I've had some ongoing teeth and gum / jaw issues for a few years and have tried various ways of tooth cleaning and miswak sticks (actually a root) is the best for me. My gums were receeding fast when I used a plastic brush, but now barely at all. Using a badger bristle brush was definitely better, and Neem sticks were a great improvement. I tried apple sticks but miswak is my favourite and the thicker ones last longer and make "brushing" quicker. I've been using them for a couple of years.
I keep the stick in a glass of water which keeps it soft, so less need for chewing (though chewing is, no doubt, a good thing) which makes the process quicker and gentler, and I use the soak water as a mouthwash. You get lots of bits of bark and fibre in you mouth. I spit it out in the loo; outside would be fine, of course. When the de-barked part becomes long I cut it back with scissors. Scratchy plastic bristles are dreadful, IMO. And where does that plastic go when they wear down?
I was talking with a lady in her 60s from west Africa (Gambia, IIRC) who had perfect white teeth. They use sticks there, and also mix charcoal with the juice / sap from plantain stalks (plantain like a banana, not the little plant called plantain) and apply that to the teeth which makes them clean, healthy and white. She told me that when she moved to the UK she was baffled by the idea of dentists.
"What is 'dentist'? I've never heard of this. We don't have this at home."
I asked, "So what do people do there when they have a problem with their teeth?"
"We don't have problems with teeth." So it seems that the whole dentistry industry is one dependent on crappy lifestyles.
The last dentist I saw (and I sincerely hope and intend that she was the last dentist I will see) had never heard of using a stick for cleaning teeth. I explained that it was very common around the world and had helped me greatly in managing my dental health. She ignored what I was telling her, was condescending, and told me to use a proper bush, talking to me like I was a child despite being over twice her age.
I could go on.