Gum Arabic Improves Gingival and Plaque Index Scores in Patients with Mild and Moderate Plaque-Induced Gingivitis

by | Nov 21, 2023 | 2022, Oral Health, Probiotics

Written by Chrystal Moulton, Staff Writer. At 30 days and at 60 days after baseline participants in the intervention group saw a significantly greater % reduction GI scores compared to placebo (P = 0.019 and P= 0.005, respectively).

dentist - oral healthGum Arabic is obtained from the Acacia Senegal or Acacia Seyal trees. It is a prebiotic rich in natural polysaccharides. In previous studies, the prebiotic function of gum Arabic was demonstrated in humans1 along with antimicrobial2 and anti-plaque effects3. In the current trial, researchers assessed the effect of gum Arabic Clinical and immunological parameters in patients with plaque induced gingivitis4.

This clinical trial was designed as a placebo-controlled, double-blind study. 176 patients were assessed for eligibility. Inclusion criteria were as follows: 20 years of age or older, diagnosis of generalized or moderate chronic plaque-induced gingivitis, and participants had to have at least 20 natural teeth. After screening, 71 patients were randomly assigned to either the intervention or the placebo in a 1:1 ratio. At baseline, all participants received a normal saline pre-procedural mouth rinse and a clinical assessment. Full mouth scaling, gingival crevicular fluid interleukin 1 beta (GCF IL-1 beta) samples were collected, and both plaque and gingival index scores (PI and GI scores, respectively) were measured at baseline. These measures were repeated 30 and 60 days from the baseline assessment. Using a periodontal probe and a dental mirror, a trained principal investigator collected gingival (GI) and plaque index (PI) scores from four tooth surfaces (mesial, distal, lingual, and buccal). Gingival crevicular fluid (GCF) was also collected from the mesiobuccal surface of the first premolar of the upper right quadrant as well as the incisor and canine tooth. Participants assigned to the intervention group received 150 grams of gum Arabic while participants assigned to the placebo received 150 grams of microcrystalline cellulose. Both powders were identical in color. Patients were told to use their fingers and apply half teaspoon of the powder to the surfaces of all dental gingival areas for 5 minutes, one hour after brushing, twice daily (morning and evening). They were told to rinse with tap water after the 5 minutes were completed. Patients were required to report any allergic reactions or complications while using the assigned powder. Patients were also prohibited from using other mouthwashes during the trial. Researchers calculated the mean GI score (MGS) and the mean PI score (MPS) as well as the percent reduction of GI and PI between measurement points (baseline, 30 days, 60 days).

Of the 176 patients assessed for this trial, 105 were excluded due to ineligibility and 11 dropped out during the trial. A total of 60 participants completed the trial. No statistical differences were observed in demographic data, mean PI score (MPS), and mean GI scores (MGS) between placebo and intervention groups at baseline. At 30 days and at 60 days after baseline participants in the intervention group saw a significantly greater % reduction in GI scores compared to placebo (P = 0.019 and P= 0.005, respectively). When broken down based on degree of gingival inflammation, patients with mild inflammation experienced significantly greater % reduction in GI scores at 30 days and at 60 days from baseline (P = 0.007 and P = 0.012, respectively). No statistically significant improvement was observed in patients with moderate gingival inflammation. Significant % reduction in PI score was also observed at 30 days in the intervention group compared to the placebo (P = 0.004). No significant difference was observed at day 60 from baseline. When further broken down based on moderate and high plaque, researchers observed statistically significant % reduction PI at day 30 and day 60 from baseline (P = 0.003 and P = 0.019, respectively). No statistically significant difference was observed for reduction in PI scores in patients with high plaque. Also, for GCC IL-1 beta levels, researchers observed a significant reduction from baseline to day 30 and from baseline to day 60 in the intervention group (P = 0.009 and P = 0.002, respectively). Significant reduction in GCF IL-1 beta levels was also observed in the placebo group from baseline to day 30 (P= 0.007). No statistically significant intergroup interactions were observed for GCF IL-1 beta levels. No adverse events were reported in either group during this trial.

Data from this trial showed that gum Arabic could be an effective solution for reducing plaque and gingival inflammation especially in patients with mild inflammation and moderate plaque buildup. Further studies will be needed to verify these findings.

Source: Gafar, Arwa M., AbdelRahman M. Ramadan, Nouar A. ElSaid, and Nazik M. Nurelhuda. “Effect of Gum Arabic on plaque-induced gingivitis: A randomised controlled trial.” The Saudi Dental Journal 34, no. 6 (2022): 494-502.

© 2022 The Authors. Production and hosting by Elsevier B.V. on behalf of King Saud University. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Posted November 21, 2023.

Chrystal Moulton BA, PMP, is a 2008 graduate of the University of Illinois at Chicago. She graduated with a bachelor’s in psychology with a focus on premedical studies and is a licensed project manager. She currently resides in Indianapolis, IN.

References:

  1. Calame W, Weseler AR, Viebke C, Flynn C, Siemensma AD. Gum arabic establishes prebiotic functionality in healthy human volunteers in a dose-dependent manner. Br J Nutr. Dec 2008;100(6):1269-75. doi:10.1017/s0007114508981447
  2. Ali BH, Al Za’abi M, Al Suleimani Y, et al. Gum arabic reduces inflammation, oxidative, and nitrosative stress in the gastrointestinal tract of mice with chronic kidney disease. Naunyn Schmiedebergs Arch Pharmacol. Aug 2020;393(8):1427-1436. doi:10.1007/s00210-020-01844-y
  3. Pradeep AR, Agarwal E, Bajaj P, Naik SB, Shanbhag N, Uma SR. Clinical and microbiologic effects of commercially available gel and powder containing Acacia arabica on gingivitis. Aust Dent J. Sep 2012;57(3):312-8. doi:10.1111/j.1834-7819.2012.01714.x
  4. Gafar AM, Ramadan AM, ElSaid NA, Nurelhuda NM. Effect of Gum Arabic on plaque-induced gingivitis: A randomised controlled trial. Saudi Dent J. Sep 2022;34(6):494-502. doi:10.1016/j.sdentj.2022.06.002