TOOTH decay, also known as dental caries, and gum disease determine a person’s oral health. Incidentally, such morbid conditions 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, Colombia 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 vital.
Why is it that, even though in most countries in the Middle East there is no significant water fluoridation or comprehensive preventive programme, the populations enjoy relatively good oral health? The answer to that question involves a practice that 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 into treatment, which consumes too much time, effort and money.
Chew 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 discovered that tombs from 3000 years before Christ contain small tree twigs whose ends had been frayed into soft fibres.
Here at home, the chew stick was popular in some rural areas some years ago. Black sage and neem stalks were commonly used to clean one’s teeth.
It has been determined that chew sticks from 13 different plants not only contain substances with antibacterial properties, but also have astringent, detergent, and abrasive properties. 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 wernikei, neem, paku and Acacia arabica. Research was conducted mainly in Nigeria, where 90% of the population uses chew sticks. Here in Guyana, we could use neem, cinnamon, lime or black sage.
A few years ago, the World Health Organization (WHO) recommended and encouraged the use of these sticks as an effective tool for oral hygiene. Experts confirmed that the toothbrush is no more effective than the chew stick in removing dental plaque.
The use of chew sticks is entirely consistent with the Primary Health Care Approach (PHCA) principles and a focus on prevention and community participation in technology. By using it, the notion of self-reliance can be encouraged and implemented in poor countries where it is locally available and does not require technology, expertise, or additional resources to manufacture. Both children and adults can use it; 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 chew sticks.
