Fagara / candle wood (toothache root)

What is Fagara / candle wood (toothache root)?

Fagara, or candle wood, is the root and root bark of a thorny West African tree, Zanthoxylum zanthoxyloides. Yoruba speakers call it orin ata, the "pepper chewing stick". People chew the fresh root to clean the teeth and numb a sore tooth.

The tree grows from Senegal to Nigeria and across the Sahel. Markets sell cut root, bark powder and ready-cut chewing sticks. Some firms now sell capsules and tinctures online.

Here is the honest verdict. The numbing, tingling feel in the mouth is real and quick. Everything else, including the well-known use for sickle cell pain, rests on lab and animal work, not on good trials in people.

Long use in West Africa is well recorded. That standing is not proof that the root works, and it is not proof that it is safe.

How does Fagara / candle wood (toothache root) work?

The clearest effect is the one you can feel. Chewing the root gives a sharp, tingling numbness in the mouth. This comes from pungent amide compounds, the same family of chemicals found in Sichuan pepper.

Why it might help sickle cell disease is far less clear. In test tubes, root extracts and their divanilloylquinic acids (the "burkinabins") slow the sickling of red blood cells. Whether that happens inside a person's body is not established.

In laboratory tests, root extracts slow some bacteria linked to plaque and gum disease. Chewing the stick also scrubs the teeth, much like a brush. The scrubbing may well be the larger part of any benefit.

One alkaloid, fagaronine, blocks an enzyme called topoisomerase in cell studies. That is a finding in dishes, from cancer research. It tells you nothing about treating cancer in a person.

In rodents, extracts have reduced pain responses and fever. Animal results often fail to repeat in people.

What forms does Fagara / candle wood (toothache root) come in?

Fagara is sold in a few quite different forms. The strength varies a lot between them. Here are the plain root forms:

- Fresh or dried root sticks, chewed as a natural toothbrush. - Cut root and root bark, boiled into a decoction. - Bark powder, used as a tooth powder or stirred into water.

You may also meet made-up products:

- Tinctures and capsules, sold online as food supplements. - Mixed herbal products, such as blends with Calotropis procera sold in parts of West Africa.

A chewing stick gives you a small, slow dose. A capsule or tincture can give far more alkaloid in one go.

Labelling is often poor. Products may not say which species, which plant part, or how strong the extract is.

Where it comes from:

Fagara has a long and well-documented place in West African medicine. Healers used the root for toothache, mouth care, fever, stomach pain and joint pain.

It was one of the best-known chewing sticks in the region. Yoruba, Hausa, Akan and Mandinka users all knew the pepper-tasting root.

The root was also a classic home treatment for sickle cell pain in Nigeria, Ghana and Burkina Faso. Researchers in Burkina Faso built a plant medicine around it from the 1990s. That work is much of the reason the plant is studied today.

This page describes that history. It is not a guide to treating yourself.

What does Fagara / candle wood (toothache root) help with?

• Toothache and sore gums: This is the use the plant is named for. Chewing the root numbs the area within a minute or two, and that part is easy to confirm yourself. The numbness is short and does not treat the cause. A rotten tooth or an abscess still needs a dentist.
• Daily tooth cleaning as a chewing stick: Chewing sticks can lower plaque when used well. Studies of chewing sticks in general support this; the scrubbing does much of the work. In laboratory tests, fagara extracts also slow some mouth bacteria. Hard chewing can wear enamel and push gums back over time.
• Sickle cell pain crisis (traditional use): This is the most common modern claim, and the weakest in terms of proof. In test tubes, extracts reduce the sickling of red cells. Human trials good enough to show a real benefit have not been published. Never use it in place of prescribed sickle cell care.
• Fever and malaria (traditional use): Healers used root decoctions for fevers. In lab tests, some compounds slow malaria parasites. There is no human trial showing it treats malaria. Malaria can kill quickly, so it needs a proper test and proper drugs.
• Joint and muscle pain: The root was used for aching joints and back pain. In rodents, extracts reduce pain responses and swelling. No good human trial has tested this. Any relief you feel may be short and may be the taste and warmth of the preparation.
• Stomach upset and poor appetite: Pungent, peppery roots have long been used to settle the gut and sharpen appetite. This is a traditional use with almost no human testing. In some people the same pungency causes burning or nausea instead.
• Wounds and skin infections (traditional use): Powdered bark was applied to sores and wounds. In laboratory tests, extracts slow several bacteria. Whether that works on a real wound is not established. Dirty plant material on an open wound can make an infection worse.

What are the side effects of Fagara / candle wood (toothache root)?

• Tingling, numbness or burning in the mouth and lips
• Excess saliva while chewing
• Gum soreness or bleeding from hard chewing
• Worn tooth enamel and receding gums with long-term stick use
• Nausea, stomach burning or cramps after swallowing
• Loose stools
• Dizziness or light-headedness
• Allergic reaction: rash, itching, swelling of the lips or face

Good to know:

Mouth tingling and extra saliva are expected, not a warning sign. Gum and enamel damage builds slowly with years of hard chewing.

Stomach effects are the usual complaint from swallowed preparations. Serious reactions appear rare in reports, but no one has run safety trials, so rare harms may simply be unrecorded.

Concentrated capsules and tinctures carry more risk than a chewed stick. Stop and get advice if anything feels wrong.

How much Fagara / candle wood (toothache root) should you take?

• Recommended daily: There is no dose proven to be safe or helpful. Nothing here is an instruction for you. For reference only: capsule labels often list 300 to 500 mg of root powder, once or twice a day. Those numbers come from makers, not from trials. Chewing sticks carry no dose at all. How much you take in depends on how long and how hard you chew. If you are thinking of a capsule or strong extract, talk to a doctor or pharmacist first.
• Best time of day: Timing does not matter for any proven effect. As a chewing stick, people use it in the morning and after meals, as they would a toothbrush.
• With or without food: If you swallow a preparation, taking it with food may reduce stomach burning. The root is peppery and can sting an empty stomach. Chewing sticks are used away from meals, as tooth cleaning.
• Time to effect: The mouth numbing starts within a minute or two of chewing. It fades within an hour. For anything else, there is no honest answer. It may do nothing at all.
• How long to take it: No safe length of use has been worked out for swallowed fagara. Repeated internal use over weeks has not been studied in people. Chewing sticks are used daily by many people in West Africa. Even so, long hard chewing can wear teeth and gums. If you use it at all, keep it short. Stop if nothing changes.