everyone receives an active treatment
How many people
60 participants
Where
1 sitePakistan
Study dates
30 Sep 2024to 7 Nov 2024
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 6 to 12 years
  • All sexes
  • No healthy volunteers
  • Child

Who may be able to join

  • Participants with informed consent
  • Children with mild intellectual disability as per American Association of Mental Deficiency (AAMD)
  • Age ranging from 6 to 12 years
  • One treatment group will be thirty children receiving triphala tooth wipes
  • The other treatment group will be thirty children receiving chlorhexidine tooth wipes

Who cannot join

  • Children who had received antibiotics within 3 months
  • Participants requiring urgent dental care during the period of study

Trial locations and contacts

1 site in 1 country.

Pakistan1 site
  • Dar-ul-Sukun

    Karachi

Other trials in Pakistan

About this study

Official title: Antibacterial Efficacy of Triphala Tooth Wipes in Reduction of Streptococcus Mutans Colonies in Differently Abled Children- A Randomized Clinical Trial

This double-blind randomized clinical trial will be conducted among differently abled institutionalized children. Sixty participants aged 6-12 years with mild intellectual disability (ID) will be enrolled in the study and divided into two treatment groups. The participants will be allocated in either of the two treatment arms through Sequentially Numbered, Opaque, Sealed Envelopes (SNOSE) by the principal investigator. One group will receive triphala tooth wipes and the other will be given chlorhexidine tooth wipes, both for 7 days twice a day. Supragingival plaque sample will be collected from the buccal surface of the permanent maxillary first molar and will be subjected to microbial analysis for Streptococcus mutans (S. mutans) colonies using colony-forming units per millilitre (CFU/ml).

The tooth wipes will be prepared by the principal investigator under supervision of Pharmacognosist at Department of Pharmaceutics and Pharmacognosy, University of Karachi, Pakistan.

Read the detailed description

Preparation of Tooth Wipes:

Preparation of Triphala Tooth Wipes- The triphala decoction will be prepared by the principal investigator at Department of Pharmaceutics and Pharmacognosy, University of Karachi, Pakistan under the supervision of Pharmacognocist. The three fruits of triphala will be bought in powder form from an ayurvedic drug vendor. A mixture will be made by combining equal proportion of all these three powders in distilled water. This will then be boiled till the volume reduces to 1/8th part of the initial volume.

A sweetener will be added to the decoction followed by filtering using a white muslin cloth and then storing in a sterile amber-coloured glass bottle in a refrigerator. This will preserve its organoleptic properties and its quality for fourteen days.

The decoction obtained will be subjected to dilution to obtain concentration. This will then be used to impregnate the marketed tooth wipes fabric. The triphala tooth wipes will be cut, folded individually, and then packed using the wet wipes machine in a plain white packing by local pharmaceutical company. Each pack will contain 16 wipes.

Preparation of Chlorhexidine Tooth Wipes- The commercially available chlorhexidine mouthwash containing will be purchased from the market and will then be used to impregnate the marketed tooth wipes fabric. The chlorhexidine tooth wipes will be cut, folded individually, and then packed using the wet wipes machine in a plain white packing by local pharmaceutical company. Each pack will contain 16 wipes.

Data Collection:

Consent- Before initiation of the study, informed consent will be taken from the parent and/or guardian.

Proforma- The questionnaire will consist of their demographic details and Intelligence Quotient (IQ) score. The Streptococcus mutans count will be assessed on day 1 and day 7 of the intervention.

IQ Score- Mild ID having IQ score of 50-55 to ~70 will be part of the study. This IQ score will be provided by the institute's clinical psychologist who examines and score the patient as per American Association of Mental Deficiency (AAMD) criteria.

Microbial Analysis of the Plaque Sample- Under aseptic measures, the buccal surface of the permanent maxillary first molar will be dried with cotton swab and the supragingival plaque sample will be collected on baseline and Day 7 of the intervention prior to mealtime using sterile Gracey curette 1/2 by the principal investigator. Each of the specimen will be transferred into different sterile Eppendorf tubes having in 0.5 ml phosphate-buffered saline (PBS) to prevent cell rupture or shrinkage due to osmosis. The samples will be transported in an Ice Box. This will be cultured on the mitis salivarius agar with bacitracin in Dow Research Institute of Biotechnology and Biomedical Sciences (DRIBBS) by the microbiologist. The plates will be incubated anaerobically at 37◦C for 48 h for growth of S. mutans colonies will then be assessed at the baseline and on Day 7 of the intervention. The S. mutans count will be classified as Class 0 (none), Class 1 (<102), Class 2 (103-104) and Class 3 (10≥5) CFU/ml showing negligible, low, moderate and high caries susceptibility respectively.

Conditions
Plaque Control
Being tested
Triphala Tooth Wipe, Chlorhexidine Tooth Wipe
Keywords
differently abled, triphala, chlorhexidine, tooth wipes

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Triphala Tooth WipeOther

    The wipes will be used 1 hour after meal time, twice daily for consecutively 7 days. The sachet seal will be opened, the wipe will be taken out and rest of the sachet sealed again. The wipes will be unfolded and wrapped around index finger of right hand and all surfaces of child's teeth, gums, roof of the mouth and tongue will be cleaned.

  • Chlorhexidine Tooth WipeOther

    Same as triphala tooth wipe

Study groups in NCT06575335
Study groupRoleWhat they receive
Triphala Tooth WipeExperimentalThe three fruits of triphala (Terminalia chebula, Emblica officinalis and Terminalia bellerica) will be bought in powder form from an herbal drug vendor. A mixture will be made by combining equal proportion of all these three powders in distilled water. This will then be boiled till the volume reduces to 1/8th part of the initial volume. A sweetener will be added to the decoction followed by filtering using a white muslin cloth and then storing in a sterile amber-coloured glass bottle in a refrigerator. The decoction obtained will be subjected to dilution to obtain 0.6% concentration. This will then be used to impregnate the marketed tooth wipes fabric. The triphala tooth wipes will be cut, folded individually, and then packed. Each pack will contain 16 wipes.
Receives: Other: Triphala Tooth Wipe
Chlorhexidine Tooth WipeActive comparatorThe commercially available mouthwash containing 0.2% chlorhexidine will be purchased from the market and will then be used to impregnate the marketed tooth wipes fabric. The chlorhexidine tooth wipes will be cut, folded individually, and then packed. Each pack will contain 16 wipes.
Receives: Other: Chlorhexidine Tooth Wipe

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Streptococcus mutans (S. mutans) count

    Colony Forming Unit per millilitre (CFU/ml) classified as Class 0 (none), Class 1 (<102), Class 2 (103-104) and Class 3 (10≥5) CFU/ml showing negligible, low, moderate and high caries susceptibility

    Measured: The S. mutans count will be assessed at baseline and at day 8 of the intervention.

Secondary outcomes (1)
  1. Plaque Index

    Silness and Loe Plaque Index: The score will range from 0 to 3; 0 (excellent), 0.1-0.9 (good), 1.0-1.9 (fair), and 2.0-3.0 (poor) oral hygiene.

    Measured: These counts will be assessed at baseline and at day 8 of the intervention.

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted28 Aug 2024
  2. Study start30 Sep 2024
  3. Primary completion7 Oct 2024
  4. Study completion7 Nov 2024

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Supportive care
Allocation
Randomised
Intervention model
Parallel groups
Model description
The participants will be allocated in either of the two treatment arms through Sequentially Numbered, Opaque, Sealed Envelopes (SNOSE) by the principal investigator.
Masking
Double blind
Who is masked
Participant, Outcomes assessor
Enrolment
60 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06575335
Sponsor's protocol ID
IRB-3384/DUHS/Approval/2024/53
Status last verified
Feb 2025
First submitted
22 Aug 2024
Last updated
17 Feb 2025
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: As it is confidential data, the investigators won't be sharing it.

Publications

  • Mosaddad SA, Tahmasebi E, Yazdanian A, Rezvani MB, Seifalian A, Yazdanian M, Tebyanian H. Oral microbial biofilms: an update. Eur J Clin Microbiol Infect Dis. 2019 Nov;38(11):2005-2019. doi: 10.1007/s10096-019-03641-9. Epub 2019 Aug 1.

    PubMed 31372904
  • Lin Y, Chen J, Zhou X, Li Y. Inhibition of Streptococcus mutans biofilm formation by strategies targeting the metabolism of exopolysaccharides. Crit Rev Microbiol. 2021 Sep;47(5):667-677. doi: 10.1080/1040841X.2021.1915959. Epub 2021 May 3.

    PubMed 33938347
  • Baca P, Castillo AM, Liebana MJ, Castillo F, Martin-Platero A, Liebana J. Horizontal transmission of Streptococcus mutans in schoolchildren. Med Oral Patol Oral Cir Bucal. 2012 May 1;17(3):e495-500. doi: 10.4317/medoral.17592.

    PubMed 22143733
  • Lemos JA, Palmer SR, Zeng L, Wen ZT, Kajfasz JK, Freires IA, Abranches J, Brady LJ. The Biology of Streptococcus mutans. Microbiol Spectr. 2019 Jan;7(1):10.1128/microbiolspec.gpp3-0051-2018. doi: 10.1128/microbiolspec.GPP3-0051-2018.

    PubMed 30657107
  • Lin Y, Zhou X, Li Y. Strategies for Streptococcus mutans biofilm dispersal through extracellular polymeric substances disruption. Mol Oral Microbiol. 2022 Feb;37(1):1-8. doi: 10.1111/omi.12355. Epub 2021 Nov 22.

    PubMed 34727414
  • da Rosa SV, Moyses SJ, Theis LC, Soares RC, Moyses ST, Werneck RI, Rocha JS. Barriers in Access to Dental Services Hindering the Treatment of People with Disabilities: A Systematic Review. Int J Dent. 2020 Jul 23;2020:9074618. doi: 10.1155/2020/9074618. eCollection 2020.

    PubMed 32774378
  • Carniello V, Peterson BW, van der Mei HC, Busscher HJ. Role of adhesion forces in mechanosensitive channel gating in Staphylococcus aureus adhering to surfaces. NPJ Biofilms Microbiomes. 2020 Aug 21;6(1):31. doi: 10.1038/s41522-020-00141-z.

    PubMed 32826897
  • Deshpande MA, Baliga S, Thosar N, Rathi N, Jyothishi S, Deulkar PV, Bane SP. Evaluation of antibacterial efficacy of Triphala toothwipes on oral Streptococcus mutans count in intellectually disabled children. Spec Care Dentist. 2021 Sep;41(5):619-625. doi: 10.1111/scd.12597. Epub 2021 Apr 14.

    PubMed 33852738
  • Prakash S, Shelke AU. Role of Triphala in dentistry. J Indian Soc Periodontol. 2014 Mar;18(2):132-5. doi: 10.4103/0972-124X.131299.

    PubMed 24872616
  • Penmetsa GS, B V, Bhupathi AP, Rani P S, B V S, M V R. Comparative Evaluation of Triphala, Aloe vera, and Chlorhexidine Mouthwash on Gingivitis: A Randomized Controlled Clinical Trial. Contemp Clin Dent. 2019 Apr-Jun;10(2):333-337. doi: 10.4103/ccd.ccd_583_18.

    PubMed 32308299
  • Kaur S, Michael H, Arora S, Harkonen PL, Kumar S. The in vitro cytotoxic and apoptotic activity of Triphala--an Indian herbal drug. J Ethnopharmacol. 2005 Feb 10;97(1):15-20. doi: 10.1016/j.jep.2004.09.050. Epub 2004 Dec 25.

    PubMed 15652269
  • Biradar YS, Singh R, Sharma K, Dhalwal K, Bodhankar SL, Khandelwal KR. Evaluation of anti-diarrhoeal property and acute toxicity of Triphala Mashi, an Ayurvedic formulation. J Herb Pharmacother. 2007;7(3-4):203-12. doi: 10.1080/15228940802152869.

    PubMed 18928142
  • Phetkate P, Kummalue T, Rinthong PO, Kietinun S, Sriyakul K. Study of the safety of oral Triphala aqueous extract on healthy volunteers. J Integr Med. 2020 Jan;18(1):35-40. doi: 10.1016/j.joim.2019.10.002. Epub 2019 Oct 16.

    PubMed 31680053
  • Peterson CT, Denniston K, Chopra D. Therapeutic Uses of Triphala in Ayurvedic Medicine. J Altern Complement Med. 2017 Aug;23(8):607-614. doi: 10.1089/acm.2017.0083. Epub 2017 Jul 11.

    PubMed 28696777
  • Padiyar B, Marwah N, Gupta S, Padiyar N. Comparative Evaluation of Effects of Triphala, Garlic Extracts, and Chlorhexidine Mouthwashes on Salivary Streptococcus mutans Counts and Oral Hygiene Status. Int J Clin Pediatr Dent. 2018 Jul-Aug;11(4):299-306. doi: 10.5005/jp-journals-10005-1530. Epub 2018 Aug 1.

    PubMed 30397374

Questions about this trial

What is this clinical trial studying?

A study testing Triphala Tooth Wipe and Chlorhexidine Tooth Wipe in people with Plaque Control, run by Dow University of Health Sciences at 1 site in Pakistan.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 2 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 17 Feb 2025. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Streptococcus mutans (S. mutans) count (time frame: The S. mutans count will be assessed at baseline and at day 8 of the intervention.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT06575335, which also lists 43 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 17 Feb 2025.

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