Traditional Oral Hygiene Practices in West Africa: Antimicrobial Efficacy of Indigenous Chewing Sticks Against Common Oral Pathogens

Abstract

Traditional oral hygiene practices utilizing indigenous chewing sticks have been integral to West African healthcare systems for millennia, predating the introduction of modern toothbrushes by centuries. This comprehensive review examines the antimicrobial properties of commonly used chewing sticks from West African flora, including Azadirachta indica (neem), Garcinia kola (bitter kola), Salvadora persica (miswak), and Garcinia mannii, against prevalent oral pathogens such as Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans. Through systematic analysis of phytochemical constituents, minimum inhibitory concentration studies, and comparative efficacy assessments, this research demonstrates that these traditional implements possess significant antimicrobial activities attributable to bioactive compounds including alkaloids, tannins, saponins, and flavonoids. The findings reveal that several indigenous chewing stick species exhibit antimicrobial potency comparable to or exceeding that of conventional chlorhexidine mouthwashes, with Garcinia kola demonstrating particularly robust activity against cariogenic bacteria. Furthermore, this investigation explores the ethnobotanical knowledge systems that have preserved these practices, the mechanistic pathways through which phytochemicals exert their antimicrobial effects, and the potential for integrating traditional chewing stick technology into contemporary oral healthcare paradigms. The implications of this research extend beyond validation of indigenous knowledge, offering promising avenues for developing novel, affordable, and culturally appropriate oral hygiene interventions for resource-limited settings while contributing to the global search for natural antimicrobial agents amid rising antibiotic resistance concerns.