A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health

Abstract

Miswak is a traditional chewing stick prepared from the roots, twigs, and stem of Salvadora persica and has been used as a natural method for tooth cleaning in many parts of the world for thousands of years. A number of scientific studies have demonstrated that the miswak (Salvadora persica) possesses antibacterial, anti-fungal, anti-viral, anti-cariogenic, and anti-plaque properties. Several studies have also claimed that miswak has anti-oxidant, analgesic, and anti-inflammatory effects. The use of a miswak has an immediate effect on the composition of saliva. Several clinical studies have confirmed that the mechanical and chemical cleansing efficacy of miswak chewing sticks are equal and at times greater than that of the toothbrush. The present article provides a review of the various therapeutic effects of Salvadora persica on oral health, which will help to elucidate the significance and importance of this indigenous oral hygiene tool.

Herbal Endodontic Irrigants

“…33 Al-Salman et al 38 suggested that 10% of water extract of miswak is an effective antimicrobial when utilized as a root canal irrrigant with necrotic pulp. Due to its good antimicrobial activity 39 and low level of cytotoxicity, it can replace sodium hypochlorite and CHX for a root canal irrigant. It can be used even in primary teeth as irrigant and is safer than sodium hypochlorite.…”

Comparison of Fluoridated Miswak and Toothbrushing with Fluoridated Toothpaste on Plaque Removal and Fluoride Release

“…Therefore, the need to address questions regarding microorganism adherence and biofilm development is crucial. 3,4 A previous study has shown miswak to be similar or even more effective than toothbrushing in plaque removal. 5,6 In addition, miswak has been shown to exhibit a higher reduction in gingivitis provided that professional instructions have been given.…”

“…Then, it is used until it loses its taste and odor. [3][4][5] Gentle, circular movements should be used to massage the gingiva and to avoid any damage and possible gingival recession. 4,5 On completion of tooth cleaning, the used bristles are trimmed away and new ones are prepared by further chewing.…”

“…However, soaking for more than 24 hours causes loss of active components but without any loss of mechanical properties. 3,4 In addition to its mechanical properties, miswak possess a certain antimicrobial effect on gingivitis and caries. It also has a minor effect on the salivary and subgingival microbiota.…”

“…The fourth and the fifth fingers are kept clenched on the palm and the thumb rests on the side opposite to the third finger. 3,4 Considering previously mentioned properties of miswak and the fact that it is readily available and cheap in countries where it is routinely used, it seems like a suitable alternative to toothbrushing with toothpaste. In 1987, the World Health Organization recommended the use of miswak to achieve good oral hygiene.…”