Efficacy of Triphala Mouthwash on Antiplaque and Antigingivitis : A Meta-analysis of Randomized Controlled Trials

Abstract

Aim: Triphala mouthwash has been suggested to be beneficial on improving plaque and gingival effects. However, the evidence from previous randomized controlled trials is not consistent. Therefore, this study aimed to assess the efficacy and safety of Triphala mouthwash. Materials and methods: PubMed, CENTRAL, CINAHL, Scopus, Web of science and ThaiLIS were systematically searched. All databases were searched from inception through to May 2018. Randomized controlled trials investigating efficacy of Triphala mouthwash on plaque and/or gingival effects were included. The study selection, data extraction and quality assessment were performed independently by two reviewers. Results: Eleven studies with 1,417 participants were included. Clinical therapeutic efficacy of Triphala mouthwash was statistically significantly better than those of a placebo group in plaque index (MD = -0.67, 95%CI -1.18 to -0.15; p = 0.01) and gingival index (MD -0.67; 95%CI -1.18 to -0.15; p=0.01). However, there were no significant differences between Triphala mouthwash and chlorhexidine mouthwash in plaque index (MD = 0.05, 95%CI -0.19 to 0.30; p = 0.67) and gingival index (MD = 0.05, 95%CI -0.19 to 0.06; p=0.30). No serious adverse event associated with Triphala mouthwash was reported during treatments. Conclusion: this meta-analysis indicated that Triphala mouthwash can effectively contribute to antiplaque and antigingivitis effects. However larger well-designed studies are required to confirm this conclusion.