IN general, every country has and should have its own system to prevent and cure its nation of diseases according to the resources and culture.

Dentists trained in the Western Scientific System usually have views on the prevention of oral disease that differ basically from those of local communities

Why is it that despite the fact that in most of the countries in the Middle East there is no significant water fluoridation or comprehensive preventive programme, yet the populations enjoy relatively good oral health? The answer to that question involves a practice which most of the world probably considers as primitive.

Dental caries and gum disease determine the level of oral health status of a person. Unfortunately, such diseases are so common that eventually, every adult in the world has one or both. Therefore, these two diseases can be considered a real public health problem.
In general, every country has and should have its own system to prevent and cure its nation of diseases according to the resources and culture.

Dentists trained in the Western Scientific System usually have views on the prevention of oral disease that differ basically from those of local communities.

Surprisingly, instead of focusing on and knowing the real causes of these two diseases (which are simply dirt and diet), and instead of directing all the efforts to invent and encourage the use of effective tools to prevent and control these two diseases effectively, the profession has fallen in treatment which consumes too much time, effort and money.
Chewing sticks are commonly used in Jordan, Saudi Arabia, and the United Arab Emirates for oral hygiene, religious and social purposes.The Ancient Egyptians were concerned about dental hygiene. We know this today because they also had a habit of being entombed with their treasures. So we were able to discover that tombs from 3 000 years before Christ, contain small tree twigs whose ends had been frayed into soft fibres.

Here at home, some years ago, especially in the rural areas the chew stick was popular. Black sage and neem stalks were commonly used to clean one’s teeth.

It has been determined that chewsticks from 13 different plants not only contain substances that possess antibacterial properties but have astringent, detergent and abrasive properties as well. These properties have encouraged some toothpaste laboratories to incorporate powdered stems and/or root material in their products. The chemical constituents of Salvadora Persica, for example, include trimethylamines, alkaloids, chlorides, high amounts of fluoride and silica, sulphur, vitamin C and small amounts of tannin, saponins, flavonoids and sterols.

The most studied chew sticks are the Miswak, Fagara Zanthoxyloides, Serindea Wernicki, Neem, Paku and Acacia Arabica. Research was conducted mainly in Nigeria where 90 per cent of the population uses chew sticks.

Recently, the World Health Organisation (WHO) has recommended and encouraged the use of these sticks as an effective tool for oral hygiene. It was confirmed by the experts that the toothbrush is not superior to the chew stick as regards its capacity to remove dental plaque.

The use of the chew sticks is entirely consistent with the Primary Health Care Approach (PHCA) principles and in particular that of a focus on prevention, community participation technology. By using it, the notion of self-reliance can be encouraged and implemented in poor countries where it is available locally and does not need technology or expertise or extra resources to manufacture it. It can be used by both children and adults, thus it is appropriate for all societies. The use of chew sticks is catching on in industrialised countries. Recently, I personally purchased in New York a pound packet of peppermint flavoured African/Jamaican chewsticks. Ironically, many years ago when Dr. Cheddi Jagan was Prime Minister, as a dentist he mooted the idea of introducing chewsticks on a national basis. The extent to which he was ridiculed is well known.