The Clinical and Antibacterial Effects of a Herbal Toothpaste Containing White Mustard Sinapis alba Extract: A Randomized Clinical Trial

<b>Objectives:</b> The aim of this double-blind, clinical trial study was to evaluate the clinical and antibacterial effects of a herbal toothpaste containing white mustard <i>Sinapis alba</i> extract in comparison to a placebo toothpaste. <b>Methods:</b> One hundred and thirteen participants with gingivitis were randomly assigned to the test group (experimental herbal toothpaste) or the control group (placebo toothpaste). The plaque index (PI), approximal plaque index (API), gingival index (GI), and bleeding on probing (BoP) were evaluated, and salivary samples for microbial evaluation of the loads of <i>Streptococcus mutans</i> and <i>Lactobacillus</i> spp. were collected at baseline (T₀) and after 4 weeks (T₁). Comparisons were performed between and within groups. <b>Results:</b> A reduction in all periodontal parameters (PI, API, GI, and BoP) was observed. The experimental toothpaste reduced the PI by 2.43, compared to a 1.95 reduction for the placebo (<i>p</i> = 0.041), and BoP by 30.6%, compared to a 26.8% reduction for the placebo (<i>p</i> = 0.037). Statistically significant reductions in salivary <i>S. mutans</i> and <i>Lactobacillus</i> spp. counts were found in the test group. Among patients who used the experimental toothpaste, 19.2% and 9.6% showed counts of <i>S. mutans</i> and <i>Lactobacillus</i> spp., respectively, below 10⁵ CFU/mL, compared to 44.2% and 40.4% in the placebo group. <b>Conclusions:</b> Toothpaste enhanced with white mustard extract was more effective in reducing the PI and BoP indices and decreasing <i>S. mutans</i> and <i>Lactobacillus</i> spp. counts compared to placebo toothpaste.