Role of triphala in oral health: A systematic review and meta-analysis

Aim: Critically assessed reviews on the effectiveness of Triphala for the promotion of oral health are hard to come by. As a result, the goal of this study was to conduct a systematic evaluation of the existing literature to determine the impact of Triphala on oral health. Materials and Methods: PubMed, PubMed Central, Campbell systematic review, Cochrane, Embase, Google Scholar, and Scopus were used to perform a systematic review of the literature. This review includes only randomized control trials (RCTs) comparing Triphala to chlorhexidine (CHX) or placebo. To perform risk of bias and meta-analysis, relevant information was collected from chosen publications. Results: The overall risk of bias was high for the majority of the included studies except two studies showed an unclear risk of bias and one study showed a low risk of bias. Statistically significant differences were observed in favor of Triphala when compared with placebos for gingival, plaque and modified plaque indices (gingival index: mean difference [MD] = −0.53, 95% confidence interval [CI] (−0.83, −0.23), P = 0.006; plaque index: MD = −0.57, 95% CI (−0.99, −0.16), P = 0.007; Quigley-Hein Plaque Index: MD = −1.12, 95% CI (−1.52, −0.72), P = 0.0001). No statistically significant difference was found between herbal and CHX mouthwashes. Conclusion: Triphala mouthwash is more effective than placebo mouthwashes in reducing gingivitis, although there was no statistically significant difference between Triphala and CHX mouthwashes in the included studies. Because of their herbal nature, Triphala mouthwashes might be regarded as an alternative to CHX mouthwashes in maintaining oral hygiene.