• Saima Naseem, Khursheed Hashmi, Fatima Fasih, Shaheen Sharafat, and Rafiq Khanani.
• Saima Naseem, MBBS, M.Phil, Pathology Department, Dow University of Health Sciences, Dow University of Health Sciences, Karachi, Pakistan.
• Pak J Med Sci. 2014 Mar 1; 30 (2): 398-403.

Background And ObjectiveMiswak is a natural tooth cleaning tool which is being used in many parts of the world since ancient times. It is known to be useful in prevention of dental caries. But still it is not used as frequently as other oral hygiene tools. This research was designed to scientifically establish antimicrobial effect of miswak in vitro against common oral pathogens.MethodsThis was a cross-sectional study involving 100 health care workers. This research was carried out in Microbiology section of Dow Diagnostic Research & Reference Laboratory. A questionnaire was designed to test oral hygiene habits of study subjects. Oral swabs were taken and microorganisms were identified by standard bacteriological methods. Test material included four different types of miswaks i.e. (1) root of the peelu (Salvadora persica) tree (in packing) (2) root of the peelu tree (without packing) (3) stem of the peelu tree & (4) stem of the neem (Azadirechta indica) tree. These miswaks were tested against three different types of microorganisms isolated from oral swabs: Staphylococcus aureus, Streptococcus mutans & Candida albicans by agar diffusion method. Inhibition zone was measured after 24 hrs of incubation at 37(o)C.ResultsAmong the miswaks used, root of the peelu tree in both packing and without packing exhibited strong antimicrobial effect against all three tested microorganisms. However miswak taken from the stem of the peelu and neem tree did not show any antimicrobial activity against all three types of the tested microorganisms.ConclusionMiswak taken from the root of the peelu tree exhibited antimicrobial activity against all the common oral pathogens and could be a good oral hygiene tool in combating dental caries.

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