Persica Chewing Gum Effects on Saliva Fluoride Concentration and Flow Rate: A Triple-Blind Randomized Clinical Trial

CONTEXT: Dental caries is a prevalent disease worldwide. Salvadora persica or Miswak could be a source of fluoride and has caries preventive effects. AIMS: The aim of this study was to compare saliva fluoride concentration and flow rate after using Persica and sodium fluoride chewing gums. SETTINGS AND DESIGN: In a triple-blind crossover randomized trial, 44 healthy volunteers (21–25 year old) were recruited according to the inclusion criteria and were randomly allocated into two groups (22 each). PARTICIPANTS AND METHODS: This study was performed within two sets of trial with a 10-day washout period. Participants (subjects) were followed a running period and matched for trial confounders. Saliva samples were collected under controlled conditions at similar time (11 am) within baseline, 5, 10, 20, and 45 min intervals preceded by 5-min chewing of Persica or sodium fluoride chewing gum. Saliva samples were analyzed for fluoride ion using hexamethyldisiloxane diffusion method. STATISTICAL ANALYSIS USED: Saliva flow rate (ml/min) and mean fluoride concentration (ppm) during different time periods in two types of gum were compared using ANOVA-repeated measures (P < 0.05). RESULTS: The difference in total means of stimulated saliva flow rates between two Persica and sodium fluoride gum intervention groups was statistically significant (P = 0.048); however, difference of fluoride concentrations was not statistically significant (P = 0.244). CONCLUSIONS: Chewing Persica containing gum released fluoride ions in saliva and increased saliva flow rate comparable with sodium fluoride chewing gum use as a gold standard.