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Not yet recruitingNCT07702383SMILEUpdated Jul 15, 2026

A Multicentre Randomised Controlled Trial Evaluating the Efficacy of the SMILE™ Module for Improving Short-term Periodontal Outcomes, Compliance, and Acceptability Among Clinical Dental Students

An interventional study of SMILE Module and Conventional Toothbrushing Module in Gingivitis and Gingivitis; Chronic, sponsored by National University of Malaysia. Not yet recruiting at 4 sites in Malaysia. Open to participants aged 18 Years to 24 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2026-07-15.

Sponsored by National University of Malaysia · Not applicable, Interventional, and Prevention

Phase
Not applicable
Study type
Interventional
Enrollment
66
Allocation
Randomized
Ages
18 Years to 24 Years
Sex
All
01

Study summary

This multicentre randomised controlled trial aims to evaluate the efficacy and safety of the SMILETM (Siwak Method for Integrated Lifestyle Enhancement) module in improving short-term periodontal outcomes, oral hygiene behaviour, and safe siwak practice among clinical dental students. Conventional toothbrushing will serve as the control intervention.

Eligible participants will be randomly assigned to either the SMILE intervention group or the conventional toothbrushing control group. Both groups will receive professional oral prophylaxis, standardised oral hygiene education, structured training according to their allocated intervention, and digital monitoring throughout the 21-day study period.

The study will assess changes in plaque accumulation, gingival health, and bleeding on probing, as well as participant compliance, behavioural outcomes, acceptability of the SMILE module, and intervention-related adverse events.

It is hypothesised that the SMILE module will effectively improve short-term periodontal outcomes, promote better compliance with the recommended oral hygiene practice, and achieve favourable acceptability while maintaining participant safety.

Read the detailed description

The participants will be recruited from four Malaysian universities and two Indonesian universities. Individuals who meet the eligibility criteria and provide written informed consent will undergo screening, oral examination, professional oral prophylaxis and any necessary dental treatment to establish a comparable baseline oral condition prior to randomisation.

Participants will then be randomly assigned in a 1:1 ratio to either the SMILE intervention group or the conventional toothbrushing control group using a computer-generated stratified randomisation sequence. Allocation concealment will be maintained through a centralised electronic allocation system. Outcome assessors and data analysts will remain blinded to group allocation.

The SMILE intervention group will receive a structured behavioural module delivered through the SMILE mobile application. The programme includes standardised instruction on siwak preparation, brushing technique, storage, recommended frequency of use, instructional videos, supervised hands-on practice, a standardised siwak kit, and daily monitoring using the mobile application with a paper logbook available as a contingency.

Participants in the control group will receive a structured conventional toothbrushing module following the same training schedule and monitoring procedures. A standardised toothbrush kit and the study application containing toothbrushing educational materials will be provided to ensure equivalent participant support and follow-up throughout the study.

Following completion of training, participants will perform their allocated oral hygiene practice for 21 consecutive days. Adherence to the assigned intervention will be monitored using the study application or the paper logbook when required. Clinical assessments will be conducted at baseline and at Day 21 by calibrated examiners using standardised periodontal examination procedures. The study is designed to determine the efficacy of the SMILE module under controlled conditions using conventional toothbrushing as the active control intervention.

02

Conditions studied

  • Gingivitis
  • Gingivitis; Chronic

Keywords

  • salvadora persica
  • siwak
  • miswak
  • Behavioural intervention
  • Randomised controlled trial,
  • oral hygiene
  • gingivitis
  • prevention
  • periodontal health
03

In context

Gingivitis

631 studies on the registry are indexed under Gingivitis; 107 are open to participants now.

This study's planned enrollment of 66 is close to the median of 66 across 507 interventional studies indexed under Gingivitis.

Browse Gingivitis studies →

Lead sponsor

National University of Malaysia is the lead sponsor of 124 studies on the registry; 45 are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 24 Years
Sexes eligible
All
Accepts healthy volunteers
Yes

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  1. Adults aged 18 - 24 years
  2. Clinical dental students enrolled at one of the participating universities.
  3. Participants with a maximum diagnosed with plaque-induced gingivitis according to the 2018 Classification of Periodontal and Peri-Implant Diseases and Conditions, without clinical attachment loss attributable to periodontitis.
  4. Have adequate oral hygiene (ranging from good to fair; score from 0 to 1.9 according to Silness and Löe plaque index (1964)
  5. Possess at least 28 natural teeth.
  6. Able to understand study procedures and provide written .
  7. Willing to comply with all study procedures, intervention instructions, and follow-up assessments.

Exclusion criteria

Exclusion Criteria:

  1. Using braces and dental prosthesis.
  2. Presence of systemic diseases known to influence oral and periodontal health
  3. Use of antibiotics for the last 3 months or any medication or known to affect oral and periodontal tissues or salivary flow
  4. Moderate or high dental caries risk
  5. Severe tooth malposition that may interfere with plaque assessment or oral hygiene procedures
  6. Participants presenting with moderate - severe dentin
  7. Participants with mucosa/ gingival trauma/recession and tooth wear
  8. Pregnancy or breastfeeding
  9. History of allergy or hypersensitivity to any material used in the study
  10. Cognitive, psychiatric, or physical conditions that may impair compliance with study procedures
Terms in these criteria, in plain language(2)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.

You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

05

Study design

Phase
Not applicable
Primary purpose
Prevention
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Single (Outcomes assessor)
Enrollment
66 participants (estimated)

Study arms

  • Experimental
    SMILE Intervention Group

    Participants assigned to this group will receive the SMILE module behavioural intervention. The intervention includes standardised training in integrated siwak practice delivered through a mobile application, supervised hands-on practice, a standardised siwak kit, daily compliance monitoring, and supporting educational materials. Participants will perform integrated siwak practice according to the standardised protocol for 21 consecutive days.

    Behavioral: SMILE Module

  • Active comparator
    Conventional Toothbrushing Control Group

    Participants assigned to this group will receive standardised oral hygiene education based on conventional toothbrushing. They will undergo the same recruitment procedures, oral examination, prophylaxis, training duration, monitoring schedule, follow-up assessments, and data collection procedures as the intervention group.

    Behavioral: Conventional Toothbrushing Module

Interventions

  • BehavioralSMILE Module

    The SMILE module intervention is a standardised behavioural oral hygiene programme designed to promote appropriate siwak use. The programme includes instruction on siwak preparation, brushing techniques, storage, replacement, frequency of use, and monitoring for safe siwak practice. Training is delivered through the SMILE mobile application using instructional videos and structured educational content, followed by supervised practical training. Participants will receive a standardised siwak kit and will be instructed to perform siwak cleaning five times daily, corresponding to the recommended practice incorporated within the module. Adherence will be monitored throughout the 21-day intervention using the mobile application and/or daily logbook.

  • BehavioralConventional Toothbrushing Module

    Participants will receive standardised training in conventional toothbrushing through a structured educational module delivered using the study mobile application. The programme includes instruction on toothbrush preparation, brushing techniques, brushing duration, and toothbrush replacement recommendations. Participants will receive a standardised toothbrush kit and will be instructed to brush their teeth twice daily for approximately two minutes throughout the 21-day intervention period. Compliance will be monitored using mobile application and daily logbook employed for the intervention group.

06

What researchers measure

Primary outcomes

  1. Change in Plaque Index (PI)

    Plaque accumulation will be assessed using the Silness and Löe Plaque Index (1964), which evaluates the amount of plaque present at the gingival margin on four tooth surfaces using a 0-3 ordinal scale. Lower scores indicate better plaque control.

    Time frame: Baseline (day 0) and day 21 after randomisation

Secondary outcomes

  1. Change in Gingival Index (GI)

    Gingival inflammation will be assessed using the Löe and Silness Gingival Index (1963), which evaluates gingival colour, consistency, and bleeding on gentle probing on a 0-3 ordinal scale. Lower scores indicate healthier gingival conditions.

    Time frame: Baseline (day 0) and day 21 after randomisation

07

Study locations

4 sites
  • Faculty of Dentistry, Universiti Kebangsaan Malaysia
    Kuala Lumpur, Kuala Lumpur 50300, Malaysia
  • Faculty of Dentistry, Universiti Sains Islam Malaysia
    Kuala Lumpur, Kuala Lumpur 55100, Malaysia
  • Kulliyyah of Dentistry, International Islamic University Malaysia
    Kuantan, Pahang 25200, Malaysia
  • Faculty of Dentistry, Universiti Teknologi MARA
    Sungai Buloh, Selangor 47000, Malaysia
08

References and documents

Individual participant data

Plan to share: No

No publications or documents are linked to this record.

09

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reachedSimilar studies: half by the dot; the band is the middle halfHalf of similar studies reached it by the dot; the band is the middle half, from a quarter to three quarters

Start is estimated for Sep 2026; primary completion for Apr 2027, 7 months later.

Of 204 non-industry interventional studies with no phase under Gingivitis, half reached primary completion within 9 months of starting (the median), counting those still running; a quarter within 4 and three quarters within 18. This study's planned 7 months is below that.

Counting every sponsor, half of 257 studies reached it within 7 months; a quarter within 3 and three quarters within 15.

How these figures are worked out, and which studies are left out of them.

Registered
Jul 8, 2026
First posted
Jul 14, 2026
StartEst.
Sep 1, 2026
Primary completionEst.
Apr 28, 2027
CompletionEst.
May 31, 2027
Last update
Jul 15, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jul 15, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT07702383
Collaborators
Universiti Sains Islam Malaysia, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Malaysia, International Islamic University Malaysia, Hasanuddin University
Responsible party
Nik Madihah Nik Aziz (Lecturer and Clinical Specialist in Periodontology, Principal Investigator, National University of Malaysia) — Principal investigator
First posted
Jul 14, 2026
Start date
Sep 1, 2026 (estimated)
Primary completion
Apr 28, 2027 (estimated)
Completion
May 31, 2027 (estimated)
Last update
Jul 15, 2026

Study contacts

Amanah Pertiwisari, drg, M.KG
Contact
p154143@siswa.ukm.edu.my
+60 10-5871-889
Shahida Mohd Said, BDS, MClinDent (Periodontology
Contact
shahidams@ukm.edu.my

Oversight

FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

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This study is not yet recruiting, as verified in Jul 2026. You cannot join it, but the record below documents what was studied.

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