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Brushing with miswak. (photo by zurijeta)

Sticks, Dirt and Charcoal… in Your Mouth?

By Sara Bruskin

We all know that fluoride toothpaste is a highly polarizing issue that has been discussed to death in dental-health forums, so let’s find something new to fight about! Here are three new trends in oral health care for you to debate.

Miswak Twig Brush

The word miswak means “tooth-cleaning stick” in Arabic. This is definitely not a new trend in the global sense, but miswaks are just now making waves in the U.S. as a natural alternative to plastic toothbrushes and store-bought dentifrices. While rubbing a stick all over your teeth may not sound entirely appealing, there may be some legitimate science behind it. A specific tree has some dental-hygiene powers that many Asian and African countries have been harnessing for centuries.

The soft inner fibers of Salvadora persica, also known as the toothbrush tree, contain silica, which is abrasive enough to remove plaque; sodium bicarbonate, which whitens teeth and raises the pH level in your mouth; and trace amounts of naturally occurring fluoride, which can be good or bad, depending on your stance on fluoride.

Although the plant’s chemical compounds are very similar to those in modern toothpastes, they may not reach your teeth to take effect, as the shape of the twig is not as conducive to brushing as toothbrushes are. Because the fibers extend straight out from the end of the twig, it can be difficult to reach some areas of your teeth, especially the back molars. The side-facing bristles of modern toothbrushes give a more convenient angle for hitting all surfaces and removing the most plaque.

Studies on miswaks are not terribly extensive, but those that exist show inconsistent results. Some indicate that they are slightly more effective than toothbrushes, while others indicate they’re slightly less beneficial, with the discrepancy often attributed to difficulties using the twig. More research is needed, but the results we
already have suggest that miswaks are more or less as effective as toothbrushes, which is why the World Health Organization recommends them in developing countries where other dental health products may be scarce.

Verdict: Miswaks seem to be effective, if used correctly. They have very similar benefits to modern toothbrushes and dentifrices, so feel free to make the switch, but only if you’re committed to following recommended brushing techniques (look at online videos). They could be a boon to backpackers.

Bentonite Clay or ‘Dirt’ Tooth Powders

Powdered bentonite clay. (photo by anna hoychuk)

Anybody who’s been on social media in the last year has probably seen advertisements for bentonite clay tooth powders. The Dirt and Primal Life Organics are the two main companies pushing them, and they claim their products can help remineralize teeth. Minerals in bentonite clay can supposedly rebuild tooth enamel, so long as there’s no glycerin to block this wondrous effect, the companies assert.

Glycerin is an ingredient added to many toothpastes to keep them from drying out, but there’s a giant smear campaign out there right now, claiming that glycerin coats your teeth for a long time and prevents them from absorbing minerals that could be strengthening and rebuilding your enamel. This idea comes from Dr. Gerard Judd, a chemist who pushed this idea despite the absence of any studies supporting his theories. In reality, glycerin is water-soluble, so it dissolves very quickly in your saliva, meaning it cannot coat your teeth for any appreciable amount of time. There has been no evidence that it’s detrimental to oral health in any other way.

While tooth powders without glycerin aren’t necessarily better, that doesn’t mean bentonite clay makes for a bad tooth cleaner. Toothpaste is mainly effective because it’s abrasive and can rub plaque off the surface of teeth, dislodging the buildup of bacteria that eats away our enamel. Bentonite clay can work for that purpose, though there is not enough research to support claims that its minerals specifically help to remineralize teeth. One of our staff members has tried it, and reports clean-feeling teeth, but spitting out the brown sludge was a little gross.

Verdict: Probably safe to use, but bentonite clay does not have enough scientifically supported benefits to make it worth staining the sink.

Activated Charcoal Tooth Powders & Pastes

Brushing with charcoal. (photo by amy gosch)

Activated charcoal is everybody’s best friend right now, appearing in face masks, juices, foot baths, tooth-care products—you name it. Hospitals use it for cases of oral poisoning, as it’s extremely porous and thus very effective at absorbing harmful substances in the stomach. Natural-remedy purveyors are now shouting from the rooftops that this sponge-like quality enables activated charcoal to absorb all sorts of impurities, from toxins in your system to surface stains on your teeth. Companies like BlackMagic and Carbon Coco base their brands on that latter claim, and sell charcoal tooth-care products for their purported whitening powers. In the context of toxicology, activated charcoal has been very well researched. In the context of tooth whitening, not so much.

Dentists are widely unsure about the efficacy and safety of charcoal tooth powders and pastes. Although these products have been used in India for at least 100 years, their newfound popularity exploded before any long-term studies could be done. The American Dental Association warns against brushing with charcoal before we know more, as it could scratch and deteriorate enamel, possibly with no benefit to tooth color at all. Researchers at the University of Maryland conducted a literature review in which they combed through the few studies that do exist, and also examined the claims made by companies selling charcoal-based tooth products. They came up with no proof of whitening effects, and three studies suggested harmful effects. The researchers also noted that “Internet advertisements included unsubstantiated therapeutic claims—such as antibacterial, antifungal, antiviral and oral detoxification, as well as potentially misleading product assertions.”

Verdict: Hold out on this one until thorough research can be conducted. If you’re absolutely determined to try it now, avoid vigorous brushing. Instead, use a mixture of activated charcoal powder and water as a mouthwash, or make a paste and apply it to your teeth for a few minutes while you walk around with a zombie mouth and scare everybody in your house.