A variety of oral hygiene measures have been performed since the dawn of time. This has been verified by various excavations done all over the world, in which toothpicks, chew sticks, tree twigs, linen strips, birds' feathers, animal bones and porcupine quills were recovered 1.
Those that originated from plants are tasty twigs and although primitive they represented a transitional step towards the modern toothbrush. It has been stated that about seventeen plants could be enumerated as natural sources for several of these oral hygiene devices 2.
The most widely used tree twigs since early times is the ..Siwak" or ..Miswak" 3 .The stick is obtained from a plant called Salvadore Persica that grows around Mecca and the Middle East area in general. It is widely used among Muslims after Prophet Mohammed ( pbuh ) realised its value as a device which should be used by Muslims to clean their teeth. In this respect our Prophet ( pbuh ) is considered the first dental educator in proper oral hygiene.
Although there is no reference to the use of Siwak in Al-Quran, yet several quotations could be read in the compendium of the sayings of Mohammed ( pbuh ) as to the benefits of Siwak in mouth cleanliness. One saying reads as follows:
"IF IT WERE NOT TOO MUCH A BURDEN ON THE BELIEVERS, I WOULD PRESCRIBE THAT THEY USE THE SIWAK BEFORE EACH PRAYER".
Several anecdotes6, incidents, and rules of ethics in using Siwak were mentioned in various references talking on the subject of cleanliness of the mouth.
Salvadora Persica is in fact a small tree or shrub with a crooked trunk, seldom more than one foot in diameter, bark scabrous and cracked, whitish with pendulous extremities. The root bark is light brown and the inner surfaces are white, odour like cress and taste is warm and pungent. Chemically the air dried stem bark os S. Persica is extracted with 80% alcohol and then extracted with ether and run through exhaustive chemical procedures. This showed that it is composed of:
1.Trim ethyl amine
2.An alkaloid which may be salvadorine
4.High amounts of fluoride and silica
7.Small amounts of Tannins, saponins, flavonoids & sterols
PURPOSE OF THE PRESENT INVESTIGATION:
Because of the great quality of oral cleanliness noticed in individuals who use Siwak as the sole device to brush their teeth and because of the low incidence of dental decay of those individuals this work was undertaken.
It is intended to study the following:
1 .The mechanical ability of Siwak as a cleaning device to the mouth and its ability to rid the mouth of bacterial plaque (aggregates harmful to the gum)
2. If Siwak is powdered and used with a toothbrush, could it act as an efficient mouth cleaner?
3. As compared to other strongly abrasive toothpowder's, could Siwak rank as highly efficient as to the used material?
Oral hygiene and patient motivation towards a clean mouth owe their birth to the teachings of Mohammed (pbuh). Due to the repeated use of Siwak during the day, the users showed an unusually high level of oral cleanliness. It is a well known fact that plaque formed immediately after meticulous tooth brushing. By the end of 24 hours the plaque is well on its way towards maturation and hence starts its deleterious effects on the gingiva 8.
Proper oral hygiene should be maintained through intensive instructions by the periodontist as well as by a great expenditure of time and dexterity on part of the patient. This item is self corrected in Muslims because Siwak users take Siwak as a device that should be used as part of their religious ritual regimen.
The results obtained in this investigation have proved that Siwak and other tree twigs 9 could act as an effective tool in removing soft oral deposits. It could be even used as an effective device in preventive dental programme's in mass populations. The indices used in this investigations were simple and adequate as they discriminated between experimental stages as well as between experimental groups.
Using starch is not quite accurate but it was meant to evaluate the degree by which Siwak and powdered Siwak could rid teeth of deposits as compared to the best abrasive viz. commercial powder.
It is noticed that the difference between first and fifth week of the mean score of plaque percentage for powdered Siwak is the highest (-11.2%) of all readings. This indicates that powdered Siwak is used with t mechanically proper device i.e. tooth brush will give a great deal of oral cleanliness.
It has been reported that Salvadora Persica contains substances that possess antibacterial properties Some other components are astringents, detergents and abrasives 8. Those properties encourage some toothpaste laboratories to incorporate powdered stems and/or root material of Salvadora persica in their products (Beckenham U.K. Sarakan Ltd.).
Although the commercial powder gave a high degree of efficiency in plaque removal yet its use over the experimental period gave a high score of gingivitis percentage within the group using the powder. It is time that plaque eradication is essential but this should not be on the expense of deleterious side effect on other tissues.
It could be concluded that Siwak and powdered Siwak are excellent tools for oral cleanliness. Because of its availability in this part of the world, being inexpensive and readily adopted by Muslims as part of their religious regimen, it is highly recommended in implementing a preventive dental health program Islamic countries. Also recommendations should be directed to manufacturers of toothpastes to include the powdered form of Siwak in a highly debriding sophisticated toothpaste.
By: Dr. M. Ragaii El-Mostehy, Dr. A.A.Al-Jassem, Dr. I.A.Al-Yassin, Dr.A.R; El-Gindy and Dr. E. Shoukry
A Miswak or Siwak is probably an alien thing to the western world. But, it’s a twig which a majority of people from Muslim countries use daily to brush their teeth. Although it might sound outdated to use twigs from trees for cleaning your teeth, studies conducted on the Miswak prove otherwise. Studies have inferred that Miswak is better than toothpaste for preventing gum disease. It is being known as chewing stick in the western world and is being looked upon as a form of alternative medicine. So, let’s analyze this “wonder twig” keeping documented scientific studies as proofs.
But first of all, why would anyone think of using a tree twig to clean their teeth? The fact is ancient man did not have the facility of a toothbrush and many cultures have used Miswak for oral hygiene. The use of Miswak is well spread in the Muslim population of the world, and is a common entity in Muslim countries. The reason for common use of Miswak by Muslims can be attributed to religious beliefs. The last messenger of Islam used it frequently and also instructed his followers to do the same and hence the practice continues widely in Muslim countries. There are 70 benefits of Miswak as suggested by Islamic Literature and many of these have been scientifically proven and the rest haven’t been studied yet.
You might be wondering what exactly a Miswak is in the first place. The Miswak is obtained from the twigs of the Arak tree (Peelu tree) although a few other trees can also be used to obtain it such as walnut and olive.
A few important benefits of Miswak
- Kills Gum disease causing bacteria.
- Fights plaque effectively.
- Fights against caries.
- Removes Bad breath and odor from mouth.
- Creates a fragrance in the mouth.
- Effectively clean between teeth due to its parallel bristles.
- Increases salivation and hence inhibits dry mouth (Xerostomia)
Scientific Studies on Miswak
Although the 70 supposed benefits of Miswak range widely, the main one we are examining is its effect on oral health. So, let’s throw some light on scientific studies conducted on Miswak.
The Wrigley Company made a study on Miswak which was published in the Journal of Agricultural and Food Chemistry. The study found that mints laced with Miswak extract were 20 times more effective in killing bacteria than ordinary mints. A small testimony to this fact is that after half an hour, the mints laced with Miswak extract killed about 60% of the bacteria where as the ordinary mints managed only 3.6%
In the August issue of Journal of Periodontology (2008) appeared a study conducted by Swedish researchers on Miswak. The study apparently found that suspended Miswak pieces in a petridish (medium for culturing bacteria) were able to kill bacteria that cause periodontal disease with out being in physical contact with the bacteria. The researchers suggested that Miswak might be giving antibiotics as gases trying to explain this phenomenon.
A study which compares toothbrushing and using Miswak (Miswak ing!) can be seen on Pubmed (U.S National Library for Medicine Service). The study concluded that Miswak was more effective than toothbrushing in reducing plaque and gingivitis provided it was used correctly. Similar studies found on the same website and elsewhere vouch for the effectiveness of Miswak over toothbrush.
A study conducted by a group of dentists at King Saud University concluded that using Miswak was at least as good as tooth brushing, if not better. There have been plenty of published studies on Miswak and infact entire books published which study its oral and systemic benefits.
Now, with all those studies chucked at you, you couldn’t help but wonder why it is so effective. This can be attributed to its strong antibacterial properties. Another important aspect to consider is that its bristles are parallel to the handle rather than perpendicular which means effective cleaning between the teeth. Now, that’s one natural toothbrush cum toothpaste cum floss.
A few related studies and articles on Miswak
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