/ 25 August 2006

More oral hygiene than you can shake a stick at

The South African public’s dental IQ is very low in comparison with the rest of the world and many people do not replace their toothbrushes as often as they should, according to the South African Dental Association.

But what if it were possible to get the same oral hygiene provided by toothpaste and toothbrushes from cheap sticks, stems and roots?

Recent studies conducted at the University of the Witwatersrand (Wits) and the Tshwane University of Technology found that African toothbrush sticks or chewing sticks contain antimicrobial (anti-bacterial) properties.

The researchers found that Zana, a chewing stick used in Ethiopia, has a good antimicrobial efficacy with minimum inhibitory concentration values ranging from between 0,25 to 4mg/ml -‒ meaning that it would take a small amount of the concentration to kill bacteria and keep your breath fresh.

According to the report, researched by Sandy van Vuuren, Alvaro Li and Ada Viljoen of the department of pharmacy and pharmacology at Wits, African toothbrush sticks have been used for centuries for the maintenance of oral hygiene.

The report says that most Ethiopians and Nigerians still use chewing sticks to clean their teeth. The World Health Organisation has also promoted the use of toothbrush sticks and has encouraged further research of their efficacy.

A study conducted by researcher Khalib Almas in 2001 showed there were various plants used as chewing sticks in West Africa, such as lime tree and the orange tree.

”The roots of the senna were used by American Negroes and those of African Laburnum were used in Sierra Leone. Neem is widely used to provide chewing sticks in the Indian subcontinent,” Almas said in the report, The Antimicrobial Effects of Seven Different Types of Asian Chewing Sticks.

Almas also wrote that the chewing sticks could be of great help in developing countries with limited oral health care facilities.

Van Vuuren says that the mechanical action of the chewing does quite a good job at removing plaque. She said that the Ethiopians sit and do it for quite a number of minutes.

”Compare that to brushing your teeth for only a minute or so,” she said.

She also said that chewing sticks can provide another alternative remedy for oral hygiene in poorer or rural areas in South Africa but that importing the sticks is expensive and therefore may hinder their sustainability.

An article published in the Journal of Contemporary Dental Practice, Antibacterial Activity of Aqueous Extracts of Selected Chewing Sticks, explains how the sticks are made and used in Nigeria: ”Chewing sticks are made from the roots, twigs and stems of plants.

”The preferred part or parts are cleaned with water to remove dirt, cut to convenient length, which varies from 15cm to 30cm, and tied into a bundle. The user holds one end directly in his mouth and chews it into a fibrous brush-like fringe, which is used to scrub the surfaces of the teeth.

”A combination of vertical and horizontal strokes of the brush on tooth surfaces removes plaque.”

Neil Campbell, CEO of the South African Dental Association, said he had never heard of the chewing sticks and that he was not sure that the plants from which they were harvested were in South Africa.

”Speaking in generalities, any brush or stick which removes plaque from teeth must be better than just letting the plaque lie on the teeth, provided the stick does not splinter and cause splinters to remain behind in the gum tissue or contain harmful chemicals which could irritate the gums,” he said.

South Africa’s dental IQ is very low, added Campbell. ”Oral health education has been sadly lacking for most South Africans.”

The sticks taste ”agreeable and not unpleasant”, according Almas’s study.

According to Almas’s study, the Babylonians recorded the use of chewing sticks in 7000 BC and their use ultimately spread throughout the Greek and Roman Empires. Chewing sticks were also used by Egyptians, Jews and in Islamic Empires.

”References to the chewing sticks can be found in the Talmud [biblical scripture] as the Quesum, the Siwak, Miswak and Arak … It is believed that the counterpart of the modern day toothbrush was unknown in Europe until 300 years ago,” the study said.

Perhaps, in order to find the solution for making sure that every South African takes care of their teeth, we need to go back to our roots.