From Tradition to Translation: Are Herbal Dentifrices Ready for Evidence-Based Dentistry? A Mini Review

Herbal toothpastes are increasingly promoted as natural alternatives to fluoride-based dentifrices, driven by consumer preference for plant-derived products and concerns regarding synthetic additives. However, integration into preventive dentistry requires robust, reproducible clinical evidence rather than biological plausibility alone. This narrative mini review critically evaluates the readiness of herbal dentifrices for mainstream clinical use. Current evidence indicates that certain formulations can reduce plaque accumulation and gingival inflammation in the short term. Yet, most trials are constrained by limited follow-up, small sample sizes, and reliance on surrogate indices. Well-designed studies assessing long-term caries prevention, periodontal toothpaste outcomes, and direct non-inferiority to fluoride toothpastes remain scarce. Bioactive plant compounds, including miswak, neem, green tea catechins, and clove, exhibit antimicrobial and anti-inflammatory properties. Nevertheless, these effects do not substitute for the fluoride-mediated remineralization mechanism fundamental to caries control. Additional challenges include variability in phytochemical standardization and insufficient long-term safety data. At present, herbal dentifrices are best positioned as adjunctive formulations. Before they can be routinely recommended, long-term randomized trials, clear phytochemical standardization, and comprehensive safety evaluation are still required.