By Dayo Yussuf
Hassan is leaning against the wall of Masjid Noor, a local mosque in Mombasa. He is chewing on a stick as the muezzin's call for evening prayers echoes in the distance.
"I use this stick about three to four times a day. It cleanses my mouth. I have used it for many years — in fact, since I was a child," says Hassan.
The stick is called siwaak. In Kenya's coastal city of Mombasa, it's a popular dental accessory, especially among the elderly. They call it "mswaki" in Swahili.
As men file past the mosque one by one, most seem to have some variant of the stick in their mouths. Siwaak comes in different types. Some look like twigs, others appear to be strands of roots.
Hassan is convinced that the one he uses has medicinal benefits. "This siwaak is called Msija. It helps remove bad breath and staves off infections," he explains.
Around 260km away, in Korogwe village of Tanzania's Tanga, Paulo Matini is heading to his shift as a night guard.
Dressed in traditional Maasai attire, he is chewing on a stick. "Since childhood, we have been using our siwaak without any toothpaste," he says.
Easy to source, easier to use
Siwaak can be sourced from a variety of plants, depending on which part of the world one lives in. It can also vary in colour, shape and taste.
In India, the siwaak that is widely used comes from neem (Azadirachta indica). In West Africa, the plant source is either lime tree (Citrus aurantafolia) or orange tree citrus (Citrus sinensis).
In other parts of Africa, the tall shrub senna (Cassia vennea) is a popular choice. In the Middle East and East Africa, siwaak is made of arak, a plant species that grows in the wild.
This chew stick is usually prepared at an average of 1cm in diameter and 15cm in length to allow ease of insertion into the mouth and placement on tooth surfaces. The middle part contains ample phloem and has a spongy texture.
After soaking it in water for at least one or two minutes, the stick becomes more chewable and easier to remove. Crushing the end portion of the bark causes it to have a brush-like appearance that makes it convenient to use.
Long in the tooth
The World Health Organisation (WHO) recommended the use of the siwaak or miswak in 1986.
At the turn of the millennium, an international consensus report on oral hygiene concluded that further research was needed to document the effects of siwaak or miswak on dental health.
Traditionally, the majority of people in Northern Africa, East Africa and the Arab countries attribute its benefits to the teachings of Prophet Mohammad.
"Miswak is recommended to be used before prayers, on waking up in the morning, before going to the mosque, before entering one's house, before and after going on a journey," Sheikh Shaaban from Nairobi tells TRT Afrika.
But for many Africans, it is more of a cultural practice passed down generations. "We were taught by our parents and grandparents to use siwaak since we were young. We teach our children the same," says Tanzanian Paulo.
There are as many opinions as there have been studies on the siwaak and its benefits or otherwise.
Dr Ramadhan Shaali, a lecturer at the school of dentistry in the University of Zanzibar, points out that although researchers differ on the optimal benefits of the chewing stick, some studies have shown the presence of beneficial components.
The evidence at hand is scientifically deemed too little to be of significance. "One of the important components of tooth paste is fluoride, which helps in preventing cavity. Using a chew stick alone denies you the ability to do that," says Dr Ramadhan.
Doctors cannot yet give definitive guidance since more research is needed, but Dr Ramadhan says there are some obvious risks that come with using the chew stick such as irritation of the gums or inadvertently destroying the enamel, or the top layer of the tooth, through hard brushing.
"You could choose to use the chew stick in alternation with the synthetic brush and toothpaste for better results," suggests Dr Ramadhan. "The challenge is using it instead of modern dental accessories."
Hygiene doesn’t cost much
In certain areas, especially where siwaak plant sources grow widely or are locally cultivated, the use of the stick as a toothbrush is economical compared to the regular ones.
In Uganda, for instance, two such trees are commonly grown, one of which is called "akakwansokwanso" (Rhus vulgaris) in the local Luganda dialect.
"The good thing with this is that I can use it once, throw it away and pluck a new one later to use," night guard Paulo says.
In Tanzania's Korogwe, journalist Majuka is invariably holding his chew stick as he sits outside his home in the evening. "There are so many trees with various flavours to choose from. You can use one in the morning and another in the evening," he says.
According to WHO, using a toothbrush with toothpaste would be the top choice when it comes to caring for teeth.
A chew stick can do the job just as well in terms of fighting plaque, gum disease and preventing any existing teeth decay from getting worse.
Containing minerals such as chloride, sodium bicarbonate and potassium, it can also strengthen the enamel in your teeth, overall leading to a healthy mouth.
