Miswak- The Natural Toothbrush

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MISWAK: THE NATURAL

TOOTHBRUSH The Miswak was known before Islam, but Islam added a religious perspective to its usage. Islamic Advice The Prophet [sallallahu alayhe wa sallam (SAWS)] recommended Muslims to clean their teeth using a miswak every day; especially after waking, when performing wudhu, before salah, when reciting the Qur'an, before sleeping, and when the mouth smells bad. There are many ahadeeth that speak about it. Following are some of them: A'isha said that the Prophet (SAWS) said, "Ten things are natural (for one to do): Trimming the moustache, growing a beard, (using) the miswak, sniffing up water, cutting the nails, washing hands, plucking armpits, shaving pubic hair, and conserving water". (Muslim). He (SAWS) said, "If it were not that it would create hardship for my people, I would have ordered them to use the miswak with every wudhu and with every salah." The miswak was known before Islam, but Islam added a religious perspective to the use of the miswak. Medical Discoveries The miswak is a natural tool for brushing the teeth. It is taken from the roots and branches

Hygiene in Islam. In the Muslim world the miswak or siwak is made from twigs or roots that are alleged to have an antiseptic effect when applied as a toothbrush. The miswak (miswaak, siwak) is a natural toothbrush made from the twigs of the Salvadora persica tree, also known as the arak tree or the peelu tree. Other tree types that are used are the olive, walnut, and other trees with bitter roots.

of particular desert trees. It differs from one region to another, but in Arabia and Asia it is taken from the Arak tree. This is the most well known variety, and is the kind that was used by the Prophet (SAWS). Its scientific name is Salvadora Persica. The miswak is also obtained from other trees. In Africa, for example, it is cut from Lime and Orange trees, and in America some are cut from the Senna tree. As the Arak tree is so well known, and as it was the kind that the Prophet (PBUH) used, it has been widely scientifically studied. We will summarize the various discoveries here. It is a tree that grows in hot equatorial countries, especially in desert valleys. It is widespread in the South of Saudi Arabia, Yemen, Sudan, Egypt and elsewhere. Salvador Persica is an upright evergreen small tree or shrub, seldom more than one foot in diameter reaching maximum height of three meters. The leaves are small, oval, thick and succulent with a strong smell cress or mustard. Health Effects of Miswak Physically, the miswak is a natural toothbrush. It is composed of a compact group of minute natural fibers that perform exactly the same job as a normal toothbrush except that it is made of natural fibers and not plastic ones. For this reason it may well be gentler on the gums. Miswak's natural toothpaste is made up of a number of substances that play an important role in cleaning teeth. Many researchers have studied the miswak in depth, and have proven that miswak contains over ten different natural chemical compounds considered essential for good oral and dental hygiene. They are: fluoride, silica, tannic acid, resins, alkaloids (salvadorine) , volatile oils (sinigrin), sulfur vitamin C, sodium bicarbonate, chlorides, calcium, benzylisothiocyanat e (BIT), and others including salicylic acids, sterols, trimethylamine, saponins, flavenoids. Some of these components are stain removers and teeth whiteners, some protect teeth against caries, some are bactericidal and antiseptic, some help in healing and to repair tissue, some promote remineralization (building) of tooth enamel, and some give the taste and smell. Cytotoxicity Results of cytotoxictests showed no cytotoxic (cell damaging) effects from using freshly cut miswak. However, the same plant use 24 hours after cutting did contain harmful components. Based on these findings researchers recommend cutting the used portion of the miswak after it has been used for a day and preparing a fresh part. Scientific Comparison Between Miswak and Toothbrushes: A clinical trial study on Ethiopian schoolchildren, comparing mefaka

(miswak) with the conventional toothbrush, found miswak to be as effective as the toothbrush in removing oral deposits. The study also found instruction and supervision to be important since the children in the sample were not familiar with miswak techniques. Gingival Recession It has been reported that miswak users have significantly more sites of gingival recession (receding gums) than toothbrush users; however, this may be a reflection of poor technique. Commercial Miswak Products Some of the known commercial toothpastes produced from the Salvadora Persica plant are: Sarkan toothpaste (UK), QualiMeswak toothpaste (Switzerland), Epident toothpaste (Egypt), Siwak-F toothpaste (Indonesia), Fluroswak miswak (Pakistan), and Dentacare Miswak Plus (Saudi Arabia). How to Use Miswak The method of preparing a miswak for use is to cut a branch or root of the Arak tree into pieces between 10 cm and 20cm in length, and between 4mm and 14mm in diameter. Occasionally some are thicker than this. Fresh miswak is brown in color, with a hot, pleasant taste. People usually strip off some of the miswak's thin bark from one end, then chew that end a little to separate the fibers so that they become like the fibers of a normal toothbrush. They then use it to brush their teeth. Length and Diameter A length of 15cm is recommended. This is convenient to grip and is easy to manipulate in a confined space. The diameter is normally less than 1 centimeter. This gives a supple stick firm enough to transmit the pressure of the cleansing action to the teeth without breaking off. Freshness: Miswak should be freshly cut so that it is supple, easily chewed, and still rich in active constituents. The root should be whitish-brown in color; a dark brown color indicates that the miswak is no longer fresh. If a stick is dry, the end for chewing should initially be soaked in fresh water for 24 hours. It should be noted that soaking for unduly long periods causes loss of active constituents and diminishes the therapeutic properties, although the mechanical effects on the teeth can still be expected to occur. The end: Before miswak is used, the end should be washed with water. It is then chewed repeatedly until the fibers stand out like the bristles of a toothbrush. These fibers should be trimmed every 24 hours. Brushing Technique The techniques employed for removing plaque mechanically are similar to that for the toothbrush and the chewing stick; i.e., vertical and horizontal brushing. The cleaning movement should always be directed away from the gingival margin of the teeth (away from the gums) on both

the buccal (outer/cheek) and lingual (inner/cheek) surfaces. Care should be taken to avoid damaging the soft tissues of the mouth. Satisfactory cleaning can be achieved if this procedure is followed for five minutes. There are two basic holds: Pen-grip (three-finger) or palm-grip (five finger-grip) . In each case the aim is to ensure firm but controlled movement of the brush end of the miswak within the oral cavity, so that every area of the mouth is reached with relative ease and convenience. When to Use Miswak In general, it is recommended that the miswak be used five times a day. The use of the miswak can be satisfying if enough time is devoted to its application during the period it is the habit of keeping it in the mouth while doing other things, so that the sick is neglected. Common Mistakes in Miswak Use 1. The end is either too thin or too thick 2. Keeping it in the mouth while doing other things. 3. Not cutting the end every day. 4. Forgetting that teeth have five faces (inner, outer, two sides, and biting/chewing face), and only cleaning the outer faces. Advocates of magnolia have long praised its properties, claiming it can alleviate the symptoms of conditions ranging from rheumatism to asthma. [1] Although not mentioned in the Qur'an, use of the miswak is frequently advocated in the Hadith (the traditions relating to the life of Muhammad). Situations where the miswak is recommended to be used include before religious practice, before entering one's house, before and after going on a journey, on Fridays, before sleeping and after waking up, when experiencing hunger or thirst and before entering any good gathering. In addition to strengthening the gums, preventing tooth decay and eliminating toothaches, the miswak is also said to halt further increase in decay that has already set in. Furthermore, it is claimed to create a fragrance in the mouth, eliminate bad odour, improve the sense of taste and cause the teeth to glow and shine. From Sahih Bukhari: Narrated Abu Huraira: The Prophet said, "If somebody eats or drinks forgetfully then he should complete his fast, for what he has eaten or drunk, has been given to him by God." Narrated 'Amir bin Rabi'a, "I saw the Prophet

cleaning his teeth with Siwak while he was fasting so many times as I can't count." And narrated Abu Huraira, "The Prophet said, 'But for my fear that it would be hard for my followers, I would have ordered them to clean their teeth with Siwak on every performance of ablution." The same is narrated by Jabir and Zaid bin Khalid from the Prophet who did not differentiate between a fasting and a nonfasting person in this respect (using Siwak). Aisha said, "The Prophet said, "It (i.e. Siwak) is a purification for the mouth and it is a way of seeking God's pleasures." Ata' and Qatada said, "There is no harm in swallowing the resultant saliva." Narrated Abu Burda: My father said, "I came to the Prophet and saw him carrying a Siwak in his hand and cleansing his teeth, saying, 'U' U'," as if he was retching while the Siwak was in his mouth." From Sahih Muslim 'Abd al-Rahman son of Abu Sa'id al-Khudri reported on the authority of his father that the Messenger of God said: Bathing on Friday for every adult, using of Miswak and applying some perfume, that is availablethese are essential. So far as the perfume is concerned, it may be that used by a lady. Supposed benefits not related to the teeth and gums include sharpening memory, curing headaches, creating a glow on the face of the one who continually uses it, strengthening the eyesight, assisting in digestion and clearing the voice. None of these claims, however, have been researched scientifically. A 2003 scientific study comparing the use of miswaak with ordinary toothbrushing concluded that the results clearly were in favor of the users who had been using the miswaak provided they had been given proper instruction in how to brush using the miswaak[1]. The WHO recommended the use of the miswaak in 1986 and in 2000 an international consensus report on oral hygiene concluded that further research was needed to document the effect of the miswak[2]. Recent research by Dr Otaybi from Saudi [2] opened a new area for research on the systemic effects of Miswak ( Sewak ) after discovering its great positive effect on the immune system. Dr.Rami Mohammed Diabi [3]who spent more than 17 years researching on Miswak effects on health and especially its anti-addiction effects [4] on smokers ( curative & Preventive sides ) had opened a great field of science and researches by his last research : "Miswak Medicine theory " or Sewak Puncture medicine [5] which led him to what is so called Beyond Sewak: World of Science and Research)[6] Miswak also is contributing in the fight against desertification (See effects of Salvadora Persica "Miswak tree" on stopping deserts and fixing the soil [7]), thereby affecting our environment and global climate.

"Miswak extract" compared to other oral disinfectants Studies indicate that Salvadora persica extract is somewhat comparable to other oral disinfectants and anti-plaque agents like Triclosan and Chlorhexidine Gluconate if used at a very high concentration.[3][4]. Maintenance A miswak should be one hand span in length when selected. If it becomes dry, it should be soaked in rose water to ensure the end is soft. The end should be cut afresh to ensure hygiene, and should never be stored near a toilet or sink. It can be used by cutting the branches instead of roots ( like people of Sudan's habit ) keeping in mind that the roots can keep the humidity of Miswak more than the branches (longer time usage). The toothbrush tree, Salvadora persica (other names Galenia asiatica, Salvadora indica, "Peelu" or "Pīlu"), is a small tree or shrub with a crooked trunk, seldom more than one foot in diameter. Its bark is scabrous and cracked, whitish with pendulous extremities. The root bark of the tree is light brown ( sand like colur ) and the inner surfaces are of even lighter shade brown , the odour is like cress and its taste is warm and pungent. Its fibrous branches have been used as toothbrushes by many Islamic communities — miswaks. It was recommended to be used before every prayer:"if it were not too much of a burden then I would tell the believers to use the siwak before every prayer" It has been scientifically proven to be very useful in the prevention of tooth decay even when used without any other tooth cleaning means. The users of siwak have shown a remarkable lack of tooth decay when compared with other toothbrushes and no tooth cleaning at all. Chemically, the air dried stem bark of S. Persica is treated with 80% alcohol and then with ether and run through exhaustive chemical procedures. This showed that it is composed of;Trim ethyl amine; An alkaloid which may be salvadorine; Chlorides; High amounts of fluoride and silica; Sulphur; Vitamin C; Small amounts of Tannins, saponins, fiavenoids & sterols; Oral hygiene and patient motivation towards a clean mouth owe their birth to the teachings of Muhammad. Due to the repeated use of Siwak during the day, the users showed an unusually high level of oral cleanliness. It is a well known fact[citation needed] that plaque formed immediately after meticulous toothbrushing. By the end of 24 hours the plaque is well on its way towards maturation and hence starts its deliterious effects on the gingiva.

Proper oral hygiene should be maintained through intensive instructions by the periodontist as well as by a great expenditure of time and dexterity on part of the patient. This item is self corrected in Muslims because Siwak users take Siwak as a device that should be used as part of their religious ritual regimen. The results obtained in this investigation have proved that Siwak and other tree twigs could act as an effective tool in removing soft oral deposits. It could be even used as an effective device in preventive dental programmes in mass populations. The indices used in these investigations were simple and adequate as they discriminated between experimental stages as well as between experimental groups. Using starch is not quite accurate but it was meant to evaluate the degree by which Siwak and powdered Siwak could rid teeth of deposits as compared to the best abrasive viz. commercial powder. It is noticed that the difference between first and fifth week of the mean score of plaque percentage for powdered Siwak is the highest (-11.2%) of all readings. This indicates that powdered Siwak is used with t mechanically proper device i.e. tooth brush will give a great deal of oral cleanliness. It has been reported that Salvadora Persica contains substances that possess antibacterial properties. Some of the other components are astringents, detergents and abrasives . Those properties encourage some toothpaste laboratories to incorporate powdered stems and/or root material of Salvadora persica in their roducts (Beckenham UK Sarakan Ltd.). Although the commercial powder gave a high degree of efficiency in plaque removal yet its use over the experimental period gave a high score of gingivitis percentage within the group using the powder. It is true that plaque eradication is essential but this should not be on the expense of deleterious side effect on other tissues. It could be concluded that Siwak and powdered Siwak are excellent tools for oral cleanliness. Because of its availability in this part of the world, being inexpensive and readily adopted by Muslims as part of their religious regimen, it is highly recommended in implementing a preventive dental health program in Islamic countries. Also recommendations should be directed to manufacturers of toothpastes to include the powdered form of Siwak in highly sophisticated toothpaste.

Salvadora persica is also highly recommended for dental care as a popular chewing stick throughout the Indian subcontinent, in the Book'Herbs Cultivation & their Utilization' ISBN 8178330644 by Asia Pacific Business Press Inc 2003 [view it via Google book search, specifically in Chapter 2] To Conclude Miswak can be a good, healthy, and natural alternative to the toothbrush

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