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Aim: The trend of cleaning teeth with miswak amidst the modern technological developments can be found in the majority of large countries. Many advantages of miswak increase its trade throughout the world, causing it to be easily obtainable on the market. However, until now, there have not been many studies that explain the active substances in miswak sold on the market. This study aims to analyze the content of active substances from various types of miswaks, which are sold freely on the market. Materials and Methods: A total of five miswaks from Saudi Arabia and Pakistan were taken as the study sample. The miswak was divided into three types of samples: powder, extract, and evaporated extract samples. All miswaks were extracted using maceration method. The chemical content was tested using Fourier-transform infrared (FTIR) spectroscopy and an ultraviolet--visible (UV--Vis) spectrophotometer. The research results were analyzed using Origin software. Results: FTIR test of the miswak powder showed that miswak B had a dominant phosphoric acid (PH) group and pH ester with a wave range of 2425-2325 cm-1. The FTIR test of the miswak extract showed phosphorus atoms at wavenumber 867.96 cm-1 with PO groups and 430.01 cm-1 with the P-Cl group in the compound. UV--Vis test of the miswak extract showed that miswak B and miswak E had higher absorbance values than other miswaks. The UV--Vis test of the evaporated miswak extract resulted in the breakdown of molecular bonds in miswak E after going through the evaporation process, causing more than one wave peak to be produced. The FTIR test of the evaporated miswak extract showed that miswak R had a strong bond between molecules. Hence, the PH group is not broken during the evaporation process. Conclusion: Miswaks which are sold freely in the market contain an active substance in the form of phosphoric acid which consists of phosphorus atoms which are beneficial to human teeth and bones. [ABSTRACT FROM AUTHOR]

Purpose: To compare the periodontal status of exclusive users of Miswak (Salvadora persica) with that of exclusive toothbrush users among adult smokers of cigarettes in Saudi Arabia. Methods: This educational-institutional study included one hundred and fifty adult patients (age and socioeconomic status matched, SES) between the ages of 18 and 75, and were listed as the group I, II, and III, with 50 participants each (participants with no oral hygiene, toothbrush users and miswak users respectively). Oral hygiene habits, the number of cigarettes smoked, and time since the habit began. Periodontal and radiographic parameters were reported. Results: All parameters related to periodontium (plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), gingival recession (Rec), clinical attachment level (CAL) and bone loss (BL)) showed that the analysed groups exhibited differences (p < 0.001). Least amount of BL (anterior and posterior) was found in toothbrush users and Miswak users, while least amount of attachment loss (both anterior and posterior) was recorded among Miswak users (p > 0.05). Positive association was found for GI (r = 0.753) and recession (r = 0.436, p < 0.001) in terms of the number of cigarettes smoked in group I, and anterior PPD (r = 0.388, p < 0.001) in group III for the duration of smoking. A negative correlation was found for BOP in group III (r = - 0.339, p < 0.05) in terms of frequency of tooth cleaning and GI (r = - 0.381) (p < 0.001) in group II, in terms of time taken attain oral hygiene. Conclusion: This study indicates less severe periodontal damage among adult current cigarette smokers in miswak users than in toothbrush users. Thus, there some potentials for miswak use for promotion of oral hygiene. [ABSTRACT FROM AUTHOR]

The objectives of the present investigation were to study fluoride (F) release from NaF-impregnated chewing sticks (Miswaks) in vitro and to study the F clearance in saliva and the F oral retention in vivo. Both fresh and old Miswaks were collected from 10 stores in Saudi Arabia and fluoridated in 0.01%, 0.1%, 0.5%, 1% and 3% NaF. The F release was studied in vitro up to 60 min. In vivo, 10 subjects used Miswaks fluoridated in 0.01%, 0.1%, 0.5%, 1% and 3% NaF for 2 min (Series I). The subjects were asked to spit out all saliva in a beaker during a 12-min period without swallowing. The F present in the obtained saliva was considered to represent the 'F retention'. In Series II, the same type of Miswaks were used as in Series I. Repeated whole saliva unstimulated samples were collected before and up to 30 min after. These two series were carried out in another 10 subjects (Series III and IV), but with Miswaks fluoridated in a more narrow range of concentration (0.05% to 0.5% NaF). Brushing with 1 g of F-containing dentifrice (0.32% NaF) was used as a control. There were only small differences between fresh and old Miswaks, but great variations were observed between Miswaks that were purchased from different stores. Miswaks fluoridated in 0.1% to 0.5% NaF could be considered as an 'optimum level' with respect to both the F concentration in saliva and the F retention. It is recommended to use fresh Miswaks impregnated in 0.1% NaF or a maximum of 0.5% NaF for a day, as they are interesting and safe products for the prevention of caries and could be widely used in countries such as Saudi Arabia. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to compare the effect of the chewing stick (miswak), and toothbrushing on plaque removal and gingival health. Materials and Methods: The participants comprised 15 healthy Saudi Arabian male volunteers aged 21 to 36 years, attending the Dental Center at Al-Noor Specialist Hospital in Makkah City in Saudi Arabia. The study was designed as a single, blind, randomized crossover study. The Turesky modified Quigley-Hein plaque and Löe-Silness gingival indices and digital photographs of plaque distribution were recorded at baseline, one week after professional tooth cleaning, and again following three weeks use of either the miswak or toothbrush. Professional tooth cleaning was repeated, and after a further three weeks use of either the miswak or toothbrush (using the alternative method to that used in the first experimental period), plaque and gingival indices, and digital photographs of plaque distribution were recorded anew. Results: Compared to toothbrushing, the use of the miswak resulted in significant reductions in plaque (p < 0.001) and gingival (p < 0.01) indices. Image analysis of the plaque distribution showed a significant difference in reduction of plaque between the miswak and toothbrush periods (p <0.05). Conclusion: It is concluded that the miswak is more effective than toothbrushing for reducing plaque and gingivitis, when preceded by professional instruction in its correct application. The miswak appeared to be more effective than toothbrushing for removing plaque from the embrasures, thus enhancing interproximal health. [ABSTRACT FROM AUTHOR]

The aim was to analyze prevailing oral hygiene practices among urban Saudi Arabians in relation to age, gender, and socio-economic background. Structured interviews were performed with 1155 regular patients at two centers providing dental care for university and military staff and their families, respectively, in the city of Makkah. Consecutive patients were stratified according to gender and age into 6 age categories from 10 to 60 years, with 50 male or female subjects in each group at each center. Oral hygiene habits were correlated with the subject's age and gender, and analyzed statistically using a generalized linear model. It was found that 73% used a toothbrush daily, while a miswak was used daily by 65%. Significant differences were found between genders and age groups, and between the centers. Regular miswak use was more prevalent among men (P < 0.01), while women used toothbrush more than miswak (P < 0.05). Regular miswak use was more frequent at older age (P < 0.001) and tooth brushing was less prevalent. Forty-four percent of the 51- to 60-year-old patients at the military center never used a toothbrush. Regular toothbrush use was more prevalent in the youngest age groups (P < 0.001). Among the 10- to 15-year-olds, 45% at the university center used only a toothbrush, while no adolescents at the military center used only a toothbrush. We conclude that there are large differences in current oral hygiene habits among Saudi Arabians, and that these are related mainly to age and socio-economic level, and to a lesser extent gender. This should be taken into account when planning oral health strategies for different categories. [ABSTRACT FROM AUTHOR]

Background: The aim of the randomized double-blinded clinical trial was to evaluate the effect of tooth brushing with Salvadora persica (miswak) sticks on Streptococcus mutans count and the mean plaque score relative to brushing with fluoridated tooth paste (FTP)., Methods: Our sample included 94 healthy, high caries-risk, 8 to 9-year-old students recruited from a government school, in Jeddah, Saudi Arabia between February and April 2016. Subjects were randomly grouped into test (provided with miswak sticks) and control groups (provided with FTP and soft brushes). Both groups were introduced to a preparatory period (PPP) of 3 weeks. Plaque score and saliva sampling were conducted prior to the PPP and in follow-up visits by a single, calibrated and blinded dentist., Results: Both groups showed a statistically significant decrease in the mean plaque score across the study (P = 0.007 and P = 0.001, respectively). In addition, subjects in the test group with abundant S. sanguinis increased from zero to six after 3 months., Conclusions: Salvadora Persica (miswak) and brushing with FTP significantly reduced plaque scores among school children. In addition, Salvadora persica was found to change the proportions of salivary bacteria in favor of species with less risk of inducing caries., Trial Registration: ClinicalTrials.gov ID #: NCT04137393.

Background: Nowadays there is a need to find naturally occurring substances from plants with antimicrobial activity as an alternative to available used antibiotics., Materials and Methods: Salvadora persica (miswak) and Commiphora gileadensis were collected, dried and extracted with either methanol or warm water and the obtained extracts were assessed for their antibacterial activity against 5 different genera of bacteria using agar well diffusion method. The tested bacteria included some human pathogens., Results: The obtained extracts exhibited considerable inhibitory effects against all the tested bacteria with various degrees of growth inhibition. It was shown that methanol extract was more effective compared to water extracts. The minimum inhibitory concentrations (MIC) of the methanol extracts ranged from 50-100 °g/ml. No toxicity was found using Artimia salina as test organism and no antitumor activity against Ehrlich ascites carcinoma., Conclusion: S. persica and C. gileadensis showed moderate to high inhibitory activity on pathogenic bacteria with no toxicity and can be used traditionally as alternative medicine.