Oral Manifestations and Microbiological Effects of Miswak and Toothbrush Users in a Sample of People of Kirkuk City

Abstract

Objectives: To assess and compare the oral hygiene, gingival conditions, and salivary microbiota levels among a group of people in Kirkuk city who used miswak or toothbrush regularly for their routine daily oral hygiene. 
 Methods: Sixty male subjects with the age range of 25-65 (mean 35.2), 30 Miswak, and 30 Toothbrush users were enrolled in the study. The oral manifestations were assessed clinically using three different indices, while the microbial effects have been studied simplified oral hygiene index (OHI-S), gingival index (GI), and decayed, missing, filled teeth index (DMFT) by determining the level of selected bacterial species in the collected saliva samples from all participants. 
 Results: It showed that all three indices (OHI-S, GI, and DMFT) were significantly higher in Miswak users than in toothbrush users. There were significantly higher pathogenic microorganisms (E.coli, Candida albicans, Klebsiella) in the saliva sample of Miswak used group than in the toothbrush group. On the other hand, there were no significant differences between the two groups regarding (S.pyogenes, Lactobacillus, and Staph aureus). Also, gum recession and tooth wear (Abrasion) were significantly higher in Miswak users than in toothbrush users (P=0.01),(P=0.001), respectively. 
 Conclusions: This study demonstrated that the Miswak appears less efficient than tooth brushing to improve oral hygiene and periodontal conditions. Moreover, the antimicrobial agents contained in the Miswak offer no advantages over tooth brushing with toothpaste.