Miswak and its relation in healing of ulcers in patients with minor aphthous stomatitis

Abstract

Recurrent aphthous stomatitis (RAS) is a disorder characterized by recurring ulcers in the oral mucosa in patients with no other signs of disease. RAS is classified according to clinical characteristics as minor ulcers, major ulcers and herpetiform ulcers. Minor ulcers are well- circumscribed, round, sometimes covered by a yellow-gray pseudo-membrane and surrounded by an erythematous halo. Forty-six male patients between the age of 14-59 years with minor recurrent aphthous stomatitis (mRAS) were refereed to private dental clinic in Tikrit city between February and August 2007. The healing time of the large single ulcer for patients in group B which used
(orabase, chlorhexidine and mixture of miswak powder with tooth-paste and miswak stick) were 6- 12 days ± 1-1.5; while for patients of group A used only orabase and chlorhexidine were 7-14 days ± 2-4 days. The reason for shortening of healing time of the ulcers in patients used miswak, may be related to that the miswak has natural antiseptic, anti-bacterial, anti-viral effects, multi-purpose stick, inhibits the growth and acid production of the pathogenic bacteria, helps in the purification of the mouth according to the recommendation of the prophet Mohammad (pbuh), that (siwak is a
purification for the mouth), contains many healing substances like vitamin C, tannin and saponins. The beneficial effects of miswak may be related to its mechanical rub, pharmacological actions and chemical contents. Antiseptics may shorten healing time, presumably by reducing bacterial colonization of the ulcer surface. Healing lasts in proportion to the severity and size of the ulcers. In conclusion, miswak powder and miswak stick are excellent tools for oral cleanliness. Recommendations should be made to manufacture of tooth paste to include the powdered form of miswak in an abrasive form of tooth paste. It is easy to apply either in paste or powder form,
inexpensive and easily available. Proper oral hygiene should be taught by dentists, but it requires a person's time and dexterity. Among those Muslims who ritually practice the use of siwak, rigid oral hygiene by a dentist may not be required. Further study is needed to know the relation between miswak and recurrence rate of ulcers.