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Molar-Incisor Hypo mineralization (MIH) was first described in 2001 as a developmental enamel defect . It is a condition in which the enamel of at least one first primary molar is affected with a qualitative defect causing abnormal translucency appearing as demarcated opacities; The permanent incisors and second primary molars can also be affected . MIH has adverse consequences on the oral health and child's quality of life. It increases the risk of caries, discomfort and teeth sensitivity .
MIH management comprises a variety of treatment options ranging from total caries removal to the polar opposite treatment option of no caries removal and non-invasive methods used to prevent caries progression . Dental caries prediction and prevention are now more important than dental caries diagnosis and treatment. Recently, the reasons for repairing dental cavities have been narrowed, and caries prevention is being used to reduce caries . Salvadora persica, commonly known as Miswak was used as a toothbrush for many years among many countries . It was reported to have a significant effect on oral health and caries prevention .Other studies have found a consistent link between the use of Miswak and a reduction in oral bacteria. However, a comprehensive assessment of using Miswak in the treatment and control of MIH among young children has yet to be conducted.
Therefore, the aim of this clinical trial is to assess the effect of SalvadoraPersica and fluoridated toothpaste on controlling hypersensitivity and preventing caries among children with MIH in primary schools. Additionally, this trial will evaluate the shade of the hypo-mineralized enamel before and after using SalvadoraPersica and fluoridated toothpaste
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Salvadora Persica (Miswak) | Experimental | Intervention Group: Participants in this group will be provided with Salvadora persica (miswak) sticks and receive training on the correct technique for its use. Miswak sticks, uniform in length and width, supplied fresh from Jeddah Central Market, Saudi Arabia, to the subjects in the test group. In this group, subjects will be instructed to brush with the miswak using the rolling technique, advised to use it three times a day under a parent's supervision, and shown how to keep it fresh by cutting off the edge of the miswak every day and storing it in the refrigerator at night. |
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| Fluoridated Toothpaste Group | Active Comparator | Control Group: Participants in this group were instructed to use only fluoridated toothpaste as part of their oral hygiene routine. Oral hygiene instructions will be given for both groups. Modified bass technique for tooth brushing twice daily, 10 seconds per quadrant, with a 1450 ppm fluoride concentration |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Salvadora persica (miswak) | Other | Salvadora persica (miswak) has been traditionally used as a natural toothbrush across various cultures for centuries. It contains several biologically active compounds, including fluoride, silica, |
| Measure | Description | Time Frame |
|---|---|---|
| To Assess the effect of Salvadora Persica on the color of MIH-affected teeth compared to brushing with fluoridated toothpaste | The VITA Easyshade® advance spectrophotometer (VITA Zahnfabrik, Bad Sackingen, Germany) will be used to assess the color of MIH-affected permanent incisors and the adjacent sound enamel | Before intervention as a baseline reading (T0), one month (T1), three months later (T2), and six months later (T3) |
| Measure | Description | Time Frame |
|---|---|---|
| the effectiveness of Salvadora Persica on the hypersensitivity of MIH-affected teeth compared to brushing with fluoridated toothpaste | Hypersensitivity can be measured using a visual analog scale (VAS) and the Schiff sensitivity scale to rate patients' pain This scale ranges from zero, representing "No Pain," to 10, representing the "Worst Pain Possible," and is categorized into four levels: mild (1-3), moderate (4-6), severe (7-9), and very severe to worst pain (10). The Schiff Cold Air Sensitivity Scale is a 4-point scale used to assess dentin hypersensitivity. A score of zero indicates no sensitivity, one signifies mild sensitivity without a request to stop the stimulus, two represents moderate sensitivity with a request to stop or visible discomfort, and three indicates severe sensitivity with a request to stop and physical withdrawal. |
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Inclusion Criteria:
Healthy children with age ranged between 6-12 years old
Exclusion Criteria:
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| Fluoridated Toothpaste | Device | Participants will use fluoridated toothpaste (1450 ppm fluoride) three times daily under parental supervision for 9 months to compare its effects with Nano-hydroxyapatite. |
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| Before intervention as a baseline reading (T0), one month (T1), three months later (T2), and six months later (T3). |
| ID | Term |
|---|---|
| D000094604 | Molar Hypomineralization |
| ID | Term |
|---|---|
| D000094603 | Dental Enamel Hypomineralization |
| D000094602 | Developmental Defects of Enamel |
| D014071 | Tooth Abnormalities |
| D018640 | Stomatognathic System Abnormalities |
| D009057 | Stomatognathic Diseases |
| D014076 | Tooth Diseases |
| D000013 | Congenital Abnormalities |
| D009358 | Congenital, Hereditary, and Neonatal Diseases and Abnormalities |
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