A root of Salvadora persica, the arak or "toothbrush tree", about 16 cm long. Chewed at one end until the fibres separate into bristles, it has been used for cleaning teeth in North Africa, the Middle East, the Horn of Africa and South Asia for thousands of years — the oldest form of toothbrush still in daily use.
Two claims you will not find here, and why
Miswak sticks are commonly sold on the line that "no additional toothpaste is needed" and as "the absolute secret tip for healthy teeth". Neither appears here, because the first is advice that could genuinely damage someone's teeth.
Fluoride toothpaste is the single best-evidenced measure there is for preventing tooth decay. The evidence base is enormous, consistent and not seriously disputed by anyone. A miswak does not reliably deliver fluoride — the wood is often said to "naturally contain fluorides", and it does contain some, but in small and highly variable amounts that are not comparable to a toothpaste and cannot be relied upon.
So: use a miswak if you like it, and it is a genuinely good tool. Do not stop using fluoride toothpaste because of it.
What the evidence actually supports
It is more positive than the correction above might suggest, and it deserves stating properly.
Systematic reviews have found that a miswak, used correctly, removes plaque at least as effectively as a manual toothbrush — and in several studies more effectively. The World Health Organization has recognised chewing sticks as an oral hygiene tool. The mechanism is not mysterious: the fibres are stiff enough to disrupt plaque, and the wood contains silica, which acts as a mild abrasive.
It also contains tannins, saponins, alkaloids and sulphur compounds including benzyl isothiocyanate, which do have measurable antibacterial activity in laboratory studies. What that means for your gums over years is much less clear than the marketing suggests.
Where it does not substitute
A miswak cleans the surfaces of teeth. It does not clean between them, which is where most adult decay and gum disease begins. Floss or interdental brushes still matter.
The way people damage their gums with it
Force. A miswak is stiffer than a toothbrush, and used hard it will abrade enamel and push the gums back. Gum recession is not reversible.
Light pressure, small movements, and always away from the gum line rather than into it.