Knowledge, Attitude, and Behavior Related to Use of Miswak (Chewing Stick): A Cross-Sectional Study from Aseer Region, Saudi Arabia

Aim: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. Subjects and Methods: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. Statistical Analysis Used: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). Results: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. Conclusions: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.