Periodontal status of adult Sudanese habitual users of miswak chewing sticks or toothbrushes

Miswak chewing sticks are prepared from the roots or twigs of Salvadora per sica plants. They are widely used as a traditional oral hygiene tool in sev eral African and Middle Eastern countries. The aim of this study was to ass ess and compare the periodontal status of adult Sudanese habitual miswak an d toothbrush users. The study population comprised male miswak users (n = 1 09) and toothbrush users (n = 104) with age range 20-65 years (mean 36.6 ye ars) having 18 or more teeth present. They were recruited among employees a nd students at the Medical Sciences Campus in Khartoum, Sudan. One examiner used the Community Periodontal Index (CPI) to score gingival bleeding, sup ragingival dental calculus, and probing pocket depth of the index teeth of each sextant. In addition, the attachment level was measured, which, along with the CPI, was used to assess the periodontal status of the two test gro ups. Gingival bleeding and denial calculus were highly prevalent in the stu dy population. Approximately 10% of the subjects had greater than or equal to 4 mm probing depth and 51% had greater than or equal to 4 mm attachment loss In one or more sextants. Subjects in the age group 40-65 years had a s ignificantly (p < 0.05) higher number of sextants with gingival bleeding an d with greater than or equal to 4 mm probing depth and attachment loss than the 30-39 years group. Miswak users had significantly) (p < 0.05) lower de ntal calculus and greater than or equal to 4 mm probing depth and higher gr eater than or equal to 4 mm attachment loss as well as a tendency (p = 0.09 ) to lower gingival bleeding in the posterior sextants than did toothbrush users. These differences were not significant in the anterior sextants. It is concluded that the periodontal status of miswak users in this Sudanese p opulation is better than that of toothbrush users, suggesting that the effi cacy of minwak use for oral hygiene in this group is comparable or slightly better than a toothbrush. Given the availability and low cost of miswak, i t should be recommended for use in motivated persons in developing countrie s.