Abstract

Background: Various oral health measures have been applied throughout the world. The most common way is to use a toothbrush and toothpaste. However, the traditional way of using chewing sticks is found in several parts of the world. Chewing sticks have a mechanical cleansing action similar to a toothbrush in addition to their antimicrobial effect.
Objective: To evaluate the efficacy of Salvadora persica (Miswak) products on oral microbial flora (bacteria and fungi) in comparison with toothbrushes and toothpaste.
Method: A cross-sectional study was conducted on 60 randomly selected participants, during the period from March to August 2021. An oral rinses sample was collected at 2-time intervals: Samples were collected before use and after one week of use from two groups (a group used Miswak and group using ordinary toothpaste). The samples were immediately processed for microbiological phenotypic conventional methods and in vitro susceptibility testing of the microbial isolates to antimicrobial.
Result: The organisms isolated from Miswak group, toothbrush and toothpaste group were identified. Among the bacterial isolates, Streptococci mutans was the most isolates 16 (53.33%) from Miswak group, and in 17 (56.67%) of toothbrush & toothpaste group, followed by Lactobacillus 12 (54%) in Miswak group and 10 (33.33%) toothbrush & toothpaste group. Staphylococci aureus was found in Miswak group 2 6.67%) and 3 10%) toothbrush & toothpaste groups respectively. Candida isolates was manly C. albicans 11 (36.67%) from Miswak group, and in 12 (40%) of toothbrush & toothpaste group, the second isolate was C. dubliniensis 2 (6.687%) Miswak group, and in 6 (20%) toothbrush & toothpaste followed by C. glabrata 1(3.33%) from Miswak group.
Conclusion: Miswak has a significant reduction effect on both bacteria, candida immediately and after a week of use.

Keywords: Oral hygiene; Oral cavity; Salvadora persica (Miswak)