Miswak or Toothbrush? What the Research Says

Many of us grew up seeing an elder clean his teeth with a miswak after fajr. Many of us also use a brush and paste every morning. So a fair question comes up. Is one better than the other? Or can we use both?

This guide is from the dental team at Salamah Care in Mohammadpur, Dhaka. We will keep it simple and honest. We will say what research shows, and what it does not show yet.

#Is miswak a respected practice?

Yes. Miswak is a twig from the arak tree. It has been used for cleaning teeth for a very long time. The Prophet (peace be upon him) encouraged the use of the siwak, and many Muslims keep this habit with love. Nothing in this article asks you to give it up.

The question here is a practical one. How well does it clean, compared with a modern brush? For that question, we can look at studies.

#What does research say about miswak?

Several reviews have gathered the studies on miswak. One review, summarised by the National Elf Service, looked at nine trials in adults. The reviews generally found that miswak reduced plaque and gum inflammation about as well as a toothbrush. In some studies, using miswak together with a brush gave a bit more plaque reduction than brushing alone.

That is good news. But please read it with care:

• The studies are small, and they were done in different ways.
• Many did not say how the miswak was used, or how often.
• Some studies report gum recession in a number of miswak users. This needs more study.
• Studies were short. We do not know as much about years of use.

So a fair summary is this. Miswak can clean teeth. It is not proven to be better than a toothbrush. And it is not proven to be a full replacement.

#Why do dentists still recommend fluoride toothpaste?

The World Health Organization names too little fluoride as one main reason oral disease is rising. Fluoride toothpaste protects teeth against cavities. It has a large amount of evidence behind it.

A miswak cleans the surface of the teeth. It does not give your teeth fluoride in the same way. This is why we say: use miswak as an addition, and keep your fluoride toothpaste.

#How do you use each one well?

A tool only works if it is used properly. Here are the basics.

Toothbrush

1. Brush twice a day for two minutes, with fluoride toothpaste.
2. Hold the brush at a slight angle to the gum line. Use short, gentle strokes.
3. Clean the outside, the inside and the chewing surface of every tooth.
4. Do not scrub hard. Hard scrubbing can hurt the gums.
5. Change the brush about every three months.

Miswak

1. Use a fresh piece. Cut off the used end every day or two.
2. Chew the end gently until it becomes soft, like a small brush.
3. Move it along the teeth, from the gum towards the tip of the tooth. Do not press hard.
4. Keep it clean and dry. Do not share it.
5. Throw it away when it is old, dirty or has lost its shape.

Neither one reaches the space between teeth well. Clean there once a day with floss or small interdental brushes.

#Which is better for children and older adults?

For young children, a soft brush with a little fluoride paste, used with a parent's help, is the safer start. A miswak twig can be hard for a small child to manage, and a splinter is a risk.

For older adults, or people with sore gums, a soft brush is often easier. If your hand is weak, a brush with a thicker handle may help. Ask your dentist what suits you.

#When should you see a dentist?

Do not wait for your next routine visit if you notice any of these:

• Gums that bleed when you clean, or look red and swollen
• Tooth pain, or sensitivity that does not settle
• A loose tooth
• A mouth sore or patch that does not heal in about three weeks
• Bad breath that keeps coming back

#What to do next

Keep your miswak if you love it. Add a soft brush and fluoride toothpaste. Clean between the teeth once a day. And visit a dentist for a check-up. Our team will look at your teeth and gums and show you how to clean them well. You can read about our dental care service, or book an appointment. You may also like our guide on how often to visit the dentist. You can call us on 01327-808822.