antiplaque efficacy of tooth and gums tonic, hiora-ga gel, and spirogyl gum paint in comparison with chlorhexidine m gel: a double-blind randomized control trial

Objective: To compare the efficacy of three different herbal products (Tooth and Gums Tonic, Hiora-GA gel, and Spirogyl Gum paint) in reducing plaque, gingival inflammation and bacterial count in comparison with chlorhexidine M gel among participants with moderate to severe periodontitis. Materials and Methods: A total of eighty participants with moderate to severe periodontitis were initially recruited after obtaining their informed consent. All participants were offered scaling and polishing on the first visit to remove visible calculus. Then, these participants were randomly divided into four groups of twenty participants each using block randomization method. Participants in Group 1, 2, 3, and 4 were given chlorhexidine M gel, Hiora-GA gel, Spirogyl Gum paint, and Tooth and Gums Tonic, respectively. All participants were instructed to brush their teeth twice day with a soft bristled toothbrush and their regular fluoridated toothpaste. They were instructed to apply the respective gels twice a day according to the manufacturer's guidelines. The posttreatment follow-up examinations for gingival and plaque changes were assessed after 30, 60, and 90 days by three trained and calibrated investigators using gingival and plaque index. The investigators and statistician were blind about group allocation. The supragingival plaque samples were collected before and 90 days after treatment from the buccal surfaces of maxillary right first permanent molar of each participant for microbial analysis. Results: The mean plaque, gingival scores significantly decreased at different intervals following intervention in all groups. The bacterial counts also significantly reduced postintervention with no significant difference in the efficacy of these products compared to chlorhexidine. Conclusion: All three herbal products were found to be effective when used along with oral prophylaxis. Hence, they can all be used as alternates to chlorhexidine in the management of periodontal diseases.