Different teeth cleaning methods from around the world, for World Oral Health Day.

Every year, March 20th kicks off World Oral Health Day—the largest global oral health awareness campaign that aims to empower people with knowledge, tools, and confidence to have the best oral health possible. With people in over 120 countries and counting using quip oral care products, we’re sharing some of the many ways people clean their teeth worldwide, and the work that still needs to be done for good oral health habits, globally.

The Global State of Mouth

Tooth decay and gum diseases, like gingivitis and periodontitis, are among the most common conditions affecting the world population, according to the World Health Organization, impacting nearly 3.5 billion people. More than 530 million children suffer from cavities and tooth decay in their primary teeth, and about 10% of the global population is affected by severe periodontal gum disease, which can result in tooth loss. These diseases are generally preventable with good oral hygiene and a healthy, whole foods-based diet. The vast number of people suffering from oral health conditions suggests that oral hygiene and diet improvements are warranted, especially in developing communities.

Much of the world's population, in particular developing nations and indigenous cultures, use traditional, old-world techniques to keep their teeth clean. We might take the concept of toothbrushes and floss for granted, but it's actually only common in the United States and other developed countries to use the kinds of nylon or electronic toothbrushes we take as commonplace. Here are some of the ways people worldwide strive to keep their teeth clean and mouth healthy.

Plants and Twigs

Plants have been used for centuries to clean teeth—a practice that persists throughout the world today. "Miswak" is an Arabic word meaning "tooth-cleaning stick," from the plant Salvadora persica and has been studied for its potential effectiveness (almost as good as a toothbrush, in some studies!) for removing plaque and preventing oral diseases. It was used by ancient Arabs to polish and whiten teeth and is still employed by many people in developing parts of the Middle East and some parts of South and Southeast Asia. To use a tooth cleaning stick, the twig's end is frayed, the resulting bristles are dampened with water or rosewater and then rubbed against the teeth in circular motions.

Often called chew sticks, twigs from aromatic trees that freshen the mouth have also been used in different cultures for thousands of years, with the first recorded use in Ancient Babylonia in 3,500 BCE but were also used in China as far back as 1600 BCE. Known by different names in different cultures—koyoji in Japanese, qesam in Hebrew, qisa in Aramaic, and mastic in Latin. Despite reported side effects of chewing sticks being associated with high level of gingival recession and tooth wear, this traditional oral hygiene practice is so common in our population that it needs further investigations according to the World Health Organization's Consensus Report on Oral Hygiene released in 2000.

Several studies have shown that this method can have similar cleaning effects of removing plaque as a conventional toothbrush, but the twigs and sticks can't reach areas between the teeth—and can damage the gentle gums and abrade your teeth. If your patients use miswak, educate yourself to inquire about habits, provide support, and show understanding of traditional oral hygiene practices.

Unconventional toothpastes

Some cultures in India, Africa, South East Asia, and South America apply salt, powder, mud, or ash with their fingers to clean their teeth. These ingredients do not contain fluoride and can be abrasive, resulting in sensitive teeth and receding gums. In some countries, people rub walnut tree bark on their teeth, which has antimicrobial properties and thought to have a whitening effect—though there have been no conclusive studies done to investigate its effectiveness or possible side effects.

Charcoal

Charcoal, another traditional tooth cleaning substance, has been making a bit of a comeback. Some modern kinds of toothpaste now contain charcoal, even though there is no evidence for safety or effectiveness. You can read more about the potential abrasiveness of charcoal here.

Oil pulling

Another traditional tooth cleaning method that does not require twigs, toothpaste, or toothbrushes is oil pulling. This ancient Ayurvedic therapeutic practice involves taking a small amount of coconut, olive, sesame, or sunflower oil and swirling it around the mouth for fifteen minutes—a process thought to wash out harmful bacteria and toxins. But, according to the American Dental Association, "there are no reliable scientific studies to show that oil pulling reduces cavities, whitens teeth or improves oral health and well-being."

While some developing nations and communities are using traditional methods to clean their teeth, the best way to take care of your teeth is brushing twice every day, for two minutes, with fluoride toothpaste, flossing once every day, and changing your brush every three months. But, many people simply don’t have access to the right tools, let alone the foundational oral health education they need to live better, healthier lives. Expanding the reach of oral health education and products will help lower the incidence of oral health conditions, which is why quip is dedicated to improving access not only in the United States, but globally. That’s why quip has worked with Global Dental Relief to improve access to oral health products, education and services in developing communities, and we will continue to share how we’re working to make a difference globally.