The aim of this study was to assess the antimicrobial activity of the miswak chewing stick (Salvadora persica) in vivo, especially on streptococcus mutans and s lactobacilli.

The study was conducted clinically using patients’ saliva and measuring the effect of miswak (chewing stick), miswak extract, toothbrush, and normal saline on mutans and s lactobacilli. Forty male subjects aged 20-45 years were included in the study; there were four groups of ten subjects each. For the study, 50% of miswak extract (solution) was used. The levels of mutans streptococci and i lactobacilli were measured using commercially available Vivacare line CRT (Caries Risk Test) i bacteria 2 in 1 kit.

Bacterial plaque is solely responsible for the initiation and progression of periodontal diseases. There are different mechanical and chemical methods available for the maintenance of oral health through plaque control. Toothbrushes and miswak (chewing sticks) are widely used for the mechanical removal of plaque.

Chlorhexidine gluconate (CHX) is one of the best-proven anti-plaque agents.

Miswak chewing sticks are prepared from the roots or twigs of Salvadora persica plants. They are widely used as a traditional oral hygiene tool in several African and Middle Eastern countries. The aim of this study was to assess and compare the periodontal status of adult Sudanese habitual miswak and toothbrush users.