Volume 79, Issue 8 p. 1474-1479
Discovery Science

Strong Antibacterial Effect of Miswak Against Oral Microorganisms Associated With Periodontitis and Caries

Abier H. Sofrata

Corresponding Author

Abier H. Sofrata

Periodontology Department, Institute of Odontology, Karolinska Institute, Stockholm, Sweden.

Department of Laboratory Medicine, Karolinska Institute.

Correspondence: Dr. Abier Sofrata, Periodontology Department, Institute of Odontology, Karolinska Institute, P.O. Box 4064, S-141 04 Huddinge, Stockholm, Sweden. Fax: 46-8-71183-43; e-mail: [email protected].Search for more papers by this author
Rolf L.K. Claesson

Rolf L.K. Claesson

Division of Oral Microbiology, Department of Odontology, Umeå University, Umeå, Sweden.

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Peter K. Lingström

Peter K. Lingström

Department of Health Sciences, Kristianstad University, Kristianstad, Sweden.

Institute of Odontology, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.

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Anders K. Gustafsson

Anders K. Gustafsson

Periodontology Department, Institute of Odontology, Karolinska Institute, Stockholm, Sweden.

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First published: 01 August 2008
Citations: 81

Abstract

Background: The chewing stick (miswak) is used for oral hygiene in many parts of the world. In addition to the mechanical removal of plaque, an antibacterial effect has been postulated; however, tests of miswak extract from Salvadora persica (Arak) disclosed only low to moderate antibacterial effects. This may be attributable to the extraction process. Our aim was to test in vitro the antibacterial effect of miswak pieces, without extraction, on bacteria implicated in the etiology of periodontitis and caries.

Methods: Miswak pieces were standardized by size and weight (0.07 and 0.14 g) and tested against Streptococcus mutans, Lactobacillus acidophilus, Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans), Porphyromonas gingivalis, and, as a reference, Haemophilus influenzae. The miswak pieces were tested in two ways: embedded in the agar plate or suspended above the agar plate.

Results: The inhibitory effect was most pronounced on P. gingivalis, A. actinomycetemcomitans, and H. influenzae, less on S. mutans, and least on L. acidophilus. Suspended miswak had comparable or stronger effects than miswak embedded in agar. The 0.14-g suspended miswak exhibited significantly greater inhibition on A. actinomycetemcomitans and H. influenzae than the 0.14-g miswak embedded in agar (P <0.01 and P <0.001, respectively).

Conclusions: Miswak embedded in agar or suspended above the agar plate had strong antibacterial effects against all bacteria tested. The antibacterial effect of suspended miswak pieces suggests the presence of volatile active antibacterial compounds.