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The article in the Pediatric Allergy & Immunology journal discusses the first reported case of anaphylaxis to miswak (Salvadora persica), a natural toothbrush used in various cultures. The patient, a 10-year-old child with asthma and food allergies, experienced anaphylaxis after using miswak, confirmed by skin prick testing. While allergic reactions to miswak are rare, this case highlights the importance of considering immediate hypersensitivity to natural products, even in atopic patients. The study was funded by the Deanship of Scientific Research and the authors declare no conflicts of interest. [Extracted from the article]

Objectives: This study evaluates the effect of using miswak chewing sticks on dental plaque, selected oral microbiota and gingival inflammation among patients with gingivitis. Methods: The study was a single‐centre, single‐examiner blind, randomized, crossover study. Twenty healthy participants were randomly assigned into two equal groups (n = 10). Group 1 were instructed to use both toothbrush and miswak (TB+M) for the first 2 weeks from baseline (T1) and only toothbrush for the next 2 weeks (T2); and Group 2, only TB during T1 and TB+M during T2. Gingival index (GI), plaque index (PI) and bleeding on probing (BOP) were evaluated at baseline (T0), T1 and T2 visits. Supra‐gingival plaque samples were taken at T0, T1 and T2. Quantification of Streptococcus mutans and Aggregatibacter actinomycetemcomitans from the supra‐gingival plaque samples were performed by real‐time polymerase chain reaction (qPCR). Results: The scores of GI, PI and BOP had significantly improved for both groups between T0 and T1. A significantly greater reduction in the percentage of sites with BOP was observed for TB+M group compared with TB group (TB+M group: from 32.2 to 14.93; TB group: from 34.00 to 26.0; p =.014). At T2, TB+M group had significant improvements (p <.05) in the PI, GI and BOP scores compared with TB group. There was no significant difference in the microbial counts of S. mutans and A. actinomycetemcomitans between the two groups at the end of the study period. Conclusions: Oral hygiene and gingival health may be improved by complementing miswak chewing sticks with toothbrushing. [ABSTRACT FROM AUTHOR]

Objective: The chewing sticks are widely used in many regions of Asia and Africa as a traditional tool to maintain oral hygiene. Salvadora persica L. (S. persica), also known as Arak or Miswak, a member of the salvadoraceae family. Chewing sticks, made up from S. persica, have chemical antibacterial properties and mechanical effects. The study aimed to investigate possible chemical effects of S. persica on dental plaque, sub‐gingival microbiota and gingival inflammation. In order to achieve this, we inactivated some sticks through boiling to be used as inactive, but mechanically comparable control sticks. Methods: In a double‐blinded crossover trial, 24 patients with mild‐to‐moderate periodontitis were randomly allocated to use either fresh activated Miswak or inactivated Miswak for 3‐week period. Plaque index (PI), gingival index (GI), visual plaque index (VPI) and bleeding on probing (BOP) were evaluated before and immediately following the experimental period. Sub‐gingival plaque samples were analysed using DNA‐DNA hybridization technique. The study was repeated with the participants switching the type of Miswak they used after a 7‐week of "washout" period. Results: There were no significant differences in the microflora after using active and inactive Miswak. Sixteen species of bacteria showed an increase (P < 0.05) after the usage of inactive Miswak, as compared to pretreatment values. No species showed a similar change after the use of active Miswak. There were no significant differences between active and inactive Miswak regarding the registered clinical variables. Conclusion: This study has not shown any clinical effect of the chemically active Miswak, but there was a tendency towards an effect on the microflora. [ABSTRACT FROM AUTHOR]

Objectives In this study, the efficacy of a miswak extract-containing toothpaste ( Salvadora persica) on gingival inflammation was compared with that of a herbal and a conventional toothpaste. Methods Non-smoking outpatients with sulcus bleeding index ( SBI) ≥25% and with periodontal pocket depths ≤3 mm were randomly selected and divided into three groups: M-group, miswak extract-containing toothpaste; P-group, herbal toothpaste; and C-group, conventional toothpaste. After instructing the patients to brush their teeth twice a day for 3 weeks with the assigned toothpaste using a flat-trimmed manual toothbrush, a thorough oral examination was performed by a calibrated examiner ( EH). The primary outcome was the SBI after 21 days. Furthermore, the amount of plaque was measured by approximal plaque index ( API). Results Sixty-six patients with a mean age of 57.8 ± 10.2 years were recruited and enrolled. After 3 weeks of brushing, all three patient groups showed a significant reduction in SBI. The P-group ( SBI reduction: 17.1% ± 9.1) and the M-group (14.5% ± 8.1) showed the strongest effect followed by the C-group (9.4% ± 7.8). All three groups showed a significant reduction in API without significant differences between the groups. Conclusions The use of each of the three tested toothpastes caused a significant reduction in gingival inflammation and amount of plaque. The miswak extract-containing toothpaste showed a similar effect as the herbal toothpaste and can be safely used for domestic oral hygiene in patients with gingivitis. [ABSTRACT FROM AUTHOR]

The Arabic miswak (Somali, adayge) is a tooth-cleaning stick from the Salvadora persica plant. In this article, we trace the social life of a 'thing,' examining meanings inscribed in the stick brush, drawing on interviews with 82 Somali refugees in Massachusetts and an analysis of local and transnational science and marketing. The miswak toothbrush symbolizes relationships to nature, homeland culture, global Islam, globalizing dental medicine, and the divine as it intersects with the lives of producers, marketers, distributors, and users, creating hybrid cultural forms in new contexts. [ABSTRACT FROM AUTHOR]

Objectives: This study examined the effects of extracts of two chewing sticks on proliferation of fibroblasts and viability of cariogenic bacteria. Methods: Aqueous extracts of miswak ( Salvadora persica; Arak tree) and derum ( Juglans regia; walnut tree) were prepared and their effects investigated on growth of Balb/C 3T3 mouse fibroblasts by measuring the mitochondrial succinic dehydrogenase activity. Furthermore, the effects on the viability of various cariogenic bacteria ( Streptococcus mutans, Streptococcus salivarius, Lactobacillus casei and Actinomyces viscosus) was also determined. Results: The data revealed that Balb/C 3T3 fibroblasts exposed to aqueous extracts of miswak or derum showed an increase in cell proliferation by 156% and 255%, respectively, in comparison with controls (p<0.0001). Furthermore, extracts from both miswak and derum had adverse effects on the growth of the cariogenic microorganisms, with derum having significantly greater antimicrobial effects than miswak and at much lower concentrations against all the bacteria tested. The most sensitive organisms were A. viscosus, followed by S. mutans, S. salivarius, with L. casei being the most resistant. Conclusion: The results show that aqueous extracts of miswak and derum enhance the growth of fibroblasts and inhibit the growth of cariogenic bacteria, with the derum extract showing greater activity than miswak. [ABSTRACT FROM AUTHOR]

This descriptive survey aimed at determining the perceived relationship among miswak, the toothbrush, and toothbrush-plus-miswak usage on oral health beliefs and behaviours of Jordanian adults, 18–60 years old, seeking dental care in the city of Irbid, northern Jordan. Patients ( n = 138) voluntarily completed a self-designed questionnaire prior to their dental appointments at public and private clinics. Overall, the level of oral health knowledge was low; of 71 people who attempted to define dental plaque, only 26% knew the meaning of dental plaque. While 12% have never been to a dentist, and 12% visit the dentist on a regular basis, the majority (63.2%) of the respondents reported that they visit the dentist only when they have pain. The majority (72%) use the toothbrush, 20.5% use the toothbrush-plus-miswak and only 3% use miswak alone. Toothbrush users believe that using the toothbrush-plus-miswak is most effective in reducing mouth debris ( χ2 = 32.069, d.f. = 16, P = 0.01); and level of education is significantly associated with the type of oral cleaning device used ( χ2 = 25.817, d.f. = 12, P = 0.05). There was no significant difference between toothbrush users and toothbrush-plus-miswak users in terms of how they perceive their oral health status. About 19% of the study participants use dental floss, 60.9% use mouth rinses and 8.3% use inter-dental brushes. Educated people (baccalaureate or associate degrees) tended to use toothbrushes and toothbrush-plus-miswak. The toothbrush-plus-miswak users are most likely to spend 1–2 min each day cleaning their teeth ( χ2 = 34.9, d.f. = 20, P = 0.02) than those using other devices. Respondents who use the toothbrush are most likely to visit the dentist when they have pain ( χ2 = 34.02, d.f. = 12, P = 0.00) than those using other devices. The oral health awareness level among Jordanian adults is poor and needs to be improved. Evidence-based and community-based dental health education and a philosophical change from disease-oriented and pain management care to primary preventive care are highly recommended for the Jordanian population. [ABSTRACT FROM AUTHOR]

Abstract Objectives : The purpose of the present investigation was to assess the salivary levels of 25 oral bacteria in relation to periodontal status and experience of caries, and to compare the levels of these bacteria between habitual miswak and toothbrush users in adult Sudanese subjects. Material and methods : The study subjects consisted of 56 individuals with age range 19–53 years (mean 35.2 years) and included 30 miswak and 26 toothbrush users. The periodontal status and presence of dental caries were assessed clinically. Whole saliva was collected from all subjects, and the levels of 25 selected bacterial species in saliva were assessed by the checkerboard DNA–DNA hybridization method using whole genomic DNA probes. Results : A high percentage of the subjects had detectable levels (≥ 105 bacterial cells) of several bacterial species in saliva. Between 12% and 16% of the subjects showed high (≥ 106 cells) salivary levels of the periodontitis-associated bacteria A. actinomycetemcomitans, P. melaninogenica , P. intermedia, C. rectus and E. corrodens, whereas only two (3.6%) and four (7.1%) subjects had high levels of P. gingivalis and F. nucleatum , respectively. There were no significant differences in the levels of all or most bacterial species by age group, gender or periodontal status. Presence of ≥ 105 L. acidophilus bacterial cells in saliva was associated with high caries scores (p = 0.02). There were significantly higher levels of A. actinomycetemcomitans , P. melaninogenica , C. rectus , P. micros , V. parvula , S. mutans , S. anginosus , A. israelii , C. sputigena, and C. gingivalis, and significantly lower levels of P. intermedia , F. nucleatum , S. sputigena , E. corrodens , L. acidophilus , S. sanguis , S. salivarius , S. oralis , and S. mitis in the miswak than in the toothbrush group. Conclusions : The findings suggest that miswak may have a selective inhibitory... [ABSTRACT FROM AUTHOR]

It is generally accepted that oral hygiene maintenance through regular removal of dental plaque and food deposits is an essential factor in the prevention of dental caries and periodontal disease. Methods for oral hygiene vary from country to country and from culture to culture. Despite the widespread use of toothbrushes and toothpastes, natural methods of tooth cleaning using chewing sticks selected and prepared from the twigs, stems or roots from a variety of plant species have been practised for thousands of years in Asia, Africa, the Middle East and the Americas. Selected clinical studies have shown that chewing sticks, when properly used, can be as efficient as toothbrushes in removing dental plaque due to the combined effect of mechanical cleaning and enhanced salivation. It has also been suggested that antimicrobial substances that naturally protect plants against various invading microorganisms or other parasites may leach out into the oral cavity, and that these compounds may benefit the users by protection against cariogenic and periodontopathic bacteria. Some clinical epidemiological studies are in support of this, and many laboratory investigations have suggested the presence of heterogeneous antimicrobial components extractable using different chemical procedures. A few recent studies have identified some of the active antimicrobial compounds. Today, chewing sticks are still used in many developing countries because of religion and/or tradition, and because of their availability. low cost and simplicity. The World Health Organization also encourages their use. The Year 2000 Consensus Report on Oral Hygiene states that chewing sticks may have a role to play in the promotion of oral hygiene, and that evaluation of their effectiveness warrants further research. [ABSTRACT FROM AUTHOR]