A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health
From the Department of Preventive Dental Sciences (Haque), College of Dentistry, and the Department of Surgery (Alsareii), College of Medicine, Najran University, Najran, Kingdom of Saudi Arabia
Address correspondence and reprint request to: Dr. Mohammad M. Haque, Department of Preventive Dental Sciences, College of Dentistry, Najran University, PO Box 1988, Najran 61441, Kingdom of Saudi Arabia. E-mail: firstname.lastname@example.org
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. Saudi Med J 2015; Vol. 36 (5): 530-543
Oral health is an integral part of overall health. Poor oral health is associated with many systemic diseases. The oral cavity is the major portal of entry, source, and site of many diseases affecting the general health status.1 Well-being and quality of life, which is measured along functional, psychosocial, and economic dimensions, is related to oral health. Poor oral and craniofacial health affects diet, nutrition, sleep, psychological status, social interaction, school, and work.1 Therefore, the maintenance of oral health is of vital interest and can be achieved mainly by mechanical and chemical means. The most common and modern mechanical method of tooth cleaning is the use of a toothbrush in combination with a dentifrice.2 However, a wide range of methods exists to maintain and preserve oral and dental hygiene around the world. Despite the widespread use of toothbrushes and dentifrices, natural methods of tooth cleaning using chewing sticks are observed in several parts of the world.3In many traditional cultures, plastic-bristle brushes are not used. Instead, the use of herbal “chewing sticks” is common. Chewing sticks are usually taken from plants, shrubs, or trees with high anti-microbial activity.4 For thousands of years, the use of plants have been closely associated with dental hygiene and therapeutic practices.5 The use of chewing sticks, which can be derived from various plants, are spread throughout Asia, Africa, South America, and the Middle East, including Saudi Arabia, and throughout the Islamic countries.3,6,7 Chewing sticks are known by different names in different cultures. These sticks are called ‘miswak’ in Arabic, ‘koyoji’ in Japanese, ‘qesam’ in Hebrew, ‘qisa’ in Aramaic, and ‘mastic’ in latin.8 ‘Miswak’ is obtained from Salvadora persica and is the most extensively used plant to prepare chewing sticks.9 In the Middle East, the most common source of miswak is the Arak Tree (Salvadora Persica).10 The Arak tree is also known as the “toothbrush tree.” The miswak is usually obtained from the roots of the Arak tree, although some sticks are also made from its twigs and stem.8,11
“Miswak” (which has synonyms in different Arabic dialects and countries, including “miswaak,” “misswak,”“miswaki,” “meswak,” “mswaki,” “sewak,” “siwak,” and “siwaki”) is an Arabic word. The conventional meaning of miswak is ‘tooth-cleaning stick’ or “stick used on teeth and gums to clean them”.7,12,13 Sticks from these plants are usually chewed or tapered on one end until they became frayed into a brush-like form, which is then used to clean the teeth in a similar manner to a toothbrush
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