Effect of Moringa Oleifera Mouthwash on bacterial load in plaque in patients having fixed orthodontic appliances

Background: With increasing trend towards improved facial esthetics, larger number of people are getting orthodontic treatments. Maintenance of adequate oral hygiene become difficult with fixed orthodontic appliances because tooth brushes can’t reach all the surfaces due to hindrance provided by fixed appliances. Thus, in order to prevent deleterious effects of braces adjunctive oral care measures like flossing and use of an efficient mouthwash is advised by orthodontists. Commercially available chemical mouthwashes especially Chlorhexidine Gluconate is very effective in preventing plaque accumulation, gingivitis and other gum health problems, but it is associated with wide variety of side effects. So, the interest is being shifted to herbal alternatives that are equally effective but have minimal to zero side effects. In the recent history Moringa Oleifera has emerged as a miracle tree and studies have shown that it has numerous health benefits and medicinal advantages as well. It also has anti-inflammatory and anti-bacterial properties. Objective: The objective of this study was to find out the efficacy of Moringa Oleifera mouthwash in reducing bacterial load in dental plaque in patients undergoing orthodontic treatment with fixed appliances. Materials and Method: A parallel arm, triple blinded, randomized controlled trial was conducted at Islamic International Dental Hospital. Total 30 participants who were starting orthodontic treatment with fixed appliances were included in the study; they were randomly allocated to two groups, Moringa Group and Control group. Bacterial load in plaque was calculated by counting the colony forming units (CFU) on blood agar medium before the fixed appliances i.e. T0. One month after that i.e. at T1, BL was recorded again and then a one litter bottle of mouthwash was given to the participants with the detailed instructions on how to use that. Placebo mouthwash was given to control group and Moringa Oleifera mouthwash was given to Moringa group. BL was recorded again after one month i.e. at T2.  Jamovi and Phyton was used to analyze the results, P value was set at ≤ 0.05 and was considered significant. Mann Whitney U test was applied to compare bacterial load in plaque between control and Moringa group. Results: Bacterial load in plaque increases from T0 to T1 but significantly decreases from T1 to T2 in Moringa group and increases from T1 to T2 in control group. Conclusion: The Moringa Oleifera mouthwash efficiently reduces the bacterial load in plaque in patients undergoing orthodontic treatment with fixed appliances. Thus, it can be used as an adjunctive oral care measure to prevent gingivitis and other deleterious effects of fixed orthodontic appliances instead of chemical mouthwashes.