Miswak research
Miswak (Salvadora persica) is one of the most studied natural tools for oral care. PubMed, the database of the U.S. National Library of Medicine, returns more than 550 papers for miswak, siwak, chewing sticks and Salvadora persica β from laboratory research to clinical trials and systematic reviews (see the search, as of September 2026).
Below are 67 of them, grouped by type, each with a link to the paper.
Please note: these studies look at miswak in general, not at MSWK products specifically. Some test the stick itself, others extracts in toothpaste or mouthwash, or bacteria in the lab. Results differ between studies. This page is for information only and is not medical advice β for dental problems, please see your dentist.
Systematic reviews and meta-analyses
Studies that pool the results of many trials.
-
The effectiveness of miswak (Salvadora persica L. and Azadirachta indica A.Juss.) practices in reducing plaque and gingivitis among adults: A systematic review and meta-analysis
Ramli H, Nor Aripin KN et al. Β· Journal of ethnopharmacology Β· 2022 Β· PubMed
Meta-analysis of 9 trials: miswak was comparable to a toothbrush for plaque and gingivitis scores; used in addition to toothbrushing it reduced both further. -
Salvadora persica L. chewing stick and standard toothbrush as anti-plaque and anti-gingivitis tool: A systematic review and meta-analysis
Adam FA, Mohd N et al. Β· Journal of ethnopharmacology Β· 2021 Β· PubMed
Meta-analysis: the Salvadora persica chewing stick controlled plaque comparably to a standard toothbrush and showed a better anti-gingivitis effect. -
Traditional Oral Hygiene Practices and Their Effectiveness: A Systematic Review of the Evidence
Shahzad M, Ahmad HA et al. Β· Oral health & preventive dentistry Β· 2026 Β· PubMed
31 studies: miswak significantly reduced plaque and gingival inflammation, comparable to or better than conventional toothbrushes. -
Antibiofilm Properties of Miswak (Salvadora persica) Compared to Conventional Oral Health Measures: A Systematic Review
Vejendla I, Krithikadatta J et al. Β· Scientifica Β· 2025 Β· PubMed
Salvadora persica use was associated with a noteworthy decrease in cariogenic bacteria and plaque; the authors call for more clinical research. -
Clinical benefits and adverse effects of siwak (S. persica) use on periodontal health: a scoping review of literature
Ramli H, Mohd-Dom TN et al. Β· BMC oral health Β· 2021 Β· PubMed
21 studies: siwak removed plaque and improved periodontal health over time. Gingival recession was reported more often in siwak users, linked to how the stick was used. -
The antiplaque/anticariogenic efficacy of Salvadora persica (Miswak) mouthrinse in comparison to that of chlorhexidine: a systematic review and meta-analysis
Jassoma E, Baeesa L et al. Β· BMC oral health Β· 2019 Β· PubMed
18 studies: miswak mouthrinses reduced plaque, streptococci and lactobacilli compared with placebo, but were less effective than chlorhexidine. -
A systematic review and meta-analysis on the comparative effectiveness of Salvadora persica - extract mouthwash with chlorhexidine gluconate in periodontal health
Adam FA, Mohd N et al. Β· Journal of ethnopharmacology Β· 2023 Β· PubMed
16 studies: Salvadora persica mouthwash significantly reduced plaque and gingival inflammation, though less than chlorhexidine. -
Biodegradable vs. conventional toothbrushes for biofilm control: a systematic review and meta-analysis of randomized trials
Mayta-Tovalino F, Espinoza-Carhuancho F et al. Β· Frontiers in oral health Β· 2026 Β· PubMed
5 trials (408 people): no clear difference in plaque between natural/biodegradable tools and plastic toothbrushes; certainty of evidence rated very low. -
Miswak and oral health: An evidence-based review
Nordin A, Bin Saim A et al. Β· Saudi journal of biological sciences Β· 2020 Β· PubMed
Across ten forms of use (stick, toothpaste, mouthwash, extracts and more), the included studies reported positive effects on plaque, gingivitis and cariogenic bacteria. -
Research Trends and Thematic Evolution of Salvadora persica (Miswak) in Oral Health: A Bibliometric Analysis
Ahmad N, Fauzi MA et al. Β· International journal of dentistry Β· 2026 Β· PubMed
Maps how miswak research has grown; notes that bibliometric data alone cannot establish clinical effectiveness. -
Does the use of miswak reduce plaque and gingivitis among adults?
Scott J, Marshman Z Β· Evidence-based dentistry Β· 2022 Β· PubMed
Evidence-Based Dentistry commentary on the 2022 meta-analysis above.
Clinical studies: the miswak stick
Trials and field studies with people using miswak or chewing sticks.
-
Comparative Effectiveness of Miswak and Toothbrushing on Dental Plaque and Gingivitis: A Randomized Controlled Trial
Abdellatif HM, Hebbal M et al. Β· Healthcare (Basel, Switzerland) Β· 2024 Β· PubMed -
Effectiveness of Salvadora persica toothbrush and Salvadora persica chewing stick in plaque and gingivitis control: a randomized control trial
Azizan NF, Mohd N et al. Β· BMC complementary medicine and therapies Β· 2023 Β· PubMed -
Can traditional oral hygiene methods compete with conventional toothbrushes in effectiveness?
Almutairi W, Duane B Β· Evidence-based dentistry Β· 2024 Β· PubMed -
Plaque Removal and Gingival Bleeding Using Biodegradable Toothbrushes: Salvadora persica, Bamboo, and Nylon: A Comparative Study
Fageeh HN, Mansoor MA et al. Β· Medical science monitor : international medical journal of experimental and clinical research Β· 2024 Β· PubMed -
A clinical investigation into the efficacy of miswak chewing sticks as an oral hygiene aid: A crossover randomized trial
Rifaey N, AlAdwani M et al. Β· International journal of dental hygiene Β· 2021 Β· PubMed -
The effect of brushing with Salvadora persica (miswak) sticks on salivary Streptococcus mutans and plaque levels in children: a clinical trial
Sabbagh HJ, AlGhamdi KS et al. Β· BMC complementary medicine and therapies Β· 2020 Β· PubMed -
Comparative effectiveness of chewing stick and toothbrush: a randomized clinical trial
Malik AS, Shaukat MS et al. Β· North American journal of medical sciences Β· 2014 Β· PubMed -
Clinical effect of miswak as an adjunct to tooth brushing on gingivitis
Patel PV, Shruthi S et al. Β· Journal of Indian Society of Periodontology Β· 2012 Β· PubMed -
Short term clinical effect of active and inactive Salvadora persica miswak on dental plaque and gingivitis
Sofrata A, Brito F et al. Β· Journal of ethnopharmacology Β· 2011 Β· PubMed -
Siwak as a oral hygiene aid in patients with fixed orthodontic appliances
Al-Teen RM, Said KN et al. Β· International journal of dental hygiene Β· 2006 Β· PubMed -
Comparative effect of chewing sticks and toothbrushing on plaque removal and gingival health
Al-Otaibi M, Al-Harthy M et al. Β· Oral health & preventive dentistry Β· 2003 Β· PubMed -
Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush
Al-Otaibi M, Al-Harthy M et al. Β· Journal of clinical periodontology Β· 2004 Β· PubMed -
The miswak (chewing stick) and oral health. Studies on oral hygiene practices of urban Saudi Arabians
al-Otaibi M Β· Swedish dental journal. Supplement Β· 2004 Β· PubMed -
The immediate antimicrobial effect of a toothbrush and miswak on cariogenic bacteria: a clinical study
Almas K, Al-Zeid Z Β· The journal of contemporary dental practice Β· 2004 Β· PubMed -
The immediate- and medium-term effects of Meswak on the composition of mixed saliva
Gazi MI, Davies TJ et al. Β· Journal of clinical periodontology Β· 1992 Β· PubMed -
Cleaning effectiveness of chewing sticks among Tanzanian schoolchildren
van Palenstein Helderman WH, Munck L et al. Β· Journal of clinical periodontology Β· 1992 Β· PubMed -
A comparative study of the efficacy of plaque control by a chewing stick and a tooth brush
Ndung'u FL, Kaimenyi JT et al. Β· East African medical journal Β· 1990 Β· PubMed -
Chewing sticks, toothpaste, and plaque removal
Danielsen B, Baelum V et al. Β· Acta odontologica Scandinavica Β· 1989 Β· PubMed -
Efficiency of traditional chewing sticks in oral hygiene programs among Ethiopian schoolchildren
Olsson B Β· Community dentistry and oral epidemiology Β· 1978 Β· PubMed -
Chemical effects of chewing sticks made of Salvadora persica
Albabtain R, Ibrahim L et al. Β· International journal of dental hygiene Β· 2018 Β· PubMed -
Investigations of a Possible Chemical Effect of Salvadora persica Chewing Sticks
Albabtain R, Azeem M et al. Β· Evidence-based complementary and alternative medicine : eCAM Β· 2017 Β· PubMed
Clinical studies: toothpaste, mouthwash and gum with miswak extract
Products that contain Salvadora persica extract rather than the stick itself.
-
Antibacterial Effect of Miswak herbal toothpaste Compared to Fluoride Toothpaste in High Caries Risk Patients: Randomized Clinical Trial
Shaalan O, El-Rashidy A Β· Journal of clinical and experimental dentistry Β· 2023 Β· PubMed -
Comparative Evaluation of the Effectiveness of 40% Miswak Mouthwash and 0.12% Chlorhexidine Mouthwash in Treating Gingivitis: A Blinded, Randomised Clinical Trial
Al-Mahmood S, Sabea DW Β· Oral health & preventive dentistry Β· 2021 Β· PubMed -
Effectiveness of a miswak extract-containing toothpaste on gingival inflammation: a randomized clinical trial
Azaripour A, Mahmoodi B et al. Β· International journal of dental hygiene Β· 2017 Β· PubMed -
Efficacy of Miswak toothpaste and mouthwash on cariogenic bacteria
Al-Dabbagh SA, Qasim HJ et al. Β· Saudi medical journal Β· 2016 Β· PubMed -
Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial
Abdulbaqi HR, Himratul-Aznita WH et al. Β· BMC complementary and alternative medicine Β· 2016 Β· PubMed -
Evaluating the anti-plaque efficacy of meswak (Salvadora persica) containing dentifrice: A triple blind controlled trial
Gupta P, Agarwal N et al. Β· Journal of pharmacy & bioallied sciences Β· 2012 Β· PubMed -
Salvadora Persica extract chewing gum and gingival health: improvement of gingival and probe-bleeding index
Amoian B, Moghadamnia AA et al. Β· Complementary therapies in clinical practice Β· 2010 Β· PubMed -
Persica Chewing Gum Effects on Saliva Fluoride Concentration and Flow Rate: A Triple-Blind Randomized Clinical Trial
Mortazavi S, Aslani A et al. Β· Contemporary clinical dentistry Β· 2019 Β· PubMed -
The effect of miswak extract on plaque pH. An in vivo study
Sofrata A, LingstrΓΆm P et al. Β· Caries research Β· 2007 Β· PubMed -
An in vivo study of the plaque control efficacy of Persica: a commercially available herbal mouthwash containing extracts of Salvadora persica
Khalessi AM, Pack AR et al. Β· International dental journal Β· 2004 Β· PubMed -
A study comparing the efficacy of a toothpaste containing extract of Salvadora persica with a standard fluoride toothpaste
Quinlan R, Robson G et al. Β· Journal of the New Zealand Society of Periodontology Β· 1994 Β· PubMed
Laboratory studies: bacteria, biofilm and composition
In-vitro research on extracts and the plantβs compounds. Lab results do not show effects in the mouth by themselves.
-
The Effect of Sub-MIC of Salvadora persica on Growth and Virulence Gene Expressions in Streptococcus mutans
Jamal AI, Jalal Balaky ST Β· Cellular and molecular biology (Noisy-le-Grand, France) Β· 2023 Β· PubMed -
Antibacterial Activities of Methanol and Aqueous Extracts of Salvadora persica against Streptococcus mutans Biofilms: An In Vitro Study
Balhaddad AA, Mokeem L et al. Β· Dentistry journal Β· 2021 Β· PubMed -
Antibiotic and Antibiofilm Activities of Salvadora persica L. Essential Oils against Streptococcus mutans: A Detailed Comparative Study with Chlorhexidine Digluconate
Khan M, Alkhathlan HZ et al. Β· Pathogens (Basel, Switzerland) Β· 2020 Β· PubMed -
Antibacterial activity of Salvadora persica against oral pathogenic bacterial isolates
Khalil MA, El-Sabbagh MS et al. Β· Nigerian journal of clinical practice Β· 2019 Β· PubMed -
Salvadora persica leaves: phytochemical profile and in vitro-inhibitory activity on inflammatory mediators implicated in periodontal disease
Kobetitsch S, Gierlikowska B et al. Β· Pharmaceutical biology Β· 2024 Β· PubMed -
Comparative evaluation of the remineralizing potential of Salvadora persica and probiotic yogurt on incipient enamel lesions: An ex-vivo study
Bakr NM, Mohamed AA et al. Β· Dental and medical problems Β· 2024 Β· PubMed -
Unraveling the metabolome composition and its implication for Salvadora persica L. use as dental brush via a multiplex approach of NMR and LC-MS metabolomics
Farag MA, Shakour ZT et al. Β· Journal of pharmaceutical and biomedical analysis Β· 2021 Β· PubMed -
Phytochemical composition, anti-biofilm and anti-quorum sensing potential of fruit, stem and leaves of Salvadora persica L. methanolic extracts
Noumi E, Snoussi M et al. Β· Microbial pathogenesis Β· 2017 Β· PubMed -
Effectiveness of Salvadora persica extracts against common oral pathogens
Balto H, Al-Sanie I et al. Β· The Saudi dental journal Β· 2017 Β· PubMed -
Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque
Abdulbaqi HR, Himratul-Aznita WH et al. Β· Archives of oral biology Β· 2016 Β· PubMed -
Antibacterial activity of Miswak Salvadora persica extracts against isolated and genetically identified oral cavity pathogens
El-Latif Hesham A, Alrumman SA Β· Technology and health care : official journal of the European Society for Engineering and Medicine Β· 2016 Β· PubMed -
Inhibitory activity of Salvadora persica extracts against oral bacterial strains associated with periodontitis: An in-vitro study
Amir Alireza RG, Afsaneh R et al. Β· Journal of oral biology and craniofacial research Β· 2014 Β· PubMed -
Cytotoxic effect of Salvadora persica extracts on human gingival fibroblast cells
Balto HA, Al-Manei KK et al. Β· Saudi medical journal Β· 2014 Β· PubMed -
Volatile compounds of Salvadora persica inhibit the growth of oral Candida species
Alili N, TΓΌrp JC et al. Β· Archives of oral biology Β· 2014 Β· PubMed -
Efficacy of miswak on oral pathogens
Sukkarwalla A, Ali SM et al. Β· Dental research journal Β· 2013 Β· PubMed -
Anti-biofilm activity of Salvadora persica on cariogenic isolates of Streptococcus mutans: in vitro and molecular docking studies
Al-Sohaibani S, Murugan K Β· Biofouling Β· 2012 Β· PubMed -
The effects of extracts of chewing sticks (Salvadora persica) on healthy and periodontally involved human dentine: a SEM study
Almas K Β· Indian journal of dental research : official publication of Indian Society for Dental Research Β· 2001 Β· PubMed
Background reviews
Overviews of miswakβs traditional use and research history.
-
Salvadora persica: Nature's Gift for Periodontal Health
Mekhemar M, Geib M et al. Β· Antioxidants (Basel, Switzerland) Β· 2021 Β· PubMed -
A review of the traditional and modern uses of Salvadora persica L. (Miswak): Toothbrush tree of Prophet Muhammad
Aumeeruddy MZ, Zengin G et al. Β· Journal of ethnopharmacology Β· 2018 Β· PubMed -
Role of Salvadora persica chewing stick (miswak): A natural toothbrush for holistic oral health
Niazi F, Naseem M et al. Β· European journal of dentistry Β· 2016 Β· PubMed -
A review of the therapeutic effects of using miswak (Salvadora Persica) on oral health
Haque MM, Alsareii SA Β· Saudi medical journal Β· 2015 Β· PubMed -
Miswak (Salvadora persica chewing stick): the natural toothbrush revisited
Almas AK, Almas K Β· Odonto-stomatologie tropicale = Tropical dental journal Β· 2014 Β· PubMed -
Pharmacological profile of Salvadora persica
Ahmad M, Imran H et al. Β· Pakistan journal of pharmaceutical sciences Β· 2011 Β· PubMed -
Salvadora persica
Khatak M, Khatak S et al. Β· Pharmacognosy reviews Β· 2010 Β· PubMed