title: Comparative effectiveness of chewing stick and toothbrush: a randomized clinical trial.
abstract: BACKGROUND
  With the increasing rate of oral diseases, the global necessity of effective and economical products for its prevention and treatment has intensified.
  
  
  OBJECTIVE
  THIS STUDY WAS TO COMPARE THE EFFECTIVENESS OF TWO ORAL HYGIENE AIDS: Chewing stick and manual toothbrush, for plaque removal and gingival health after one month of a randomized clinical trial.
  
  
  METHODS
  Dental students (age 18-22 years) of a public sector dental hospital were recruited. Sample size was determined using the American Dental Association guidelines. Participants were randomized into two interventional groups and provided with either chewing sticks or toothbrushes. Pre- and post-intervention examinations were executed by two blind and calibrated examiners using plaque and gingival dental indices. Statistical analysis included descriptive statistics, paired t-test, and two sample independent t-tests.
  
  
  RESULTS
  Fifty subjects were recruited with mean age 20 ± 0.66 years (80% were females and 20% were males). Except for the mean plaque scores of toothbrush users (which increased at post-intervention examination), all other scores showed reduction. In contrast to the final mean gingival scores, a significant difference (P = < 0.0001) in the final mean plaque score was observed for the two respective interventional groups.
  
  
  CONCLUSIONS
  Chewing stick has revealed parallel and at times greater mechanical and chemical cleansing of oral tissues as compared to a toothbrush.
authors: Department of Community Dentistry (DIKIOHS), Dow University of Health Sciences, Karachi, Pakistan.
authors: Aeeza S
authors: AS
authors: Malik
authors: Department of Science of Dental Materials, Multan Medical and Dental College, Multan, Pakistan.
authors: Malik S
authors: MS
authors: Shaukat
authors: Department of Community Dentistry (DIKIOHS), Dow University of Health Sciences, Karachi, Pakistan.
authors: Ambrina A
authors: AA
authors: Qureshi
authors: Department of Research, Dow University of Health Sciences, Karachi, Pakistan.
authors: Rasheed
authors: R
authors: Abdur
keywords: Dental caries; Dental plaque; Miswak; Primary prevention; Tooth brushing