Effectiveness of Coconut Oil Pulling and Moringa Mouthwash Versus Chlorhexidine in Reducing Gingivitis in Diabetic Children

September 12, 2026 updated by: Amira Yehia Zakaria

Effectiveness of Coconut Oil Pulling and Moringa Mouthwash Versus Chlorhexidine in Reducing Gingivitis in Diabetic Children: A Randomized Controlled Pilot Study

Gingivitis is a common and reversible inflammatory condition, mainly caused by dental plaque, and is particularly prevalent among children. Children with diabetes mellitus are more susceptible because of altered immune responses, impaired healing, and changes in the oral microbiota.

Although mechanical plaque control is the primary method of prevention, poor oral-hygiene compliance in children highlights the need for safe adjunctive treatments. Chlorhexidine, while highly effective, can cause staining, taste alteration, and mucosal irritation, limiting its long-term pediatric use.

Natural alternatives such as coconut oil and Moringa oleifera have attracted attention because of their antimicrobial, anti-inflammatory, and antioxidant properties. Coconut oil, particularly its lauric acid content, may reduce oral pathogens, plaque, and gingival inflammation. Moringa contains bioactive compounds such as flavonoids, phenolic acids, and isothiocyanates that may help reduce inflammation, oxidative stress, and microbial load.

However, comparative clinical evidence on coconut oil versus Moringa for managing gingivitis in diabetic children remains limited, highlighting the need for further clinical research to determine their safety and effectiveness in this vulnerable population.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Gingivitis represents one of the most prevalent inflammatory diseases affecting the gingival tissues and remains a major public health concern worldwide, particularly among pediatric populations. It is primarily induced by dental plaque biofilm accumulation along the gingival margin, resulting in gingival inflammation characterized by redness, swelling, bleeding on probing, and discomfort. Although gingivitis is considered a reversible condition, if left untreated, it may progress to periodontitis, leading to irreversible destruction of periodontal supporting structures and eventual tooth loss.

Children with systemic conditions, especially diabetes mellitus, exhibit a higher susceptibility to gingival inflammation due to altered immune responses, impaired wound healing, and changes in oral microbial flora.

Mechanical plaque control through tooth brushing and professional prophylaxis remains the cornerstone of gingivitis prevention and management. However, compliance with routine oral hygiene practices among children is often suboptimal. Therefore, adjunctive therapeutic agents with antimicrobial and anti-inflammatory properties have gained increasing attention. Chlorhexidine mouthwash is widely considered the gold standard chemical plaque control agent; nevertheless, its long-term use is associated with adverse effects including tooth staining, taste alteration, and mucosal irritation, limiting its acceptability among pediatric patients. This has led to growing interest in exploring natural and herbal alternatives that are safe, cost-effective, and well tolerated.Coconut oil has recently gained popularity as a natural oral health agent, particularly through the practice of oil pulling, which is a traditional Ayurvedic technique involving swishing oil in the oral cavity. Coconut oil contains a high concentration of medium-chain fatty acids, predominantly lauric acid, which possesses potent antimicrobial, anti-inflammatory, and antioxidant properties. Lauric acid has demonstrated effectiveness against various oral pathogens, including Streptococcus mutans and Candida species, by disrupting microbial cell membranes and inhibiting biofilm formation. Additionally, coconut oil may reduce gingival inflammation by modulating inflammatory mediators and enhancing tissue healing. Several clinical studies have reported improvements in plaque and gingival indices following coconut oil use, suggesting its potential as a safe adjunctive therapy in managing gingivitis.

Moringa oleifera, commonly referred to as the "miracle tree," is another herbal product that has gained considerable attention for its medicinal and nutritional benefits. It is rich in bioactive compounds including flavonoids, phenolic acids, vitamins, minerals, and essential amino acids. Moringa extracts exhibit strong antimicrobial activity against a broad spectrum of oral microorganisms and possess significant anti-inflammatory and antioxidant effects. These properties are primarily attributed to phytochemicals such as quercetin, chlorogenic acid, and isothiocyanates, which reduce oxidative stress and suppress inflammatory pathways. Recent experimental and clinical studies have suggested that moringa-based formulations may improve periodontal health by reducing plaque accumulation, gingival inflammation, and microbial load, making it a promising natural therapeutic agent.

Despite the documented therapeutic potential of coconut oil and moringa individually, comparative clinical studies evaluating their effectiveness in reducing gingivitis, particularly among diabetic children, remain limited. Pediatric diabetic patients constitute a vulnerable group requiring safe, well-tolerated, and effective adjunctive oral health interventions. Natural herbal agents such as coconut oil and moringa may provide affordable and culturally acceptable alternatives, especially in developing countries where access to conventional dental care may be limited.

Study Type

Interventional

Enrollment (Estimated)

30

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Study Locations

  • Egypt
    • Cairo,Egypt
      • Cairo, Cairo,Egypt, Egypt, 11511
        • Faculty of dentistry cairo university

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Age from 6 to 12 years.
  • Both males and females.
  • Diabetic Children with mild to moderate gingivitis.
  • Medically stable, without other systemic conditions affecting oral health.
  • Written informed consent obtained from parents or legal guardians and assent from the child.

Exclusion Criteria:

  • Severe gingival or periodontal disease
  • Hypersensitivity or allergy to coconut oil, moringa, chlorhexidine, or any component of the study interventions.
  • Presence of systemic conditions other than diabetes that may affect results
  • Antibiotics use, corticosteroids, that may influence gingival health within the past 4 weeks.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Moringa olfera mouthwash
Children will swish aqueous extract preparation from moringa leaves for 1 minute daily for 4 weeks
Other: Chlorhexidine mouthwash
Active comparator
Experimental: Coconut oil pulling
Oil pulling with 5 mL of virgin coconut oil will be used for swishing for 1 minute once daily under parental supervision.
Other: Chlorhexidine mouthwash
Active comparator
Active Comparator: Chlorhexidine mouthwash
0.12% chlorhexidine mouthwash will be used for Swishing for 1 minute once daily for 4 weeks
Other: Moringa olfera mouthwash
Intervetion
Other: coconut oil pulling
Intervention

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Gingival Health
Time Frame: baseline before treatment, immediately after, after 2 weeks and after 4 weeks.
Clinical examination using the Gingival Index
baseline before treatment, immediately after, after 2 weeks and after 4 weeks.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Porphyromonas gingivalis count
Time Frame: baseline before treatment, immediately after, after 2 weeks and after 4 weeks.
Microbiological analysis manual colony counting
baseline before treatment, immediately after, after 2 weeks and after 4 weeks.

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Patient Acceptability
Time Frame: baseline before treatment, immediately after, after 2 weeks and after 4 weeks.
5-point Likert scale questionnaire
baseline before treatment, immediately after, after 2 weeks and after 4 weeks.
Patient compliance
Time Frame: on week 2 and week 4
self-reported adherence using the Modified Morisky Medication Adherence Scale
on week 2 and week 4

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Amira Yehia Zakaria

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

October 1, 2026

Primary Completion (Estimated)

November 1, 2026

Study Completion (Estimated)

November 1, 2026

Study Registration Dates

First Submitted

September 12, 2026

First Submitted That Met QC Criteria

September 12, 2026

First Posted (Actual)

September 17, 2026

Study Record Updates

Last Update Posted (Actual)

September 17, 2026

Last Update Submitted That Met QC Criteria

September 12, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Gingivitis reducing mouthwash

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

supporting information

IPD Sharing Time Frame

4 weeks

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • ICF

Study Data/Documents

  1. Study Protocol
    Information identifier: Protocol

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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