Abstract
There have been many studies on the practice of maintaining dental health. Although most people currently use a toothbrush to maintain the cleanliness of mouth, specific populations still used miswak as an alternative tool for oral health care. This study was designed to answer the future challenges of use of miswak as a tool to maintain oral health according to modern sciences. The history, features, function, modernization, and method in miswak were discussed in this article. The effect of miswak on periodontal health and antimicrobial has also been explained thoroughly in this article. Thus, miswak can be said to be a natural source of material that has many benefits in the improvement of oral health. The miswak extract has been modified and added in toothpaste, mouthwash, endodontic irrigation treatment, and for testing DNA. The miswak is used widely as a tool for brushing teeth and is like or better than a standard toothbrush. Key words: Miswak, Salvadora persica, chewing stick, siwak  
Highlights
Journal of Dentistry and Oral HygieneThere have been many studies on the practice of maintaining dental health
The use of sticks from the Salvadora persica plant to clean the teeth and mouth is widely known in traditional Arabic culture
It was suggested for miswak users to support planning to strengthen the evidence of the current trial, especially in developing countries where oral health care services are limited for ordinary people
Summary
There have been many studies on the practice of maintaining dental health. Most people currently use a toothbrush to maintain the cleanliness of mouth, specific populations still used miswak as an alternative tool for oral health care. This study was designed to answer the future challenges of use of miswak as a tool to maintain oral health according to modern sciences. The history, features, function, modernization, and method in miswak were discussed in this article. The effect of miswak on periodontal health and antimicrobial has been explained thoroughly in this article. Miswak can be said to be a natural source of material that has many benefits in the improvement of oral health. The miswak is used widely as a tool for brushing teeth and is like or better than a standard toothbrush
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