People in both India and Africa have used neem twigs as tooth brushes for centuries. Neem twigs contain antiseptic ingredients necessary for dental hygiene. Neem powder is also used to brush teeth and massage gums.

In Germany many researchers have shown that neem extracts prevent tooth decay and periodontal disease.

Infections, tooth decay, bleeding and sore gums have all been treated successfully with daily use of neem mouth rinse or neem leaf extract added to the water. Some people have reported a total reversal of gum degeneration after using neem for only a few months.