Alternative oral care

DENTAL caries, commonly known as tooth decay and gum disease, determine the level of oral health of a person. Unfortunately, such diseases are so common that eventually, every adult in the world has one or both. The countries with the best oral health are the United States, Denmark and Canada. Those countries whose populations have the worst mouths are Poland, Columbia and Australia. Because these conditions are so common, they are considered a real public health problem especially because the lawmakers and politicians globally do not consider it to be vital.

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 primitive.

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 3000 years before Christ contain small tree twigs whose ends had been frayed into soft fibres.
Here at home, some years ago, especially in 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 thirteen 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 trimethylamine, 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 wernikei, Neem, Paku and Acaccia Arabica. Research was conducted mainly in Nigeria where 90 percent of the population uses chew sticks. Here in Guyana, we could use neem, cinnamon, lime or black sage.

Recently, the World Health Organization (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. For example, it is quite common in pharmacies in the United States. You can easily buy a pound packet of peppermint flavoured African/Jamaican chewsticks.

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