Now playing
02:13
This company wants to make brushing your teeth fun
Now playing
02:11
'I can't stop staring': Internet reacts to actress' transformation for role
Now playing
00:57
Simon Cowell hits golden buzzer for singer fighting cancer on 'AGT'
President Joe Biden, with a brood X cicada on his back, walks to board Air Force One upon departure, Wednesday, June 9, 2021, at Andrews Air Force Base, Md. Biden is embarking on the first overseas trip of his term.
Alex Brandon/AP
President Joe Biden, with a brood X cicada on his back, walks to board Air Force One upon departure, Wednesday, June 9, 2021, at Andrews Air Force Base, Md. Biden is embarking on the first overseas trip of his term.
Now playing
02:16
Biden has run-in with cicada before boarding Air Force One
Now playing
00:48
See ominous landspout tornado darken Colorado skies
Now playing
00:46
See a classic typewriter made entirely of Legos
TikTok/AliciaSilverstone
Now playing
00:39
Alicia Silverstone recreates iconic scene with her son
Balenciaga
Now playing
02:18
High-heeled Crocs may sell for as much as $1K
WTVR
Now playing
01:48
What mom and daughter did with 80,000 penny child support payment
'Baywatch' star David Hasselhoff joins Germanys Covid-19 vaccination campaign, in a video posted by Germanys health ministry.
Twitter/BMG_Bund
'Baywatch' star David Hasselhoff joins Germanys Covid-19 vaccination campaign, in a video posted by Germanys health ministry.
Now playing
00:46
Hear David Hasselhoff's Covid-19 vaccine message
JOHANNESBURG, SOUTH AFRICA - OCTOBER 02: Prince Harry, Duke of Sussex and Meghan, Duchess of Sussex attend a Creative Industries and Business Reception on October 02, 2019 in Johannesburg, South Africa.   (Photo by Chris Jackson/Getty Images)
Chris Jackson/Getty Images
JOHANNESBURG, SOUTH AFRICA - OCTOBER 02: Prince Harry, Duke of Sussex and Meghan, Duchess of Sussex attend a Creative Industries and Business Reception on October 02, 2019 in Johannesburg, South Africa. (Photo by Chris Jackson/Getty Images)
Now playing
01:16
Foster: Harry and Meghan's new baby's name a nod to the Queen
PASADENA, CALIFORNIA - JANUARY 18: Kim Kardashian West of 'The Justice Project' speaks onstage during the 2020 Winter TCA Tour Day 12  at The Langham Huntington, Pasadena on January 18, 2020 in Pasadena, California. (Photo by David Livingston/Getty Images)
David Livingston/Getty Images North America/Getty Images
PASADENA, CALIFORNIA - JANUARY 18: Kim Kardashian West of 'The Justice Project' speaks onstage during the 2020 Winter TCA Tour Day 12 at The Langham Huntington, Pasadena on January 18, 2020 in Pasadena, California. (Photo by David Livingston/Getty Images)
Now playing
00:47
'I feel like a failure': Kim Kardashian on troubles with Kanye
TikTok
Now playing
01:13
'The Sandlot' star recreates iconic movie scene
Clockwork
Now playing
02:20
Robot manicure really 'nails it'
courtney cox ed sheeran friends dance routine mxp vpx_00000930.png
Courtney Cox/Warner Bros
courtney cox ed sheeran friends dance routine mxp vpx_00000930.png
Now playing
00:36
Ed Sheeran and Courteney Cox recreate famous 'Friends' dance routine
@amyschumer/Instragram
Now playing
00:55
See Amy Schumer react to birthday trolling
CNN —  

Most people use toothbrushes, toothpaste and dental floss to clean their teeth, but their use is by no means universal. Many indigenous groups, as well as people in developing countries, use traditional techniques to clean their teeth. Some of these techniques are more effective than others.

Many people in the Middle East, and some parts of South and Southeast Asia, use twigs from the arak tree (known as miswak) to clean their teeth. They fray the end of the twig, dampen the resulting bristles with water or rosewater and then rub the bristles against their teeth (see video below).

The wood of the arak tree (Salvadora persica) has a high concentration of fluoride and other antimicrobial components that prevent tooth decay.

Twigs from other trees, especially aromatic trees that freshen the mouth, are used in different cultures. These so-called chew sticks have been in use for thousands of years. The first recorded use was in ancient Babylonia (3500BC) but they were also used in China as far back as 1600BC.

Miswak or siwak - arabian toothbrush for tooth cleaning.
Shutterstock
Miswak or siwak - arabian toothbrush for tooth cleaning.

Using twigs can have similar cleaning effects as a conventional toothbrush, as shown in several studies. But the sticks can’t reach areas between the teeth, and if they aren’t used properly, they can damage the gums and abrade the teeth.

In some cultures, people rub various substances onto their teeth with their fingers. For example, in some Muslim countries, people rub walnut tree bark on their teeth. The bark of this tree has antimicrobial properties and is also believed to have a whitening effect. However, no studies have been conducted to investigate its effectiveness or side effects.

Fingers

Some people in rural India, Africa, Southeast Asia and South America use brick powder, mud, salt or ash to clean their teeth. Although these ingredients effectively remove stains and plaque, they don’t contain fluoride and are often abrasive, resulting in sensitive teeth and receding gums.

Charcoal, which is also a traditional tooth cleaning powder, is making a bit of a comeback. Some modern toothpastes and toothbrushes now contain this ingredient, and evidence suggests that it can bind to harmful bacteria and inactivate them.

But not all natural products can be recommended. Betel quid and areca nuts – which are often used in Southeast Asia for tooth cleaning – stain the teeth and gums. And worse than that, they are associated with an increased risk of oral cancer.

Another tooth cleaning method that doesn’t involve toothpaste or a toothbrush is oil pulling – an ancient Ayurvedic practice. Here, a small amount of coconut, sesame, sunflower or olive oil is swirled around the mouth for 15 minutes. This is believed to wash out bacteria and toxins. Oil pulling, when performed along with routine brushing and flossing, can help to reduce gum inflammation, according to recent studies.

Charcoal on a toothbrush to whiten teeth
Shutterstock
Charcoal on a toothbrush to whiten teeth

Modern methods

Tooth decay (caries) and gum disease (gingivitis and periodontitis) are among the most common diseases, with most of the world population affected, according to the World Health Organization.

Get CNN Health's weekly newsletter

Sign up here to get The Results Are In with Dr. Sanjay Gupta every Tuesday from the CNN Health team.

With few exceptions, these diseases are preventable with ideal oral hygiene and a healthy diet. The high percentage of people suffering from these diseases suggests that most people’s oral hygiene methods are not up to the ideal standard and need to be improved.

Modern oral hygiene devices are specifically designed to clean even difficult to reach areas in the mouth and are highly effective, but only when done correctly. However, some alternative cleaning techniques, such as oil pulling, are useful additions.

Josefine Hirschfeld is an Academic Clinical Lecturer in Restorative Dentistry at the University of Birmingham in the UK. This article is republished from The Conversation under a Creative Commons license