Chewing sticks versus toothbrushes in West Africa. A pilot study

Chewing sticks are used for tooth cleaning by many populations. Despite the fact that they contain antimicrobial substances that could conceivably benefit oral hygiene, there have been few attempts to evaluate properties in vivo. This pilot, cross-sectional study recorded the oral hygiene and gingival health of adult Ghanaens who used chewing sticks, toothbrushes, or a combination of both for tooth cleaning. Plaque and gingivitis scores were higher in the chewing stick users, although these were primarily due to differences in men. Men had poorer oral hygiene and gingival health than women, irrespective of the oral hygiene regimen. The same differences were apparent for city and rural dwellers, with no overall differences observed between these two groups. The longer time that is necessary for cleaning with chewing sticks may explain the apparent reduced cleaning efficiency in men. The antimicrobial substances contained in chewing sticks appear to provide no additional benefits to those produced by the antimicrobial activity of commercially available toothpastes.