Background: Azadirachta indica, commonly known as the Neem tree, has various reported therapeutic effects including its antimicrobial effects. Multiple researchers have studied the effects of Neem extract gels against gingival and periodontal bacteria and reported a significant antibacterial effect and minimum or no adverse effects as to chlorhexidine. Neem tree extracts induced-decrease in gingival inflammation, dental plaque, and bacterial count have also been reported when compared with standard chlorhexidine. Thus, the rationale of our study is to evaluate the effectiveness of Neem tree (Azadirachta indica) extract against presenting complaints of pregnant females.

Methodology: This experimental study was performed at tertiary care hospital of Karachi. The sample size was calculated to be as n =46. The participants were recruited using a sequential sampling strategy. The research was conducted on pregnant women who agreed to participate and reported to OPD in 1^st trimester. For group randomization, the participants were handed an envelope, and randomization was done by single-blind technique. Before sampling, participants were told not to clean their teeth. Each group comprised 23 pregnant females and was separated into two groups (Group 1, positive control (who used commercially available mouth rinse), and Group 2, Neem tree extract rinse group). For rinses, the experimental group received diluted neem tree extract, and the positive controls received a typical commercially available mouth rinse. The participants were instructed to use the rinses twice a day after breakfast and before sleeping. The gingival pocket depth, bleeding tendency, halitosis, and gingival swelling were evaluated before and after 3 months to compare the results, and participants were asked about the taste and any post-use discomfort by the rinse.

Results; The mean age of females was 27 ± 8, and most of the females 32 (69.5%) visited the OPD at the 11^th -14^th week of gestation. The most common complaint was halitosis 36 (82.6%) and gingival bleeding 28 (60.8%). The mean pocket depth observed pre-experimentally was 1.9 ± 0.4. After the 3 months of the experiment when patients were asked about their previous presenting complaints their responses were similar in both the groups. Chi's square analysis didn't show any significant difference between commercially available mouth rinse and neem tree extract rinse. When examined intraorally we also had the nonsignificant findings.

Conclusion: Neem tree extract rinse and commercially available mouth rinse showed comparable results in reducing presenting complaints, gingival bleeding, and pocket depth.

Key words: Azadirachta indica, Mouth rinse, Pregnancy, Presenting Complaints