Chewing sticks: timeless natural toothbrushes for oral cleansing

It is generally accepted that oral hygiene maintenance through regular remo val of dental plaque and food deposits is an essential factor in the preven tion of dental caries and periodontal disease. Methods for oral hygiene var y from country to country and from Culture to culture. Despite the widespre ad use of toothbrushes and toothpastes, natural methods of tooth cleaning u sing chewing sticks selected and prepared from the twigs, stems or roots fr om 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 mechan ical cleaning and enhanced salivation. It has also been suggested that anti microbial 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 i n support of this, and many laboratory investigations have suggested the pr esence of heterogeneous antimicrobial components extractable using differen t chemical procedures. A few recent studies have identified some of the act ive antimicrobial compounds. Today, chewing sticks are still used in many d eveloping countries because of religion and/or tradition, and because of th eir availability, low cost and simplicity. The World Health Organization al so encourages their use. The Year 2000 Consensus Report on Oral Hygiene sta tes that chewing sticks may have a role to play in the promotion of oral hy giene, and that evaluation of their effectiveness warrants further research .