DENTAL caries, commonly known as tooth decay and gum disease, determine a person’s oral health level. Unfortunately, such diseases are so common that every adult in the world eventually 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 lawmakers and politicians globally do not consider them to be vital.

Why is it that even though 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 that most of the world probably considers being 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 and 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 contain substances that possess antibacterial properties and have astringent, detergent, and abrasive properties. These properties have encouraged some toothpaste laboratories to incorporate powered 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, sulfur, 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 Acacia Arabica. The 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 using these sticks as an effective tool for oral hygiene. The experts confirmed 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, particularly that of a focus on prevention and community participation technology. By using it, the notion of self-reliance can be encouraged and implemented in developing countries where it is available locally and does not need technology or expertise, or extra resources to manufacture it. Both children and adults can use it, thus it is appropriate for all societies. The use of chew sticks is catching on in industrialized 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.