Efficacy of Miswak (salvadora persica) in preventing dental caries
Fatemeh Ezoddini-Ardakani
DOI: 10.4236/health.2010.25074   PDF    HTML     11,072 Downloads   23,927 Views   Citations


The rate of dental caries and periodontal diseases in the world is still high, regardless of progress in the oral and dental hygiene. The natural toothbrush or chewing stick called “Mis- wak” has been used since ancient history. In this research the efficacy of Miswak in preventing dental caries was investigated and compared with the efficacy of toothbrush and tooth- paste. The analytical and clinical trial method was applied for this research among high sch- ool’s students in the city of Yazd, Iran, 2006. Three hundred eighty second year’s students (190 cases and 190 controls) were examined dentally. Then the Miswak was distributed to the case group and required trainings were given to both groups. After one year, the examinations were repeated. For analyzing the data one-way variance analysis test, Kai square, Paired t-test and two variable analyses were used. In the beginning of this study, there were no significant differences between two groups (cases and controls) regarding their dental situation and the frequency of brushing their teeth (p-value = 0.162). In addition, there were no significant differences in DMFT between the two groups. The data collected at the end of the study showed a significant increase in DMFT in the control group (p-value = 0.000). There was 55% increase in the rate of dental caries in control group compared to case group (0.89 before the study and 1.38 after the study). The risk of dental caries for each tooth in control group was 9.35 times more than case group (9.14% and 0.98% respectively). Dental caries rate was detected slightly less in the case group at the end of this study. This might be as a result of the antimicrobial effects of Miswak. A longer study with more cases is needed to prove this suggestion.

Share and Cite:

Ezoddini-Ardakani, F. (2010) Efficacy of Miswak (salvadora persica) in preventing dental caries. Health, 2, 499-503. doi: 10.4236/health.2010.25074.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Galati, E.M., Monforte, M.T., Forestieri, A.M., Miceli, N., Bade, A. and Trovato, A. (1999) Salvadora persica L: Hypolipidemic activity on experimental hypercholesterolemia in rat. Phytomedicine, 6(3), 181-185.
[2] Kimery, M.J. and Stallard, R.E. (1992) The evolutionary development and contemporary utilization of various oral hygiene procedures. Periodontal Abstracts, 16, 90-97.
[3] Abderahim, M. and Jurner, J.E. (1983) In vitro evaluation of Saudi Arabian tooth tree (Salvadoran Persica). Odontostomatological Tropicale, 613, 145-148.
[4] Wolinsky, L.E. and Sote, E.O. (1984) Isolation of natural plaque inhibiting substances from Nigerian chewing sticks. Caries Research, 18(3), 216-225.
[5] Akpata, E.S. and Akinrimisi, E. (1977) Antibacterial activity of extracts from some African Chewing sticks. Oral Surgery, 44(5), 717-722.
[6] Elvin-Lewis, M., Hall, J.B. and Adu-uta, M. (1980) The dental health of chewing stick users of southern Ghana, preliminary finding. Journal of Preventive Dentistry, 6, 151-154.
[7] Almas, K. (1999) The antimicrobial effects of extracts of Azadirachta Indica (NEEM) and Salvadora Persica (Arak) chewing sticks. Indian Journal of Dental Research, 10(1), 23-26.
[8] Olsson, B. (1978) Efficiency of traditional chewing sticks in oral hygiene programs among Ethiopian School- children. Community Dentistry and Oral Epidemiology, 6, 105-109.
[9] Al-lafi, T. and Ababneh, H. (1995) The effect of the extract of the Miswak (chewing sticks) used injordan and the middle east on oral bacteria. International Dental Journal, 45(3), 218-222.
[10] Danielsen, B.O., Vibeke, B., Manji, F. and Fejerskov, O. (1989) Chewing sticks, tooth paste and plaque removal. Acta Odontol Scand, 47, 121-125.
[11] Akhtar, M. and Ajmal, M. (1981) Significance of chewing sticks (Miswak) in oral hygiene from a pharmacological viewpoint. Journal of Pakistan Medical Association, 31(4), 89-95.
[12] Farooqi, M.I.H. and Srivastava, J. (1983) The tooth tree (Salvadora persica). Quarterly Journal of Crude Drug Research, 81(4), 1297-1299.
[13] El-Mostehy, M.R., Al-Jassem, A.A., Al-Yassin, I.A., et al. (1983) Miswak as an oral health device preliminary chemical and clinical evaluation. Hamdard, 26, 41-50.
[14] Khoory, T. (1999) The use of chewing sticks in preventive oral hygiene. Clinic Preventive Dentistry, 5, 11-14.
[15] Almas, K., Al-Bagieh, N. and Akpata, E.S. (1997) In vitro antimicrobial effects of freshly cut and 1-month old miswac (chewing stick). Biomedical Letters, 56, 145-149.
[16] Almas, K. and Al-Zeid, Z. (2004) The immediate antimicrobial effect of a toothbrush and Miswak on cariogenic bacteria: A clinical study. Journal of Contemporary Dental Practice, 5(1), 105-114.
[17] Wolinsky, L.E., Mania, S., Nachnani, S., et al. (1996) The inhibiting effect of aqueous Azadirechta indica (Neem) extract upon bacterial properties influencing in vitro plaque formation. Journal of Dental Research, 75(2), 816- 822.
[18] Al-Bagieh, N.H. and Weinberg, E. (1989) Benzylisothicyanate: A possible agent for controlling dental caries. Microbios, 39, 143-151.
[19] Chawla, H.S. (1983) A new natural source for topical fluoride. Journal of the Indian Dental Association, 55 (10), 419-422.
[20] Darout, I.A., Albandar, J.A. and Nils, S. (2000) Periodontal status of adult Sudanese habitual users of Miswac chewing sticks or toothbrushes. Acta Odontol Scand. 58, 31-37.
[21] Faiez, N.H. (1995) Miswac: The natural toothbrush. The Journal of clinical Dentistry, 8(5), 125-129.
[22] Magbool, G. (1992) Prevalence of dental caries in school children in Al-Khobar Saudi Arabia. Journal of Dentistry for Children, 59(5), 384-386.
[23] Norton, M.R. and Addy, M. (1989) Chewing sticks versus toothbrushes in West Africa. A pilot study. Clinical Preventive Dentistry, 11(3), 11-13.
[24] Char, D.C.N., Dogao, A.U. and Dogan, M.M. (1987) SEM, XRF. and EMPA evaluation of Middle Eastern toothbrush “Salvadora persica”. Journal of Electron Microscopy Technology, 5, 145.
[25] Guile, E.E., Al-Shammery, A.R. and El-Backly, M.N. (1996) Oral health survey of Saudi Arabia: Oral health knowledge attitudes and practice among adults. Journal of Dental Research, 75, 1276.
[26] Sofrata, A.H., Claesson, R.L., Lingström, P.K. and Gustafsson, A.K. (2008) Strong antibacterial effect of Miswak against oral microorganisms associated with periodontitis and caries. Journal of Periodontology, 79(8), 1474-1479.
[27] Almas, K. (2002) The effect of Salvadora persica extract (Miswak) and chlorhexidine gluconate on human dentin: A SEM study. The Journal of Contemporary Dental Practice, 3(3), 27-35.
[28] Sofrata, A., Lingström, P., Baljoon, M. and Gustafsson, A. (2007) The effect of Miswak extract on plaque pH. An in vivo study. Caries Research, 41(6), 451-454.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.