Triangulation of Scientific Evidence and Cultural Knowledge to Develop an Evidence-Based Guideline for Chewing Stick Practice

Background Data triangulation enhances the credibility of mixed method research findings but is rarely described in study designs. Integrating comprehensive, relevant scientific evidence is essential for informed oral healthcare decisions in evidence-based dentistry. However, no standardised guideline exists for chewing stick practice in oral hygiene. This study aimed to develop a comprehensive guideline on chewing stick practice. Methods Data were collected through interviews with contemporary Islamic scholars, focus group discussions with users, and a systematic literature review. These data were combined using a joint table to facilitate data triangulation ensuring convergent validation of the findings and completeness of data. Themes and subthemes identified through qualitative analysis steered the integration process. Results A total of 49 statements were generated from the data and categorised into three themes and fourteen subthemes. Most of the statements in “Preparation of chewing stick” (66.7%) and “Method of toothbrushing” (66.1%) themes were derived from convergent data, while all themes incorporated complementary data to construct statements for the integrated method of chewing stick practice guidelines. Two statements under the “Preparation of chewing stick” theme were constructed using divergent data. The “Method of toothbrushing” theme was refined from the initial framework, embedding the “Area of brushing” subtheme within the “Toothbrushing technique” to better procedural alignment. Conclusions A systematic integration approach using a joint display table provided a comprehensive perspective on chewing stick practice. Triangulating multiple data sources strengthen the findings and contributed to an evidence-based guideline for standardised chewing stick use in oral hygiene care.